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  • 1.
    Andersson, E. K.
    et al.
    Lunds universitet.
    Strand, A. Sjostrom
    Lund universitet.
    Willman, A.
    Högolan i Malmö.
    Borglin, Gunilla
    Conceptions of caring among a group of coronary care nurses2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, p. S62-S62Article in journal (Refereed)
  • 2.
    Andersson, Ewa K.
    et al.
    Blekinge Inst Technol, Dept Hlth, SE-37179 Karlskrona, Sweden.;Lund Univ, Dept Hlth Sci, Lund, Sweden..
    Sjostrom-Strand, Annica
    Lund Univ, Dept Hlth Sci, Lund, Sweden..
    Willman, Ania
    Blekinge Inst Technol, Dept Hlth, SE-37179 Karlskrona, Sweden.;Malmo Univ, Dept Care Sci, Malmo, Sweden..
    Borglin, Gunilla
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Malmo Univ, Dept Care Sci, Nursing, Malmo, Sweden. .
    Registered nurses views of caring in coronary care - a deductive and inductive content analysis2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 23-24, p. 3481-3493Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. To extend nurses' descriptions of how they understood caring, as reflected in the findings of an earlier study (i.e. the hierarchical outcome space) and to gain additional understandings and perspectives of nurses' views of caring in relation to a coronary care patient case. Background. Scientific literature from the 1970s-1990s contains descriptions of caring in nursing. In contrast, the contemporary literature on this topic - particularly in the context of coronary care - is very sparse, and the few studies that do contain descriptions rarely do so from the perspective of nurses. Design. Qualitative descriptive study. Methods. Twenty-one nurses were interviewed using the stimulated recall interview technique. The data were analysed using deductive and inductive qualitative content analysis. Results. The results of the iterative and integrated content analysis showed that the data mainly reproduced the content of the hierarchical outcome space describing how nurses could understand caring; however, in the outcome space, the relationship broke up (i.e. flipped). The nurses' views of caring could now also be understood as: person-centredness 'lurking' in the shadows; limited 'potential' for safeguarding patients' best interests; counselling as virtually the 'only' nursing intervention; and caring preceded by the 'almighty' context. Their views offered alternative and, at times, contrasting perspectives of caring, thereby adding to our understanding of it. Conclusion. Caring was described as operating somewhere between the nurses caring values and the contextual conditions in which caring occurred. This challenged their ability to sustain caring in accordance with their values and the patients' preferences. Relevance to clinical practice. To ensure that the essentials of caring are met at all times, nurses need to plan and deliver caring in a systematic way. The use of systematic structures in caring, as the nursing process, can help nurses to work in a person-centred way, while sustaining their professional values.

  • 3. Andersson, Ewa Kazimiera
    et al.
    Borglin, Gunilla
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Sjöström-Strand, Annica
    Willman, Ania
    Standing alone when life takes an unexpected turn: being a midlife next of kin of a relative who has suffered a myocardial infarction2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 864-871Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Suffering a myocardial infarction (MI) is a life-threatening event that impacts not only on the individual concerned but also on the next of kin. However, there seems to be a paucity of naturalistic inquiries that focus specifically on midlife next of kin and their experience of being close to a relative who has suffered an MI. This study aims to elucidate the experience of being a midlife next of kin of a relative who has suffered a myocardial infarction. METHOD: Nine women and four men in midlife participated in the focused interviews, which were conducted and analysed during 2010/2011 using Lindseths and Norbergs' description of the phenomenological hermeneutical method. FINDINGS: Four themes - Solely responsible, Lurking unease, Left out of the picture and Life on hold - formed the basis of the core theme Standing alone when life takes an unexpected turn. The core theme was interpreted as a central phenomenon encompassing the experience of being solely responsible for the well-being of their relative and the family, thus putting their own life on hold. The core theme also reflected the next of kin's experience of being left out of the picture when it came to the relative's care before and after the MI. CONCLUSION: The next of kin's negative feelings of standing alone were further intensified by their experience of being left out of the picture by the healthcare professionals concerning their relative's care. As a cardiac nurse, it would seem essential to have knowledge about the experiences of next of kin in connection with a relative's MI event. Such knowledge can facilitate the planning and organisation of nursing care and at the same time address the next of kin's role in the recovery and rehabilitation process.

  • 4. Andersson, Ewa Kazimiera
    et al.
    Borglin, Gunilla
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Willman, Ania
    The experience of younger adults following myocardial infarction.2013In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 23, no 6, p. 762-72Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate the meaning of the experience of younger people (< 55 years) during their first year following a myocardial infarction. We analyzed 17 interviews using a phenomenological-hermeneutic method. The core theme and central phenomenon was the everyday fight to redress the balance in life, which encompassed an existential, physical, and emotional battle to regain a foothold in daily life. The aftermath of a life-threatening event involved a process of transition while at the same time creating a new meaning in life. Lack of energy and its impact on the complex interplay of midlife combined with unreasonable demands from employers and health care professionals seemed to color the experience of the informants. The knowledge gained in this study can constitute a valuable contribution to overall quality assurance in nursing care and the development of nursing interventions for the cardiac rehabilitation of younger patients.

  • 5.
    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. 

  • 6.
    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.

  • 7.
    Bee, P.
    et al.
    Manchester University.
    Borglin, Gunilla
    Manchester University.
    Keeley, P.
    Manchester University.
    Lovell, K.
    Manchester University.
    Cognitive behavioural therapy for people with physical illness: A systematic review of the literature2006In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 61, no 3, p. 404-404Article in journal (Refereed)
  • 8. Bohman, Doris M
    et al.
    Borglin, Gunilla
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Student exchange for nursing students: Does it raise cultural awareness'? A descriptive, qualitative study.2014In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 3, p. 259-264Article in journal (Refereed)
    Abstract [en]

    With free movement for citizens within the European Union and with distant parts of our globe becoming more accessible, cultural awareness and cultural competence are becoming important skills for nurses. Internationalisation and raising awareness of other cultural contexts are essential elements in Swedish higher education, thus explaining the variety of student exchange programmes that are available. The aim of this study was to explore Swedish nursing students' perceptions of student exchange and their experiences. Data were collected through group interviews and then analysed following the principles of content analysis. Our analysis resulted in three categories: Preparing to go abroad, Reasons for going abroad and From expectation to experience. Cultural aspects and cultural awareness were emphasised as strong motivational factors, both personal and professional, behind participation in student exchange programmes. Information was also highlighted as a crucial means of reaching potential students as well as the power of knowledge through personal experience. This study highlights the importance of student exchange in expanding the individual student's personal and professional horizons. It also stresses the importance of including a transcultural nursing element in nursing curricula.

