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  • 151.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Närstående inom intensivvård: Att få styrka genom bekräftelse: innebörden av närstående för personer som varit svårt sjuka2007Conference paper (Other (popular science, discussion, etc.))
  • 152.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Närstående inom intensivvård från intensivvårdssjuksköterskors perspektiv2007Conference paper (Other (popular science, discussion, etc.))
  • 153.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Närstående till svårt sjuka personer inom intensivvård2006Conference paper (Other (popular science, discussion, etc.))
  • 154.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Aktivitet: Ständig information dämpar närståendes ångest2005Other (Other (popular science, discussion, etc.))
  • 155.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Close relatives of critically ill persons in intensive and critical care: the experiences of close relatives and critical care nurses2006Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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  • 156.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Innebörden av närstående för personer som varit svårt sjuka och vårdats på en intensivvårdsavdelning2007In: NOKIAS : Nordisk kongress för anestesi- och intensivvårdssjuksköterskor: sjukvård i ett föränderligt samhälle : Stockholm, Sverige 22-23 november 2007, Riksföreningen för anestesi och intensivvård , 2007, p. 4-Conference paper (Other academic)
  • 157.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Närstående inom intensivvård2009In: Temadag NOFI i Borås, 20-21 april 2009, 2009Conference paper (Other academic)
  • 158.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Närstående till personer som drabbats av akut, svår sjukdom2009In: Att leva med sjukdom, Stockholm: Norstedts akademiska förlag , 2009, p. 120-132Chapter in book (Other academic)
  • 159.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Närstående till personer som drabbats av akut, svår sjukdom2014In: Att leva med sjukdom, Lund: Studentlitteratur AB, 2014, 2, p. 121-131Chapter in book (Other (popular science, discussion, etc.))
  • 160.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Närståendes situation, delaktighet och betydelse när en svårt sjuk person vårdas på IVA2013In: Omvårdnad på avancerad nivå: kärnkompetenser inom sjuksköterskans specialistområden, Lund: Studentlitteratur AB, 2013Chapter in book (Other (popular science, discussion, etc.))
  • 161.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Upplevelser vid akut, svår sjukdom2009In: Att leva med sjukdom, Stockholm: Norstedts akademiska förlag , 2009, p. 51-69Chapter in book (Other academic)
  • 162.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Upplevelser vid akut,svår sjukdom2014In: Att leva med sjukdom, Studentlitteratur AB, 2014, 2, p. 45-60Chapter in book (Other (popular science, discussion, etc.))
  • 163.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Andersson, Staffan
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Experiences of a follow-up visit to an ICU2008In: 3rd EfCCNa Congress and the 27th Aniarti congress: Influencing Critical Care Nursing in Europe 9-11 October 2008, Florence, Italy, European federation of Critical Care Nursing associations , 2008Conference paper (Other academic)
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  • 164.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Andersson, Staffan
    Söderberg, Siv
    Re-visiting the ICU Experiences of follow-up visits to an ICU after discharge: a qualitative study2008In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 24, no 4, p. 233-241Article in journal (Refereed)
    Abstract [en]

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

  • 165.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Boström, Jonas
    Division of Surgery, Skellefteå Hospital, Sweden.
    Karlsson, Ann-Christin
    Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Women's experiences of undergoing total knee joint replacement surgery2017In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 32, no 2, p. 86-95Article in journal (Refereed)
    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.

  • 166.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    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 present2015In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 20, no 6, p. 322-330Article in journal (Refereed)
    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.

  • 167.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Forsberg, Angelica
    Intensive Care Unit 57, Sunderby Hospital, Luleå, Sweden.
    Patients’ perceptions of short-term recovery after a gastric bypass2018In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 5, p. 681-688Article in journal (Refereed)
    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.

  • 168.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Forsberg, Angelica
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Peripheral intravenous catheter difficulty: A clinical survey of registered nurse and critical care nurse performance2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 3-4, p. 686-694, article id 15960276Article in journal (Refereed)
    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.

