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  • 1. Berg, Katarina
    et al.
    Kjellgren, Karin
    Unosson, Mitra
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Postoperative recovery and its association with health-related quality of life among day surgery patients.2012In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 11, no 1, p. Article ID: 24-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Day surgery holds advantages for both the patient and the health care organization. However, recovery beyond the first postoperative week and following different types of surgery has not been explored to any greater degree. The current aims were to prospectively describe postoperative recovery and health-related quality of life among different groups of day surgery patients and to explore the association between postoperative recovery and health-related quality of life 30 days after discharge.

    METHODS: A consecutive sample of 607 adult day surgery patients undergoing orthopaedic, gynaecological or general surgery was included. Postoperative recovery was assessed on days 1, 7 and 14 using the Swedish Post-discharge Surgery Recovery scale and the Quality of Recovery-23 scale. The EQ-5D was used to assess health-related quality of life preoperatively and 30 days following discharge. A repeated measure ANOVA was conducted to evaluate postoperative recovery from day 1 to day 14 and between different surgical groups. Hierarchical multiple linear regression models were used to explore the association between postoperative recovery and health-related quality of life.

    RESULTS: Postoperative recovery improved from day 1 to 14 in all surgical groups (p<0.001). The orthopaedic patients had lower postoperative recovery on day 14 compared to the general and the gynaecological patients (p<0.001). Health-related quality of life was lower among orthopaedic patients (p<0.001), even if significant improvements over time were seen in all groups. Recovery on day 7 was associated with health-related quality of life 30 days after the day surgery (p<0.05).

    CONCLUSION: Particularly orthopaedic day surgical patients seem to favour a closer follow-up in order to support recovery and thereby also positively influence health-related quality of life.

  • 2.
    Ekstedt, Mirjam
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet, Sweden.
    Lindblad, Marlene
    Ersta Sköndal Bräcke university college, Sweden;KTH Royal instute of technology, Sweden, Sweden.
    Löfmark, Anna
    University of Gävle, Sweden.
    Nursing students' perception of the clinical learning environment and supervision in relation to two different supervision models: a comparative cross-sectional study2019In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 18, no 1, p. 1-12, article id 49Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge concerning nursing students' experiences of the clinical learning environment and how supervision is carried out is largely lacking. This study compares nursing students' perceptions of the clinical learning environment and supervision in two different supervision models: peer learning in student-dedicated units, with students working together in pairs and supervised by a "preceptor of the day" (model A), and traditional supervision, in which each student is assigned to a personal preceptor (model B). Methods: The study was performed within the nursing programme at a university college in Sweden during students' clinical placements (semesters 3 and 4) in medical and surgical departments at three different hospitals. Data was collected using the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, CLES+T, an instrument tested for reliability and validity, and a second instrument developed for this study to obtain deeper information regarding how students experienced the organisation and content of the supervision. Independent t-tests were used for continuous variables, Mann-Whitney U-tests for ordinal variables, and the chi-square or Fischer's exact tests for categorical variables. Results: Overall, the students had positive experiences of the clinical learning environment and supervision in both supervision models. Students supervised in model A had more positive experiences of the cooperation and relationship between student, preceptor, and nurse teacher, and more often than students in model B felt that the ward had an explicit model for supervising students. Students in model A were more positive to having more than one preceptor and felt that this contributed to the assessment of their learning outcomes. Conclusions: A good learning environment for students in clinical placements is dependent on an explicit structure for receiving students, a pedagogical atmosphere where staff take an interest in supervision of students and are easy to approach, and engagement among and collaboration between preceptors and nurse teachers. This study also indicates that supervision based on peer learning in student-dedicated rooms with many preceptors can be more satisfying for students than a model where each student is assigned to a single preceptor.

  • 3.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Safipour, Jalal
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bachrach-Lindström, Margareta
    Linköping University.
    Hultsjö, Sally
    Linköping University.
    Swedish version of measuring cultural awareness in nursing students: validity and reliability test2016In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 15, article id 25Article in journal (Refereed)
    Abstract [en]

    Background

    Nearly 20 % of the Swedish population is foreign-born. Increased exposure of patients from diverse cultures means there is an urgent need to address their unique requirements and provide optimal health care to a diverse population. Nursing schools thus have an important goal of educating nurses to ensure they are culturally competent. Culturally competent care improves safety and equity for patients. To measure cultural awareness among nursing students in Sweden, the aim of this study was to translate, adapt and test the validity and reliability of the Swedish version of a cultural awareness scale which has not previously been tested.

    Methods

    A total of 158 nursing students from three universities in Sweden completed the 36-item questionnaire on cultural awareness. Verification of face and content validity and a translation/reverse translation process were first carried out.

