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  • 1. Andersson, Ewa Kazimiera
    et al.
    Willman, Ania
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Sjostrom-Strand, Annica
    Borglin, Gunilla
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Registered nurses' descriptions of caring: a phenomenographic interview study2015Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, nr 16, artikel-id 16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Nursing has come a long way since the days of Florence Nightingale and even though no consensus exists it would seem reasonable to assume that caring still remains the inner core, the essence of nursing. In the light of the societal, contextual and political changes that have taken place during the 21st century, it is important to explore whether these might have influenced the essence of nursing. The aim of this study was to describe registered nurses' conceptions of caring. METHODS: A qualitative design with a phenomenographic approach was used. The interviews with twenty-one nurses took place between March and May 2013 and the transcripts were analysed inspired by Marton and Booth's description of phenomenography. RESULTS: The analysis mirrored four qualitatively different ways of understanding caring from the nurses' perspective: caring as person-centredness, caring as safeguarding the patient's best interests, caring as nursing interventions and caring as contextually intertwined. CONCLUSION: The most comprehensive feature of the nurses' collective understanding of caring was their recognition and acknowledgment of the person behind the patient, i.e. person-centredness. However, caring was described as being part of an intricate interplay in the care context, which has impacted on all the described conceptions of caring. Greater emphasis on the care context, i.e. the environment in which caring takes place, are warranted as this could mitigate the possibility that essential care is left unaddressed, thus contributing to better quality of care and safer patient care.

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  • 2.
    Appelgren, Marie
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Bahtsevani, Christel
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Persson, Karin
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Borglin, Gunilla
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Nurses’ experiences of caring for patients with intellectual developmental disorders: a systematic review using a meta-ethnographic approach2018Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 17, artikel-id 51Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: Research suggests that registered nurses (RNs) do not feel adequately prepared to support patients with intellectual disability disorder (IDD). This is unsurprising, as few European health sciences curricula include undergraduate and graduate training courses in IDD. As RNs are often in the front line of care, eliciting in-depth knowledge about how they experience nursing this group of patients is vital. Our aim in this study was to develop a conceptual understanding about RNs’ experiences of nursing patients with IDD. Method: We undertook a systematic review and meta-ethnography to synthesise qualitative research studies found in PubMed, CINAHL, PsycINFO, ERIC databases and by manual searching to identify additional studies. We condensed translatable second-order constructs, and developed an idiomatic translation. Finally, we formulated line of argument (LOA) syntheses to capture the core of the idiomatic translations. Results: We included eighteen published studies from eight countries involving 190 RNs. The RNs’ experience of nursing patients with IDD were reflected in 14 LOAs. Six of these reflected a tentatively more distinctive and at times unique conceptualisation of RNs’ experience of nursing this group of patients. The remaining eight LOAs represented a conceptualisation of nursing per se, a conceptualisation of nursing that was interpreted as a universal experience regardless of context and patient group. Conclusion: Lack of awareness and knowledge are likely breeding grounds for the ‘otherness’ that still surrounds this group of patients. In encounters between patients and RNs, focusing on the person behind the disability label could be one way to secure relevant nursing care for patients with IDD. Undertaking appropriate under- and postgraduate education alongside the implementation of nursing models focusing on patient-centred care would help RNs in reducing the health and care inequalities this group of patients still face.

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  • 3.
    Bengtsson, Mariette
    et al.
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Carlson, Elisabeth
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Knowledge and skills needed to improve as preceptor: development of a continuous professional development course: a qualitative study part I2015Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, artikel-id 51Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Preceptors are expected to have the skills to be able to form an effective learning environment and facilitate a constructive clinical learning experience for students and new employees. Internationally, access to education for preceptors varies, with preceptors worldwide requesting more education in preceptorship. This article is based on a two-part study focusing on both the development and evaluation of a continuous, credit-bearing professional development course. The aim of this part of the study was to investigate and include preceptors’ requests and educational needs when developing a continuous professional development course on an advanced level. Methods: This study used a qualitative research approach. In total, 64 preceptors (62 women and two men) answered one single written, self-administered global question online. The participants were all interested in teaching and had completed an undergraduate training in preceptorship. The collected data was analysed by content analysis inspired by Burnard’s description of themethod. Results: The participating preceptors illuminated two main themes: ‘Tools for effective precepting of students and healthcare professionals’ and ‘in-depth knowledge and understanding of preceptorship in an academic setting’. The results suggest that vital components for preceptor preparation could be a) teaching and learning strategies, b) reflective and critical reasoning, c) communication models, d) the role of the preceptor, and e) preceptorship. Conclusion: Using the results from this study as a guide, a continuous professional development course was designed to assist preceptors in deepening their knowledge of preceptorship in regard to planning, leading and implementing educational activities directed at students, healthcare professionals, patients and their families. The course content focuses on skills needed for preceptorship and is based on adult learning principles. A continuous, credit-bearing professional development course must include an exam by which participants are formally assessed and graded; therefore, a written assignment was included as part of the course.