  • 9.
    Bohman, Doris M.
    et al.
    Högskolan i Blekinge.
    Ericsson, Terese
    Högskolan i Blekinge.
    Borglin, Gunilla
    Swedish nurses' perception of nursing research and its implementation in clinical practice: a focus group study2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 525-533Article in journal (Refereed)
    Abstract [en]

    Background: Nowadays, nursing research is seen as an integral part of professional nursing although implementing knowledge derived from nursing research into the practice setting is still problematic. Current research, conducted mainly with a descriptive quantitative design, highlights the struggle experienced by Registered Nurses (RNs) to use and implement research findings in clinical practice. Therefore, the aim of this naturalistic inquiry was to explore nurses' perception of nursing research and its implementation in a clinical context. Method and sample: A qualitative approach was chosen, and four focus group discussions were conducted. The groups comprised a total of 16 RNs (three men and 13 women) working in a secondary care setting. The transcribed texts were analysed, inspired by Burnard's description of content analysis. Findings: The texts were interpreted as representing three predominant themes: scholastic, individual and contextual influences highlighted as influential components impacting on the RNs' views on research and its implementation as well as on their readiness to accept and support it. However, the most influential aspect permeating our themes was their educational background - the type of qualification they held. In general, the RNs with a Bachelor of Science in Nursing viewed research and the implementation of knowledge in practice more favourably than those RNs with a diploma. Conclusion: Our findings, although based on a small qualitative study, are congruent with others, indicating that further research is warranted concerning the impact of education on RNs' views of nursing research and its implementation. Hence, it might well be that the RNs' educational point of departure needs to be stressed more than what so far have been anticipated. In the meanwhile, it is possible that a number of strategies could be tested to promote a more favourable view in these issues and where the nursing education has the possibility to influence this endeavour.

  • 10.
    Bohman, Doris M.
    et al.
    Högskolan i Blekinge.
    Mattsson, Linda
    Karlshamns Primary Care Trust.
    Borglin, Gunilla
    Primary healthcare nurses' experiences of physical activity referrals: an interview study2015In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 16, no 3, p. 270-280Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study is to illuminate primary health care (PHC) nurses' experiences of physical activity referrals (PARs). Background: Despite extensive knowledge about the substantial health effects physical activities can produce, fewer and fewer people in our modern society regularly engage in physical activity. Within health care and, particularly, within the PHC arena, nurses meet people on a daily basis who need help to engage in a healthier lifestyle. The possibility of issuing written prescriptions for physical activities, often referred to as PARs, has been introduced as a tool to support such lifestyles. However, even though PHC nurses can prescribe physical activities, studies investigating their experience in this type of nursing intervention are rare. Methods: For this study, 12 semi-structured interviews were conducted with PHC nurses, and the transcribed texts were analysed using a qualitative content analysis. Findings: Two categories - PARs, an important nursing intervention, and PARs, the necessity of organisational support - reflected the nurses' experiences in using PARs. Conclusion: Our findings suggest that viewing the PAR as a complex intervention, with all that this entails, might be one approach to increasing the number of PARs being issued. Simpler systems, more time and the potential for testing the effectiveness of follow-ups could be possible ways of achieving this.

  • 11. Borglin, Gunilla
    Promoting critical thinking and academic writing skills in nurse education2012In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 32, no 5, p. 611-613Article in journal (Refereed)
    Abstract [en]

    Although academic skills, conceptualised as writing and critical thinking, are a vital part of university studies, research indicates that many students leave without having mastered these skills effectively. This research also reflects on nursing students. Nursing could also be said to be hampered by a number of complex educational challenges that are likely to impact on the academic socialisation process in general. These challenges include being a relatively 'young' academic discipline, the 'theory-practice' divide, a knowledge bed lying on a complex intersection of two 'antithetical sciences' and, at least in the Scandinavian countries, an increasing number of nurse educators with a PhD in nursing science but with limited time to develop their own teaching skills. In combination, these challenges have the potential to act as stumbling blocks, both from a teaching and learning perspective. I would suggest that a departure in teaching from theoretical educational models, such as Lea and Street's 'academic literacies model,' including skills, socialisation and academic literacy models simultaneously, could be one of several ways forward to create a learning environment that takes these issues into account.

  • 12.
    Borglin, Gunilla
    et al.
    Hogskolan i Blekinge.
    Gustafsson, Markus
    Hogskolan i Blekinge.
    Krona, Hans
    Hogskolan i Blekinge.
    A theory-based educational intervention targeting nurses' attitudes and knowledge concerning cancer-related pain management: A study protocol of a quasi-experimental design2011In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 11, article id 233Article in journal (Refereed)
    Abstract [en]

    Background: Pain is one of the most frequent problems among patients diagnosed with cancer. Despite the availability of effective pharmacological treatments, this group of patients often receives less than optimal treatment. Research into nurses' pain management highlights certain factors, such as lack of knowledge and attitudes and inadequate procedures for systematic pain assessment, as common barriers to effective pain management. However, educational interventions targeting nurses' pain management have shown promise. As cancer-related pain is also known to have a negative effect on vital aspects of the patient's life, as well as being commonly associated with problems such as sleep, fatigue, depression and anxiety, further development of knowledge within this area is warranted. Methods/design: A quasi-experimental study design will be used to investigate whether the implementation of guidelines for systematic daily pain assessments following a theory-based educational intervention will result in an improvement in knowledge and attitude among nurses. A further aim is to investigate whether the intervention that targets nurses' behaviour will improve hospital patients' perception of pain. Data regarding nurses' knowledge and attitudes to pain (primary outcome), patient perception regarding pain (secondary outcome), together with socio-demographic variables, will be collected at baseline and at four weeks and 12 weeks following the intervention. Discussion: Nursing care is nowadays acknowledged as an increasingly complicated activity and "nursing complexity is such that it can be seen as the quintessential complex intervention." To be able to change and improve clinical practice thus requires multiple points of attack appropriate to meet complex challenges. Consequently, we expect the theory-based intervention used in our quasi-experimental study to improve care as well as quality of life for this group of patients and we also envisage that evidence-based guidelines targeting this patient group's pain will be implemented more widely.

  • 13.
    Borglin, Gunilla
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Malmö University, Malmö, Sweden.
    Hentzel, Johanna
    Blekinge Cty Council, Primary Hlth Care RN, Nursing, Blekinge, Sweden..
    Bohman, Doris M.
    Blekinge Inst Technol, Dept Hlth, Fac Hlth Sci, Blekinge, Sweden..
    Public health care nurses' views of mothers' mental health in paediatric healthcare services: A qualitative study2015In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 16, no 5, p. 470-480Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate public health nurses' perceptions and experiences of mental health and of the prevention of mental ill health among women postpartum, within paediatric healthcare services. Background: Although maternal health following childbirth should be a priority within primary care, it is known that women postpartum do not always receive the support they need to adapt to and cope with motherhood. Research implies that postnatal problems lack recognition and are not always acknowledged in routine practice. Few studies have been presented on this topic or from the perspective of nurses. Methods: For this study, eight semi-structured interviews were conducted with public health nurses, and the transcribed texts were analysed through a process inspired by Burnard's description of the four-step qualitative content analysis. Findings: Three categories - external influences on postpartum mental health, screening for and preventing postpartum mental ill health and paediatric healthcare services as a platform for support - were interpreted to reflect the nurses' perceptions and experiences of mental health among women postpartum and of the prevention of mental ill health among women postpartum. Conclusion: We found that public health nurses can have an important role in supporting mothers' mental health postpartum. Although caution is warranted in interpreting our results, the findings concur with those of other studies, highlighting that an equal care emphasis on both the mother and child can be an important aspect of successful support. Implementing person-centred care might be one strategy to create such an emphasis, while also promoting the mental health of new mothers. Public health nurses have a unique opportunity to support mothers' transition into healthy motherhood, especially because they are likely to meet both mothers and children on a regular basis during the first year after birth.