  • 169.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Vem kontrollerar smärtan?: patienters upplevelser av egenkontroll och behandlingsmål i sjukgymnastik2007In: Svensk rehabilitering, ISSN 1403-4468, Vol. 8/9, no 4:1, p. 56-62Article in journal (Other academic)
  • 170.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Grip, Kerstin
    Örebro University Hospital, Department of Anaesthesiology and Intensive Care.
    Hamrén, Mikaela
    Ullevaal University Hospital, Oslo.
    Experiences of ICU diaries: touching a tender wound2009In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 14, no 2, p. 61-67Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe peoples' experiences of a personal diary written when they were critically ill and receiving care in an intensive care unit (ICU). BACKGROUND: In some ICUs, diaries are written by the ICU staff and close relatives of those who are critically ill and mechanically ventilated, but there is a lack of studies that focus on the experiences of the formerly critically ill of personal diaries written when in an ICU. METHODS: Qualitative personal interviews were conducted with nine people who were formerly critically ill. The interview texts were analysed using qualitative content analysis. FINDINGS: From the analysis of the data, one theme emerged - touching a tender wound, with four categories: being afraid and being deeply touched, appreciating close relatives' notes, a feeling of unreality and gaining coherence. The participants were deeply touched when they read the diary for the first time. Parts of it were experienced as unreal, as if they were reading about someone else. The diary provided necessary knowledge about what had happened during the time when the participants were critically ill and from which they had only fragmented or no memories at all. Even though it aroused strong feelings, reading the diary was experienced as an important support for a long time after their stay in the ICU. Experiencing that one was not fully aware of what had happened and then reading about oneself being critically ill and about one's close relatives' experiences was interpreted as touching a tender wound. CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: It is suggested that a diary may be a tool that can help formerly critically ill people to gain a sense of coherence concerning their critical illness experience, but reading it can be painful and demanding.

  • 171.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Jansson, Anna
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Human Work Science.
    Critical Care Nurses Experiences of Temporary Staffing in ICU2017Conference paper (Refereed)
  • 172.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Johansson, Maria
    Intensive Care Unit, Gällivare Hospital.
    Mattsson, Mia
    Intensive Care Unit 57, Sunderby Hospital.
    Strömbäck, Ulrica
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Nursing Care of ICU Patients Lightly Sedated with Dexmedetomidine2016In: Journal of Clinical Intensive Care and Medicine, ISSN 2639-6653, Vol. 1, p. 5-13Article in journal (Refereed)
    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.

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  • 173.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Inger
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Critical care nurses' experiences of nursing mothers in ICU after complicated childbirth2013In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 18, no 5, p. 251-257Article in journal (Refereed)
    Abstract [en]

    Background: Providing nursing care for a critically ill obstetric patient or a patient who has just become a mother after a complicated birth can be a challenging experience for critical care nurses (CCNs). These patients have special needs because of the significant alterations in their physiology and anatomy together with the need to consider such specifics as breastfeeding and mother-child bonding. Aim: The aim with this study was to describe CCNs' experience of nursing the new mother and her family after a complicated childbirth. Method: The design of the study was qualitative. Data collection was carried out through focus group discussions with 13 CCNs in three focus groups during spring 2012. The data were subjected to qualitative content analysis. Findings: The analysis resulted in the formulation of four categories: the mother and her vital functions are prioritized; not being responsible for the child and the father; an environment unsuited to the new family and collaboration with staff in neonatal and maternity delivery wards. Conclusion and relevance to clinical practice: When nursing a mother after a complicated birth the CCNs give her and her vital signs high priority. The fathers of the children or partners of the mothers are expected to take on the responsibility of caring for the newborn child and of being the link with the neonatal ward. It is suggested that education about the needs of new families for nursing care would improve the situation and have clinical implications. Whether the intensive care unit is always the best place in which to provide care for mothers and new families is debatable. © 2013 British Association of Critical Care Nurses.

  • 174.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Inger
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Mothers' experiences of a stay in an ICU after a complicated childbirth2014Conference paper (Refereed)
  • 175.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Inger
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Mothers' experiences of a stay in an ICU after a complicated childbirth2012In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 17, no 2, p. 64-70Article in journal (Refereed)
    Abstract [en]

    Background: To be cared for in an intensive care unit (ICU) after a complicated childbirth is often an unplanned and transforming experience, and there is lack of studies describing mothers' experiences of this phenomenon.

    Aim: The aim of this study was to describe the experiences of becoming a mother after a complicated delivery and a stay in an ICU.

    Methods: Qualitative personal interviews were conducted with eight mothers. The interview texts were subjected to qualitative thematic content analysis.