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  • 4.
    Bengtsson, Mariette
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Ivarsson Ekedahl, Ann-Britt
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Sjöström, Karin
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Errors linked to medication management in nursing homes: an interview study2021Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 20, nr 1, artikel-id 69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The number of errors in medication management in nursing homes is increasing, which may lead to potentially life-threatening harm. Few studies on this subject are found in the municipal nursing home setting, and causes need to be identified. The aim of this study was to explore perceptions of errors connected to medication management in nursing homes by exploring the perspective of first-line registered nurses, registered nurses, and non-licensed staff involved in the care of older persons.

    METHODS: A qualitative research approach was applied based on semi-structured interviews with 21 participants at their workplaces: Seven in each of the occupational categories of first-line registered nurses, registered nurses, and non-licensed staff. Subcategories were derived from transcribed interviews by content analysis and categorized according to the Man, Technology, and Organization concept of error causation, which is as a framework to identify errors.

    RESULTS: Mistakes in medication management were commonly perceived as a result of human shortcomings and deficiencies in working conditions such as the lack of safe tools to facilitate and secure medication management. The delegation of drug administration to non-licensed staff, the abandonment of routines, carelessness, a lack of knowledge, inadequate verbal communication between colleagues, and a lack of understanding of the difficulties involved in handling the drugs were all considered as risk areas for errors. Organizational hazards were related to the ability to control the delegation, the standard of education, and safety awareness among staff members. Safety issues relating to technology involved devices for handling prescription cards and when staff were not included in the development process of new technological aids. A lack of staff and the lack of time to act safely in the care of the elderly were also perceived as safety hazards, particularly with the non-licensed staff working in nursing homes.

    CONCLUSIONS: The staff working in nursing homes perceive that the risks due to medication management are mainly caused by human limitations or technical deficiencies. Organizational factors, such as working conditions, can often facilitate the occurrence of malpractice. To minimize mistakes, care managers need to have a systemwide perspective on safety issues, where organizational issues are essential.

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  • 5.
    Borglin, Gunilla
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV). Department of Nursing Education, Lovisenberg Diaconal University College, 0456, Oslo, Norway.
    Eriksson, Miia
    Department of Neurology, Skåne University Hospital, SE-222 42, Malmö, Sweden.
    Rosén, Madeleine
    Department of Neurology, Skåne University Hospital, SE-222 42, Malmö, Sweden.
    Axelsson, Malin
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Registered nurses' experiences of providing respiratory care in relation to hospital- acquired pneumonia at in-patient stroke units: a qualitative descriptive study2020Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 19, nr 1, artikel-id 124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: This study aimed to describe registered nurses' (RNs) experiences of providing respiratory care in relation to hospital acquired pneumonia (HAP), specifically among patients with acute stroke being cared for at in-patient stroke units.

    BACKGROUND: One of the most common and serious respiratory complications associated with acute stroke is HAP. Respiratory care is among the fundamentals of patient care, and thus competency in this field is expected as part of nursing training. However, there is a paucity of literature detailing RNs' experiences with respiratory care in relation to HAP, specifically among patients with acute stroke, in the context of stroke units. As such, there is a need to expand the knowledge base relating to respiratory care focusing on HAP, to assist with evidence-based nursing.

    DESIGN: A qualitative descriptive study.

    METHOD: Eleven RNs working in four different acute stroke units in Southern Sweden participated in the current study. The data were collected through semi-structured interviews, and the transcribed interviews were analysed using inductive content analysis.

    RESULTS: Three overarching categories were identified: (1), awareness of risk assessments and risk factors for HAP (2) targeting HAP through multiple nursing care actions, and (3) challenges in providing respiratory care to patients in risk of HAP. These reflected the similarities and differences in the experiences that RNs had with providing respiratory care in relation to HAP among in-patients with acute stroke.