  • 14.
    Borglin, Gunilla
    et al.
    Lunds universitet.
    Jakobsson, U
    Lunds universitet.
    Edberg, A K
    Lunds universitet.
    Hallberg, I R
    Lunds universitet.
    Older people in Sweden with various degrees of present quality of life: their health, social support, everyday activities and sense of coherence2006In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 14, no 2, p. 136-146Article in journal (Refereed)
    Abstract [en]

    Public health policies in most European countries are concerned with how to keep older people living independently with a qualitatively good life in the community as long as possible. However, knowledge about what may characterise those seemingly 'healthy' older people is sparse. The aim of the study was to investigate the characteristics of a sample of people (75+) reporting various degrees of Quality of Life (QoL) with respect to QoL in different areas, as well as self-rated health, health problems, social support, everyday activities and sense of coherence. A postal questionnaire was sent out in spring 2001 to a randomly selected population-based sample (n= 600) in the southern parts of Sweden. A two-step cluster analysis was performed (n= 385, mean age 84.6, SD = 5.7) with 'present QoL' as clustering attribute. Three groups were disclosed, classified as high, intermediate and low present QoL, of which 33.8% could be regarded being at risk of low QoL. Those with low present QoL (18.4%) were the oldest and most vulnerable, a majority were women with 'poor or bad' self-rated health, high frequencies of health problems, low total QoL, low social support and sense of coherence and less physically active. Those with high present QoL (47.8%) reported more 'excellent or good' self-rated health, physical activity, satisfactory social support and higher sense of coherence and total QoL than the other two groups. Those with intermediate present QoL (33.8%) had more of 'poor or bad' self-rated health, more health problems were less physically active, had lower total QoL and sense of coherence, and less social support than those with high present QoL. The sample seemed to reflect the ageing process in that the respondents were at different stages of ageing. However, the fact that the level of social support, sense of coherence and self-rated health followed the same curve as QoL may indicate that some are more vulnerable to low present QoL given the same health and these should be targeted in preventive programmes since they report low QoL.

  • 15.
    Borglin, Gunilla
    et al.
    Lund universitet.
    Jakobsson, U
    Lund universitet.
    Edberg, A K
    Lund universitet.
    Hallberg, I R
    Lund universitet.
    Self-reported health complaints and their prediction of overall and health-related quality of life among elderly people2005In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 42, no 2, p. 147-158Article in journal (Refereed)
    Abstract [en]

    Objective: To describe and compare self-reported health complaints, overall and health-related quality of life and to investigate how health complaints, age, gender, marital status, living and dwelling conditions and socio-economy predicted overall and health-related quality of life.Data and Method: A sample of 469 persons (aged 75-99) responded to a postal questionnaire. Multiple linear regression analysis was used to examine possible predictors.Result: Self-reported health complaints such as pain, fatigue and mobility impairment significantly predicted low overall and health-related quality life. Women had significantly lower overall and health-related quality of life than men, and a significantly higher degree of self-reported health complaints. The regression models had more similarities than differences, implying that the overall quality of life instrument were sensitive to physical influences only supposed to be detected by health-related quality of life instruments. Several of the health complaints predicting low quality of life are amenable for being relieved by nursing care. In the care of older people nurses need to assess for several health complaints simultaneously and be aware of their possible interaction when outlining interventions. Nurses are able to facilitate early detection of health complaints negatively affecting quality of life by implementing more pro-active preventive work as well as a higher degree of thorough and systematic assessments. It also seems important to consider that older woman's and men's needs for high quality of life may differ. (C) 2004 Elsevier Ltd. All rights reserved.

  • 16.
    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.

  • 17.
    Borglin, Gunilla
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Högskolan i Blekinge.
    Richards, David A.
    Exter University.
    Bias in experimental nursing research: Strategies to improve the quality and explanatory power of nursing science2010In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 47, no 1, p. 123-128Article in journal (Refereed)
    Abstract [en]

    In a guest editorial in this journal, Rahm Hallberg [Rahm Hallberg, I., 2006. Challenges for future nursing research: providing evidence for health-care practice. international Journal of Nursing Studies 43, 923-927] called for research which has greater explanatory power to determine the effectiveness of nursing interventions. in this paper we critique the suggestion made by the evidence-based nursing movement that randomisation per se is the principal route to better quality nursing research. In contrast, we evaluate the new CONSORT criteria for pragmatic RCTs, which assess the quality of strategies to reduce selection, performance, attrition and detection biases, allowing many different types of comparative studies to be covered by application of the checklist. We propose that randomisation alone is a necessary but insufficient strategy and that nursing researchers rise to Rahm Hallberg's challenge by adopting the extended criteria to assist in the critical appraisal, design and reporting of all experimental research in nursing.

  • 18.
    Borglin, Gunilla
    et al.
    Malmö universitet, Lovisenberg Diaconal Univ Coll, Norge.
    Thach, Emelie Hew
    Home Care Hlth Care & Welf Trust, Malmö.
    Jeppsson, Maria
    Social Serv Dept, Special Accommodat, Trelleborg.
    Forss, Katarina Sjogren
    Malmö universitet.
    Registered nurse's experiences of continence care for older people: A qualitative descriptive study2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, article id e12275Article in journal (Refereed)
    Abstract [en]

    Aim This study aimed to illuminate nurses' experience of continence care for older people receiving home care, either in their own home or in an assisted living facility. Background Registered Nurses (RNs) have a major role to play in identifying and establishing appropriate actions regarding continence care for older people. However, the crucial nursing care pathway for continence care is commonly described as poor. Methods Interviews were conducted with 11 RNs providing home care, and the transcribed texts were analysed using inductive content analysis. Result The impressions of RNs were categorised according to four themes: perceptions of continence care, an open approach to continence care, the need for personalised aid fittings and the importance of teamwork in continence care. Key findings were the importance of teamwork; the need for nurses to embrace leadership at the point of care and be more visible in terms of the provision of direct care; substantiation that evidence-based interventions, such as scheduled toileting and prompted voiding, should constitute the norm in continence care within the context of home care; and the need for nurses to support the right of older persons to receive an assessment of their continence problems, deemed to be the minimum standard of quality care. Conclusion The provision of continence care that is based on key nursing standards, such as evidence-based and person-centred care, as well as individualised continence care that is based on evidenced-based guidelines, would ensure an improvement in the continence care that is presently on offer to older people. Implications for practice Nurses need to embrace leadership at the point of care and to be more visible with the provision of direct care in order to improve continence care for older people receiving home care.

  • 19. Dupin, Cécile Marie
    et al.
    Borglin, Gunilla
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Debout, Christophe
    Rothan-Tondeur, Monique
    An ethnographic study of nurses' experience with nursing research and its integration in practice.2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 9, p. 2128-2139Article in journal (Refereed)
    Abstract [en]

    AIM: To report from a study aimed at illuminating how French Registered Nurses experience and engage in nursing research in clinical practice.

