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  • 1.
    Abelsson, Anna
    et al.
    Jönköping University, Sweden.
    Gustafsson, Marcus
    Jönköping University, Sweden.
    Petersen, Christina
    Jönköping University, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Physical stress triggers in simulated emergency care situations2021In: Nursing Open, E-ISSN 2054-1058, Vol. 8, no 1, p. 156-162Article in journal (Refereed)
    Abstract [en]

    Aim

    To practise emergency care situations during the education can be stressful. The aim of this study is to identify factors that cause stress in simulated emergency care.

    Design

    A descriptive observational study.

    Methods

    Video recordings (N = 26) subjected to observation with written field notes in turn subjected to interpretive qualitative content analysis.

    Results

    To assess the patient's condition and decide what measures to take trigger stress reactions. If the students failed to connect the correct and relevant information in the conversation with the physician, the students showed signs of stress. Also, to calculate medication dosages stress the students.

  • 2.
    Andersson, Lisbet
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Almerud Österberg, Sofia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kronoberg County Council, Sweden.
    Johansson, Pauline
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Green Sustainable Development.
    The interplay between children, their parents and anaesthesia staff during the child's anaesthesia - An observational study2022In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 31, no 15-16, p. 2240-2251Article in journal (Refereed)
    Abstract [en]

    Aims and objectives To interpret and understand the interplay between children, their parents, and anaesthetic staff to gain a greater understanding of children being anaesthetised. Background Anaesthesia induction is a stressful procedure for the child and parents in the technologically advanced environment in the operating room (OR). Anaesthesia staff are a key resource for ensuring safety and interplays, but the meeting is often short, intensive, and can affect the child and the parent. Design A qualitative observational design with a hermeneutic approach. Methods Twenty-seven non-participant observations were conducted and videotaped when children were being anaesthetised. The SRQR checklist was used. Results The result is presented as a theatre play with three headings; the scene, the actors, and the plot. The scene was not designed for the child or the parent's comfort and could lead to anxiety and insecurity. Four themes described the interplays: The need to be inviting and to be invited, The need for varying compliance, The need for mutual dependence, and The need to give and to receive emotional support. The plot could lead to uncertainty, and the interplay could change between being caring and uncaring depending on the actors. Conclusions The technologically advanced environment in the OR constituted an emotional obstacle, but the anaesthesia staff themselves can be a powerful resource creating a caring environment. The outcome of the plot may depend on the anaesthesia staff's bearing. Relevance to clinical practice A caring approach in the OR requires a willingness from the anaesthesia staff to invite the child to participate and find a balance between helping the parents to find their place in the OR and support them in supporting their child. The findings can start reflections in the unit on how to create a more caring environment.

  • 3.
    Björk, Maria
    et al.
    Jönköping University, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Odzakovic, Elzana
    Jönköping University, Sweden.
    Hellström, Amanda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandlund, Christina
    Karolinska Institutet, Sweden;Academic Primary Health Care Centre Stockholm, Sweden.
    Ulander, Martin
    Linköping University, Sweden;Linköping University Hospital, Sweden.
    Lind, Jonas
    Linköping University, Sweden;County Hospital Ryhov, Sweden.
    Pakpour, Amir H.
    Jönköping University, Sweden.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden;Western Norway Univ Appl Sci, Norway.
    ., Jönköping University Sleep Well Research Group
    Jönköping University, Sweden.
    Validation of two brief instruments (the SURE and CollaboRATE) to measure shared decision-making in patients with restless legs syndrome2024In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 33, no 4, article id e14071Article in journal (Refereed)
    Abstract [en]

    Restless legs syndrome (RLS) is a common neurological disorder characterised by an urge to move arms and legs, usually associated with discomfort, pain, motor restlessness, and sleep disturbance. An individually adapted treatment is needed but difficult to optimise, which makes shared decision-making (SDM) important. However, brief validated instruments on how patients with RLS perceive their involvement in treatment decisions are lacking. Therefore, the aim was to validate two instruments, SURE (Sure of myself, Understand information, Risk-benefit ratio, Encouragement, i.e., to assess decisional conflict) and CollaboRATE (brief patient survey focused on SDM, i.e., to assess SDM), in patients with RLS. A cross-sectional design, including 788 participants with RLS (65% females, mean [SD] age 70.8 [11.4] years) from a national patient organisation for RLS, was used. A postal survey was sent out to collect data regarding weight, height, comorbidities, demographics, and RLS-related treatment data. The following instruments were included: the SURE, CollaboRATE, Restless Legs Syndrome-6 Scale, and eHealth Literacy Scale. Confirmatory factor analysis and Rasch models were used to assess the validity and reliability of the SURE and CollaboRATE. Measurement invariance, unidimensionality, and differential item functioning (DIF) across age, gender, and medication groups were assessed. The SURE and CollaboRATE were both identified as unidimensional instruments with satisfactory internal consistency. No DIF across age and gender was identified, while significant DIF was observed for both the SURE and CollaboRATE regarding medication use categories. However, both the SURE and CollaboRATE are potential instruments to be used in research, but also as reflection tools by healthcare professionals, patients, and students to explore and assess SDM, and support its development in clinical care.

