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Rehnsfeldt, A., Slettebo, A., Lohne, V., Sæteren, B., Lindwall, L., Heggestad, A. K., . . . Nåden, D. (2022). Dignity in relationships and existence in nursing homes' cultures. Nursing Ethics, 29(7-8), 1761-1772
Open this publication in new window or tab >>Dignity in relationships and existence in nursing homes' cultures
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2022 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 29, no 7-8, p. 1761-1772Article in journal (Refereed) Published
Abstract [en]

Introduction: Expressions of dignity as a clinical phenomenon in nursing homes as expressed by caregivers were investigated. A coherence could be detected between the concepts and phenomena of existence and dignity in relationships and caring culture as a context. A caring culture is interpreted by caregivers as the meaning-making of what is accepted or not in the ward culture. Background: The rationale for the connection between existence and dignity in relationships and caring culture is that suffering is a part of existence, as well as compassion in relieving suffering, and ontological interdependency. Aim: To describe different expressions of dignity in relationships and existence in context of caring cultures from the perspective of the caregivers. Research design: The methodology and method are hermeneutic. The method used was to merge the theoretical preunderstanding as one horizon of understanding with empirical data. Participants and research context: Focus group interviews with caregivers in nursing homes. Ethical considerations: The principles of the Helsinki Declaration have been followed to, for example, preserve self-determination, integrity, dignity, confidentiality and privacy of the research persons. Findings: Data interpretation resulted in four themes: Encountering existential needs that promote dignity in a caring culture; To amplify dignity in relationships by the creative art of caring in a caring culture; Violation of dignity by ignorance or neglect in a non-caring culture and The ethic of words and appropriated ground values in a caring culture. Discussion: Dignity-promoting acts of caring, or dignity-depriving acts of non-caring are adequate to see from the perspective of dignity in relationships and existence and the caring culture. Conclusions: Dignity in relationships seems to touch the innermost existential life, as the existential life is dependent on confirmation from others.

Place, publisher, year, edition, pages
Sage Publications, 2022
Keywords
Caring culture, dignity, dignity in relationships, ethics, existence, existential, hermeneutics
National Category
Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-91529 (URN)10.1177/09697330211041739 (DOI)000824955500001 ()35801831 (PubMedID)2-s2.0-8513386236 (Scopus ID)
Available from: 2022-08-19 Created: 2022-08-19 Last updated: 2023-02-01Bibliographically approved
Blomberg, A.-C., Lindwall, L. & Bisholt, B. (2022). Operating theatre nurses' with managerial responsibility: Self-reported clinical competence and need of competence development in perioperative nursing. Nursing Open, 9(1), 692-704
Open this publication in new window or tab >>Operating theatre nurses' with managerial responsibility: Self-reported clinical competence and need of competence development in perioperative nursing
2022 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 9, no 1, p. 692-704Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to investigate operating theatre nurses (OTNs) with managerial responsibility, and their self-rated clinical competence and need for competence development in perioperative nursing. Design: A cross-sectional study was applied using a modified version of Professional Nurse Self-Assessment Scale of Clinical Core Competence I. Method: Data were collected from 303 OTNs in Sweden, 80 of whom indicated that they had managerial responsibility. Statistics analysis was used to identify the relationships between background variables to compare OTNs with and without managerial responsibility and their need for competence development. Results: OTNs with an academic degree and managerial responsibility self-rated their clinical competence higher compared with OTNs without an academic degree. It also turned out that OTNs with RN education and 1-year advanced nursing in theatre care, and master's 60 credits had a lower need for competence development in cooperation and consultation, professional development and critical thinking.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2022
Keywords
competence, competence development, operating theatre nurse, perioperative nursing
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-87332 (URN)10.1002/nop2.1120 (DOI)000714932200001 ()34741502 (PubMedID)2-s2.0-85118484337 (Scopus ID)
Available from: 2021-11-22 Created: 2021-11-22 Last updated: 2022-05-16Bibliographically approved
Lindwall, L. & Lohne, V. (2021). Human dignity research in clinical practice: A systematic literature review. Scandinavien Journal of Caring Sciences, 35(4), 1038-1049
Open this publication in new window or tab >>Human dignity research in clinical practice: A systematic literature review
2021 (English)In: Scandinavien Journal of Caring Sciences, Vol. 35, no 4, p. 1038-1049Article in journal (Refereed) Published
Abstract [en]

Background This literature study describes caring science research on human dignity in different clinical practice. We already know a good deal about human dignity in nursing care but how do patients, nurses, healthcare professionals and next of kin experience human dignity in clinical practice?