    CONCLUSIONS: The findings from this study suggest that the RNs experience organisational challenges in providing respiratory care for HAP among patients with acute stroke. Respiratory care plays a vital role in the identification and prevention of HAP, but our findings imply that RNs' knowledge needs to be improved, the fundamentals of nursing care need to be prioritised, and evidence-based guidelines must be implemented. RNs would also benefit from further education and support, in order to lead point-of-care nursing in multidisciplinary stroke teams.

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  • 6.
    Borglin, Gunilla
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Räthel, Kristina
    Helene, Paulsson
    Sjögren Forss, Katarina
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Registered nurse’s working at elderly care centers experience of depressive symptoms among older people: a qualitative descriptive study2019Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 18, artikel-id 43Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Depressive symptoms and/or depression are commonly experienced by older people. Both are underdiagnosed, undertreated and regularly overlooked by healthcare professionals. Healthcare facilities for people aged ≥ 75 years have been in place in Sweden since 2015. The aim of these care centres, which are managed by registered nurses (RNs), is to offer care adjusted to cater to the complex needs and health problems of older people. Although the mental health of older people is prioritised in these centres, research into the experience of RNs of depressive symptoms and/or depression in older people in this setting is limited. Therefore, this study aimed to illuminate RNs, working at care centres for older people, experience of identifying and intervening in cases of depressive symptoms. Methods: The data for this qualitative descriptive study were collected through interviews (n = 10) with RNs working at 10 care centres for older people in southern Sweden. The transcribed texts were analysed using inductive content analysis. Results: The participants’ experiences could be understood from four predominant themes: (1) challenging to identify, (2) described interventions, (3) prerequisites for identification, and (4) contextual influences. Key findings were that it was difficult to identify depression as it often manifested as physical symptoms; evidence-based nursing interventions were generally not the first-line treatment used; trust, continuity and the ability of RNs to think laterally; and the context influenced the ability of RNs to manage older people’s depressive symptoms and/or depression. Conclusions: The process of identifying depressive symptoms and performing an appropriate intervention was found to be complex, especially as older people were reluctant to present at the centres and provided obscure reasons for doing so. A nurse-patient relationship that was built on trust and was characterised by continuity of care was identified as a necessary prerequisite. Appropriate nursing interventions—afforded the same status as pharmacological treatment—are warranted as the first-line treatment of depression. Further research is also needed into efficacious nursing interventions targeting depressive symptoms and/or depression.

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  • 7.
    Carlson, Elisabeth
    et al.
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Bengtsson, Mariette
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Perceptions of preceptorship in clinical practice after completion of a continuous professional development course: a qualitative study: Part II2015Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, nr 14, artikel-id 41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background For health care professionals, clinical practice is a vital part of education, and in several countries teaching is a regulated part of the role of nurses and health care staff. The added responsibility of taking on the teaching of students during clinical practice; thus, balancing clinical and educational demands, might lead to feelings of stress and burn-out. Being a skilled and experienced professional is not automatically linked to being a skilled educator as teaching of a subject is a whole different story. Preceptors who participate in educational initiatives are better prepared to address challenges and are more satisfied with the preceptor role. The aim of the current study was to evaluate preceptors’ experiences of preceptorship in clinical practice after completion of a credit bearing continuous professional development course on advanced level. Methods This was a small-scale interpretative qualitative study drawing data from focus group interviews and written accounts from reflective journals. Data were analysed through the process of naturalistic inquiry. Results Our findings show that the participants, who took part in and completed the CPD course, had developed skills and competences they believed to be necessary to drive pedagogical development at their respective work-places. This is illustrated by the main category Leading educational development and explained by four sub-categories: 1/ increased ability to give collegial support; 2/ increased trust in one´s abilities; 3/ increased emphasis on reflection; and 4/ increased professional status. Conclusions A well-structured program based on the needs of preceptors and developed in partnership between educational and clinical settings seems to be successful in terms of preceptors’ perceived increase of their competence, abilities and professional status. What seems to be missing, not only from the current study but also from previous research, is to what extent properly prepared preceptors impact on student learning and this needs to be further investigated.

