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Heikkilä, KristiinaORCID iD iconorcid.org/0000-0001-8489-0757
Publications (10 of 39) Show all publications
Wijk, H., Ponzer, S., Heikkilä, K., Kihlstroem, L. & Nordquist, J. (2019). Factors influencing effectiveness in postgraduate medical education - a qualitative study of experiences of the responsible clinical consultants. BMC Medical Education, 19, Article ID 3.
Open this publication in new window or tab >>Factors influencing effectiveness in postgraduate medical education - a qualitative study of experiences of the responsible clinical consultants
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2019 (English)In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 19, article id 3Article in journal (Refereed) Published
Abstract [en]

BackgroundMedical education leaders are important for educational quality in postgraduate medical education. Their work tasks are complex and contain different components. However, factors that are influencing leaders effectiveness in completing these tasks are unexplored. Understanding and developing these factors is most likely essential to strengthen postgraduate medical education and to consequently improve the quality in health care delivery. This study explores the experiences of factors that influence effectiveness of clinical consultants responsible for postgraduate medical education at clinical departments. Effectiveness was defined as fulfillment of work tasks.MethodsA qualitative study was performed with data gathered through semi-structured face-to-face interviews with 17 consultants responsible for postgraduate medical education. Data was analyzed by qualitative content analysis.ResultsFindings clustered into four themes of factors influencing effectiveness: individual (being an expert, social competence), relational (support and cooperation, communication), attitudinal (shared vision, organizational values, colleagues' attitudes) and structural (organizational characteristics, regulations and guidelines, conditions for the role). The factors were experienced to influence effectiveness in a positive or a negative direction.Conclusions This study shed light on the complex and interrelated factors experienced to have impact on the role of consultant responsible for postgraduate medical education. Viewing the result through the concept of power, the role mainly relies on personal power sources like expert and referent power whereas power connected to the position often are lacking. To increase effectiveness of the role, a differentiated strategy which involves activities at both individual, group and organizational levels is needed.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Qualitative research, Medical education, Leadership, Effectiveness, Professional development, Clinical consultant, Educational effectiveness, Postgraduate
National Category
Other Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-79735 (URN)10.1186/s12909-018-1433-6 (DOI)000454904700003 ()30606174 (PubMedID)2-s2.0-85059494374 (Scopus ID)
Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2019-08-29Bibliographically approved
Qvistgaard, M., Almerud Österberg, S., Heikkilä, K., Thorén, A.-B. & Lovebo, J. (2017). Patients’ experiences with at-home preoperative skin disinfection before elective hip replacement surgery. Journal of Perioperative Practice, 27(7-8), 162-166
Open this publication in new window or tab >>Patients’ experiences with at-home preoperative skin disinfection before elective hip replacement surgery
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2017 (English)In: Journal of Perioperative Practice, ISSN 1750-4589, Vol. 27, no 7-8, p. 162-166Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to describe patients' experiences with preoperative skin disinfection carried out in their home before elective hip replacement surgery with the aim of lowering the microbial burden and avoiding surgical site infections. The literature was reviewed for relevant studies. Optimal preparations before surgery depend on patients being able to assimilate preoperative information and instructions. The study was based on 14 interviews with patients who had undergone elective hip replacement surgery. Data were analysed with qualitative manifest content analysis according to Graneheim and Lundman (2004). The main categories of findings were: patients' experience of obstacles and limitations, the importance of supportive surroundings, and personal resources as strength when performing preoperative skin disinfection. The findings of this study agree with earlier studies showing a lack of compliance to preoperative skin disinfection. The findings also suggest reasons for non-compliance. Preoperative skin disinfection involves many important steps that need to be accomplished to ensure the maximum effect on microbial burden on skin surface. These steps can be difficult for some patient groups. Perioperative dialogue is one way to identify patients' individual needs and to help patients participate in the process. The study concludes that patients who carried out skin disinfection at home before surgery have a great responsibility to prepare themselves. The challenge for perioperative nurses who work with preoperative information is to identify and individually guide those patients who need extended support so that all patients with elective hip replacement surgery receive the same quality of care. Further research should focus on how caregivers discover individuals with extended needs and on identifying the kind of support that is effective to achieve optimal conditions for hip replacement surgery.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-67252 (URN)10.1177/1750458917027007-804 (DOI)2-s2.0-85051617431 (Scopus ID)
Available from: 2017-08-15 Created: 2017-08-15 Last updated: 2019-05-28Bibliographically approved
Ehrlich, K., Emami, A. & Heikkilä, K. (2017). The relationship between geographical and social space and approaches to care among rural and urban caregivers caring for a family member with Dementia: a qualitative study. International Journal of Qualitative Studies on Health and Well-being, 12(1), 1-11, Article ID 1275107.
Open this publication in new window or tab >>The relationship between geographical and social space and approaches to care among rural and urban caregivers caring for a family member with Dementia: a qualitative study
2017 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, p. 1-11, article id 1275107Article in journal (Refereed) Published
Abstract [en]