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  • 4.
    Darcy, L.
    et al.
    Jönköping University, Sweden.
    Björk, M.
    Jönköping University, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Enskär, S.
    Jönköping University, Sweden.
    The life of the preschool aged child with cancer in Sweden2014In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 61, no S2, p. 190-190Article in journal (Other academic)
    Abstract [en]

    Objectives: The majority of children who receive a cancer diagnosis are in the 1‐to‐6 year age group. Survival rates are high, roughly 75%, but treatment is aggressive and requires long and frequent hospital admissions and causes adverse side effects. Health care focus is shifting from surviving childhood cancer to living with it on a daily basis. The young child's experiences are crucial to providing evidence based care. The aim of this study was to explore the everyday life of preschool aged children as expressed by the child and their parents during the first year post diagnosis

    Methods: Interviews were conducted with children and their parents connected to a paediatric oncology unit in Southern Sweden. A qualitative content analysis of interview data from three time points, shortly after diagnosis, six months and one year post diagnosis were made.

    Results: A dramatic change in the young child's everyday life was described, with experiences of feeling like a stranger, under attack and lonely. Experiences over time of gaining control, making a normality of the illness and treatment and feeling lonely were described. This process may be seen as a striving for an everyday life.

    Conclusions: Nurses have a major role to play in the process of striving the child goes through by giving and updating information, making them participary in their care and assuring access to both parents and peers. Ongoing contact with preschool is vital. Addressing these issues and updating them regularly can assist the young child in their transition to living with cancer. Longitudinal studies with young children are vital in capturing their variety of experiences through the cancer trajectory and necessary to ensure quality care.

  • 5.
    Darcy, Laura
    et al.
    Jönköping University, Sweden;University of Borås, Sweden.
    Björk, Maria
    Jönköping University, Sweden;University of Skövde, Sweden.
    Enskär, Karin
    Jönköping University, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden;University of Borås, Sweden.
    The process of striving for an ordinary, everyday life, in young children living with cancer, at six months and one year post diagnosis2014In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 6, p. 605-612Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Health care focus is shifting from solely looking at surviving cancer to elements of attention relating to living with it on a daily basis.The young child's experiences are crucial to providing evidence based care. The aim of this study was to explore the everyday life of young children as expressed by the child and parents at six months and one year post diagnosis.

    METHODS: Interviews were conducted with children and their parents connected to a paediatric oncology unit in Southern Sweden. A qualitative content analysis of interview data from two time points, six months and one year post diagnosis, was carried out.

    RESULTS: The process of living with cancer at six months and at one year post diagnosis revealed the child's striving for an ordinary, everyday life. Experiences over time of gaining control, making a normality of the illness and treatment and feeling lonely were described.

    CONCLUSION: Nurses have a major role to play in the process of striving for a new normal in the world post-diagnosis, and provide essential roles by giving the young child information, making them participatory in their care and encouraging access to both parents and peers. Understanding this role and addressing these issues regularly can assist the young child in the transition to living with cancer. Longitudinal studies with young children are vital in capturing their experiences through the cancer trajectory and necessary to ensure quality care.

  • 6.
    Darcy, Laura
    et al.
    Jönköping University, Sweden;University of Borås, Sweden.
    Björk, Maria
    Jönköping University, Sweden;University of Skövde, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden;University of Borås, Sweden.
    Granlund, Mats
    Jönköping University, Sweden.
    Enskär, Karin
    Jönköping University, Sweden.
    Following young children's health and functioning in everyday life through their cancer trajectory2016In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 33, no 3, p. 173-189Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge of living with childhood cancer, through the trajectory, is sparse.

    Aim: The aim of this study was to follow young children’s health and functioning in everyday life through their cancer trajectory.

    Methods: Data were gathered longitudinally from a group of 13 young children and their parents connected to a pediatric oncology unit in Sweden. The International Classification of Functioning, Disability and Health for Children and Youth structure was used to identify difficulties in health and functioning in everyday life, in interview and questionnaire data. Descriptive statistical analysis was performed to show patterns of difficulty over a 3-year period from diagnosis.

    Results: Difficulties experienced by children declined and changed over time. An increase in difficulties with personal interactions with others and access to and support from health care professionals was seen 2 to 3 years after diagnosis and start of treatment. Similar patterns are seen within individual children’s trajectories in relation to diagnosis but individual patterns were seen for each child.