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  • 8.
    Drott, Jenny
    et al.
    Division of Nursing Science, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Surgery, Linköping University Hospital, Linköping, Sweden.
    Engström, My
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Surgery Sahlgrenska, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Jangland, Eva
    Department of Surgical Sciences, Nursing Research, Uppsala University, Uppsala, Sweden.
    Fomichov, Victoria
    Unit for Public Health and Statistics, County Council of Östergötland, Linköping University, Linköping, Sweden.
    Malmström, Marlene
    Department of Health Sciences, Lund University, Lund, Sweden; Department of Surgery and Gastroenterology, Skåne University Hospital, Malmö, Sweden.
    Jakobsson, Jenny
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Factors related to a successful professional development for specialist nurses in surgical care: a cross-sectional study2023Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 22, nr 1, artikel-id 79Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: A high level of competence among staff is necessary for providing patient-safe surgical care. Knowledge regarding what factors contribute to the professional development of specialist nurses in surgical care and why they choose to remain in the workplace despite high work requirements is needed. To investigate and describe the organizational and social work environment of specialist nurses in surgical care as part of studying factors that impact on professional development.

    METHOD: This was a cross-sectional study with a strategic convenience sampling procedure that recruited 73 specialist nurses in surgical care in Sweden between October to December 2021. The study was guided by STROBE Statement and checklist of cross-sectional studies. The validated Copenhagen Psychosocial Questionnaire was used, and additional demographic data. Descriptive statistics were performed and the comparison to the population benchmarks was presented as the mean with a 95% confidence interval. To study potential differences among the demographic and professional characteristics, pairwise t tests were used with Bonferroni adjustment for multiple comparisons with a significance level of 5%.

    RESULTS: Five domains were identified as factors related to success, as they received higher scores in relation to population benchmarks: quality of leadership, variation of work, meaning of work and work engagement as well as job insecurity. There was also a significant association between a having a manager with low nursing education and job insecurity (p = 0.021).

    CONCLUSIONS: Quality of leadership is important for the professional development of specialist nurses in surgical care. Strategic work seems to include managers with a higher nursing education level to prevent insecure professional working conditions.

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  • 9.
    Glantz, Andreas
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Örmon, Karin
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Sandström, Boel
    “How do we use the time?”: an observational study measuring the task time distribution of nurses in psychiatric care2019Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 18, artikel-id 67Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The nurse’s primary task in psychiatric care should be to plan for the patient’s care in cooperation with the patient and spend the time needed to build a relationship. Psychiatric care nurses however claim that they lack the necessary time to communicate with patients. To investigate the validity of such claims, this time-motion study aimed at identifying how nurses working at inpatient psychiatric wards distribute their time between a variety of tasks during a working day. Methods: During the period of December 2015 and February 2016, a total of 129 h and 23 min of structured observations of 12 nurses were carried out at six inpatient wards at one psychiatric clinic in southern Sweden. Time, frequency of tasks and number of interruptions were recorded and analysed using descriptive statistics. Results: Administering drugs or medications accounted for the largest part of the measured time (17.5%) followed by indirect care (16%). Relatively little time was spent on direct care, the third largest category in the study (15.3%), while an unexpectedly high proportion of time (11.3%) was spent on ward related tasks. Nurses were also interrupted in 75% of all medication administering tasks. Conclusions: Nurses working in inpatient psychiatric care spend little time in direct contact with the patients and medication administration is interrupted very often. As a result, it is difficult to establish therapeutic relationships with patients. This is an area of concern for both patient safety and nurses’ job satisfaction.

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  • 10.
    Jakobsson, Jenny
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV). Malmö universitet, Centrum för tillämpad arbetslivsforskning och utvärdering (CTA).
    Örmon, Karin
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV). The Västra Götaland Region Competence Center on Intimate Partner Violence, Gothenburg, Sweden.
    Axelsson, Malin
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Berthelsen, Hanne
    Malmö universitet, Centrum för tillämpad arbetslivsforskning och utvärdering (CTA). Malmö universitet, Odontologiska fakulteten (OD).
    Exploring workplace violence on surgical wards in Sweden: a cross-sectional study2023Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 22, nr 1, artikel-id 106Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Workplace violence is a global threat to healthcare professionals' occupational health and safety and the situation has worsened during the COVID-19 pandemic. This study aimed to explore workplace violence directed against assistant and registered nurses working on surgical wards in Sweden.

    METHODS: This cross-sectional study was conducted in April 2022. Using a convenience sampling procedure, 198 assistant and registered nurses responded to an online questionnaire developed for this specific study. The questionnaire comprised 52 items and included, among other items, subscales from validated and previously used instruments. Data analysis included descriptive statistics, the chi-square test, and independent-samples t-test.

