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  • 1.
    Abrahamsen Grøndahl, Vigdis
    et al.
    Östfold university Norway.
    Persenius, Mona
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Helgesen, Ann Karin
    Östfold university, Norway.
    The use of life stories and its influence on persons with dementia, their relatives and staff: A systematic mixed studies review2017In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16, no 28, article id 28Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dementia is an important predictor of nursing home admissions. Due to progressive dementia symptoms, over time it becomes difficult for persons with dementia to communicate their wishes and participate in decisions concerning their everyday lives. Their well-being, sense of dignity, integrity and personhood are at risk. The persons' life stories have been highlighted as particularly important in dementia care and are referred to as seeing the person beyond the dementia. The aim of this study was to explore and describe the use of life stories and its influence on persons with dementia living in nursing homes, their relatives and staff.

    METHODS: A systematic mixed studies review was conducted. The literature searches were performed in the following databases: CINAHL, PubMed and PsycINFO and the Cochrane library, as well as by hand searching references in the studies included. An updated search was performed eight months after the first search. Data was synthesised inspired by integrative analysis.

    RESULTS: Three studies using quantitative design and two studies (presented in three papers) using qualitative design representing research from 2006 to 2015 were included in the review. Life stories generally had a positive influence on the persons with dementia, their relatives, and staff. The use of life stories might contribute to 'Maintenance of the person with dementia as a whole person rather than a demented patient'. On the other hand, enabling persons with dementia to tell their own story could be a challenge. For the staff it could be challenging when sensitive information emerged uninvited. Involving relatives could also be difficult as to whose story were uncovered.

    CONCLUSIONS: The use of person's life story might be of significance, but there is not enough evidence to make any statement about its importance as the research is scarce. Studies, including randomised controlled trials, are needed to measure the impact of life story work on the physiological and psychological aspects of persons with dementia, and also how it influences their relatives and staff.

  • 2.
    Andersson, Ewa Kazimiera
    et al.
    Blekinge Institute of Technology; Lund University.
    Willman, Ania
    Blekinge Institute of Technology, Malmö University.
    Sjöström-Strand, Annica
    Lund University.
    Borglin, Gunilla
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Malmö University.
    Registered nurses’ descriptions of caring: A phenomenographic interview study2015In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, no 1Article in journal (Refereed)
    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. 

  • 3.
    Appelgren, Marie
    et al.
    Malmö univeristet, City Malmö Borough Adm Operat Support Management.
    Bahtsevani, Christel
    Mamö universitet.
    Persson, Karin
    Malmö universitet.
    Borglin, Gunilla
    Malmö universitet.
    Nurses' experiences of caring for patients with intellectual developmental disorders: a systematic review using a meta-ethnographic approach2018In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 17, article id 51Article in journal (Refereed)
    Abstract [en]

    BackgroundResearch 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.MethodWe 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.ResultsWe 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.ConclusionLack 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.Trial registrationPROSPERO 2017: CRD42017077703.

  • 4. Ballangrud, Randi
    et al.
    Husebo, Sissel Eikeland
    Aase, Karina
    Aaberg, Oddveig Reiersdal
    Vifladt, Anne
    Berg, Geir Vegard
    Hall-Lord, Marie Louise
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    "Teamwork in hospitals": a quasi-experimental study protocol applying a human factors approach2017In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16, article id 34Article in journal (Refereed)
    Abstract [en]