    BACKGROUND: Nursing research in France is mainly conducted by nurses working at clinical research units rather than by dedicated nurse researchers. Education, i.e. advanced degrees, in the field of nursing research is still in its infancy and not yet consistent with the international context. Outside France, the general perception is that nursing research is a unified part of professional nursing. Consequently, in-depth knowledge about how nurses in a French clinical context might experience and engage in nursing research is still lacking.

    DESIGN: The design of this study was influenced by an ethnographic approach as described by the French anthropologists Beaud and Weber.

    METHOD: Data, participatory observations, field notes and interviews (n = 6) were collected in a teaching hospital between April-August 2012. The field consisted of a wound-care unit and clinical research units. Collected data were analysed based on Beaud and Weber's description of analysis.

    RESULTS: Three beliefs were identified: being a unified part of a research team, being an integral part of 'crosswise - across' activities and being part of research activities.

    CONCLUSION/IMPLICATION FOR RESEARCH: Commitment to nursing research was strengthened by patient-related issues. Based on this context, nursing research would likely benefit from the support of a naturalized reciprocity between clinical practice and research.

  • 20.
    Fagerstrom, Cecilia
    et al.
    Högskolan i Blekinge.
    Borglin, Gunilla
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Mobility, functional ability and health-related quality of life among people of 60 years or older2010In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 22, no 5-6, p. 387-394Article in journal (Refereed)
    Abstract [en]

    Background and aims: Knowledge about Health-Related Quality of Life (HRQoL) in advanced age is sparse. This study investigated to what extent mobility factors explained older people's HRQoL when age, gender and functional ability (ADL) were controlled for. Methods: Subjects were 1128 people aged 60-96 participating in a Swedish longitudinal multi-center cohort study. Besides descriptive and correlation statistics, a three-tier multiple logistic regression analysis was performed, which included the ADL scale, mobility tests and items, with physical and mental HRQoL as outcome variables. Results: In the models containing the control variables, functional ability was found to be associated with both physical and mental HRQoL. In the models including both functional ability and mobility factors, the importance of functional ability remained for mental but not for physical HRQoL. The mobility factors were found to have a stronger negative influence on HRQoL, i.e., physical and mental, than functional ability in itself. Conclusions: For optimal identification of various types of disabilities and their impact on older people's HRQoL, the ADL scale should be used together with more target-specific tests of disabilities. However, in certain situations, it appears that one mobility factor alone - the ability to walk - has the capacity to pick up changes in both physical and mental HRQoL. Thus, it is important that healthcare professionals should focus activities toward maintaining older people's mobility as a means of enhancing their HRQoL.

  • 21.
    Fiddler, M.
    et al.
    Manchester University.
    Borglin, Gunilla
    Manchester University.
    Galloway, A.
    Manchester University.
    Jackson, C.
    Manchester University.
    Lovell, K.
    Manchester University.
    Developing a framework for admission and discharge: a nurse-led initiative within a mental health setting2007In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 14, no 7, p. 705-712Article in journal (Refereed)
    Abstract [en]

    Admission to a mental health inpatient setting is one important aspect of care which requires collaborative working between Community Mental Health Teams (CMHTs) and ward staff. However, links are not always formalized. The failure of effective gatekeeping coupled with inconsistent admission and discharge practices further complicates the situation for all those involved. A number of local changes, for example, adoption of a centralized bed bureau, together with policy changes, initiated a nurse-led practice development project. It was predicted that by creating a framework for more formalized communication between the different disciplines admission and discharge processes would be improved, thus enhancing service users' satisfaction and empowering all staff participating in the process. During the project, 132 service users were notified as potentially requiring admission. Admissions were avoided and diverted for 22 of them. The quality of the communication and information shared between the CMHTs and ward staff was significantly improved. Accessing inpatient beds, at times still remained problematic, as beds could only remain ring-fenced on 65% of occasions. This initiative, conducted within a 'real world setting', showed that it is possible to improve admission and discharge practices by creating a framework for a formalized communication process between disciplines.

  • 22.
    Fiddler, Magdalen
    et al.
    Manchester University.
    Borglin, Gunilla
    Högskolan i Blekinge.
    Galloway, Adrian
    Manchester Mental Hlth & Social Care Trust.
    Jackson, Carl
    Manchester Mental Hlth & Social Care Trust.
    McGowan, Linda
    Manchester University.
    Lovell, Karina
    Manchester University.
    Once-a-week psychiatric ward round or daily inpatient team meeting?: A multidisciplinary mental health team's experience of new ways of working2010In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 19, no 2, p. 119-127Article in journal (Refereed)
    Abstract [en]

    Evidence indicates that while service users are dissatisfied with current ward round practices, studies of how professionals experience this practice are sparse. This study highlights staff view of the once-a-week psychiatric ward round compared to a reformed ward round taking place every weekday. Interviews were conducted at one acute psychiatric ward in north-west England. Our analysis revealed a core theme, 'forming a new way of working', which could be understood from three themes. The theme, 'bound by tradition', emphasized how the traditional ward round represented a double-edged sword: it provided a safe structure, but it also highlighted a shared awareness of an urgent need to leave old ways of working behind. The process of change became discernable in the themes 'juggling the change' and 'light at the end of the tunnel', which showed that restructuring the traditional ward round was both possible and valued. We found that staff views on ward rounds are more complex than had been earlier understood, but new ways of working can be implemented, if the impact of tradition, the process of change, and the time to bed down are taken into account.

  • 23.
    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.

  • 24.
    Forss, Katarina Sjogren
    et al.
    Malmö universitet.
    Persson, Karin
    Malmö universitet.
    Borglin, Gunilla
    Malmö universitet.
    Nursing students' experiences of caring for ethnically and culturally diverse patients: A scoping review2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 37, p. 97-104Article in journal (Refereed)
    Abstract [en]

    Little is known about nursing students' experiences of caring for patients from diverse cultures, which is an important factor in educational settings when it comes to understanding whether the teaching strategies applied are successful. Thus, the aim of this study was to conduct a scoping review of the literature, thereby synthesising existing studies to explore nursing students' experiences of caring for patients with different cultural backgrounds from theirs. A systematic article search was done in PubMed, CINAHL and ERIC. A total of 996 studies were found in the searches and finally seven studies met the inclusion criteria and were included. The analysis of the seven included studies was interpreted to represent two overarching themes, namely the challenge of communication and non-mutual language and the challenge of culture and culturally influenced behaviour, representing nursing students' experiences of caring for patients with a different cultural background from theirs. A major challenge for nursing educators appears to be creating pedagogical interventions that cultivate a humble, solicitous and caring curiosity among students, such that they do not perceive only challenges in caring for culturally diverse patients.