    RESULTS: The most frequently reported type of workplace violence was humiliation (28.8%), followed by physical violence (24.2%), threats (17.7%), and unwanted sexual attention (12.1%). Patients and patients' visitors were reported as the main perpetrators of all kinds of exposure. Additionally, one third of the respondents had experienced humiliation from colleagues. Both threats and humiliation showed negative associations with work motivation and health (p < 0.05). Respondents classified as working in a high- or moderate-risk environment were more frequently exposed to threats (p = 0.025) and humiliation (p = 0.003). Meanwhile, half of the respondents were unaware of any action plans or training regarding workplace violence. However, of those who indicated that they had been exposed to workplace violence, the majority had received quite a lot or a lot of support, mainly from colleagues (range 70.8-80.8%).

    CONCLUSION: Despite a high prevalence of workplace violence, and especially of humiliating acts, there appeared to be low preparedness within the hospital organizations to prevent and/or handle such incidents. To improve these conditions, hospital organizations should place more emphasis on preventive measures as part of their systematic work environment management. To help inform such initiatives, it is suggested that future research should focus on the identification of suitable measures regarding different types of incidents, perpetrators, and settings.

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  • 11.
    Jassim, Taghrid
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Carlson, Elisabeth
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Bengtsson, Mariette
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Preceptors' and nursing students' experiences of using peer learning in primary healthcare settings: a qualitative study2022Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 21, nr 1, artikel-id 66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Due to the need for students to integrate theory with practice, current research seeks the best learning and teaching models in primary healthcare settings. The aim of this study was to explore preceptors' and nursing students' experiences of using peer learning during clinical practice in primary health care. Methods A qualitative research approach was used based on semi-structured interviews with seven preceptors and ten nursing students. The interviews were transcribed and analyzed by using content analysis based on an inductive reasoning. Results Preceptors and students perceived peer learning as an educational model to be beneficial for learning in primary care settings. They found the model to be stimulating, challenging, and leading to development of professional identity and nursing skills. All informants were positive towards the peer learning experience, with students reporting they were seen as individuals, despite working in pairs. However, the physical environment was demanding with regards to telephone counseling issues, limited opportunities for using computers, and the use of small examination rooms. Conclusion This study shows that, despite the complex learning environment, peer learning as an educational model appears to work well in a primary healthcare setting. However, much improvement is needed to facilitate the students' learning process. Consequently, conditions for clinical practice and learning beneficial to both students and preceptors should be prioritized by management.

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  • 12. Ljungbeck, Birgitta
    et al.
    Sjögren Forss, Katarina
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Advanced nurse practitioners in municipal healthcare as a way to meet the growing healthcare needs of the frail elderly: a qualitative interview study with managers, doctors and specialist nurses2017Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The number of frail elderly people with complex nursing and medical care needs is increasing, and consequently, the healthcare burden. The implementation of Advanced Nurse Practitioners globally has been shown to make healthcare more effective and increase patient safety, continuity of care and access to care. In Sweden, research about Advanced Nurse Practitioners is limited. Thus, this study aimed to investigate the opinions of managers, doctors and nurses in primary care and municipal healthcare about the role of ANPs in municipal healthcare as a way to meet the increasing healthcare needs of the frail elderly. Methods: Managers, doctors and specialist nurses in primary care and municipal healthcare adopted a qualitative, descriptive design through 12 semi-structured interviews. The data were analysed using content analysis. Results: The participants expressed both opportunities as well as challenges with Advanced Nurse Practitioners in municipal healthcare. This role considered to satisfy frail elderly people’s healthcare needs and making the Healthcare more effective as the doctors would have more time for other patients. The challenges mainly consist of doubts from the managers whether the nurses would be motivated to pursue further education to become an Advanced Nurse Practitioner if the role becomes a reality. The doctors were unsure if the nurses would consider taking the responsibility the role would imply. Conclusions: Advanced Nurse Practitioner is considered to be a valuable resource not only for the frail elderly but also for the nurses in the municipal healthcare and for the doctors in primary care as they probably would make Healthcare more effective. They might be a way to meet the increasing healthcare needs of frail elderly, however there are also challenges to overcome before they can become a reality in a Swedish healthcare context. Consequently, this role deserves further investigation.