    Findings: The analysis resulted in one theme; wishing to be in control and together as a family, and six categories; being or not being prepared, feeling afraid, not being as ill as the others, knowing about the baby, worrying about the father and having someone to talk to. The findings highlight the need to receive continual information about what is happening, especially with the baby, and the need to be together as a family.

    Conclusion and relevance to clinical practice: The mothers need support and encouragement from the staff throughout their hospital stay, and sometimes afterwards. There is a need to receive information, especially about the baby, and to have one's family close by, when in an ICU despite illness severity. How the new family is met by the staff is of great importance.

  • 176.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Nyström, Natalie
    ICU/Emergency Department, Kiruna Hospital.
    Sundelin, Gunilla
    Strömsund's Health Care Centre.
    Rattray, Janice
    School of Nursing and Midwifery, University of Dundee.
    People's experiences of being mechanically ventilated in an ICU: a qualitative study2013In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 29, no 2, p. 88-95Article in journal (Refereed)
    Abstract [en]

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

  • 177.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Rogmalm, Katarina
    ICU, Piteå hospital.
    Marklund, Lisa
    Medical Division, Piteå hospital.
    Wälivaara, Britt-Marie
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Follow-up visit in an ICU: receiving a sense of coherence2018In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 23, no 6, p. 308-315Article in journal (Refereed)
    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.

  • 178.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Close relatives’ experiences of transitions when living with a person with traumatic brain injury2011Conference paper (Other academic)
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  • 179.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Close relatives in intensive care from the perspective of critical care nurses2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 9, p. 1651-1659Article in journal (Refereed)
    Abstract [en]

    The aim was to describe critical care nurses' experiences of close relatives within intensive care. Background. There is a lack of research describing critical care nurses' experiences of the significance of close relatives in intensive care. Knowledge in this area will support critical care nurses to develop good nursing care for the critically ill person and their close relatives. Design and method. The design of the study was qualitative. Data collection was carried out through focus group discussions with 24 critical care nurses in four focus groups during spring 2004. The data were subjected to qualitative thematic content analysis. Results. The focus groups discussions showed that the presence of close relatives was taken for granted by critical care nurses and it was frustrating if the critically ill person did not have any. Information from close relatives made it possible for critical care nurses to create individual care for the critically ill person. They supported close relatives by giving them information, being near and trying to establish good relations with them. Close relatives were important. Critical care nurses lacked forums for reflection and discussion about the care given. Relevance to clinical practice. This study indicates that close relatives are a prerequisite for critical care nurses to give good nursing care to meet the needs of the critically ill person. A communication based on mutual understanding is necessary if critical care nurses are to be able to support close relatives. Dealing constantly with situations that were ethically difficult without any chance to reflect was an obstacle for critical care nurses to improve their work with close relatives

  • 180.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Critical care nurses experiences of follow-up visits to an ICU2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 19-20, p. 2925-2932Article in journal (Refereed)
    Abstract [en]

    Aim.  The aim of this study was to describe critical care nurses' experiences of follow-up visits for formerly critically ill people discharged from an intensive care unit and their close relatives.Background.  The critical illness experience affects the ill person and their close relatives not only during the stay in an intensive care unit, but also for a long time afterwards. Follow-up visits were introduced to offer people the opportunity to talk about their experiences. This activity has not been studied earlier from the perspective of critical care nurses.Design.  The design of this study was qualitative.Method.  Eight critical care nurses narrated their experiences of follow-up visits by formerly critically ill people and their close relatives to an intensive care unit. Data were collected during 2007-2008. Qualitative thematic content analysis was applied to the interview texts.Results.  The findings show that to feel they were doing a good job it was vital for the critical care nurses to be well prepared for the follow-up visits. It was difficult, in a positive way, to recognise formerly critically ill people when they returned looking healthy. The critical care nurses were disappointed that their former patients remembered so few real events. The follow-up visits gave the critical care nurses a new picture of how the critically illness experience influenced the former patient's everyday life during and after their stay in the intensive care unit and how it affected the lives of their close relatives.Conclusions.  Through sharing the experiences of formerly critically ill peoples' and their close relatives' critical care nurses receive valuable feedback about their work.Relevance to clinical practice.  Receiving feedback about one's work from follow-up visits gives critical care nurses the possibility for to evaluate given care. Follow-up visits to intensive care units can provide them with valuable knowledge that might lead to improved nursing care.