Aim To summarise studies on human dignity to gain a deeper understanding of how it can be achieved in caring science research and to gain a broader understanding of the differences and similarities across caring contexts. The aim was also to gain a broader understanding of the differences and similarities of human dignity across different clinical practice.

Method The literature review re-analysed 28 empirical studies on human dignity are experienced from acute, psychiatric, elderly and rehabilitation care. The data analysis strategy was conducted in a systematic and critical way and consisted of a five-step method.

Result Maintaining dignity was described when caregivers had the time and the will to see and listen to patient and had the courage to see what they did not want to see, allowing their inner powers to act with the purpose of doing good. In elderly care, it was important that elderly persons are involved as members of society and experience respect, confidence, security and charity. Indignity was described when caregivers did not allow patients to have their will and when they had unethical attitudes, ignoring patients and creating powerlessness. The feeling of being abandoned and not being taken seriously are also described in elderly care.

Conclusion Findings show how caregivers fulfil their ethical responsibility by seeing, listening and being a part of the time and place. The will to do good includes the courage to preserve dignity and human value rests on being created as a human being. More research is needed about ethical and moral responsibility in clinical practice.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
caring science, human dignity, clinical practice, systematic literature review
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-81170 (URN)10.1111/scs.12922 (DOI)000583732600001 ()
Available from: 2021-11-19 Created: 2020-11-02 Last updated: 2021-11-19Bibliographically approved
Lindwall, L. (2020). Etik och värdighet i praxis: den kliniska vården (1ed.). In: D Nåden & V Lohne (Ed.), Verdighet og sårbarhet - en vitenskapelig antologi: (pp. 209). Oslo: Gyldendal Norsk Forlag A/S
Open this publication in new window or tab >>Etik och värdighet i praxis: den kliniska vården
2020 (Swedish)In: Verdighet og sårbarhet - en vitenskapelig antologi / [ed] D Nåden & V Lohne, Oslo: Gyldendal Norsk Forlag A/S, 2020, 1, p. 209-Chapter in book (Other academic)
Place, publisher, year, edition, pages
Oslo: Gyldendal Norsk Forlag A/S, 2020 Edition: 1
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-80918 (URN)978-82-05-51392-1 (ISBN)
Available from: 2020-10-19 Created: 2020-10-19 Last updated: 2020-10-19Bibliographically approved
Blomberg, A.-C., Lindwall, L. & Bisholt, B. (2019). Operating theatre nurses' self-reported clinical competence in perioperative practice: A mixed method study. Nursing Open, 6(4), 1510-1516
Open this publication in new window or tab >>Operating theatre nurses' self-reported clinical competence in perioperative practice: A mixed method study
2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 4, p. 1510-1516Article in journal (Refereed) Published
Abstract [en]

Background: During many years the operating theatre nurse's clinical competence has been describing in relation to patient safety, but the nursing care of the patient remains unclear. Therefore, we want in this study to investigate the relationship between background factors of operating theatre nurses self-rated clinical competence and describe factors of importance for development of clinical competence in perioperative nursing.Methods: A cross-sectional study with a mixed method approach was chosen. The instrument Professional Nurse Self-Assessment Scale of Clinical Core Competence was used for self-rating operating theatre nurses' clinical competence in perioperative nursing, and an open-ended question was added to describe factors of importance for development of clinical competence. In total, 1057 operating theatre nurses in Sweden were asked to participate, and 303 responded (28 %). They had different educational backgrounds and professional experiences, and were employed in universities or central/regional and district hospitals.Results: Academic degree, professional experience and place of employment were significant for the development of the operating theatre nurses' clinical competence. Academic degree appeared to affect operating theatre nurse leadership and cooperation, as well as how consultations took place with other professions about patient care. Being employed at a university hospital had a positive effect on professional development and critical thinking.Conclusions:  An academic degree influenced the operating theatre nurses' ability to act in complex situations, and along with professional experience strengthened the nurses' ability to use different problem-solving strategies and face the consequences of decisions made. Scientific knowledge and interprofessional learning and competence development in medical technologies should supplement nursing care for the development of clinical competence.

Place, publisher, year, edition, pages
Hoboken: , 2019
Keywords
mixed method, operating theatre nurse, perioperative nursing, clinical competence
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-69842 (URN)10.1002/nop2.352 (DOI)000480822100001 ()
Note

Artikeln ingick som manuskript i Blombergs doktorsavhandling.