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  • 13.
    Manderius, Charlotta
    et al.
    Psychiatric assessment unit, adult psychiatry, Region Skane, Helsingborg, Sweden.
    Clintståhl, Kristofer
    Psychiatric psychosis unit, adult psychiatry, Region Skane, Helsingborg, Sweden.
    Sjöström, Karin
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Örmon, Karin
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV). Regionhälsan, The Västra Götaland Competence Centre on Intimate Partner Violence, Gothenburg, Sweden.
    The psychiatric mental health nurse's ethical considerations regarding the use of coercive measures: a qualitative interview study2023Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 22, nr 1, artikel-id 23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In psychiatric inpatient care, situations arise where it may be necessary to use coercive measures and thereby restrict individual autonomy. The ethical principles of healthcare, i.e., respect for autonomy, beneficence, nonmaleficence, and justice, are recognized as central aspects in healthcare practice, and nurses must be clear about which ethical theories and principles to prioritize and what values are needed for a thorough ethical consideration. The aim of this study is to shed light on psychiatric mental health nurses' ethical considerations and on the factors influencing them when performing coercive measures.

    METHODS: This qualitative interview study included twelve psychiatric mental health nurses with experience from psychiatric inpatient care. A content analysis was made. The interviews were audio recorded and transcribed verbatim, and categories were formulated.

    RESULTS: The study revealed a duality that created two categories: Ethical considerations that promote the patient's autonomy and health and Obstacles to ethical considerations. Based on this duality, ethical considerations were made when performing coercive measures to alleviate suffering and promote health. The result shows a high level of ethical awareness in clinical work. However, a request emerged for more theoretical knowledge about ethical concepts that could be implemented among the staff.

    CONCLUSION: The psychiatric mental health nurses in this study strive to do what is best for the patient, to respect the patient's autonomy as a guiding principle in all ethical considerations, and to avoid coercive measures. An organizational ethical awareness could increase the understanding of the difficult ethical considerations that nurses face with regard to minimizing the use of coercive measures in the long run.

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  • 14.
    Sjögren Forss, Katarina
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Nilsson, Jane
    Borglin, Gunilla
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Registered nurses’ and older people’s experiences of participation in nutritional care in nursing homes: a descriptive qualitative study2018Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 17, artikel-id 19Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background The evaluation and treatment of older people’s nutritional care is generally viewed as a low priority by nurses. However, given that eating and drinking are fundamental human activities, the support and enhancement of an optimal nutritional status should be regarded as a vital part of nursing. Registered nurses must therefore be viewed as having an important role in assessing and evaluating the nutritional needs of older people as well as the ability to intervene in cases of malnutrition. This study aimed to illuminate the experience of participating in nutritional care from the perspectives of older people and registered nurses. A further aim is to illuminate the latter’s experience of nutritional care per se. Methods A qualitative, descriptive design was adopted. Data were collected through semi-structured interviews (n = 12) with eight registered nurses and four older persons (mean age 85.7 years) in a city in the southern part of Sweden. The subsequent analysis was conducted by content analysis. Result The analysis reflected three themes: ‘participation in nutritional care equals information’, ‘nutritional care out of remit and competence’ and ‘nutritional care more than just choosing a flavour’. They were interpreted to illuminate the experience of participation in nutritional care from the perspective of older people and RNs, and the latter’s experience of nutritional care in particular per se. Conclusions Our findings indicate that a paternalistic attitude in care as well as asymmetry in the nurse-patient relationship are still common characteristics of modern clinical nursing practice for older people. Considering that participation should be central to nursing care, and despite the RN’s awareness of the importance of involving the older persons in their nutritional care this was not reflected in reality. Strategies to involve older persons in their nutritional care in a nursing home context need to take into account that for this population participation might not always be experienced as an important part of nursing care.

