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  • 201.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Söderberg, Siv
    Receiving power through confirmation: the meaning of close relatives for people who have been critically ill2007Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 59, nr 6, s. 569-76Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 202. Engström, Åsa
    et al.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Spouses experiences of their partners' being cared for in an intensive care unit2004Inngår i: Workgroup of European nurse researchers. Biennial conference (12 : Lisboa : 2004), WENR , 2004, s. 79-Konferansepaper (Annet vitenskapelig)
  • 203. Engström, Åsa
    et al.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The experiences of partners of critically ill persons in an intensive care unit2004Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 20, nr 5, s. 299-310Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 204.
    Engström, Åsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Transition as experienced by close relatives of people with traumatic brain injury2011Inngår i: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 43, nr 5, s. 253-260Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 205.
    Enqvist, Aina
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad. Vårdhögskolan i Boden.
    Johansson, Karin C
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Ändrat vandringsbeteende i samband med förändrad vårdmiljö på en demensavdelning1990Rapport (Annet vitenskapelig)
  • 206.
    Ericsson, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Filipsson, Joakim
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Att känna sig trygg vid intrahospitala transporter av kritiskt sjuka patienter – upplevda behov hos intensivvårdssjuksköterskor med 0-3 års yrkeserfarenhet2017Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Att arbeta som nyutbildad intensivvårdssjuksköterska kan upplevas som väldigt krävande. Det krävs både specificerad kunskap om olika komplexa sjukdomstillstånd och att intensivvårdssjuksköterskan ska kunna hantera den högteknologiska miljön som en intensivvårdsavdelning utgör. När patienter vårdas på intensivvårdsavdelning förekommer olika intrahospitala transporter under vårdtiden, vilket medför ökade risker för patienterna. Tidigare studier visar att det förekommer ett högre antal oväntade händelser och en större otrygghet bland intensivvårdssjuksköterskor med kort arbetserfarenhet av intensivvård i samband med intrahospitala transporter. Syftet med detta examensarbete var att beskriva behov hos intensivvårdssjuksköterskor med mindre än fem års arbetserfarenhet för att känna sig trygga i samband med intrahospitala transporter av kritiskt sjuka patienter. Nio intensivvårdssjuksköterskor med <5 års arbetserfarenhet av intensivvård deltog i studien. Datainsamlingen genomfördes med semistrukturerade intervjuer, vilka sedan analyserades med en kvalitativ innehållsanalys. Analysen resulterade i tre kategorier: behov av att ha kompetent vårdpersonal med god samarbetsförmåga, behov av att ha en miljö som är anpassad för transporter och behov av att genomföra en omsorgsfull planering för att känna sig förberedd, vilka sedan resulterade i ett tema: behov av att känna kontroll över situationen med stöd från vårdteamet. Resultatet av denna studie visar vikten av att det implementeras en rutin vid intensivvårdsavdelningar för nyutbildade intensivvårdssjuksköterskor som tar anställning vid arbetsplatserna. Största vikten bör läggas på att intensivvårdssjuksköterskor ska omges av ett kompetent vårdteam med en tillåtande miljö, där det finns tid och möjlighet för god och individanpassad handledning.

  • 207.
    Eriksson, Jenny
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Prim, Sofia
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Faktorer som påverkar livskvaliteten hos personer med lungcancer: En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    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.

  • 208.
    Eriksson, Jonas
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Hansen, Linnéa
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Upplevelsen av att ha överlevt ett hjärtstopp: De drabbades och närståendes perspektiv2018Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Hjärtstopp innebär en stor förändring i livet och medför många frågor och funderingar för de drabbade och de närstående. Syftet med denna litteraturstudie var därför att beskriva upplevelsen av att ha överlevt ett hjärtstopp ur de drabbades och deras närståendes perspektiv. I analysen ingick nio vetenskapliga studier som analyserades med metoden kvalitativ innehållsanalys med en manifest ansats. Resultatet av litteraturstudien presenteras sedan i fyra kategorier som skapats utifrån analysen; Den första tiden är svår, Upplevelser av vården, Kroppen och sinnet begränsar, samt Händelsen väcker existentiella frågor. I resultatet framkom att sociala relationer och mötet med vården var av stor betydelse för känslor och upplevelser av tiden efter hjärtstoppet. Det framkom också att de drabbade efter hjärtstoppet fick fysiska och kognitiva svårigheter och de svåraste att acceptera var minnessvårigheterna. Hjärtstoppet väckte också många existentiella frågor, tankar om framtiden och hopp om en god framtid. Ett hjärtstopp påverkar inte bara de som drabbats utan även de närstående påverkas i hög grad, därför kan det också behövas mer forskning på området eftersom det finns begränsat antal vetenskapliga studier inom ämnet. Det framkom även att det finns utvecklingspotential gällande det stöd och informationsunderlag som idag används.