Knowledge about family caregivers in rural areas remains sparse. No studies to date have addressed the sociocultural aspects in caregiving, thus neglecting potentially significant data. This study aimed to explore and better understand family caregivers’ experiences in rural and urban areas and the sociocultural spheres that these two areas represent. How do family caregivers approach their caregiving situation? A hermeneutical approach was chosen to uncover the underlying meanings of experiences. Open-ended in-depth interviews were conducted. The ontological and epistemological roots are based on hermeneutic philosophy, where a human being’s existence is viewed as socially constructed. The study followed a purposeful sampling. Semi-structured in-depth interviews were conducted with 12 rural and 11 urban family caregivers to persons with dementia. These were then analyzed in accordance with the hermeneutical process. The findings provide insight into the variations of family caregiver approaches to caregiving in rural and urban areas of Sweden. There seemed to be a prevalence of a more accepting and maintaining approach in the rural areas as compared to the urban areas, where caregiving was more often viewed as an obligation and something that limited one’s space. Differences in the construction of family identity seemed to influence the participants approach to family caregiving. Therefore, community-based caregiving for the elderly needs to become aware of how living within a family differs and how this affects their views on being a caregiver. Thus, support systems must be individually adjusted to each family’s lifestyles so that this is more in tune with their everyday lives.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Dementia, family caregivers, qualitative research, rural, urban
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-61359 (URN)10.1080/17482631.2016.1275107 (DOI)2-s2.0-85051236714 (Scopus ID)
Available from: 2017-03-14 Created: 2017-03-14 Last updated: 2019-08-29Bibliographically approved
Berglund, A., Heikkilä, K., Bohm, K., Schenck-Gustafsson, K. & von Euler, M. (2015). Factors facilitating or hampering nurses identification of stroke in emergency calls. Journal of Advanced Nursing, 71(11), 2609-2621
Open this publication in new window or tab >>Factors facilitating or hampering nurses identification of stroke in emergency calls
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2015 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 71, no 11, p. 2609-2621Article in journal (Refereed) Published
Abstract [en]

Aims. To explore the factors that facilitate or hamper identification of stroke in emergency calls concerning patients with stroke who have fallen or been in a lying position.

Background. Early identification of stroke in emergency calls is vital but can be complicated as the patients may be unable to express themselves and the callers generally are bystanders. In a previous study, we found presentation of fall or the patient being in a lying position to be the major problem in 66% of emergency calls concerning, but not dispatched as acute stroke.

Design. A qualitative study using interpretive phenomenology.

Methods. Analysis of transcribed emergency calls concerning 29 patients with stroke diagnoses at hospital discharge, in 2011 and presented with fall/lying position.

Findings. Patients' ability to express themselves, callers' knowledge of the patient and of stroke, first call-takers' and nurses' authority, nurses' coaching and nurses' expertise skills facilitated or hindered the identification of stroke. Certain aspects are adjustable, but some are determined by the situation or on callers' and patients' abilities and thus difficult to change. Nurses' expertise skills were the only theme found to have a decisive effect of the identification of stroke on its own.

Conclusion. To increase identification of stroke in emergency calls concerning stroke, the first call-takers' and nurses' action, competence and awareness of obstacles are crucial and if strengthened would likely increase the identification of stroke in emergency calls. In complicated cases, nurses' expertise skills seem essential for identification of stroke.

Keywords
dispatching, emergency call, emergency medical service, facilitators, identification, nurse, nursing, obstacles, prehospital, stroke
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-46974 (URN)10.1111/jan.12729 (DOI)000362515300014 ()26183379 (PubMedID)2-s2.0-84942981424 (Scopus ID)
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2019-02-27Bibliographically approved
Ehrlich, K., Boström, A.-M., Mazaheri, M., Heikkilä, K. & Emami, A. (2015). Family caregivers' assessment of caring for a relative with dementia: a comparison of urban and rural areas. International Journal of Older People Nursing, 10(1), 27-37
Open this publication in new window or tab >>Family caregivers' assessment of caring for a relative with dementia: a comparison of urban and rural areas
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2015 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 1, p. 27-37Article in journal (Refereed) Published
Abstract [en]

AIM: This study aimed to describe and compare urban and rural family caregivers' reactions to caring for a relative with dementia and to examine the associations between caregiving and socio-demographic factors.