    Results

    The results indicate that one item (no 13) caused weak reliability and validity, and therefore it was removed. The reliability test result (with 35 items) showed Cronbach’s Alpha ranged from 0.60 to 0.87. The Model ChiSq group fit for five factors was 50.44 (31.27–77.06; Df = 5; p < 0.001), and the RMSEA was 0.24 (C.I 95 % = 0.18–0.30).

    Conclusion

    The findings of the validity and reliability tests revealed that the CAS-scale for the 35 items is valid and reliable for use with Swedish nursing students. However, the CAS should be further tested in larger and more diverse samples of nursing students before being used in different socio-cultural settings.

  • 4.
    Israelsson, Johan
    et al.
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Hospital, Sweden;Linköping University, Sweden.
    Lilja, Gisela
    Lund University, Sweden;Skåne University Hospital, Sweden.
    Bremer, Anders
    University of Borås, Sweden;Kalmar County Hospital, Sweden.
    Stevenson-Ågren, Jean
    Linnaeus University, Faculty of Arts and Humanities, Department of Languages. University of Sheffield, UK.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University, Sweden.
    Post cardiac arrest care and follow-up in Sweden: a national web-survey2016In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 15, no 1Article in journal (Refereed)
    Abstract [en]

    Background: Recent decades have shown major improvements in survival rates after cardiac arrest. However, few interventions have been tested in order to improve the care for survivors and their family members. In many countries, including Sweden, national guidelines for post cardiac arrest care and follow-up programs are not available and current practice has not previously been investigated. The aim of this survey was therefore to describe current post cardiac arrest care and follow-up in Sweden.

    Methods: An internet based questionnaire was sent to the resuscitation coordinators at all Swedish emergency hospitals (n = 74) and 59 answers were received. Quantitative data were analysed with descriptive statistics and free text responses were analysed using manifest content analysis.

    Results: Almost half of the hospitals in Sweden (n = 27, 46 %) have local guidelines for post cardiac arrest care and follow-up. However, 39 % of them reported that these guidelines were not always applied. The most common routine is a follow-up visit at a cardiac reception unit. If the need for neurological or psychological support are discovered the routines are not explicit. In addition, family members are not always included in the follow-up.

    Conclusions: Although efforts are already made to improve post cardiac arrest care and follow-up, many hospitals need to focus more on this part of cardiac arrest treatment. In addition, evidence-based national guidelines will have to be developed and implemented in order to achieve a more uniform care and follow-up for survivors and their family members. This national survey highlights this need, and might be helpful in the implementation of such guidelines.

  • 5.
    Marklund, Birgitta
    et al.
    University of Kalmar, School of Human Sciences.
    Wilde-Larsson, Bodil
    Ahlstedt, Staffan
    Nordström, Gun
    Adolescents' experiences of being food-hypersensitive: a qualitative study2007In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955Article in journal (Refereed)
  • 6.
    Nygårdh, Annette
    et al.
    Jönköping University.
    Malm, Dan
    Jönköping University ; County Hospital Ryhov.
    Wikby, Kerstin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Ahlström, Gerd
    Lund University.
    The complexity in the implementation process of empowerment-based chronic kidney care: a case study2014In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 13, no 1, p. 1-10, article id 22Article in journal (Refereed)
    Abstract [en]

    Background: This study is part of an interactive improvement intervention aimed to facilitate empowerment-based chronic kidney care using data from persons with CKD and their family members. There are many challenges to implementing empowerment-based care, and it is therefore necessary to study the implementation process. The aim of this study was to generate knowledge regarding the implementation process of an improvement intervention of empowerment for those who require chronic kidney care.

    Methods: A prospective single qualitative case study was chosen to follow the process of the implementation over a two year period. Twelve health care professionals were selected based on their various role(s) in the implementation of the improvement intervention. Data collection comprised of digitally recorded project group meetings, field notes of the meetings, and individual interviews before and after the improvement project. These multiple data were analyzed using qualitative latent content analysis.

    Results: Two facilitator themes emerged: Moving spirit and Encouragement. The healthcare professionals described a willingness to individualize care and to increase their professional development in the field of chronic kidney care. The implementation process was strongly reinforced by both the researchers working interactively with the staff, and the project group. One theme emerged as a barrier: the Limitations of the organization. Changes in the organization hindered the implementation of the intervention throughout the study period, and the lack of interplay in the organization most impeded the process.

    Conclusions: The findings indicated the complexity of maintaining a sustainable and lasting implementation over a period of two years. Implementing empowerment-based care was found to be facilitated by the cooperation between all involved healthcare professionals. Furthermore, long-term improvement interventions need strong encouragement from all levels of the organization to maintain engagement, even when it is initiated by the health care professionals themselves.