  • 209.
    Eriksson, My
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Grönlund, Erika
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    "Kommer vi aldrig ses mer" Hur vårdpersonal kan stödja barn till en förälder i livets slut2016Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    I livet är sjukdom och död oundviklig och oförutsägbar. När en familjemedlem drabbas av en allvarlig eller livshotande sjukdom innebär det omställningar för familjen. Att förlora en förälder är ett av det mest traumatiska ett barn kan uppleva och det kan påverka många områden och perioder i barnets liv. Syftet var att undersöka hur vårdpersonal kan stödja barn som har en förälder i livets slutskede. För att besvara syftet och de specifika frågeställningarna genomfördes en integrerad litteraturstudie där 14 stycken vetenskapliga studier analyserades. Varje frågeställning besvarades med en syntes. Resultatet visade att barn har ett stort behov av stöd då de upplevde vissa dagar som ett rent helvete med känslor som oro, ångest och stress. För barnet var det viktigt att förstå vad det var som hände med den sjuke föräldern, men även att själv bli sedd av vårdpersonalen. För att kunna hantera situationen fanns ett stort behov av information, både från föräldrar och vårdpersonal. Personalens sätt att ge stöd påverkades huruvida förälder och/eller barn tog till sig sjukdom och information, samt barnets eget sätt att hantera den pågående situationen. Barnen behövde även ges möjlighet att samtala med någon utomstående vuxen som de kände förtroende och tillit för. För barnen var tiden tillsammans med föräldern viktig och betydelsefull. De var trots detta tillslut beredda att ge upp den för att få slut på förälderns lidande. Resultatet visade att förälderns sjukdom och mående påverkade hela familjen, därför bör familjen ses som en helhet och vården bör ha ett familjecentrerat fokus. Detta för att inkludera och stödja barnet under denna kaosartade tid. 

  • 210.
    Europe, Eeva
    et al.
    Huddinge universitetssjukhus, Fysioterapin.
    Axelsson, Karin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Tyni-Lenné, Raija
    Huddinge universitetssjukhus, Fysioterapin.
    Om upplevelse av sjukdom och livssituation hos kvinnor med kronisk hjärtsvikt2001Inngår i: Nordisk fysioterapi, ISSN 1402-3024, Vol. 5, nr 2, s. 50-7Artikkel i tidsskrift (Annet vitenskapelig)
    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

  • 211.
    Fagerlund, Ulrika
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lidén, Carin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Att leva med bipolär sjukdom: En kvalitativ analys av två kvinnors berättelser2016Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    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.

  • 212.
    Farhadova, Nilufar
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Örnblom, Julia
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Kvinnors upplevelser av det dagliga livet efter hjärtinfarkt - en litteraturstudie2018Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    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.

  • 213.
    Ferner, Emma
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Petäjäniemi, Kristina
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Sjuksköterskors upplevelser av att vårda patienter med dialys: En litteraturstudie2018Independent thesis Basic level (professional degree), 180 hpOppgave
    Abstract [sv]

    Njursvikt blir allt vanligare omkring i världen och är en påfrestande sjukdom som orsakar många förändringar i personens vardagsliv på grund av dess symtom och behandling. Sjuksköterskan har ett stort ansvar kring dessa patienter både gällande hälsa, behandling och utbildning. Syftet med denna litteraturstudie var att studera sjuksköterskors upplevelser av att vårda patienter med dialys. I studien ingick tio kvalitativa artiklar som analyserades enligt kvalitativ innehållsanalys med manifest ansats. Analysen resulterade slutligen i fem kategorier vilka var; Att ha nära relationer, Ett stressande och krävande arbete, Att känna sig otillräcklig, Svårigheter att utbilda och kommunicera och att bli berörd och vilja ge stöd. I resultatet framkom att sjuksköterskor har nära relationer med patienter som behandlas med dialys och dessa relationer beskrevs som bekväma men kunde även orsaka en känslomässig trötthet. Arbetet upplevdes stressande och krävande på grund av oerfarenhet, sjukdomens komplexitet, arbetsmiljön och den svåra tekniken. Otillräcklighet upplevdes när sjuksköterskorna inte hade tillräckligt med tid, när kommunikationen med läkare var bristande och när patienterna var missnöjda. Att utbilda och stödja patienterna kunde upplevas som svårt, men resulterade i känslor av stolthet när det lyckades. Slutsatsen är att nära relationer med patienterna gör att sjuksköterskor kan ge en bättre vård och se individuella behov. Även patienten upplever en trygghet med en kontinuerlig kontakt. För att minska stress och känsla av otillräcklighet så behövs mer utbildning för sjuksköterskor som arbetar med dialys. Mer forskning inom området behövs då studier inom ämnet är begränsat.