    Background: Effective teamwork and sufficient communication are critical components essential to patient safety in today's specialized and complex healthcare services. Team training is important for an improved efficiency in inter-professional teamwork within hospitals, however the scientific rigor of studies must be strengthen and more research is required to compare studies across samples, settings and countries. The aims of the study are to translate and validate teamwork questionnaires and investigate healthcare personnel's perception of teamwork in hospitals (Part 1). Further to explore the impact of an inter-professional teamwork intervention in a surgical ward on structure, process and outcome (Part 2). Methods: To address the aims, a descriptive, and explorative design (Part 1), and a quasi-experimental interventional design will be applied (Part 2). The study will be carried out in five different hospitals (A-E) in three hospital trusts in Norway. Frontline healthcare personnel in Hospitals A and B, from both acute and non-acute departments, will be invited to respond to three Norwegian translated teamwork questionnaires (Part 1). An inter-professional teamwork intervention in line with the TeamSTEPPS recommend Model of Change will be implemented in a surgical ward at Hospital C. All physicians, registered nurses and assistant nurses in the intervention ward and two control wards (Hospitals D and E) will be invited to to survey their perception of teamwork, team decision making, safety culture and attitude towards teamwork before intervention and after six and 12 months. Adult patients admitted to the intervention surgical unit will be invited to survey their perception of quality of care during their hospital stay before intervention and after six and 12 month. Moreover, anonymous patient registry data from local registers and data from patients' medical records will be collected (Part 2). Discussion: This study will help to understand the impact of an inter-professional teamwork intervention in a surgical ward and contribute to promote healthcare personnel's team competences with an opportunity to achieve changes in work processes and patient safety.

  • 5.
    Ballangrud, Randi
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Department of Nursing, Faculty of Health, Care and Nursing, Gjøvik University College, Teknologivn. 22, Gjøvik, 2815, Norway .
    Persenius, Mona
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Hedelin, Birgitta
    Department of Nursing, Faculty of Health, Care and Nursing, Gjövik Univeristy College, Norway.
    Hall-Lord, Marie Louise
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Department of Nursing, Faculty of Health, Care and Nursing, Gjøvik University College, Teknologivn. 22, Gjøvik, 2815, Norway .
    Exploring intensive care nurses' team performance in a simulation-based emergency situation, − expert raters' assessments versus self-assessments: an explorative study2014In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 13, no 47Article in journal (Refereed)
    Abstract [en]

    Background

    Effective teamwork has proven to be crucial for providing safe care. The performance of emergencies in general and cardiac arrest situations in particular, has been criticized for primarily focusing on the individual's technical skills and too little on the teams' performance of non-technical skills. The aim of the study was to explore intensive care nurses' team performance in a simulation-based emergency situation by using expert raters' assessments and nurses' self-assessments in relation to different intensive care specialties.

    Methods

    The study used an explorative design based on laboratory high-fidelity simulation. Fifty-three registered nurses, who were allocated into 11 teams representing two intensive care specialties, participated in a videotaped simulation-based cardiac arrest setting. The expert raters used the Ottawa Crisis Resource Management Global Rating Scale and the first part of the Mayo High Performance Teamwork Scale to assess the teams' performance. The registered nurses used the first part of the Mayo High Performance Teamwork Scale for their self-assessments, and the analyses used were Chi-square tests, Mann–Whitney U tests, Spearman's rho and Intraclass Correlation Coefficient Type III.

    Results

    The expert raters assessed the teams' performance as either advanced novice or competent, with significant differences being found between the teams from different specialties. Significant differences were found between the expert raters' assessments and the registered nurses' self-assessments.

    Conclusions

    Teams of registered nurses representing specialties with coronary patients exhibit a higher competence in non-technical skills compared to team performance regarding a simulated cardiac arrest. The use of expert raters' assessments and registered nurses' self-assessments are useful in raising awareness of team performance with regard to patient safety.

  • 6.
    Borglin, Gunilla
    et al.
    Malmö universitet, Lovisenberg Diaconal Univ Coll, Norge.
    Rathel, Kristina
    Skånes universitetssjukhus.
    Paulsson, Helena
    Åstorp Primary Care Ctr, Region Skåne.
    Forss, Katarina Sjogren
    Malmö universitet.
    Registered nurses experiences of managing depressive symptoms at care centres for older people: a qualitative descriptive study2019In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 18, no 1, article id 43Article in journal (Refereed)
    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.

  • 7.
    Forss, Katarina Sjogren
    et al.
    Högskolan i Malmö.
    Nilsson, Jane
    Borough Adm West, Malmö.
    Borglin, Gunilla
    Högskolan i Malmö.
    Registered nurses' and older people's experiences of participation in nutritional care in nursing homes: a descriptive qualitative study2018In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 17, article id 19Article in journal (Refereed)
    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.