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  • 15.
    Stenberg, Marie
    et al.
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Carlson, Elisabeth
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Swedish student nurses' perception of peer learning as an educational model during clinical practice in a hospital setting: an evaluation study2015Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, artikel-id 48Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Peer learning, a collaborative learning model has no tradition in clinical education for undergraduate student nurses in Sweden, and little is reported of the student experience. An increasing number of students have led to a pressing need for preceptors and clinical placements thus, highlighting the need for a supportive educational model. The objectives for the current study were to explore how student nurses’ evaluated peer learning as an educational model during clinical practice in a hospital setting, and to compare perceptions among student nurses from year one and three. Methods A questionnaire developed for the purpose of this study was developed and responded to by 62 (year one) and 73 (year three) student nurses. Data were collected between 2011 and 2013. The questionnaire contained six open- ended and eight closed questions on a four point Likert-scale. Written responses were analysed by content analysis and the closed questions by using descriptive statistics. Mann-Whitney U-test was used to examine differences in relation to students from year one and three. Results The peer learning experience was evaluated in a positive way. Statistical significance differences were shown for two out of eight closed questions. The peer learning activities were evaluated as supportive and relevant for learning. Three categories emerged from the content analysis: “a feeling of safety”, “a sense of competition” and “the learning experience”. Conclusion A feeling of safety seems to be connected to students’ perception of increased learning and independence. However, the sense of negative competition needs to be addressed when students are prepared for the teaching and learning activities in the peer learning model. Finally, what needs to be further investigated is what challenges and opportunities the peer learning model presents to preceptors.

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  • 16.
    Stolt, Minna
    et al.
    University of Turku, Finland.
    Kottorp, Anders
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Suhonen, Riitta
    University of Turku, Finland.
    A Rasch analysis of the self-administered Foot Health Assessment Instrument (S-FHAI)2021Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 20, nr 1, artikel-id 98Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Reliable and valid measurement is the foundation of evidence-based practice. The self-administered Foot Health Assessment Instrument (S-FHAI) was recently developed to measure patients' evaluations of their own foot health. Evidence regarding the psychometric properties of the S-FHAI is limited. The aim of this study was to investigate those properties by using a Rasch analysis.

    METHODS: This methodological study analysed secondary data that was collected from nurses (n = 411) in 2015. The psychometric properties of the S-FHAI were evaluated using the Rasch model. Unidimensionality was analysed first, followed by item functioning, person misfit and differential item functioning (DIF).

    RESULTS: The S-FHAI demonstrated evidence of unidimensionality, with an acceptable item fit according to the Rasch model. Person fit and person separation were low, however, indicating restricted separation among different respondents. Item separation was high, demonstrating clear discrimination between the items. No DIF was detected in relation to gender, but significant DIF was demonstrated in relation to age for 6 of the 25 items.

    CONCLUSIONS: The S-FHAI has potential for use in investigating self-reported foot health. The Rasch analysis revealed that the psychometric properties of the instrument were acceptable, although some issues should be addressed to improve the scale. In future, it may be beneficial to analyse the sensitivity of the items and to test the S-FHAI in more diverse patient populations.

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  • 17.
    Striberger, Rebecka
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV). Skane Univ Hosp, Vasc Ctr, Dept Cardiothorac & Vasc Surg, Malmö, Sweden..
    Zarrouk, Moncef
    Skane Univ Hosp, Vasc Ctr, Dept Cardiothorac & Vasc Surg, Malmö, Sweden.;Lund Univ, Dept Clin Sci, Malmö, Sweden..
    Kumlien, Christine
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV). Skane Univ Hosp, Vasc Ctr, Dept Cardiothorac & Vasc Surg, Malmö, Sweden..
    Axelsson, Malin
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Illness perception, health literacy, self-efficacy, adherence and quality of life in patients with intermittent claudication - a longitudinal cohort study2023Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 22, nr 1, artikel-id 167Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patients with intermittent claudication need lifelong treatment with secondary prevention to prevent cardiovascular events and progression of atherosclerotic disease. Illness perception, health literacy, self-efficacy, adherence to medication treatment, and quality of life are factors influencing patients' self-management. Knowledge of these factors could be important when planning for secondary prevention in patients with intermittent claudication.

    Aim: to compare illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life in in patients with intermittent claudication.

    Methods: A longitudinal cohort study was conducted with 128 participants recruited from vascular units in southern Sweden. Data were collected through medical records and questionnaires regarding illness perception, health literacy, self-efficacy, adherence to treatment, and quality of life.

    Results: In the subscales in illness perception, patients with sufficient health literacy reported less consequences and lower emotional representations of the intermittent claudication. They also reported higher self-efficacy and higher quality of life than patients with insufficient health literacy. In comparison between men and women in illness perception, women reported higher illness coherence and emotional representations associated with intermittent claudication compared to men. A multiple regression showed that both consequences and adherence were negative predictors of quality of life. When examining changes over time, a significant increase in quality of life was seen between baseline and 12 months, but there were no significant differences in self-efficacy.