BACKGROUND: Most studies on family caregivers' experiences caring for older people with dementia have been conducted in urban areas, and little is known about the experiences of family caregivers living in rural areas.

DESIGN: A cross-sectional study design was used.

METHODS: A total of 102 caregivers (response rate 85%) from urban (n=57) and rural (n=46) areas completed the Caregiver Reaction Assessment (CRA) Scale and demographic information. Data were analysed using descriptive and inferential statistics and linear regression models.

RESULTS: Overall, family caregivers reported high satisfaction even if they also reported high impact on finances and daily living. Rural caregivers experienced a higher negative impact on finances but reported more support from family members than urban caregivers. Age, gender and relationship were significantly associated with four of the five CRA subscales. Educational level and geographical setting were not associated with any of the CRA subscales.

CONCLUSIONS: The results of the study raise questions about the financial situation of older female caregivers and on the expectations of built-in family structures in urban and rural areas. Further studies focusing on the meaning and constitution of a family would help us to understand how these factors influence family caregiving both in rural and urban areas.

IMPLICATIONS FOR PRACTICE: To provide person-centred care and to avoid stereotyped caregiving, a better picture of traditions in family caregiving can improve a more differentiated and appropriate professional caregiving pliable with the cultural context in which it is carried out.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015
Keywords
Caregiver Reaction Assessment Scale, Dementia, Family caregiver, Regression model, Rural and urban areas
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-41869 (URN)10.1111/opn.12044 (DOI)
Available from: 2015-04-08 Created: 2015-04-08 Last updated: 2019-02-27Bibliographically approved
Berglund, A., Heikkilä, K., Bohm, K., Schenck-Gustafsson, K. & von Euler, M. (2015). Obstacles and facilitators in emergency calls about stroke: Nurses' skills enable identification of stroke. International Journal of Stroke, 10, 113-113
Open this publication in new window or tab >>Obstacles and facilitators in emergency calls about stroke: Nurses' skills enable identification of stroke
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2015 (English)In: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 10, p. 113-113Article in journal, Meeting abstract (Other academic) Published
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-46094 (URN)000359304000267 ()
Available from: 2015-09-04 Created: 2015-09-04 Last updated: 2019-02-27Bibliographically approved
Fryden, H., Ponzer, S., Heikkilä, K., Kihlstrom, L. & Nordquist, J. (2015). Roles, tasks and educational functions of postgraduate programme directors: a qualitative study. Postgraduate medical journal, 91(1080), 588-593
Open this publication in new window or tab >>Roles, tasks and educational functions of postgraduate programme directors: a qualitative study
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2015 (English)In: Postgraduate medical journal, ISSN 0032-5473, E-ISSN 1469-0756, Vol. 91, no 1080, p. 588-593Article in journal (Refereed) Published
Abstract [en]

Background A programme director is often required to organise postgraduate medical education. This leadership role can include educational as well as managerial duties. Only a few published studies have explored programme directors' own perceptions of their role. There is a need to explore the use of theoretical frameworks to improve the understanding of educational roles.

Objective To explore programme directors' own perceptions of their role in terms of tasks and functions, and to relate these roles to the theoretical framework developed by Bolman and Deal.

Methods Semi-structured interviews were conducted with 17 programme directors between February and August 2013. The data were subjected to content analysis using a deductive approach.

Results The various roles and tasks included by participants in their perceptions of their work could be categorised within the framework of functions described by Bolman and Deal. These included: structuring the education (structural function); supporting individuals and handling relations (human resource function); negotiating between different interests (political function); and influencing the culture at the departmental level (symbolic function). The functions most often emphasised by participants were the structural and human resource functions. Some tasks involved several functions which varied over time.

Conclusions Programme directors' own perceptions of their roles, tasks and functions varied widely. The theoretical framework of Bolman and Deal might be helpful when explaining and developing these roles.

National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-46900 (URN)10.1136/postgradmedj-2015-133315 (DOI)000361841600012 ()26318376 (PubMedID)2-s2.0-84943813615 (Scopus ID)
Available from: 2015-10-26 Created: 2015-10-26 Last updated: 2019-02-27Bibliographically approved
Möller, R., Shoshan, M. & Heikkilä, K. (2015). What is the reward?: Medical students’ learning and personal development during a research project course. Medical Education Online, 20, 1-9, Article ID 28441.
Open this publication in new window or tab >>What is the reward?: Medical students’ learning and personal development during a research project course
2015 (English)In: Medical Education Online, ISSN 1087-2981, E-ISSN 1087-2981, Vol. 20, p. 1-9, article id 28441Article in journal (Refereed) Published
Abstract [en]

Background: Until recently, the outcome of medical students’ research projects has mainly been assessed in terms of scientific publications, whereas other results important for students’ development have been less studied. The aim of this study was to investigate medical students’ experiences of learning as an outcome of the research project course.