  • 214.
    Fethi, Hemayon
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Sjuksköterskors upplevelser av att vårda patienter i livets slutskede En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Palliativ vård innebär för individen att det inte längre finns möjlighet att bli botad. Denna vårdform räknas som en viktig vård-filosofi med egen specifik kunskap. Grundstenarnaär omhändertagande och vård av den drabbade individen för vilken lindrande vård blir aktuell i livets slutskede. Syftet med studien var att beskriva sjuksköterskors upplevelser av att vårda patienter i livets slutskede. För att kunna beskriva sjuksköterskors upplevelser används metoden kvalitativinnehållsanalys medinduktiv ansats.Analysen resulterade i fem kategorier: Att bli känslomässigt berörd; Att känna sig obekväm; Att känna sig otillräcklig; Att se närvaro och fysisk beröring som betydelsefullt samt Att se palliativ vård som givande och tillfredsställande.Resultatet visade att ett gott teamarbete förhindrades av tidsbrist och underbemanning men underlättades av stöd från kollegor och positiv feedback. Sjuksköterskor upplevde även att de kunde känna sig obekväma att arbeta med patienter i ett palliativt skede.

    Nyckelord:Palliativ vård, patient, omvårdnad, sjuksköterska, upplevelser, kvalitativ metod, litteraturstudie.

  • 215.
    Fhärm, Simon
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Karlberg, Daniel
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Ambulanssjuksköterskors erfarenheter av att prehospitalt föreslå vårdnivå för patienter2018Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: I Sverige minskar antalet akutmottagningar, samtidigt går det att se en trend där antalet patienter som söker vård på akutmottagningen ökar. Det ökade patientflödet är en av orsakerna till att väntetiderna på akutmottagningar runt om i landet är fortsatt höga. Många landsting har öppnat möjligheten för prehospital personal att lämna patienter i hemmet alternativt transportera dem till andra vårdinrättningar än akutmottagningen. Detta för att förbättra patientens omhändertagande i de fall där patienten inte är i behov av akutsjukvård. Ett problem som uppstår när ambulanssjuksköterskor bedömer patienter som inte har något uppenbart akut tillstånd, är att systemen som används för prehospital triagering inte är anpassade för detta. För att kunna utforma bedömningssystem och riktlinjer som på ett bättre sätt motsvarar den prehospitala miljön, behöver ambulanssjuksköterskors upplevelse av att föreslå annan vårdnivå för patienter utforskas. Syfte: Att beskriva ambulanssjuksköterskors erfarenheter av att prehospitalt föreslå vårdnivå för patienter. Metod: Studien har designats som en intervjustudie med kvalitativ induktiv ansats. Resultat: Resultatet visar att ambulanssjuksköterskor finner det viktigt att kombinera sin kunskap och intuition vid klinisk bedömning av patienten. Det var också viktigt att ta patienter och närstående på allvar och att skapa trygghet. Att medvetandegöra sitt kommunikationssätt var också av betydelse för att skapa ett förtroende hos patienter. Ambulanssjuksköterskor beskrev också att de behövde stöd från både kollegor och organisation för att kunna göra säkra prioriteringar vid prehospitala bedömningar. Slutsats: Ambulanssjuksköterskor eftersträvar att göra en korrekt klinisk bedömning av patienten för att avgöra lämplig vårdnivå. I nuläget är stödet från de riktlinjer som finns ett trubbigt redskap. Ytterligare forskning inom området behövs därför för att kunna utforma riktlinjer som på ett bättre sätt kan stödja ambulanssjuksköterskor i deras bedömningar.

  • 216.
    Fischer Grönlund, Catarina E. C.
    et al.
    Umeå University.
    Söderberg, Anna I.S.
    Umeå University.
    Zingmark, Karin
    County Council of BD.
    Sandlund, S. Mikael
    Umeå University.
    Dahlqvist, Vera
    Ersta Sköndal University College.
    Ethically difficult situations in hemodialysis care: Nurses’ narratives2015Inngår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 22, nr 6, s. 711-722Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Providing nursing care for patients with end-stage renal disease entails dealing with existential issues which may sometimes lead not only to ethical problems but also conflicts within the team. A previous study shows that physicians felt irresolute, torn and unconfirmed when ethical dilemmas arose. Research question: This study, conducted in the same dialysis care unit, aimed to illuminate registered nurses’ experiences of being in ethically difficult situations that give rise to a troubled conscience. Research design: This study has a phenomenological hermeneutic approach. Participants: Narrative interviews were carried out with 10 registered nurses working in dialysis care. Ethical considerations: The study was approved by the Ethics Committee of the Faculty of Medicine, Umeå University. Results: One theme, ‘Calling for a deliberative dialogue’, and six sub-themes emerged: ‘Dealing with patients’ ambiguity’, ‘Responding to patients’ reluctance’, ‘Acting against patients’ will’, ‘Acting against one’s moral convictions’, ‘Lacking involvement with patients and relatives’ and ‘Being trapped in feelings of guilt’. Discussion: In ethically difficult situations, the registered nurses tried, but failed, to open up a dialogue with the physicians about ethical concerns and their uncertainty. They felt alone, uncertain and sometimes had to act against their conscience. Conclusion: In ethical dilemmas, personal and professional integrity is at stake. Mistrusting their own moral integrity may turn professionals from moral actors into victims of circumstances. To counteract such a risk, professionals and patients need to continuously deliberate on their feelings, views and experiences, in an atmosphere of togetherness and trust.