  • 7.
    Nygårdh, Annette
    et al.
    Jönköping University.
    Wikby, Kerstin
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Malm, Dan
    Jönköping University ; County Hospital Ryhov.
    Ahlström, Gerd
    Lund University.
    Empowerment in outpatient care of persons with chronic kidney disease: The family members' perspective2011In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, p. 10-21, article id 21Article in journal (Refereed)
    Abstract [en]

    Background

    Family members of persons with pre-dialysis chronic kidney disease may experience feelings of vulnerability and insecurity as the disease follows its course. Against this background, the aim of the present study was to explore empowerment in outpatient care as experienced by these family members.

    Methods

    An inductive approach for qualitative data analysis was chosen. The study sample comprised 12 family members of pre-dialysis patients at an outpatient kidney clinic. Two interviews with each family member were subjected to content analysis to gain an understanding of empowerment from the family members' perspective.

    Results

    Having strength to assume the responsibility was the main theme that emerged from the following five sub-themes: Being an involved participant, Having confirming encounters, Trusting in health-care staff, Comprehending through knowledge, and Feeling left out. Four of these five sub-themes were positive. The fifth subtheme illuminated negative experience, indicating the absence of empowerment.

    Conclusions

    Family members' experience of empowerment is dependent on their ability to assume the responsibility for a relative with chronic kidney disease when needed. The findings emphasise the need for a family perspective and the significance of a supportive environment for family members of persons in outpatient care.

  • 8.
    Tuvesson, Hanna
    et al.
    Malmö University.
    Wann-Hansson, Christine
    Malmö University.
    Eklund, Mona
    Lund University.
    The ward atmosphere important for the psychosocial work environment of nursing staff in psychiatric in-patient care2011In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, article id 12Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. The aims of the present study were to investigate in what way different aspects of the ward atmosphere were related to the psychosocial work environment, as perceived by nursing staff working in psychiatric in-patient care, and possible differences between nurses and nurse assistants.

    METHODS: 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses.

    RESULTS: The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate.

    CONCLUSIONS: The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.

  • 9.
    Wireklint-Sundström, Birgitta
    et al.
    University of Borås, Sweden.
    Holmberg, Mats
    University of Borås, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Karlsson, Thomas
    University of Gothenburg, Sweden.
    Andersson, Henrik
    University of Borås, Sweden.
    Possible effects of a course in cardiovascular nursing on prehospital care of patients experiencing suspected acute coronary syndrome: a cluster randomised controlled trial2016In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 15, no 1, article id 52Article in journal (Refereed)
    Abstract [en]

    Background:Current research suggests that nurses can influence the outcome for patients with acute coronary syndrome (ACS). The aim of this study has been to evaluate whether a course in cardiovascular nursing (CVN) can improve ambulance nurses' (ANs') prehospital care of patients experiencing suspected ACS, related to pain intensity.

    METHODS: 

    This is a cluster randomised controlled trial that was conducted in the ambulance services. Patients were allocated to one of two groups: in the first group, patients were treated by ANs who had attended the CVN course and in the second group patients were treated by ANs without this qualification. Inclusion criteria were: 1/pain raising suspicion of ACS, and 2/pain score ≥4 on a visual analogue scale (VAS). The primary outcome was the estimated intensity of pain or discomfort according to VAS 15 min after randomisation. Secondary outcomes were estimated intensity of pain or discomfort on admission to hospital and further requirement of pain treatment, as well as symptoms such as paleness and/or cold sweat; nausea and/or vomiting; anxiety, dyspnea, degree of alertness, respiratory depression and aggressiveness. A further secondary outcome measured was survival to 30 days. Lastly, a final diagnosis was made. A total of 38 ANs attended the CVN course. There were 1,747 patients who fulfilled the inclusion criteria.

    RESULTS: 

    The pain score did not differ significantly between the two groups fifteen minutes after randomisation (median value of VAS was 4.0 in both groups). On admission to hospital the pain score was significantly lower for patients treated by an AN who had attended the CVN course (n = 332) compared with those treated by an AN who had not attended the course (n = 1,415) (median 2.5 and 3.0 respectively, p = 0.001). The ANs who had attended the course used higher doses of morphine.

    CONCLUSIONS: 

    An educational intervention with a CVN course did not relate significantly to more efficient pain relief in suspected ACS during the first 15 min. However, this intervention was associated with more effective pain relief later on in the prehospital setting. Thus, a CVN course for ANs appears to be associated with reduced pain intensity among patients experiencing suspected ACS. This result needs however to be confirmed in further trials.

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