Available from: 2018-10-23 Created: 2018-10-23 Last updated: 2019-11-22Bibliographically approved
Blomberg, A.-C., Bisholt, B. & Lindwall, L. (2019). Value conflicts in perioperative practice. Nursing Ethics, 26(7-8), 2213-2224, Article ID 969733018798169.
Open this publication in new window or tab >>Value conflicts in perioperative practice
2019 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 26, no 7-8, p. 2213-2224, article id 969733018798169Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:: The foundation of all nursing practice is respect for human rights, ethical value and human dignity. In perioperative practice, challenging situations appear quickly and operating theatre nurses must be able to make different ethical judgements. Sometimes they must choose against their own professional principles, and this creates ethical conflicts in themselves.

OBJECTIVES:: This study describes operating theatre nurses' experiences of ethical value conflicts in perioperative practice.

RESEARCH DESIGN:: Qualitative design, narratives from 15 operating theatre nurses and hermeneutic text interpretation.

ETHICAL CONSIDERATION:: The study followed ethical principles in accordance with the Helsinki Declaration and approval was granted by the local university ethics committee.

FINDINGS:: The result showed that value conflicts arose in perioperative practice when operating theatre nurses were prevented from being present in the perioperative nursing process, because of current habits in perioperative practice. The patient's care became uncaring when health professionals did not see and listen to each other and when collaboration in the surgical team was not available for the patient's best. This occurred when operating theatre nurses' competence was not taken seriously and was ignored in patient care.

CONCLUSION:: Value conflicts arose when operating theatre nurses experienced that continuity of patient care was lacking. They experienced compassion with the patient but still had the will and ability to be there and take responsibility for the patient. This led to feelings of despair, powerlessness and of having a bad conscience which could lead to dissatisfaction, and even resignations.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Care ethics, perioperative practice, theatre nurses, value conflicts
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-70021 (URN)10.1177/0969733018798169 (DOI)000486024000029 ()30345880 (PubMedID)
Available from: 2018-11-01 Created: 2018-11-01 Last updated: 2019-10-10Bibliographically approved
Abelsson, A., Lindwall, L., Suserud, B.-O. & Rystedt, I. (2018). Ambulance Nurses' Competence and Perception of Competence in Prehospital Trauma Care. Emergency Medicine International, Article ID 5910342.
Open this publication in new window or tab >>Ambulance Nurses' Competence and Perception of Competence in Prehospital Trauma Care
2018 (English)In: Emergency Medicine International, ISSN 2090-2840, E-ISSN 2090-2859, article id 5910342Article in journal (Refereed) Published
Abstract [en]

Introduction. We focus on trauma care conducted in the context of a simulated traumatic event. This is in this study defined as a four-meter fall onto a hard surface, resulting in severe injuries to extremities in the form of bilateral open femur fractures, an open tibia fracture, and a closed pelvic fracture, all fractures bleeding extensively. Methods. The simulated trauma care competence of 63 ambulance nurses in prehospital emergency care was quantitatively evaluated along with their perception of their sufficiency. Data was collected by means of simulated trauma care and a questionnaire. Results. Life-saving interventions were not consistently performed. Time to perform interventions could be considered long due to the life-threatening situation. In comparison, the ambulance nurses' perception of the sufficiency of their theoretical and practical knowledge and skills for trauma care scored high. In contrast, the perception of having sufficient ethical training for trauma care scored low. Discussion. This study suggests there is no guarantee that the ambulance nurses' perception of theoretical and practical knowledge and skill level corresponds with their performed knowledge and skill. The ambulance nurses rated themselves having sufficient theoretical and practical knowledge and skills while the score of trauma care can be considered quite low.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2018
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-67358 (URN)10.1155/2018/5910342 (DOI)000431616600001 ()
Available from: 2018-05-24 Created: 2018-05-24 Last updated: 2020-01-23Bibliographically approved
Lindwall, L., Råholm, M.-B., Lohne, V., Caspari, S., Heggestad, A. K., Sæteren, B., . . . Nåden, D. (2018). Clinical application research through reflection, interpretation and new understanding: A hermeneutic design. Scandinavian Journal of Caring Sciences, 32(3), 1157-1167
Open this publication in new window or tab >>Clinical application research through reflection, interpretation and new understanding: A hermeneutic design
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2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 3, p. 1157-1167Article in journal (Refereed) Published
Abstract [en]