  • 181.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Follow up visits to an ICU: Critical care nurses’ experiences2011Conference paper (Other academic)
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  • 182.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Follow-up visits in a critical care unit from the perspective ot the critical care nurse2011Conference paper (Other academic)
  • 183.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Receiving power through confirmation: the meaning of close relatives for people who have been critically ill2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 59, no 6, p. 569-76Article in journal (Refereed)
    Abstract [en]

    This paper is a report of a study to elucidate the meaning of close relatives for people who have been critically ill and received care in an intensive care unit. Background. Falling critically ill can bring about a difficult change in life. In previous reports such events are described as frightening experiences, and close relatives are described as an important source of support in this difficult situation. Method. A purposive sample of 10 adults, eight men and two women, narrated how they experienced their close relatives during and after the time they were critically ill. The data were collected in 2004. The interview texts were transcribed and interpreted using a phenomenological hermeneutic approach influenced by the philosophy of Ricoeur. Findings. One major theme was identified, experiencing confirmation, with six sub-themes: receiving explanations; a feeling of being understood; a feeling of safety; gaining strength and will-power; having possibilities and realizing their value. Close relatives served as tools for the person who was ill, facilitating better communication and an increased ability to do various things. Simultaneously, feelings of dependence on the close relatives were expressed. There were descriptions of loneliness and fear in the absence of close relatives and, in order to feel safe, the participants wanted their close relatives to stay near them. Conclusion. Close relatives are vital, as they are the ill person's motivation to stay alive and to continue the struggle. Their presence is of great importance for the ill person and must be facilitated by staff.

  • 184. Engström, Åsa
    et al.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Spouses experiences of their partners' being cared for in an intensive care unit2004In: Workgroup of European nurse researchers. Biennial conference (12 : Lisboa : 2004), WENR , 2004, p. 79-Conference paper (Other academic)
  • 185. Engström, Åsa
    et al.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    The experiences of partners of critically ill persons in an intensive care unit2004In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 20, no 5, p. 299-310Article in journal (Refereed)
    Abstract [en]

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

  • 186.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Transition as experienced by close relatives of people with traumatic brain injury2011In: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 43, no 5, p. 253-260Article in journal (Refereed)
    Abstract [en]

    When someone is afflicted by a traumatic brain injury (TBI), it entails a sudden change in the lives of their close relatives. Relatives provide the primary support system for the person with TBI, and new living patterns have to be developed by the family to achieve balance in the new situation. There is an absence of studies focusing on the process of transition for people living close to a person with TBI, especially in a long-term relationship. The aim of this study, therefore, was to describe such transitions experienced by the close relatives of people with TBI. Five close relatives, all women, who lived with or close to a person with TBI in the northern part of Sweden, were interviewed. The data were analyzed in accordance with the qualitative interpretive method and performed in a series of steps to arrive at a description of the transition. The findings of the analysis are presented in 4 categories: the starting point of the transitions, transitions in pattern of daily life, transitions in relationship, and transitions in social life. The transitions of daily life for close relatives began suddenly as the person with TBI was injured unexpectedly. The relatives could feel lonely as former friends were gone or avoided them. How the person with TBI was met by other people strongly affected how the close relatives felt. Although they struggled to lessen the dependence of the person with TBI on them, they also felt anxious about how things would be if close relatives were no longer there for that person. The findings are discussed with reference to works by the philosophers Buber, Le´vinas, and Lo¨ gstrup and theories of transition.