  • 217.
    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 tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    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 coparenting2018Inngår i: Journal of Neonatal Nursing, ISSN 1355-1841, E-ISSN 1878-089X, Vol. 24, nr 6, s. 306-312Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 218.
    Flaten Härnvall, Elin
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Pettersson, Evelina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Sjuksköterskors upplevelse av arbetsmiljön i hemsjukvården: En litteraturstudie2018Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    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.

  • 219.
    Forsberg, Angelica
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Patients' experiences of undergoing surgery: From vulnerability towards recovery -including a new, altered life2015Doktoravhandling, med artikler (Annet vitenskapelig)
    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.

  • 220.
    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 situations2018Inngår i: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 36, nr 2, s. 64-70Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 221.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    From reaching the end of the road to a new lighter life: People's experiences of undergoing Gastric Bypass surgery2014Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, nr 2, s. 93-100Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 222.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lindgren, Elenor
    Department of Intensive Care, Sunderby Hospital.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Being transferred from an intensive care unit to a ward: searching for the known in the unknown2011Inngår i: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 17, nr 2, s. 110-116Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    People who have been cared for in intensive care units (ICUs) are transferred between different levels of care and hospitals. The aim with this study was to describe peoples’ experiences of being cared for in an ICU and transferred to a ward. An inductive, descriptive qualitative study was performed with qualitative individual interviews with 10 participants. The interviews were transcribed verbatim and subjected to qualitative thematic content analysis which resulted in one theme; searching for the known in the unknown, and five categories. The findings showed the importance of being prepared for the transfer and knowing what was going to happen. Some participants felt secure in the ICU and excluded on the ward, others appreciated leaving the stressful environment in the ICU for a more peaceful ward. Feelings of anxiety and exposure were experienced during the transfer and it was helpful if staff involved were known to the participants. Better information and patients’ involvement concerning the transfer from ICUs to general wards are suggested as means of improving nursing care. Further studies are needed to improve continuity of care for critically ill people

  • 223.
    Forsberg, Angelica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Engström, Åsa
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    People's experiences of suffering a lower limb fracture and undergoing surgery2014Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, nr 1-2, s. 191-200Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe people's experiences of suffering a lower limb fracture and undergoing surgery, from the time of injury through to the care given at the hospital and recovery following discharge.BACKGROUND: There is a lack of research on people's experiences of suffering a lower limb fracture and undergoing surgery - from injury to recovery.DESIGN: A qualitative approach was used.METHODS: Interviews with nine participants were subjected to thematic content analysis.RESULTS: One theme was expressed: from realising the seriousness of the injury to regaining autonomy. Participants described feelings of frustration and helplessness when realising the seriousness of their injury. The wait prior to surgery was a strain and painful experience, and participants needed orientation for the future. They expressed feelings of vulnerability about being in the hands of staff during surgery. After surgery, in the postanaesthesia unit, participants expressed a need to have control and to feel safe in their new situation. To mobilise and regain their autonomy was a struggle, and participants stated that their recovery was extended.CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: Participants found themselves in a new and unexpected situation and experienced pain, vulnerability and a striving for control during the process, that is, 'from realising the seriousness of the injury to regaining autonomy'. How this is managed depends on how the patient's needs are met by nurses. The nursing care received while suffering a lower limb fracture and undergoing surgery should be situation specific as well as individual specific. The safe performance of technical interventions and the nurse's comprehensive explanations of medical terms may help the patient to feel secure during the process.