The implementation of theoretical knowledge in clinical practice and the implementation of good clinical practice into theory have been of interest in caring science for the last 30 years. The aim of this article was to elaborate and discuss a methodology named clinical application research. The method is grounded in a hermeneutical design inspired by Gadamer's philosophy. The methodology, clinical application research, has been used in a research project A life in dignity and experiences from the researchers forms the bases for the elaboration and discussion. The project was performed in collaboration with residents, family caregivers and healthcare providers at six nursing homes in Scandinavia. The material for this article is based on the previous research, that is the results from 10 different articles showing the meaning of dignity and indignity in daily life in nursing homes. Data were generated from 56 individual interviews and 18 focus-group interviews with a total of 40 staff members with five to eight participants at every interview session. By reflection, interpretation and new understanding our results provide knowledge about dignity and how to preserve dignity for older people in an appropriate ethical way. The methodology was relevant for the research project A life in dignity and relevant to caring practice in nursing homes as it opens new possibilities and new ways of thinking when performing dignified care to older people.

Place, publisher, year, edition, pages
Blackwell Publishing, 2018
Keywords
Caring science, Clinical application research, Healthcare providers, Hermeneutics, Human dignity, Older persons, adult, article, caregiver, clinical article, controlled study, female, human, human experiment, interview, male, nursing home, philosophy, resident, Scandinavia, scientist, staff, thinking
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-66550 (URN)10.1111/scs.12561 (DOI)000445450800018 ()2-s2.0-85042200193 (Scopus ID)
Available from: 2018-03-02 Created: 2018-03-02 Last updated: 2019-03-14Bibliographically approved
Abelsson, A., Rystedt, I., Suserud, B.-O. & Lindwall, L. (2018). Learning High-Energy Trauma Care Through Simulation. Clinical Simulation in Nursing, 17, 1-6
Open this publication in new window or tab >>Learning High-Energy Trauma Care Through Simulation
2018 (English)In: Clinical Simulation in Nursing, ISSN 1876-1399, E-ISSN 1876-1402, Vol. 17, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Simulation provides the opportunity to learn how to care for patients in complexsituations, such as when patients are exposed to high-energy trauma such as motor vehicle accidents.The aim of the study was to describe nurses’ perceptions of high-energy trauma care through simulationin prehospital emergency care. The study had a qualitative design. Interviews were conductedwith 20 nurses after performing a simulated training series. Data were analyzed using a phenomenographicmethod. The result indicates that simulation establishes, corrects, and confirms knowledge andskills related to trauma care in prehosp ital emergency settings. Trauma knowledge is readily availablein memory and can be quickly retrieved in a future trauma situation.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
simulation, learning, experience, phenomenography, method, ambulance, prehospital emergency care, trauma
National Category
Health Sciences
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-65548 (URN)10.1016/j.ecns.2017.11.009 (DOI)000428714000001 ()2-s2.0-85039151313 (Scopus ID)
Available from: 2018-01-08 Created: 2018-01-08 Last updated: 2020-01-23Bibliographically approved
Nilsson, M., Lindwall, L., Nilsson, J. & From, I. (2018). Patientens delaktighet i val av vårdgivare: En litteratur review. Nordisk tidsskrift for helseforskning, 14(1)
Open this publication in new window or tab >>Patientens delaktighet i val av vårdgivare: En litteratur review
2018 (Swedish)In: Nordisk tidsskrift for helseforskning, ISSN 1504-3614, E-ISSN 1891-2982, Vol. 14, no 1Article in journal (Refereed) Published
Abstract [en]

The idea behind care choice is that healthcare providers would be more responsive to patients’ health problems and needs and in doing so compete with increased quality and that patients should be able to choose from this. The question is how patients choose a healthcare provider by themselves. The aim was to describe what affected when patients chose healthcare providers. A literature review was carried out. The results showed that patients’ choice of healthcare providers depended on the following three themes: their own care experiences, caring relationships with staff and service provided by caregivers. The underlying idea of care choice is competition based on quality of care, but the results show that patients make their choices based on other factors as described in the result and therefore improvement can be achieved if focus is placed on being responsive for patient care needs.

National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-87374 (URN)10.7557/14.4440 (DOI)
Available from: 2021-11-23 Created: 2021-11-23 Last updated: 2021-11-30Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-9363-5667

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