  • 25.
    Gustafsson, M.
    et al.
    Högskolan i Blekinge.
    Bohman, D. M.
    Högskolan i Blekinge.
    Borglin, Gunilla
    Challenges of conducting experimental studies within a clinical nursing context2014In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 27, no 2, p. 133-136Article in journal (Refereed)
    Abstract [en]

    In recent years, several distinguished scholars have advocated for nursing research that may carry strong evidence for practice. Their advocacy have highlighted that nursing science has reached a point where as nurse researchers we need to develop the questions we ask and design studies that have the power to produce solid, translational, evidence-based knowledge. To do so, we need to carry out experimental tests on complex, everyday nursing interventions and activities. We also need to create public space to present accounts of our endeavours pursuing this type of design in clinical practice. This paper will discuss some of the most important insights gained from conducting a quasi-experimental study in which the aim was to investigate the effect of a theory-based intervention, targeting knowledge and attitudes among registered nurses regarding cancer pain management. The importance of careful practical and methodological planning is emphasised, and the need for participation-friendly interventions is discussed. (C) 2014 Elsevier Inc. All rights reserved.

  • 26.
    Gustafsson, Markus
    et al.
    Högskolan i Blekinge.
    Borglin, Gunilla
    Högskoan i Blekinge.
    Can a theory-based educational intervention change nurses' knowledge and attitudes concerning cancer pain management?: A quasi-experimental design2013In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, article id 328Article in journal (Refereed)
    Abstract [en]

    Background: Registered Nurses (RNs) play an important role in caring for patients suffering from cancer pain. A lack of knowledge regarding pain management and the RNs' own perception of cancer pain could act as barriers to effective pain management. Educational interventions that target RNs' knowledge and attitudes have proved promising. However, an intervention consisting of evidence-based practice is a multifaceted process and demands behavioural and cognitive changes to sustain the effects of the intervention. Therefore, our study aimed to investigate if a theory-based educational intervention could change RNs' knowledge and attitudes to cancer pain and pain management, both four and 12 weeks after the start of the intervention. Methods: A quasi-experimental design with non-equivalent control groups was used. The primary outcome was measured using a modified version of the instrument Nurses' Knowledge and Attitudes Survey Regarding Pain (NKAS) at baseline, four weeks and 12 weeks after the start of the intervention to evaluate its persistence. The intervention's educational curriculum was based on the principles of Ajzen's Theory of Planned Behaviour and consisted of interactive learning activities conducted in workshops founded on evidence-based knowledge. The RN's own experiences from cancer pain management were used in the learning process. Results: The theory-based educational intervention aimed at changing RNs knowledge and attitudes regarding cancer pain management measured by primary outcome NKAS resulted in a statistical significant (p<0.05) improvement of total mean score from baseline to four weeks at the intervention ward. Conclusions: The findings of this study, suggest that a theory-based educational intervention focused at RNs can be effective in changing RN's knowledge and attitudes regarding cancer pain management. However, the high number of dropouts between baseline and four weeks needs to be taken into account when evaluating our findings. Finally, this kind of theory-based educational intervention with interactive learning activities has been sparsely researched and needs to be evaluated further in larger projects.

  • 27.
    Keeley, Philip
    et al.
    Manchester University.
    Creed, Francis
    Manchester University.
    Tomenson, Barbara
    Manchester University.
    Todd, Chris
    Manchester University.
    Borglin, Gunilla
    Manchester University.
    Dickens, Chris
    Manchester University.
    Psychosocial predictors of health-related quality of life and health service utilisation in people with chronic low back pain2008In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 135, no 1-2, p. 142-150Article in journal (Refereed)
  • 28.
    Olsson, Cecilia
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Ringner, Anders
    Umea Univ, Dept Nursing, SE-90187 Umea, Sweden..
    Borglin, Gunilla
    Blekinge Inst Technol, Dept Hlth Sci, SE-37971 Karlskrona, Sweden.;Malmo Univ, Fac Hlth & Soc, SE-20506 Malmo, Sweden..
    Including systematic reviews in PhD programmes and candidatures in nursing Hobson's choice'?2014In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 2, p. 102-105Article in journal (Refereed)
    Abstract [en]

    Nowadays, gathering and synthesising evidence, i.e. conducting systematic reviews, is considered an important part of any health service research endeavour. Reviewing the literature, however suggest that it is not yet common that PhD students/doctoral candidates publish systematic reviews or even include a high quality review of the literature as a part of their PhD programme or candidature. Implying that systematic reviewing skills might not be acquired by going through an education on a postgraduate level. Additionally, scholars debating systematic reviews 'to be or not to be' as a part of research training seem to be sparse, especially within the field of nursing. In this issue for debate, we would like to propose that the absence of systematic reviews' in this context might severely hamper the 'up and coming' researchers as well as the research conducted. We envisage that this lack can have a negative impact on international nursing practice, and therefore propose that systematic reviews should be considered, whenever appropriate, as a mandatory part of any PhD programme or candidature. We believe that abilities in systematic reviewing will be a sought after research skills in the near future. Including systematic reviews would promote i) refined, well-grounded adequate research questions, ii) PhDs with broad and elevated methodological skills, iii) an increased level of evidence based nursing praxis. However, to make this a reality, supervisors, PhD students, and candidates would need to understand the value of this kind of research activity. Finally, lobbying University faculty boards and grant providers that are not inclined to view literature reviews as 'proper' research or as an important part of health service research, needs to be put on the agenda. (C) 2014 Elsevier Ltd. All rights reserved.

  • 29.
    Richards, David A.
    et al.
    Exter University.
    Borglin, Gunilla
    Högskolan i Blekinge.
    Complex interventions and nursing: Looking through a new lens at nursing research2011In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 48, no 5, p. 531-533Article in journal (Refereed)
  • 30.
    Richards, David A.
    et al.
    Exter University.
    Borglin, Gunilla
    Implementation of psychological therapies for anxiety and depression in routine practice: Two year prospective cohort study2011In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 133, no 1-2, p. 51-60Article in journal (Refereed)
    Abstract [en]

    Introduction: Worldwide, health systems are improving access to empirically supported psychological therapies for anxiety and depression. Evaluations of this effort are limited by the cross sectional nature of studies, short implementation periods, poor data completeness rates and lack of clinically significant and reliable change metrics. Objective: Assess the impact of implementing stepped care empirically supported psychological therapies by measuring the prospective outcomes of patients referred over a two year period to one improving Access to Psychological Therapies service in the UK. Method: We collected demographic, therapeutic and outcome data on depression (PHQ-9) and anxiety (GAD-7) from 7859 consecutive patients for 24 months between 1st July 2006 and 31st August 2008, following up these patients for a further one year. Results: 4183 patients (53%) received two or more treatment sessions. Uncontrolled effect size for depression was 1.07 (95% CI: 0.88 to 1.29) and for anxiety was 1.04 (0.88 to 1.23). 55.4% of treated patients met reliable improvement or reliable and clinically significant change criteria for depression, 54.7% for anxiety. Patients received a mean of 5.5 sessions over 3.5 h, mainly low-intensity CBT and phone based case management. Attrition was high with 47% of referrals either not attending for an assessment or receiving an assessment only. Conclusions: Recovery rates for patients receiving stepped care empirically supported treatments for anxiety and depression in routine practice are 40 to 46%. Only half of all patients referred go on to receive treatment. Further work is needed to improve routine engagement of patients with anxiety and depression. (C) 2011 Elsevier B.V. All rights reserved