    Conclusion: Illness perception differs in relation to level of health literacy and between men and women. Further, the level of health literacy seems to be of importance for patients' self-efficacy and quality of life. This illuminates the need for new strategies for improving health literacy, illness perception, and self-efficacy over time. For example, more tailored information regarding secondary prevention could be provided to strengthen self-management to further improve quality of life in patients with intermittent claudication.

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  • 18.
    Theodoridis, Kyriakos
    et al.
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Noghi, Adina
    Borglin, Gunilla
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    The discharge conversation: a phenomenographic interview study2020Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 19, nr 1, artikel-id 59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Studies have highlighted deficiencies in the information given by nurses to surgical patients. Studies also show that the role of the nurse in connection with the discharge of patients after surgery is unclear. The aim of the study was therefore to elicit and to explore registered nurses' conceptions of the phenomenon ofnursing care information given to surgical patients in connection with hospital discharge. Method Semi-structured interviews were conducted with fifteen nurses at surgical unites at the southern parts of Sweden. The interviews were transcribed and then analysed according to the phenomenographic approach. Result The analysis resulted into three descriptive categories which conjointly may be said to express the general conceptions of the informants. Thus, according to the informants, the provision of nursing care information in connection with the discharge of surgical patients is: (i) not a nursing priority, (ii) adapted to the context of care, and (iii) a possible enhancement of the nursing process and the quality of care. Conclusion The result of the study implies that the discharge conversation may be seen as an opportunity for the nursing profession to formalise and to enhance the quality of care in connection with the discharge of surgical patients.

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  • 19. Tuvesson, Hanna
    et al.
    Wann-Hansson, Christine
    Malmö högskola, Fakulteten för hälsa och samhälle (HS).
    Eklund, Mona
    The ward atmosphere important for the psychosocial work environment of nursing staff in psychiatric in-patient care2011Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, nr 12Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants. METHODS: 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses. RESULTS: The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate. CONCLUSIONS: The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.

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  • 20.
    Vejzovic, Vedrana
    Malmö universitet, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Professionals’ experiences with paediatric colonoscopy: an interview study2019Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 18, nr 7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Colonoscopy plays a crucial role in the diagnosis of paediatric inflammatory bowel disease (IBD), adolescents comprise 25% of all cases of IBD. Several studies have found that a safe, informative, and effective colonoscopy, performed in a child-friendly atmosphere with minimal distress to the child, is difficult to achieve. The aim of this study was to describe nurse’s experiences of the pre-colonoscopy procedure prior in children. Methods A qualitative design with a thematic content analysis approach was used. Fifteen nurses at a children’s hospital participated in interviews regarding their experiences of the bowel cleansing procedure with PEG in children. Results Four key themes were extracted from the nurses’ experiences; lack of knowledge, challenges surrounding information, responsibility without control and assembly line- like procedure.. Conclusions This study shows that nurses feel that they need more time and education opportunities before involved in paediatric colonoscopies.

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  • 21.
    Wann-Hansson, Christine
    et al.
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    Wennick, Anne
    Malmö högskola, Fakulteten för hälsa och samhälle (HS), Institutionen för vårdvetenskap (VV).
    How do patients with peripheral arterial disease communicate their knowledge about their illness and treatments?: A qualitative descriptive study2016Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, nr 15, artikel-id 29Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Peripheral arterial disease is a chronic illness, and patients with peripheral arterial disease should receive advice about lifestyle changes and medical therapies to reduce further atherosclerotic complications. Previous research has indicated that patients with peripheral arterial disease lack information about their disease and secondary prevention measures. The aim was to elucidate how patients with peripheral arterial disease communicate their knowledge about their illness and treatments. Methods: During 2009, seven focus group interviews were conducted with twenty-one patients (50–81 years old) with peripheral arterial disease and were analysed using content analysis. Results: When respondents with PAD communicate their knowledge about the illness and its treatments they “Navigate through uncertainty, believes and facts about PAD, displaying an active or passive information-seeking behaviour”. After discharge, they felt a feeling of relief at first, which was later exchanged into uncertainty from their restricted knowledge about the illness and how to behave following revascularisation. For example, during the discussions about risk factors, smoking was noted as a major risk factor, that triggered feelings of guilt. Thus, the respondents needed to consult other sources of information to manage their everyday lives. Conclusions: Following endovascular treatment, the short amount of time spent with peripheral arterial disease patients requires innovative guidance in clinical practice to meet individuals’ needs regardless of whether the patient actively or passively understands and manages their peripheral arterial disease.

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