  • 224.
    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 procedure2017Inngår i: ACORN: The Journal of Perioperative Nursing in Australia, ISSN 1448-7535, Vol. 30, nr 3, s. 13-22Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 225.
    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 perspective2018Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, nr 2, s. 188-199Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 226.
    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 health2018Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, nr 6, s. 834-843Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 227.
    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 procedure2015Inngår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 30, nr 4, s. 280-289Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 228.
    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 month2015Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, nr 13-14, s. 1825-1836Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 229.
    Forsberg, Cajsa
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Kinnunen, Pia
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Sjuksköterskans arbetsmiljö och dess påverkan på patientsäkerheten: - En systematisk litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Hälso- och sjukvården ska verka för en trygg och säker plats som främjar hälsa och minskar lidande. Det innebär att sjuksköterskan i sitt arbete ska agera för att patientsäkerheten efterlevs i syfte att undvika vårdskador. Dock visar studier att sjuksköterskans arbetsmiljö inverkar på patientsäkerheten. Syftet med studien var därför att undersöka vilka faktorer i sjuksköterskans arbetsmiljö som kan påverka patientsäkerheten med utgångspunkt i två frågeställningar; vilka faktorer i arbetsmiljön kan bidra till ökad patientsäkerhet och vilka faktorer i arbetsmiljön kan motverka en god patientsäkerhet. Litteraturstudien genomfördes som en systematisk litteraturöversikt där datainsamlingen hämtats utifrån aktuell forskning från elva artiklar framtagits från tre olika databaser. Resultatet lyfter tio kategorier som framkom av analysen och påvisade både positiva faktorer som tydlig kommunikation, stödjande arbetsplats, delaktighet, samarbete och preventivt arbete samt negativa faktorer som bristande kommunikation, bristande målbild och vårdkultur, missnöje, hög arbetsbelastning och kompetensbrist som påverkade sjuksköterskans arbetsmiljö och i sin tur även patientsäkerheten. Resultatdiskussionen lyfter förslag på åtgärder för att främja positiva och motverka negativa arbetsmiljöfaktorer vilka ses som betydelsefulla för att patientsäkerheten ska upprätthållas och öka. I slutsatsen framkommer att förbättring av patientsäkerheten krävs för att positiva faktorer i arbetsmiljön ska stimuleras och omsättas i högre utsträckning medan negativa faktorer bör reduceras och förändras. En fungerande kommunikation kunde stimulera övriga arbetsmiljöfaktorer vilket därmed kunde leda till förbättringar i arbetsmiljön som i sin tur ökade patientsäkerheten.

  • 230.
    Forslund, Ann-Sofie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    A second chance at life: A study about people suffering out-of-hospital cardiac arrest2014Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    AimThe overall aim of this thesis was to describe people’s lives before and aftersuffering out-of-hospital cardiac arrest with validated myocardial infarction aetiology (OHCA-V). The following specific aims were formulated: describe trends in incidence, outcome and background characteristics among people who suffered OHCA-V (I), describe risk factors and thoughts about lifestyle among survivors(II),elucidate meanings of people’s lived experiences of surviving 1month after the event (III),and elucidate meanings of people’s lived experiencesof surviving 6 and 12 months after the event (IV)MethodsData were collected from the Northern Sweden MONICA myocardial registryand from interviews with people surviving OHCA-V. Quantitative and qualitative methodologies were used for analysis.ResultsThe incidence of OHCA-V decreased during the 19 years studied, and people aged 25-64 had an increased survival rate. The proportion of people with a history of ischemic heart disease (IHD) before the event decreased over theyears. Among people surviving OHCA-V, 60% had no prior history of IHD, but 20% had three cardiovascular risk factors (i.e., hypertension, diabetes mellitus,hypercholesterolemia and/or lipid lowering medication, current smoker). People surviving were aware of their risk factors and their descriptions of their lifestylefocused on the importance of having people around, feeling happy and having a positive outlook on life. They made their own choices regarding how to livetheir lives, which they often referred to as “living a good life.” Meanings of surviving during the first year can be understood as a pendulum ́s motion.Participants narrated they thought about the fact that they had been dead and returned to life. They also expressed they wished to know what had happened tothem while they were dead, but at the same time they wanted to put the event behind them and look forward. People surviving OHCA-V were striving to gettheir ordinary life back, but they also wondered if life would be the same. The cardiac arrest affected their body, which felt unfamiliar to them, and they felt they had to learn to feel secure in their body again. People survivingexpressed they had been given a second chance at life, and they described the event had affected their outlook on life.ConclusionThis thesis shows that people suffering OHCA-V are the most likely to die, but the survival rate is increasing. Many people had no known history of IHD beforethe event, but some had known risk factors for cardiovascular disease. To address these facts it is important for health care to focus both on primary andsecondary preventive measures to avoid complications connected to cardiovascular disease. Participants described their thoughts about their lifestyle,which was connected to what they found important in their lives; preventive 3 measures should be linked to those things to be more successful. People thatsurvived experienced pendulum emotions during their first year, and amovement back and forth in time was expressed. Health care personnel could support people surviving OHCA-V by talking with them about their thoughts connected to the past, present and future.Keywordsincidence, myocardial infarction, out-of-hospital cardiac arrest, survival, trends,life experiences, qualitative research