  • 31.
    Richards, David A.
    et al.
    Exter University.
    Borglin, Gunilla
    Malmö universitet.
    'Shitty nursing' - The new normal?2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 91, p. 148-152Article in journal (Refereed)
    Abstract [en]

    In this article we ask our profession to consider whether something is rotten at the core of modern nursing. We will use our own experiences as patients, together with published literature, to ask questions of our profession in perpetrating what one of our colleagues recently, and with great embarrassment, referred to as 'shitty nursing'. Our intention is most certainly not to offend any readers, for this term has been used in literature for more than one hundred years to describe bad situations, including those where events or people's behaviour are of a low standard. Our intention instead, is to challenge ourselves, the profession and you the reader by raising a measured debate which seems at present to be missing within the profession. We examine the potential idea that poor nursing care may not be the exception, but horrifyingly, may be the new normal. We are particularly concerned that patients' fundamental care needs may be falling into an ever widening gap between assistant and registered nurses. Whilst we acknowledge the potential causes of poor nursing care, causes that are often cited by nurses themselves, we come to the conclusion that a mature profession including clinicians, educators, administrators, researchers and regulators cannot continually blame contextual factors for its failings. A mature profession with an intact contract between itself and society must shoulder some of the responsibility for its own problems. We do suggest a way forward, including a mix of reconciliation, refocus and research, underpinned by what we argue is a much needed dose of professional humility. Readers may take us to task for potentially overstating the problem, ignoring non-nursing drivers, and downplaying other significant factors. You may think that there is much in nursing to glory in. However, we make no apology for presenting our views. Our lived experiences tell us something different. As professional nurses our main aim is to ensure that our adverse experiences as patients are statistical anomalies, and our future encounters with nursing care represent all that we know to be excellent in our profession. We leave you to judge and comment. (C) 2018 Published by Elsevier Ltd.

  • 32.
    Richards, David A.
    et al.
    Exter University.
    Coulthard, Vania
    Exter University.
    Borglin, Gunilla
    Högskolan i Blekinge, Högskolan i Malmö.
    The State of European Nursing Research: Dead, Alive, or Chronically Diseased? A Systematic Literature Review2014In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 11, no 3, p. 147-155Article in journal (Refereed)
    Abstract [en]

    Background Reviews of nursing research have suggested that most is descriptive; with no more than 15% providing strong evidence for practice. No studies have examined this from the perspective of nursing research conducted in Europe. Objective The aim of this study was to review reports of European clinical nursing research in the top 20 nursing journals in 2010 to establish a baseline of nursing research activity in the year immediately prior to the launch of a European Science Foundation network to increase the proportion of intervention research in Europe. Methods We identified eligible reports that were then data-extracted by two independent reviewers. Disagreements were resolved through pair discussion and independent arbitration. We appraised and synthesized topics, methods, and the extent to which studies were programmatic. We synthesized data as proportions of study reports meeting our a priori categorization criteria. Results We identified 1995 published reports and included 223 from 21 European countries, of which 193 (86.6%) reported studies of primary research only, 30 (13.5%) secondary research, and three (1.4%) a mix of primary and secondary. Methodological description was often poor, misleading, or even absent. One hundred (44.8%) articles reported observational studies, 87 (39.0%) qualitative studies. We found 26 (11.7%) articles reporting experimental studies, 10 (4.5%) of which were randomized controlled trials. We found 29 (13.0%) reports located within a larger program of research. Seventy-six (34.1%) articles reported studies of nursing interventions. Linking Evidence to Action European research in nursing reported in the leading nursing journals remains descriptive and poorly described. Only a third of research reports concerned nursing interventions, and a tiny proportion were part of a programmatic endeavor. Researchers in nursing must become better educated and skilled in developing, testing, evaluating, and reporting complex nursing interventions. Editors of nursing journals should insist on systematic reporting of research designs and methods in published articles.

  • 33.
    Richards, David A.
    et al.
    Exter University, Högskolan i Vestlandet, Norge.
    Hanssen, Tove Aminda
    Tromsö universitet.
    Borglin, Gunilla
    Malmö universitet.
    The Second Triennial Systematic Literature Review of European Nursing Research: Impact on Patient Outcomes and Implications for Evidence-Based Practice2018In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 15, no 5, p. 333-343Article in journal (Refereed)
    Abstract [en]

    Background: European research in nursing has been criticized as overwhelmingly descriptive, wasteful and with little relevance to clinical practice. This second triennial review follows our previous review of articles published in 2010, to determine whether the situation has changed.Objective: To identify, appraise, and synthesize reports of European nursing research published during 2013 in the top 20 nursing research journals.Methods: Systematic review with descriptive results synthesis.Results: We identified 2,220 reports, of which 254, from 19 European countries, were eligible for analysis; 215 (84.7%) were primary research, 36 (14.2%) secondary research, and three (1.2%) mixed primary and secondary. Forty-eight (18.9%) of studies were experimental: 24 (9.4%) randomized controlled trials, 11 (4.3%) experiments without randomization, and 13 (5.1%) experiments without control group. A total of 106 (41.7%) articles were observational: 85 (33.5%) qualitative research. The majority (158; 62.2%) were from outpatient and secondary care hospital settings. One hundred and sixty-five (65.0%) articles reported nursing intervention studies: 77 (30.3%) independent interventions, 77 (30.3%) interdependent, and 11 (4.3%) dependent. This represents a slight increase in experimental studies compared with our previous review (18.9% vs. 11.7%). The quality of reporting remained very poor.Linking Evidence to Action: European research in nursing remains overwhelmingly descriptive. We call on nursing researchers globally to raise the level of evidence and, therefore, the quality of care and patient outcomes. We urge them to replicate our study in their regions, diagnose reasons for the lack of appropriate research, identify solutions, and implement a deliberate, targeted, and systematic global effort to increase the number of experimental, high quality, and relevant studies into nursing interventions. We also call on journal editors to mandate an improvement in the standards of research reporting in nursing journals

  • 34.
    Richards, David A.
    et al.
    Exter University.
    Ross, Sarah
    Exter University.
    Robens, Sarah
    Devon Partnership NHS Trust, Exter.
    Borglin, Gunilla
    Högskolan i Malmö.
    The DiReCT study - improving recruitment into clinical trials: a mixed methods study investigating the ethical acceptability, feasibility and recruitment yield of the cohort multiple randomised controlled trials design2014In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 15, article id 398Article in journal (Refereed)
    Abstract [en]