  • 8.
    Nordang, Kirsten
    et al.
    Faculty of Health, Care and Nursing, Gjøvik University College, Gjøvik, Norway.
    Hall-Lord, Marie Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Farup, Per
    Norwegian University of Science and Technology, Trondheim, Norway.
    Burnout in health-care professionals during reorganizations and downsizing. A cohort study in nurses2010In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 9, no 8, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Background

    Burnout is a psychological reaction triggered by interaction between personal characteristics and stress factors. Reorganizations and downsizing with increased workload imply stress for health-care professionals. This is a study of burnout in nurses during a period with two comprehensive reorganizations.     

    Methods

    In this quasi-experimental retrospective cohort study, burnout was assessed in nurses         with long work experience in three surveys during a 30 months' period with two comprehensive reorganizations and downsizing of a hospital unit with mostly seriously ill patients with cancer. Burnout was measured with Bergen Burnout Indicator (BBI) at each survey, and "Sense of Coherence" (SOC) with Antonovsky's questionnaire at the last survey.     

    Results

    One man and 45 women aged 30 to 65 years were invited to the surveys. There was a         significant increase in burnout during the study period, the mean increase in BBI-score         was 12.5 pr year (p < 0.001). The proportion of satisfied nurses at the first and last survey were 84% and 35% respectively, and the proportions with burnout were 0% and 29% respectively (p < 0.001). Except for auxiliary nurses with experience from  the medical department, all subgroups experienced a significant increase in BBI. Burnout was associated with low SOC (p < 0.001, r square 0.33).     

    Conclusions

    There was a significant development of burnout in a group of nurses during a period         with two reorganizations and downsizing. Burnout was associated with low SOC. Working  with seriously ill patients with cancer has probably made the nurses exceptionally  vulnerable to the stress and workload related to the reorganizations

  • 9.
    Ringnér, Anders
    et al.
    Umeå University, Umeå University Hospital.
    Björk, M.c d
    Jönköping University, University of Skövde.
    Olsson, Cecilia
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Graneheim, Ulla Hällgren
    Umeå University, University West.
    Person-centred information to parents in paediatric oncology (the PIFBO study): A study protocol of an ongoing RCT2015In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, no 69, p. 1-6Article in journal (Refereed)
    Abstract [en]

    Background: Parents of children with cancer experience a demanding situation and often suffer from psychological problems such as stress. Trying to coping with the complex body of information about their child’s disease is one factor that contributes to this stress. The aim of this study is to evaluate an intervention for person-centred information to parents of children with cancer that consists of four sessions with children’s nurses trained in the intervention method. Methods/Design: This is a multi-centre RCT with two parallel arms and a 1:1 allocation ratio. The primary outcome is illness-related parental stress. Secondary outcomes are post-traumatic stress symptoms, anxiety, depression, satisfaction with information, expected and received knowledge, and experiences with health care providers. A process evaluation is performed to describe experiences and contextual factors. Data are collected using web questionnaires or paper forms according to the parents’ preference, audio recording of the intervention sessions, and qualitative interviews with parents and the intervention nurses. Discussion: Few studies have evaluated information interventions for parents of children with cancer using large multi-centre RCTs. This intervention is designed to be performed by regular staff children’s nurses, which will facilitate implementation if the intervention proves to be effective. Trial registration: Clinical trials NCT02332226(December 11, 2014).

  • 10.
    Struksnes, S
    et al.
    Avdelingen for helse, omsorg og sykepleie, Högskolan i Gjövik.
    Hall-Lord, Marie-Louise
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Bachrach-Lindstrom, M
    Slåsletten, R
    Johansson, Inger
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    The nursing staff's opinion of falls among persons with dementia: A cross-sectional study2011In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, no 13Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the nursing staff's opinion of caring for older persons with dementia with the focus on causes of falls, fall-preventing interventions, routines of documentation and report and the nursing staff's experiences and reactions when fall incidents occur. A further aim was to compare these areas between registered nurses (RNs) and enrolled nurses (ENs) and staff with 5 and >5 years of employment in the care units in question.

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