  • 231.
    Forslund, Ann-Sofie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Gemensamt HLV.
    Att ha överlevt hjärtstopp utanför sjukhus2014Inngår i: Att leva med sjukdom, Lund: Studentlitteratur AB, 2014, 2, s. 61-69Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
  • 232.
    Forslund, Ann-Sofie
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Preventing cardiac death in diabetes2011Inngår i: Nursing Times, ISSN 0954-7762, E-ISSN 1338-6263, Vol. 107, nr 40, s. 34-Artikkel i tidsskrift (Annet vitenskapelig)
  • 233.
    Forslund, Ann-Sofie
    et al.
    Department of Medicine, Sunderby hospital.
    Lundblad, Dan
    Department of Medicine, Sunderby Hospital.
    Jansson, Jan-Håkan
    Skelleftea Hospital, Department of Medicine .
    Zingmark, Karin
    Department of Medicine, Sunderby Hospital.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Risk factors among people surviving out-of-hospital cardiac arrest and their thoughts about lifestyle2013Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, nr Suppl. 1, s. S13-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: To describe risk factors among people surviving out-of-hospital cardiac arrest and their thoughts about lifestyle.Design: An explanatory mixed methods design was used.Methods: All people registered in the northern Sweden Monica myocardial registry between the year 1989 to 2007 who survived out-of-hospital cardiac arrest with validated myocardial infarction aetiology and were alive at the 28th day after the onset of symptoms (n=71) were included in the quantitative analysis. Thirteen of them participated in interviews conducted in 2011 and analysed via a qualitative manifest content analysis.Results: The quantitative results showed that about 60% of the people had no history of ischemic heart disease or hypertension before the out-of-hospital cardiac arrest whereas 25% and 17% had been diagnosed with myocardial infarction and diabetes mellitus, respectively. Eighty percent of the people had total cholesterol levels greater than 5.0 mmol/l and/or were taking lipid lowering medications. Almost half were smokers and overweight. The qualitative results are presented in three categories ‘descriptions of lifestyle after surviving’, ‘modifying the lifestyle to the new life situation’ and ‘a changed view on life’. The participants described that their lifestyle focused on the importance of being needed and meaning something to others, feeling well and doing things of their choice. They tried to find a reason why the cardiac arrest happened and make appropriate lifestyle changes although they made their own assessmnet of risk behaviours. The participants expressed being grateful for a second chance at life and tried to have a positive outlook on life.Conclusions: For most people in this study out-of-hospital cardiac arrest was the first symptom of coronary heart disease. In the interviews the participants expressed that they were well informed about their cardiovascular risk factors and the benefits of risk factor treatment. In spite of that, some of the patricipants chose to ignore this knowledge to some extent and preferred to live a ‘good life’. A life where risk factor treatment played a minor part. The results of this study indicates that health care workers and patients should focus more on the meaningful and joyful things in life and try to adopt healthy behaviours and lifestyle changes linked to these things.

  • 234.
    Forslund, Ann-Sofie
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Lundblad, Dan
    Department of Medicine, Sunderby Hospital.
    Jansson, Jan-Håkan
    Department of Public Health and Clinical Medicine, Umeå university.
    Zingmark, Karin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Risk factors among people surviving out-of-hospital cardiac arrest and their thoughts about what lifestyle means to them: a mixed methods study2013Inngår i: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 13, nr August, artikkel-id 62Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background The known risk factors for coronary heart disease among people prior suffering an out-of-hospital cardiac arrest with validated myocardial infarction aetiology and their thoughts about what lifestyle means to them after surviving have rarely been described. Therefore the aim of the study was to describe risk factors and lifestyle among survivors. Methods An explanatory mixed methods design was used. All people registered in the Northern Sweden MONICA myocardial registry between the year 1989 to 2007 who survived out-of-hospital cardiac arrest with validated myocardial infarction aetiology and were alive at the 28th day after the onset of symptoms (n = 71) were included in the quantitative analysis. Thirteen of them participated in interviews conducted in 2011 and analysed via a qualitative manifest content analysis. Results About 60 % of the people had no history of ischemic heart disease before the out-of-hospital cardiac arrest, but 20 % had three cardiovascular risk factors (i.e., hypertension, diabetes mellitus, total cholesterol of more or equal 5 mmol/l or taking lipid lowering medication, and current smoker). Three categories (i.e., significance of lifestyle, modifying the lifestyle to the new life situation and a changed view on life) and seven sub-categories emerged from the qualitative analysis. Conclusions For many people out-of-hospital cardiac arrest was the first symptom of coronary heart disease. Interview participants were well informed about their cardiovascular risk factors and the benefits of risk factor treatment. In spite of that, some chose to ignore this knowledge to some extent and preferred to live a "good life", where risk factor treatment played a minor part. The importance of the support of family members in terms of feeling happy and having fun was highlighted by the interview participants and expressed as being the meaning of lifestyle. Perhaps the person with illness together with health care workers should focus more on the meaningful and joyful things in life and try to adopt healthy behaviours linked to these things.