    Background: The 'cohort multiple Randomised Controlled Trial' (cmRCT) design has been proposed as a potential solution to poor recruitment into clinical trials. The design randomly selects participants eligible for experimental treatments from a pre-enrolled cohort of patients, recruiting participants to multiple trials from a single cohort. Controls remain unaware of their participation in specific trials. Methods: We undertook a mixed methods study to determine the ethical acceptability, the proportion of patients in a routine service consenting to cohort participation, the proportion of these who would consent to being hypothetically randomly selected to receive new treatments, and the views of clinicians on the acceptability of the design. We submitted our cmRCT design for ethical review and recruited participants from people with anxiety and depression attending a community mental health service of twenty-one clinicians. We recorded the proportion of patients who were offered participation in the DiReCT study and the proportion that consented to researcher contact, medical record sharing, and who accepted to be randomly allocated to active treatment procedures in future hypothetical unspecified clinical trials. We used a thematic framework analysis to analyse clinician interviews. Results: We obtained a favourable ethical opinion from the UK Health Research Authority. Clinicians approached 131/752 (17%) potentially eligible participants for consent. Of these 131, 84 (64%) initially consented to be contacted by a researcher and all but one consented to being randomised into future trials. We confirmed consent for 71 (54%) of participants approached by clinicians, of whom 69 (53%) consented to being randomised into hypothetical future trials, 9% (69/752) of all potentially eligible patients. The interviewed clinicians described issues impacting on their ability to recruit participants in terms of clinical concerns for patient wellbeing, work pressure, their views of both general research and the specific DiReCT study, and how they viewed patients' responses to being offered participation in the study. Conclusions: The cmRCT system offers the potential to improve the recruitment into clinical trials and is acceptable ethically and to many patients. Overcoming the multiple factors driving the difficulties clinicians experience in patient recruitment is likely to require the application of significant implementation science-informed effort

  • 35.
    Sandstrom, Boel
    et al.
    Högskolan i Blekinge, Lunds universitet.
    Borglin, Gunilla
    Nilsson, Roland
    Skåne University Hospital.
    Willman, Ania
    Högskolan i Blekinge.
    Promoting the Implementation of Evidence-Based Practice: A Literature Review Focusing on the Role of Nursing Leadership2011In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 8, no 4, p. 212-223Article in journal (Refereed)
    Abstract [en]

    Objectives: Despite a growing interest in evidence-based practice (EBP), the implementation into clinical practice of knowledge derived from research has proved to be a cumbersome process. Additionally, the literature seems to present a fragmented picture with research mainly focusing on a few factors of possible importance, among which leadership appears to be one of the more important. Thus, this study aimed to systematically review the literature regarding leadership and its possible influence on the process of implementing EBP.Approach: A literature review was conducted. Electronic database searches were conducted to identify studies on leadership, administrators, managers, implementation, evidence-based and nursing. The search identified 43 potentially relevant papers, of which 36 were excluded after an appraisal was performed by two independent reviewers. Results were extracted and synthesised into a narrative text.Findings: Seven papers were included in the literature review. The findings can be divided into three major areas: (1) characteristics of the leader, (2) characteristics of the organisation and (3) characteristics of the culture. Our findings indicate that leadership is vital for the process of implementing EBP in nursing and also highlights the possible importance of the organisation and the culture in which the leader operates. These factors together with their characteristics were interpreted to be intrinsic in the creation of a nursing milieu that is open and responsive to the implementation of EBP.Conclusions: Although there seems to be scholarly agreement that leadership is a vital part of the process of implementing EBP, more rigorous research is needed concerning the possible role of the leader. Our findings also indicate that leadership cannot be studied in isolation or without being clearly defined.

  • 36.
    Sandstrom, Boel
    et al.
    Högskolan i Blekinge, Lunds universitet, Högskolan i Malmö.
    Willman, Ania
    Högskolan i Blekinge, Högskolan i Malmö.
    Svensson, Bengt
    Lund universitet.
    Borglin, Gunilla
    Höhskolan i Blekinge, Högskolan i Malmö.
    Perceptions of national guidelines and their (non) implementation in mental healthcare: a deductive and inductive content analysis2015In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 10, article id 43Article in journal (Refereed)
    Abstract [en]

    Background: National guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines. Methods: The study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second inductively by means of qualitative content analysis. Results: Our deductive analysis showed that the text strongly reflected two out of three categorisation matrices, i.e. evidence and context representing the PARIHS framework. However, the key element of facilitation was poorly mirrored in the text. Results from the inductive analysis can be seen in light of the main category sitting on the fence; thus, the informants' perceptions reflected ambivalence and contradiction. This was illustrated by conflicting views and differences in culture and ideology, a feeling of security in tradition, a certain amount of resistance to change and a lack of role clarity and clear directions. Together, our two analyses provide a rich description of an organisational culture that is highly unlikely to facilitate the implementation of the national guidelines, together with a distrust of the source behind such guidelines, which stands in stark contrast to the high confidence in the knowledge of experienced people in authority within the organisational context. Conclusions: Our findings have highlighted that, regardless of by whom guidelines are released, they are not likely to be utilised or implemented if those who are responsible for implementing them do not trust the source. This aspect (i.e. contextual trust) is not covered by PARIHS.

  • 37.
    Sandström, Boel
    et al.
    Blekinge högskola.
    Willman, Ania
    Malmö högskola.
    Svensson, Bengt
    Borglin, Gunilla
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    'How do we know if this is the best?' Mental health-care professionals' views on national guidelines for psychosocial interventions.2014In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 23, no 3, p. 221-31Article in journal (Refereed)
    Abstract [en]

    National guidelines are released regularly, and professionals are expected to adopt and implement them. However, studies dealing with mental health-care professionals' views about guidelines are sparse. The aim of the present study was to highlight mental health-care staff's views on the Swedish national guidelines for 'psychosocial interventions for schizophrenia or schizophrenia-type symptoms' and their implementation. The study took place in the southeast parts of Sweden, and data were collected through five group interviews consisting of 16 professionals working either in the county council or in the municipalities. The transcribed text was analysed by content analysis, revealing two categories. The first category 'a challenge to the practice of care as known' reflected that the release of guidelines could be perceived as a challenge to prevailing care and culture. The second category 'anticipating change to come from above' mirrored views on how staff expected the implementation process to flow from top to bottom. To facilitate working in accordance with guidelines, we suggest that future guidelines should be accompanied by an implementation plan, where the educational needs of frontline staff are taken into account. There is also a need for policy makers and managers to assume responsibility in supporting the implementation of evidence-based practice.

  • 38.
    Sandström, Boel
    et al.
    Blekinge Högskola.
    Willman, Ania
    Malmö högskola.
    Svensson, Bengt
    Lunds universitet.
    Borglin, Gunilla
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Mapping attitudes and awareness with regard to national guidelines: an e-mail survey among decision makers.2014In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 22, no 7, p. 884-893Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The adoption of evidence-based guidelines within the mental health field has been slow. Changing inadequate practice is therefore a formidable challenge for mental health-care managers.

    AIM: To explore decision-makers' attitudes and awareness regarding the national guidelines for psychosocial interventions targeting people with schizophrenia.

    METHOD: A questionnaire distributed by e-mail to 592 Swedish decision-makers was analysed using descriptive and comparative techniques.

    RESULTS: Significantly more of the top-level mental health-care managers than politicians stated that they knew about the national guidelines (i.e. their release and content) and they considered the guidelines to be a good source of support for planning and allocating resources.