  • 187.
    Enqvist, Aina
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care. Vårdhögskolan i Boden.
    Johansson, Karin C
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Ändrat vandringsbeteende i samband med förändrad vårdmiljö på en demensavdelning1990Report (Other academic)
  • 188.
    Eriksson, Berne
    et al.
    Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburgh, Sweden.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care. Department of Public Health and Clinical Medicine, Section of Medicine, University of Umeå, Umeå, Sweden.
    Nilsson, Ulf
    Department of Public Health and Clinical Medicine, Section of Medicine, University of Umeå, Umeå, Sweden.
    Strandkvist, Viktor
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation. Dept of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, the OLIN unit, Umeå university, Umeå, Sweden.
    Backman, Helena
    Dept of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, the OLIN unit, Umeå university, Umeå, Sweden.
    High prevalence of COPD among adults with heart disease2019In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54, no suppl. 63, article id OA293Article in journal (Other academic)
  • 189.
    Eriksson, Jenny
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Prim, Sofia
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Faktorer som påverkar livskvaliteten hos personer med lungcancer: En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Lungcancer är en vanlig och allvarlig sjukdom som vanligen orsakas av rökning. Då sjukdomen har stor påverkan på livet är det viktigt att kunna hjälpa personer som drabbats av lungcancer att hantera sjukdomen. Syftet med denna studie var att sammanställa vilka faktorer som påverkar livskvaliteten hos personer med lungcancer. Metoden som valdes var en integrerad litteraturöversikt där vetenskapliga artiklar söktes i tre databaser. 16 artiklar med kvalitativ och kvantitativ ansats samt mixad metod analyserades vilket resulterade i fyra huvudfaktorer: fysiska faktorer, sociala faktorer, emotionella faktorer och existentiella faktorer. Resultatet visar att dessa faktorer påverkar livskvaliteten hos personer med lungcancer genom att de fysiska symtomen begränsar deras dagliga liv, sociala relationer förändras, de kan drabbas av psykisk ohälsa och frågor om deras egen existens uppkommer. Det är viktigt att som sjuksköterska känna till dessa faktorer för att kunna hjälpa och stötta dessa personer så att de kan uppnå en så god livskvalitet som möjligt trots sjukdom.

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  • 190.
    Eriksson, Linn
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Stoltz, Erika
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Personers uppleverser av att leva med Crohns sjukdom: - En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Crohns sjukdom är en inflammatorisk tarmsjukdom som påverkar den drabbade personens dagliga liv i stor utsträckning. Syftet med studien var att beskriva personers upplevelser av att leva med Crohns sjukdom. Studien är en litteraturstudie där tio artiklar analyserades med kvalitativ innehållsanalys med manifest ansats. Analysen resulterade i fem kategorier; att känna rädsla och oro, att känna sig begränsad och behöva anpassa livet, att självbild och livslust förändras, att andra personers attityder och förståelse har stor betydelse samt att acceptera sjukdomen och ta kontroll över livet. Resultatet visade att personer med Crohns sjukdom upplever en oro i det dagliga livet, att informationen om sin sjukdom är bristfällig, ett behov av att kompromissa med sin självidentitet och svårigheter att upprätthålla relationer. Slutsatsen är att en tillitsfull relation mellan vårdpersonal och patient är en förutsättning för god omvårdnad. Genom att arbeta personcentrerat och utveckla en förståelse för upplevelserna av att leva med Crohns sjukdom kan vård och omvårdnad anpassas efter personens behov. En vårdrelation kan vara en resurs för att samtala om jobbiga eller stigmatiserade ämnen och kan upplevas stödjande i transitionsprocessen till att lära sig leva med sjukdomen. Vidare forskning bör undersöka varför en del personer har lättare att acceptera sjukdomen än andra.

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  • 191.
    Europe, Eeva
    et al.
    Huddinge universitetssjukhus, Fysioterapin.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Tyni-Lenné, Raija
    Huddinge universitetssjukhus, Fysioterapin.
    Om upplevelse av sjukdom och livssituation hos kvinnor med kronisk hjärtsvikt2001In: Nordisk fysioterapi, ISSN 1402-3024, Vol. 5, no 2, p. 50-7Article in journal (Other academic)
    Abstract [en]

    The purpose of this study was to describe how women with chronic heart failure (CHF) experience becoming ill, being ill and how they adjust to their new life situation. Qualitative interviews were carried out with 16 women with CHF (aged 4172 years). Interviews were analysed using qualitative content analysis as a method. The content was sorted in three categories: To become ill, To be ill and To be a carrier of a chronic heart disease. To become ill was described by bodily discomfort, emotional experiences and contact with health care. To be ill was described through having troubles, to be in need of help and support, adaptation to the illness and to be scared. To be a carrier of a chronic heart disease was described by attitudes towards physical activity, attitudes towards cigarette smoking and a lifelong medication. These women describe their illness experience in various ways. Their descriptions confirm the earlier knowledge of consequences of CHF and also reveal new knowledge. This may increase our understanding of how it is to live with a chronic heart failure and this understanding can be used in planning the rehabilitation