  • 235.
    Forslund, Ann-Sofie
    et al.
    The Northern Sweden MONICA Myocardial Registry, Department of Research, Norrbotten County Council.
    Lundblad, Dan
    Department of Medicine, Sunderby Hospital.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Sudden cardiac death among people with diabetes: preventive measures documented in their medical records2010Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, nr 23/24, s. 3401-3409Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: The purpose of this study was to examine how prevention of complications for people with diabetes mellitus had been conducted, as described in their medical records, focusing particularly on sudden cardiac death. A further aim was to compare the documentation with guidelines for diabetes care. Background: Diabetes mellitus is associated with an increased risk of cardiovascular disease, death and sudden cardiac death. About half of those affected by sudden cardiac death are assumed to have had one or more risk factors for cardiovascular disease that could have been treated effectively resulting in a reduced risk of sudden death. Design: Survey. Method: Fifty-six people diagnosed with diabetes mellitus, who had died of a sudden cardiac arrest between the years 2003-2005, from the Northern Sweden MONICA myocardial registry were included. These people's medical records were examined with regard to documentation of the care given during the year prior to the person's sudden cardiac death. Results: The qualitative content analysis resulted in four categories: individualised goals for diabetes care; prevention of complications; self-care; and factors which may affect ability to adhere to treatment. The quantitative analysis showed that few people with diabetes mellitus achieved goals for metabolic control, compared with those set in guidelines for diabetes mellitus care.Conclusion. To prevent complications for people with diabetes mellitus, it is a challenge for nurses and physicians to involve people with diabetes mellitus in their own care to improve the prognosis. Relevance to clinical practice: Examination of medical records of people with diabetes mellitus showed that documentation could be more informative and systematic. It is important to achieve better adherence to treatment and to increase people's understanding of their illness

  • 236.
    Forslund, Ann-Sofie
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Jansson, Jan-Håkan
    Department of Medicine, Skellefteå Hospital.
    Lundblad, Dan
    Department of Public Health and Clinical Medicine, University of Umeå.
    Trends in incidence and outcome of out-of-hospital cardiac arrest among people with validated myocardial infarction2013Inngår i: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 20, nr 2, s. 260-267Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: To describe trends in incidence, outcome, and background characteristics among people who suffered an out-of-hospital cardiac arrest with validated myocardial infarction aetiology (OHCA-V).Methods and results: People from the northern Sweden MONICA myocardial registry (1989–2007) with OHCA-V (n = 2977) were divided in two age groups (25–64 and 65–74 years). Both those who were resuscitated outside hospital and those who died before resuscitation was started were included in the study. The younger age group was studied during 1989–2007 and the older group during 2000–2007. The incidence of OHCA-V decreased in both the younger group (men p < 0.0001, women p = 0.04) and the older group (men p < 0.0001, women p < 0.0007, respectively). The proportion with a history of ischaemic heart disease prior to the event decreased (p < 0.0001). The proportion of previous myocardial infarction decreased (p < 0.0001), diabetes mellitus increased (p = 0.001), coronary interventions increased (p < 0.0001), and survival after OHCA-V increased (p < 0.0001) in the younger group but not in the older group. Long-term survival after OHCA-V was better in the younger than in the older group (p = 0.026).Conclusion: The incidence of OHCA-V decreased in both sexes. The proportion surviving after OHCA-V was small but increased, and long-term survival (≥28 days) was better in the younger age group. Primary preventive measures may explain most of the improvements. However, the effects of secondary preventive measures cannot be excluded.

  • 237.
    Forslund, Ann-Sofie
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Zingmark, Karin
    County Council of Norrbotten, Department of Research and Development.
    Jansson, Jan-Håkan
    Department of Public Health and Clinical Medicine, Sunderby Research Unit, Umeå University.
    Lundblad, Dan
    Department of Public Health and Clinical Medicine, Sunderby Research Unit, Umeå University.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Meanings of people's lived experiences of surviving an out-of-hospital cardiac arrest, 1 month after the event2014Inngår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 29, nr 5, s. 464-471Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The out-of-hospital cardiac arrest (OHCA) survival rate has been poor and stable for a long time, but more recent studies describe its increase. However, there are few studies in which people narrate their experiences from surviving. Objective: The aim of this study was to elucidate meanings of people's lived experiences of surviving an OHCA with validated myocardial infarction (MI) etiology, 1 month after the event. Methods: A purposive sample of 2 women and 9 men was interviewed between February 2011 and May 2012. A phenomenological hermeneutical method was used for analysis, which involved 3 steps: naive reading and understanding, structural analysis, and comprehensive understanding. Results: There were 2 themes, (1) returning to life and (2) revaluing life, and five subthemes, (1a) waking up and missing the whole picture, (1b) realizing it was not time to die, (2a) wondering why and seeking explanations, (2b) feeling ambiguous in relations, and (2c) wondering whether life will be the same. All were constructed from the analysis. Conclusions: Surviving an OHCA with validated MI etiology meant waking up and realizing that one had experienced a cardiac arrest and had been resuscitated. These survivors had memory loss and a need to know what had happened during the time they were dead/unconscious. They searched for a reason why they experienced an MI and cardiac arrest and had gone from being "heart-healthy" to having a lifelong illness. They all had the experience of passing from life to death and back to life again. For the participants, these differences led to a revaluation of what is important in life.