    CONCLUSION: If those responsible for allocating resources (i.e. politicians) are unaware of the dissemination of national guidelines or their content, and they do not perceive the national guidelines to be a good source of support for planning and allocating resources, this is likely to have a negative influence on the remit of nurse managers as well as nursing practice.

    IMPLICATIONS FOR NURSING MANAGEMENT: Top-level mental health-care managers have a vital role to play in the implementation of national guidelines. However, our findings indicate that implementing national guidelines in practice could be virtually impossible without strategic government support.

  • 39.
    Spilsbury, Karen
    et al.
    York University.
    Stuttard, Lucy
    York Universiy.
    Adamson, Joy
    York Universiy.
    Atkin, Karl
    York Universiy.
    Borglin, Gunilla
    York Universiy.
    Mccaughan, Dorothy
    York Universiy.
    Mckenna, Hugh
    Ulster University.
    Wakefield, Ann
    Manchester University.
    Carr-Hill, Roy
    York Universiy.
    Mapping the introduction of Assistant Practitioner roles in Acute NHS (Hospital) Trusts in England2009In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 17, no 5, p. 615-626Article in journal (Refereed)
    Abstract [en]

    Aims This mapping study describes current or planned introduction of assistant practitioner roles in English National Health Service Acute Hospital Trusts.Background In the last decade there has been a growth in nursing support workforce numbers and their scope of practice. An important United Kingdom support worker development is the Assistant Practitioner role.Method A national census was carried out (April 2007) via an emailed questionnaire to Directors of Nursing. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using thematic analysis.Results Eighty-five per cent (143/168) of Directors of Nursing, from all 10 English Strategic Health Authorities, responded. Forty-six per cent (n = 66) of Trusts had introduced assistant practitioners and 22% (n = 31) were planning to implement the role before 2009. There is wide variation in assistant practitioner numbers across and between Strategic Health Authorities, Trusts and clinical areas. Resistance to the role existed in 32% (n = 46) of Trusts. Reasons for resistance included no perceived need for the role, lack of evidence of effectiveness, financial constraints and professional and patient safety concerns.Implications for nursing management These findings, which contribute to the international evidence-base on health care support workers roles, provide nurse managers with numbers of assistant practitioners and their deployment. This is useful for Nurse Managers making workforce decisions.

  • 40.
    Tuvesson, Hanna
    et al.
    Högskolan i Blekinge.
    Borglin, Gunilla
    Högskolan i Malmö.
    The challenge of giving written thesis feedback to nursing students2014In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 11, p. 1343-1345Article in journal (Refereed)
    Abstract [en]

    Providing effective written feedback on nursing student's assignments can be a challenging task for any assessor. Additionally, as the student groups tend to become larger, written feedback is likely to gain an overall more prominent position than verbal feedback. Lack of formal training or regular discussion in the teaching faculty about the skill set needed to provide written feedback could negatively affect the students' learning abilities. In this brief paper, we discuss written feedback practices, whilst using the Bachelor of Science in Nursing thesis as an example. Our aim is to highlight the importance of an informed understanding of the impact written feedback can have on students. Creating awareness about this can facilitate the development of more strategic and successful written feedback strategies. We end by offering examples of some relatively simple strategies for improving this practice. (C) 2014 Elsevier Ltd. All rights reserved.

  • 41.
    Wakefield, Ann
    et al.
    Manchester University.
    Spilsbury, Karen
    York University.
    Atkin, Karl
    York University.
    McKenna, Hugh
    Ulster University.
    Borglin, Gunilla
    Manchester University.
    Stuttard, Lucy
    York University.
    Assistant or substitute: Exploring the fit between national policy vision and local practice realities of assistant practitioner job descriptions2009In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 90, no 2-3, p. 286-295Article in journal (Refereed)
    Abstract [en]

    Objectives: To understand the extent to which the assistant practitioner role is described as 'assistive' in formal job descriptions and analyse whether the term 'assistive' has been stretched to encompass more 'substitutive' or 'autonomous' characteristics. Methods: Sixteen AP job descriptions representing all clinical divisions across one UK acute NHS Hospital Trust were both macro- and micro-analysed for broad similarities and differences in line with Hammersley and Atkinson's analytical framework. The analysis specifically focused on how clinical tasks were related to clinical responsibility, from this the job descriptors were then indexed as belonging to one of five discrete categories. Results: Our analysis revealed the following categories: fully assistive (n = 1), supportive/assistive (n = 7), supportive/substitutive (n = 4), substitutive/autonomous (n = 3) and fully autonomous (n = 1). From this, a number of anomalies manifest in the form of divergent organisational expectations regarding the AP role. Conclusions: This study highlights a series of tensions extant between policy vision and implementation of the AP role in practice. Introduction of new healthcare roles requires compromise and negotiation, to shape and define what social space incumbents of these and existing roles will occupy. However the way in which new roles are defined will determine how they become embraced and embedded within future healthcare services.

  • 42.
    Wong, Arnold Y. L.
    et al.
    Hong Kong Polytech University.
    Forss, Katarina Sjogren
    Malmö universitet.
    Jakobsson, Jenny
    Malmö universitet.
    Schoeb, Veronika
    Malmö universitet.
    Kumlien, Christine
    Malmö University.
    Borglin, Gunilla
    Malmö universitet.
    Older adult's experience of chronic low back pain and its implications on their daily life: Study protocol of a systematic review of qualitative research2018In: Systematic Reviews, E-ISSN 2046-4053, Vol. 7, article id 81Article in journal (Refereed)
    Abstract [en]

    Background: Of various chronic diseases, low back pain (LBP) is the most common and debilitating musculoskeletal condition among older adults aged 65 years or older. While more than 17 million older adults in the USA suffer from at least one episode of LBP annually, approximately six million of them experience chronic LBP that significantly affects their quality of life and physical function. Since many older adults with chronic LBP may also have comorbidities and are more sensitive to pain than younger counterparts, these older individuals may face unique age-related physical and psychosocial problems. While some qualitative research studies have investigated the life experiences of older adults with chronic LBP, no systematic review has integrated and synthesized the scientific knowledge regarding the influence of chronic LBP on the physical, psychological, and social aspects of lives in older adults. Without such information, it may result in unmet care needs and ineffective interventions for this vulnerable group. Therefore, the objective of this systematic review is to synthesize knowledge regarding older adults' experiences of living with chronic LBP and the implications on their daily lives. Methods/design: Candidate publications will be sought from databases: PubMed, CINAHL, and PsycINFO. Qualitative research studies will be included if they are related to the experiences of older adults with chronic LBP. Two independent reviewers will screen the titles, abstracts, and full-text articles for eligibility. The reference lists of the included studies will be checked for additional relevant studies. Forward citation tracking will be conducted. Meta-ethnography will be chosen to synthesize the data from the included studies. Specifically, the second-order concepts that are deemed to be translatable by two independent reviewers will be included and synthesized to capture the core of the idiomatic translations (i.e., a translation focusing on salient categories of meaning rather than the literal translation of words or phrases). Discussion: This systematic review of qualitative evidence will enable researchers to identify potential unmet care needs, as well as to facilitate the development of effective, appropriate, person-centered health care interventions targeting this group of individuals.

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