  • 192.
    Fagerlund, Ulrika
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lidén, Carin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Att leva med bipolär sjukdom: En kvalitativ analys av två kvinnors berättelser2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Psykisk ohälsa är ett av Sveriges största folkhälsoproblem. Psykiska besvär kanvariera från lindriga symtom så som nedstämdhet till allvarliga psykiska symtom.Bipolär sjukdom är en allvarlig långvarig sjukdom som kännetecknas av depressivaperioder med sänkt stämningsläge, medan de maniska perioderna ger en ökad energioch tankeverksamhet som kantas av omdömeslöshet. Syftet med denna studie var attbeskriva två kvinnors upplevelser av att leva med bipolär sjukdom. Tvåsjälvbiografier analyserades med kvalitativ innehållsanalys med manifest ansats.Analysen resulterade i sex kategorier: att uppleva hälsa och ohälsa relaterat till mani,att uppleva utanförskap, att uppleva sjukdomens mörker, att behandlingen inte löstealla problem, att uppleva närstående både på gott och ont samt att uppleva hälsa ivardagen. Slutsatsen blev att upplevelsen av att leva med bipolär sjukdom är komplexoch mångfacetterad samt att den har stor effekt på personens upplevelser av allt fråndet egna livet och den egna vardagen till livet som sådant. Därmed påverkarsjukdomen också livets alla dimensioner så som synen på sig själv, relationer,yrkesliv. Detta kräver ett holistiskt förhållningssätt, och ställer stora krav påkunskaper från vårdens sida för att kunna erbjuda god omvårdnad till dessa personer.Ytterligare kvalitativ forskning behövs för att öka kunskapen och förståelsen förhelheten av hur det är att leva med en så komplex diagnos som bipolär sjukdom.

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  • 193.
    Farhadova, Nilufar
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Örnblom, Julia
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Kvinnors upplevelser av det dagliga livet efter hjärtinfarkt - en litteraturstudie2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att drabbas av hjärtinfarkt innebär en stor förändring i det dagliga livet. Sjukdomen påverkar de drabbade på olika sätt och kvinnors och mäns upplevelser efter en hjärtinfarkt skiljer sig åt. Syftet med denna litteraturstudie var att beskriva kvinnors upplevelser om det dagliga livet efter en hjärtinfarkt. Litteraturstudien var baserad på femton vetenskapliga studier som analyserades enligt Bengtssons metod för kvalitativ innehållsanalys. Resultaten beskrevs i fem kategorier: att inte känna igen sin kropp och förlora sin självständighet, att känna sig begränsad och rädd för att återinsjukna, att behöva stöd för att få en gynnsam hälsoprocess och ett ökat välbefinnande, att behöva kontinuitet och känna sig förberedd och att hitta mening och nya strategier för att få balans i det nya livet. Resultatet visade kvinnors upplevelser runt det dagliga livet efter hjärtinfarkten. Stöd från hälso- och sjukvårdspersonal är viktig för hur kvinnorna klarar av sin situation. Slutsatsen var att vårdpersonalen måste arbeta personcentrerat med hänsyn till kvinnornas individuella behov för att ge bättre vård till kvinnor som genomgått en hjärtinfarkt.

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  • 194.
    Filipsson, Elisabeth
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Trönnhagen, Emelie
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Närståendes upplevelser av avancerad vårdplanering: En litteraturstudie2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    När en patient har drabbats av obotlig sjukdom, och död kan väntas inom en överskådlig tid bör vårdpersonal erbjuda planering av den palliativa vården för patient och närstående. Syftet med planeringen är att vägleda och möjliggöra förberedelse, val av vårdform och skapa delaktighet och valfrihet inför behandling. Här samtalas det även om önskningar inför livets slut. Denna process kan medföra många svårigheter för både närstående och patient. Närstående är ett känslomässigt stöd för patienten och kan hjälpa till att föra dennes talan i en svår situation. Syftet med studien var därför att beskriva närståendes upplevelser av avancerad vårdplanering. En systematisk litteratursökning i databaserna Cinahl och PubMed genomfördes och efter kvalitetsgranskning valdes slutligen elva studier. Dessa analyserades med kvalitativ manifest innehållsanalys och resulterade i fem slutliga kategorier: Att vilja vara engagerad i vården, Att ha behov av planerad och återkommande information, Att behöva prata om döden trots att ämnet var svårt, Att önska samtal vid rätt tidpunkt, Att inte vilja men känna sig tvungen att ta beslut. Studiens slutsatser visade att närstående ville vara engagerade i vården och deltog oftast i all kommunikation med vårdpersonal. Det visade sig att det fanns många svårigheter för närstående vid deltagande av beslut gällande patientens vård. Det var tydligt att tidpunkten för brytsamtal hade stor betydelse. Samtalen bör vara återkommande och påbörjas redan i primärvården. Kommunikationen ska ges med finkänslighet, den är mycket betydelsefull eftersom närstående söker stöd i den svåra situation de befinner sig i. Patient och närstående behöver i den palliativa vården ses som en enhet och det är viktigt att sjuksköterskan har kunskap i ämnet. Det behövs mer forskning inom området, palliativ vård inriktat på hälsa och välbefinnande är idag relativt outforskat i Sverige.