Method: Written reflections of 50 students were analyzed by manifest inductive content analysis.

Results: Three categories emerged: ‘thinking as a scientist’, ‘working as a scientist’, and ‘personal development’. Students became more aware about the nature of knowledge, how to generate new knowledge, and developed skills in scientific thinking and critical appraisal. Unexpectedly, effects on personal characteristics, such as self-confidence, self-discipline, independence, and time management skills were also acknowledged.

Conclusions: We conclude that individual research projects enhance research-specific skills and competencies needed in evidence-based clinical work and are beneficial for personal and professional development.

Place, publisher, year, edition, pages
CoAction Publishing, 2015
Keywords
Learning outcomes, Qualitative research, Medical students, Science and scientific, Learning to research
National Category
Other Health Sciences Nursing
Research subject
Pedagogics and Educational Sciences, Education; Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-50990 (URN)10.3402/meo.v20.28441 (DOI)000360998300001 ()26344390 (PubMedID)2-s2.0-84947967235 (Scopus ID)
Available from: 2016-03-17 Created: 2016-03-17 Last updated: 2019-02-27Bibliographically approved
Suvanto, A.-L. & Heikkilä, K. (2014). Att minnas kriget: sverigefinska erfarenheter (1ed.). In: Susanne Rolfner Suvanto (Ed.), Äldres psykiska hälsa och ohälsa: prevention, förhållningssätt och arbetsmetoder (pp. 64-89). Stockholm: Gothia Förlag AB
Open this publication in new window or tab >>Att minnas kriget: sverigefinska erfarenheter
2014 (Swedish)In: Äldres psykiska hälsa och ohälsa: prevention, förhållningssätt och arbetsmetoder / [ed] Susanne Rolfner Suvanto, Stockholm: Gothia Förlag AB, 2014, 1, p. 64-89Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Gothia Förlag AB, 2014 Edition: 1
National Category
Psychiatry
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-39847 (URN)978-91-7205-855-2 (ISBN)
Available from: 2015-02-10 Created: 2015-02-10 Last updated: 2019-02-27Bibliographically approved
Lindstrom, V., Heikkilä, K., Bohm, K., Castren, M. & Falk, A.-C. (2014). Barriers and opportunities in assessing calls to emergency medical communication centre: a qualitative study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 22, Article ID 61.
Open this publication in new window or tab >>Barriers and opportunities in assessing calls to emergency medical communication centre: a qualitative study
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2014 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 22, article id 61Article in journal (Refereed) Published
Abstract [en]

Introduction: Previous studies have described the difficulties and the complexity of assessing an emergency call, and assessment protocols intended to support the emergency medical dispatcher's (EMD) assessment have been developed and evaluated in recent years. At present, the EMD identifies about 50-70 % of patients suffering from cardiac arrest, acute myocardial infarction or stroke. The previous research has primarily been focused on specific conditions, and it is still unclear whether there are any overall factors that may influence the assessment of the call to the emergency medical communication centre (EMCC). Aim: The aim of the study was to identify overall factors influencing the registered nurses' (RNs) assessment of calls to the EMCC. Method: A qualitative study design was used; a purposeful selection of calls to the EMCC was analysed by content analysis. Results: One hundred calls to the EMCC were analysed. Barriers and opportunities related to the RN or the caller were identified as the main factors influencing the RN's assessment of calls to the EMCC. The opportunities appeared in the callers' symptom description and the communication strategies used by the RN. The barriers appeared in callers' descriptions of unclear symptoms, paradoxes and the RN's lack of communication strategies during the call. Conclusion: Barriers in assessing the call to the EMCC were associated with contradictory information, the absence of a primary problem, or the structure of the call. Opportunities were associated with a clear symptom description that was also repeated, and the RN's use of different communication strategies such as closed loop communication.

Keywords
Emergency medical services, Emergency medical communication centre, Dispatch centre, Emergency medical dispatcher, Registered nurse, Assessment
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-39331 (URN)10.1186/s13049-014-0061-3 (DOI)000346868900001 ()2-s2.0-84920760065 (Scopus ID)
Available from: 2015-01-22 Created: 2015-01-22 Last updated: 2019-02-27Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-8489-0757

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