    Conclusions and Clinical Implications: Health care professionals need to plan for ongoing contact with school services and information and support pathways, beyond the treatment period. A person-centered philosophy of care is required throughout the cancer trajectory.

  • 7.
    Darcy, Laura
    et al.
    Jönköping University, Sweden.
    Knutsson, Susanne
    University of Borås, Sweden.
    Huus, Karina
    Jönköping University, Sweden.
    Enskär, Karin
    Jönköping University, Sweden.
    The everyday life of the young child shortly after receiving a cancer diagnosis, from both children's and parent's perspectives2014In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 37, no 6, p. 445-456Article in journal (Refereed)
    Abstract [en]

    Background: Providing qualified, evidence-based healthcare to children requires increased knowledge of how cancer affects the young child's life. There is a dearth of research focusing on the young child's experience of everyday life.

    Objective: The purpose of this study was to explore young children's and their parents' perceptions of how cancer affects the child's health and everyday life shortly after diagnosis.

    Methods: Thirteen children with newly diagnosed cancer aged 1 to 6 years and their parents, connected to a pediatric oncology unit in Southern Sweden, participated in this study through semistructured interviews. Child and parent data were analyzed as a family unit, using qualitative content analysis.

    Results: Everyday life was spent at hospital or at home waiting to go back to hospital. Analysis led to the following categories: feeling like a stranger, feeling powerless, and feeling isolated.

    Conclusions: The child wants to be seen as a competent individual requiring information and participation in care. Parents need to be a safe haven for their child and not feel forced to legitimize painful and traumatic procedures by assisting with them. Nurses play a major role in the lives of children. Research with and on the young child is necessary and a way of making them visible and promoting their health and well-being.

    Implications for practice: Nurses need to reevaluate the newly diagnosed child's care routines so as to shift focus from the illness to the child. This requires competent nurses, secure in their caring role.

  • 8.
    Desai, Priti P.
    et al.
    East Carolina Univ, USA.
    Flick, Samantha L.
    Childrens Hosp Philadelphia, USA.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Brimhall, Andrew S.
    East Carolina Univ, USA.
    Practices and Perceptions of Nurses Regarding Child Visitation in Adult Intensive Care Units2020In: American Journal of Critical Care, ISSN 1062-3264, E-ISSN 1937-710X, Vol. 29, no 3, p. 195-203Article in journal (Refereed)
    Abstract [en]

    Background Provision of developmentally appropriate support for child visitors in adult intensive care units (ICUs) would benefit patients and young visitors. Research on best practices for child visitation in adult ICUs is limited. Objectives To explore the perceptions and practices of nurses working in adult ICUs in the United States regarding child visitation and the role of child life specialists in this setting. Methods Data were collected from 446 adult ICU nurses via a cross-sectional survey. The survey explored perceptions and practices regarding child visitation, access to child-friendly resources, and the feasibility of having a child life specialist in adult ICUs. Results Several participants (303, 67.9%) felt that children were at risk for psychological trauma from visiting an adult ICU. Some participants (122, 27.4%) reported that their ICUs did not have policies for child visitation. Logistic regression showed that nurses with a master's degree were 1.8 times (P < .05) more likely to believe that young children (0-5 years) should visit. Nurses (105 of 197, 53.3%) were more likely to allow young children to visit if the patient was the child's parent or if the patient was dying. Child-friendly resources were not routinely available. Nurses expressed that adult ICUs could benefit from child life specialists facilitating child visitation. Conclusions Nurses were inconsistently open to child visitation. Exceptions for older children (> 6 years), children whose parent was the patient, patients' illness severity, and end of life allowed more child visitation. Ways to facilitate child-friendly visitation in adult ICUs are discussed.

  • 9.
    Dinho, Anastazia Emil
    et al.
    Catholic Univ Hlth & Allied Sci, Tanzania;Jönköping University, Sweden.
    Mårtensson, Lena B.
    University of Skövde, Sweden;Univ Queensland, Australia.
    Georgsson, Mattias
    Jönköping University, Sweden.
    Laisser, Rose
    Catholic Univ Hlth & Allied Sci, Tanzania.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Tanzanian midwives' clinical practices and experiences in caring for women with antepartum hemorrhage: a critical incident technique study2024In: BMC Pregnancy and Childbirth, E-ISSN 1471-2393, Vol. 24, no 1, article id 613Article in journal (Refereed)
    Abstract [en]

    Background

    Antepartum hemorrhage (APH) is an obstetric emergency that complicates pregnancy worldwide and continues to lead to hemorrhagic conditions in parts of Tanzania. Midwifery education received by midwives consists theoretical knowledge on the subject but with no or minimal practical skills in the laboratory, which may reduce their practical capacity as graduated midwives. This study therefore aimed to explore midwives' clinical actions and experiences regarding the care of women with APH in Mwanza region.

