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Heikkilä, KristiinaORCID iD iconorcid.org/0000-0001-8489-0757
Publications (10 of 42) Show all publications
Heikkilä, K., Andersson, S., Lagerbielke, E., Persson, C., Sandgren, A. & Werkander Harstäde, C. (2022). Mealtime interventions and their outcomes in care homes for older people considering the five aspects meal model: An integrative review. Geriatric Nursing, 47, 171-182
Open this publication in new window or tab >>Mealtime interventions and their outcomes in care homes for older people considering the five aspects meal model: An integrative review
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2022 (English)In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 47, p. 171-182Article in journal (Refereed) Published
Abstract [en]

Mealtimes are important events in care homes for physical and social well-being. However, residents usually have little input concerning meal timings, what food is offered, and how it is served. This integrative review explored mealtime interventions and their outcomes in care homes related to the Five Aspects Meal Model (FAMM). Research articles published 2010–2021 were searched for in ASSIA, CINAHL, PsycINFO, PubMed, and SveMed+ and resulted in 13 articles focusing on interventions. The analysis was based on the aspects of FAMM: room, meeting, product, management control system, and atmosphere. The result shows that even though interventions specifically focused on one aspect, they often evaluated outcomes related to several aspects. Different aspects can work together to foster effective mealtimes. FAMM eased to visualise the usefulness of mealtime interventions from a broad perspective and can be a useful tool for assessing and improving mealtime situations in clinical practice.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Care homes, Five aspects meal model, Integrative review, Mealtime interventions, Older adults
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-115627 (URN)10.1016/j.gerinurse.2022.07.011 (DOI)000837090400001 ()35926339 (PubMedID)2-s2.0-85135512083 (Scopus ID)
Available from: 2022-08-02 Created: 2022-08-02 Last updated: 2023-04-17Bibliographically approved
Hadziabdic, E., Sarstrand Marekovic, A.-M., Salomonsson, J. & Heikkilä, K. (2021). Experiences of nurses educated outside the European Union of a Swedish bridging program and the program’s role in their integration into the nursing profession: a qualitative interview study. BMC Nursing, 20(1), Article ID 7.
Open this publication in new window or tab >>Experiences of nurses educated outside the European Union of a Swedish bridging program and the program’s role in their integration into the nursing profession: a qualitative interview study
2021 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 20, no 1, article id 7Article in journal (Refereed) Published
Abstract [en]

Background: Countries all over the world are experiencing a shortage of registered nurses (RNs). Therefore, some countries, including Sweden, have tried to solve this by recruiting internationally educated nurses (IENs). Countries offer bridging programs as educational support to qualify IENs for nursing work in the destination country. However, there is little research on IENs’ experiences of bridging programs in European countries and how these programs facilitate their integration into the world of work and their new society. The aim of this study is to explore the experiences of nurses, originally educated outside the EU (European Union)/EES, of the Swedish bridging program and of the program’s role in facilitating their integration into the nursing profession in Sweden.

Methods: A qualitative descriptive design was used to explore the topic based on 11 informants’ perspectives and experiences. Purposive sampling was used to recruit participants at one university in Sweden. Data were collected by individual interviews using a semi- structured interview guide during the year 2019 and were analysed using an interpretative thematic approach.

Results: Two main themes emerged from the analysis: 1) Return to nursing, and 2) The bridging program as a tool for transition to nursing in Sweden. The first theme includes conditions and experiences such as personal motivation and determination, and support from others that the participants described as important in order to achieve the goal of re-establishing themselves as registered nurses in Sweden. Furthermore, the second theme describes the participants’ experiences of the bridging program as mostly positive because it led to new learning and achievements that were valuable for the transition to nursing in Sweden; however, the participants also emphasised the challenges of their transition into the nursing profession, which were related to instances of misrecognition of their professional competence and the uncertain outcome of the program.

Conclusions: This study found that the bridging program facilitated integration into the nursing profession for nurses educated outside the EU/EES, especially knowledge gained in clinical-based training. Thus, it is important to recognise and value the IENs’ experience and previous knowledge and training when developing the bridging program’s curriculum.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2021
Keywords
Bridging program experience, Nurses educated outside the EU/EES, Qualitative interview study, Transition
National Category
Sociology Specific Languages Other Health Sciences
Research subject
Social Sciences, Sociology; Humanities, Swedish as a Second Language; Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-100043 (URN)10.1186/s12912-020-00525-8 (DOI)000607876200001 ()2-s2.0-85098944570 (Scopus ID)2021 (Local ID)2021 (Archive number)2021 (OAI)
Available from: 2021-01-15 Created: 2021-01-15 Last updated: 2023-04-03Bibliographically approved
Wijk, H., Heikkilä, K., Ponzer, S., Kihlström, L. & Nordquist, J. (2021). Successful implementation of change in postgraduate medical education: a qualitative study of programme directors. BMC Medical Education, 21, Article ID 213.
Open this publication in new window or tab >>Successful implementation of change in postgraduate medical education: a qualitative study of programme directors
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2021 (English)In: BMC Medical Education, E-ISSN 1472-6920, Vol. 21, article id 213Article in journal (Refereed) Published
Abstract [en]

Introduction

Leaders in postgraduate medical education are responsible for implementing educational change. Although difficulties in implementing change are described both in the general leadership literature as well as in the field of medical education, knowledge of what characterises successful change leadership in postgraduate medical education is limited. The aim of this study is to explore the process used by educational leaders in successful change implementation in postgraduate medical education.

Methods

Semi-structured interviews were conducted with 16 programme directors to explore how they had implemented successful change projects. The sample consisted of programme directors who had reported in a previous survey having high educational impact at their workplace. Interviews were analysed using Ödman’s qualitative interpretative method.

Results

The interviews identified similarities in how participating programme directors had implemented changes. Five interconnected themes crystallised from the data: (1) belonging to a group, (2) having a vision and meaning, (3) having a mandate for change, (4) involving colleagues and superiors, and (5) having a long-term perspective.

Conclusions

Our findings illuminate important aspects of successful change management in postgraduate medical education. Change is ideally based on a clear vision and is implemented in coalition with others. A long-term strategy should be planned, including involvement and anchoring of key persons in several discrete steps as change is implemented. While some of these findings are congruent with the general literature on change management, this study emphasises the importance of a mandate, with successful change leadership dependent on coalition and the facilitation provided by the next level of leadership.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2021
Keywords
Qualitative research, Medical education, Leadership, Faculty development, Postgraduate, Change management
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Pedagogics and Educational Sciences, Education; Natural Science, Medicine
Identifiers
urn:nbn:se:lnu:diva-102162 (URN)10.1186/s12909-021-02606-x (DOI)000640502700003 ()33853598 (PubMedID)2-s2.0-85104397775 (Scopus ID)2021 (Local ID)2021 (Archive number)2021 (OAI)
Available from: 2021-04-15 Created: 2021-04-15 Last updated: 2023-04-03Bibliographically approved
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, 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: 2022-02-10Bibliographically 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: 2022-04-19Bibliographically 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
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ORCID iD: ORCID iD iconorcid.org/0000-0001-8489-0757

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