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  • 195.
    Fischhaber, Josephine
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Larsson Albèr, Bjarne
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Musik och dess inverkan på oro i samband med anestesi och operation2020Independent thesis Advanced level (professional degree), 40 credits / 60 HE creditsStudent thesis
    Abstract [en]

    Background: Previous research has demonstrated that it is common to experience anxiety during surgery and anesthesia. Anxiety is characterized by nervousness, uneasy thoughts and physiological reactions. The physiological reactions of anxiety are similar to those of a stress reaction, which may affect intra- and postoperative outcomes. To use music during the course of surgery is considered as a nursing intervention, which may be used by the nurse anesthetist to ease the anxiety of patients. Aim: To conduct a literature review of previous results on the use of music as a nursing intervention, to reduce the patient's anxiety during anesthesia and surgery. Additionally, another aim was to explore the characteristics of the music intervention which are associated with lower levels of anxiety. Method: A literature review with an integrative design was conducted.  Searches were conducted in 2020 in PubMed and CINAHL databases for peer-reviewed scientific articles published in English regarding music interventions during surgery and anesthesia and identified 126 potentially relevant studies. After a structured quality assessment, 17 relevant studies were identified and analyzed. Results: The 17 included studies all regarded planned surgeries with the results overall indicating that music was associated with lower levels of anxiety among patients undergoing surgeries requiring anesthesia. Music seems to work as a distraction for patients and can also provide a safe familiarity in an unknown and scary environment. Three characteristics that affected the effectiveness of the music intervention to reduce anxiety levels were generated: how and when the music was played, what type of music was played and the duration of the intervention. Overall, music during surgery is most effective when it is played through a loudspeaker, compared with using headphones. Cultural context affects the choice of music and the effectiveness of the intervention and the duration can also impact the results. Conclusion: Calming music played through a loudspeaker during surgery is an effective nursing intervention that can be implemented to reduce patient anxiety in itself or as a complement alongside existing interventions. Music as a nursing intervention is both cost effective and time efficient. More research is needed regarding the patient’s experience and implementation in different settings.

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  • 196.
    Fisher, Duncan
    et al.
    The Family Initiative, Heron House, Chiswick Mall, London, UK.
    Khashu, Minesh
    Poole Hospital NHS Foundation Trust Poole, Dorset, UK. Bournemouth University, Bournemouth, UK.
    Adama, Esther A.
    Edith Cowan University School of Nursing and Midwifery in Perth, WA, Australia.
    Feeley, Nancy
    Centre for Nursing Research & Lady Davis Institute - Jewish General Hospital, McGill University, Montréal, Quebec, Canada.
    Garfield, Craig F.
    Departments of Pediatrics and Medical Social Sciences, Northwestern University Feinberg School of Medicine. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
    Ireland, Jillian
    Poole Hospital NHS Foundation Trust Poole, Dorset, UK. Bournemouth University, Bournemouth, UK.
    Koliouli, Flora
    Centre d’Études des Rationalités et des Savoirs, Laboratoire Interdisciplinaire Solidarités, Sociétés, Territoires (LISST-CERS), University of Toulouse, Toulouse, France.
    Lindberg, Birgitta
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Nørgaard, Betty
    Department of Paediatrics, Lillebaelt Hospital, Kolding, Denmark.
    Provenzi, Livio
    0-3 Center for the at Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, LC, Italy.
    Thomson-Salo, Frances
    Centre for Women's Mental Health, Royal Women's Hospital, Carlton, Australia.
    van Teijlingen, Edwin
    Centre for Midwifery, Maternal & Perinatal Health, Faculty of Health & Social Sciences, Bournemouth House, Bournemouth University, Bournemouth, UK.
    Fathers in neonatal units: Improving infant health by supporting the baby-father bond and mother-father coparenting2018In: Journal of Neonatal Nursing, ISSN 1355-1841, E-ISSN 1878-089X, Vol. 24, no 6, p. 306-312Article in journal (Refereed)
    Abstract [en]