  • 238.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    A moral endeavour in a demoralizing context: Psychiatric inpatient care from the perspective of professional caregivers2015Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Patients in psychiatric care experience a need for and expect to develop interpersonal relationships with professional caregivers and to be respected and listened to. Despite demands for care to be person-centred and recovery-oriented, patients experience that psychiatric inpatient care fails to meet their expectations. Nursing research suggest that nurses aspire to engage with and meet the needs of patients, but that the strenuous reality of inpatient care prevents them from doing so. Exploring the content and context of psychiatric inpatient care from the perspective of professional caregivers might provide valuable insights regarding what caregivers do, and more importantly it can aid in understanding why they do what they do.This thesis aimed to explore the content and context of adult psychiatric inpatient care from the perspective of professional caregivers. This was achieved by clarifying the concept of person-centred care in the context of inpatient psychiatry, describing staff members’ reasoning on their choice of action and perceptions of interprofessional collaboration in challenging situations in inpatient psychiatric care settings, and exploring nurses’ experiences of good nursing practice in the specific context of inpatient psychiatry. A systematic review of the literature identified 34 scholarly papers that were analysed using evolutionary concept analysis. Focus group interviews were conducted with 26 professional caregivers and analysed using qualitative content analysis. Individual qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and analysed using an interpretive descriptive approach to qualitative analysis.Reviewing the literature on person-centred care in inpatient psychiatry clarified how person-centred care is expected to result in quality care when interpersonal relationships are used to promote recovery. Professional caregivers’ reasoning on choice of action described different concerns in caregiver-patient interaction resulting in a focus on either meeting patients’ individual needs or solving staff members’ own problems. Describing professional caregivers’ perceptions of interprofessional collaboration suggested that they are being constrained by difficulties in collaborating with each other and a lack of interaction with patients. Exploring nurses’ experiences of good nursing practice revealed how circumstances in the clinical setting affect nurses’ ability to work through relationships. It is argued that these findings describe the workings of two opposing forces in psychiatric inpatient care. The concept of caring as a process forms the basis for discussing the content of care as a moral endeavour in which nurses strive to do good. The concept of demoralizing organizational processes is used to discuss the context of care as demoralizing and allowing for immoral actions.The main conclusions to be drawn are that, from a nursing perspective, nurses in psychiatric inpatient care need to focus on patients’ experiences and needs. For this they need sufficient resources and time to be present and develop relationships with patients.Nurses in psychiatric inpatient care also need to take personal responsibility for their professional practice. Attempts to transform psychiatric care in a person-centred direction must consider all of these aspects and their interrelatedness. Further research on psychiatric inpatient care is needed to understand more about how the content of care relates to the context of care.

  • 239.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    A moral endeavour in a demoralizing context: Psychiatric inpatient care from the perspective of professional caregivers2016Inngår i: American Psychiatric Nurses Association 30th Annual Conference, Hartford, Connecticut, October 19-22, 2016., 2016Konferansepaper (Fagfellevurdert)
  • 240.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Activity: The Tidal model of mental health recovery2015Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 241.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Bemötande vid psykisk ohälsa2010Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 242.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Evolutionär begreppsanalys2015Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 243.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Extravak - vad gör vi och varför?2010Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 244.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Få specialistutbildade sjuksköterskor i psykiatrin2012Annet (Annet (populærvitenskap, debatt, mm))
  • 245.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Omvårdnad i psykiatrisk slutenvård - gör vi det vi borde göra?2015Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 246.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Psyche2013Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Psykiatriska riksföreningen för sjuksköterskors tidskrift

  • 247.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Psykiatrisjuksköterska och stolt!2010Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Facebookgrupp. Initiativtagare och gruppadministratör.

  • 248.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Psykiatriska riksföreningen för sjuksköterskor2013Annet (Annet (populærvitenskap, debatt, mm))
  • 249.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Psykisk ohälsa och psykiatrisk vård2011Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 250.
    Gabrielsson, Sebastian
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Aktivitet: Sjuksköterska i psykiatrisk vård - möjligheter och utmaningar2015Konferansepaper (Annet (populærvitenskap, debatt, mm))
2345678 201 - 250 of 984
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