    The Family Initiative's International Neonatal Fathers Working Group, whose members are the authors of this paper, has reviewed the literature on engaging fathers in neonatal units, with the aim of making recommendations for improving experience of fathers as well as health outcomes in neonatal practice. We believe that supporting the father-baby bond and supporting co-parenting between the mother and the father benefits the health of the baby, for example, through improved weight gain and oxygen saturation and enhanced rates of breastfeeding. We find, however, that despite much interest in engaging with parents as full partners in the care of their baby, engaging fathers remains sub-optimal. Fathers typically describe the opportunity to bond with their babies, particularly skin-to-skin care, in glowing terms of gratitude, happiness and love. These sensations are underpinned by hormonal and neurobiological changes that take place in fathers when they care for their babies, as also happens with mothers. Fathers, however, are subject to different social expectations from mothers and this shapes how they respond to the situation and how neonatal staff treats them. Fathers are more likely to be considered responsible for earning, they are often considered to be less competent at caring than mothers and they are expected to be “the strong one”, providing support to mothers but not expecting it in return. Our review ends with 12 practical recommendations for neonatal teams to focus on: (1) assess the needs of mother and father individually, (2) consider individual needs and wants in family care plans, (3) ensure complete flexibility of access to the neonatal unit for fathers, (4) gear parenting education towards co-parenting, (5) actively promote father-baby bonding, (6) be attentive to fathers hiding their stress, (7) inform fathers directly not just via the mother, (8) facilitate peer-to-peer communication for fathers, (9) differentiate and analyse by gender in service evaluations, (10) train staff to work with fathers and to support co-parenting, (11) develop a father-friendly audit tool for neonatal units, and (12) organise an international consultation to update guidelines for neonatal care, including those of UNICEF.

  • 197.
    Flaten Härnvall, Elin
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Pettersson, Evelina
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sjuksköterskors upplevelse av arbetsmiljön i hemsjukvården: En litteraturstudie2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att vårda patienter i hemmet kan innebära utmaningar då det är svårare att anpassa arbetsmiljön. Detta har stor betydelse för hälso- och sjukvården då arbetsmiljön påverkar både sjuksköterskors hälsa, omvårdnadsarbetet, patienters upplevelse av vården och patientsäkerheten. Syftet med denna litteraturstudie var att beskriva sjuksköterskors upplevelse av arbetsmiljön i hemsjukvården. Litteraturstudien inleddes med en systematisk litteratursökning i databaser som, efter kvalitetsgranskning, resulterade i nio vetenskapliga artiklar som gick vidare till analysen. Artiklarna analyserades med en kvalitativ manifest innehållsanalys med induktiv ansats. Analysen resulterade i fyra kategorier: Att ledarskap och organisation har stor betydelse, Att utsättas för risker och faror, Att prioritera patientens behov framför den egna hälsan, Att arbeta i en miljö som inte är optimal. Resultatet visade att sjuksköterskor upplevde brist på stöd, oro för den egna hälsan samt att arbetsmiljön i hemsjukvården var både riskfylld och ej optimal att bedriva vård i. Slutsatsen är att sjuksköterskor behöver mer stöd från sina arbetsgivare samt mer tid och resurser. Arbetsmiljön hindrar även sjuksköterskor i hemsjukvården från att arbeta effektivt.

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  • 198.
    Forsberg, Angelica
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Patients' experiences of undergoing surgery: From vulnerability towards recovery -including a new, altered life2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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  • 199.
    Forsberg, Angelica
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Critical care nurses'  experiences of performing successful peripheral intravenous catherisation i difficult situations2018In: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 36, no 2, p. 64-70Article in journal (Refereed)
    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.

  • 200.
    Forsberg, Angelica
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    From reaching the end of the road to a new lighter life: People's experiences of undergoing Gastric Bypass surgery2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 2, p. 93-100Article in journal (Refereed)
    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.

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