    Method

    Qualitative, inductive approach with critical incident technique was used. Data were analysed using the critical incident technique, and a question guide consisting of eleven open-ended questions was used to collect data from 44 out of 60 midwives who graduated not less than one year. A total of 522 critical incidents, with 199 actions and 323 experiences, were identified and categorized into five main areas. Ethical approval was obtained.

    Results

    Midwives' clinical actions and experiences in caring for women with APH are affected by the knowledge and skills obtained during training at school. They have insufficient theoretical knowledge and practical skills, leading to inadequate identification of the problem and the implementation of care. A need for additional preventive care is described and structural issues, such as co-operation, referral to other instances, access to equipment and relevant treatments need to be improved.

    Conclusion

    The actions taken to provide care for women with APH were related to their ability to identify problems, implement care and carry out structural initiatives. However, the midwives' experience was influenced by an attempt to understand the seriousness of the situation and the existence of an organizational challenge. The results can provide knowledge and tools to improve midwives' education and clinical practice and in the long run, prevent complications, improves health and minimize suffering in women with APH.

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  • 10.
    Enskär, Karin
    et al.
    Jönköping University, Sweden.
    Björk, Maria
    Jönköping University, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden;University of Borås, Sweden.
    Granlund, Mats
    Jönköping University, Sweden.
    Darcy, Laura
    Jönköping University, Sweden;University of Borås, Sweden.
    Huus, Karina
    Jönköping University, Sweden.
    A Swedish perspective on nursing and psychosocial research in paediatric oncology: A literature review2015In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 19, no 3, p. 310-317Article, review/survey (Refereed)
    Abstract [en]

    PURPOSE: A dramatic improvement in outcomes of survival rates of childhood cancer has been seen. Caring science research is central in providing skills and knowledge to the health care sector, but few overviews of the content of published research have been carried out. The aim of this review was to investigate the content and methodology of published studies in paediatric oncology relevant to caring science, and also to compare possible differences in content and method of the published studies from the nursing and psychosocial perspectives.

    METHOD: A systematic literature review was performed of 137 published articles on paediatric oncology relevant to caring science in Sweden.

    RESULTS: The results show that most of the studies were descriptive or comparative ones with a quantitative design. Most of them focused on parents (43%) or children (28%). Most of the studies investigated wellbeing (88%), using questionnaires (54%) or interviews (38%). Several different measurement instruments had been used. While the results were often clearly presented, the clinical implications were more diffuse. The most acknowledged research fund was the Swedish Childhood Foundation (75%).

    CONCLUSIONS: To reflect the children' perspectives in paediatric oncology require that future researchers take on the challenge of including children (even young ones) in research. The use of a limited number of agreed measurement instruments is desirable. The biggest challenge for the future is to make a shift from explorative to intervention studies. There is an urgent need to transform research results into clinical practice.

  • 11.
    Enskär, Karin
    et al.
    Jönköping University, Sweden.
    Darcy, Laura
    University of Borås, Sweden.
    Björk, Maria
    Jönköping University, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Huus, Karina
    Jönköping University, Sweden.
    Experiences of young children with cancer and their parents with nurses’ caring practices during the cancer trajectory2020In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 37, no 1, p. 21-34Article in journal (Refereed)
    Abstract [en]

    Children with cancer require repeated hospitalizations and the family?s everyday life and routines undergo change. Concrete descriptions of how nurses act when caring for children with cancer throughout the various phases of care and treatment are sparsely highlighted in the literature. The aim of this study was to describe young children with cancer and their parents? experiences of nurses? caring practices over a 3-year period, from diagnosis to follow-up. This study is based on semistructured interviews with 25 children newly diagnosed with cancer, aged 1 to 6 years, and their parents, connected to a pediatric oncology unit in Sweden. Child and parent data were analyzed with a deductive content analysis using Swanson?s theory of caring. The result shows that nurse care practices directed toward young children with cancer and their parents are to some extent similar across a 3-year period from diagnosis to follow-up but also differ in some ways. Nurses? caring practices aim to support children and parents in the transition to a ?new normal.? Child- and family-friendly care processes include the following: creating hope and a trustful relationship, asking rather than assuming, providing knowledge and information, performing tasks skillfully, displaying an interest in the child?s and parents? life outside the hospital, and helping the family to trust in the future and other health care providers. Based on these results, we recommend the development of a standardized and structured nursing care plan or clinical guideline with detailed information on how to carry out clinical nurse care practices in the different phases.

  • 12.
    Enskär, Karin
    et al.
    Jönköping University, Sweden.
    Huus, Karina
    Jönköping University, Sweden.
    Björk, Maria
    Jönköping University, Sweden;University of Skövde, Sweden.
    Granlund, Mats
    Jönköping University, Sweden.
    Darcy, Laura
    Jönköping University, Sweden;University of Borås, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden;University of Borås, Sweden.
    An analytic review of clinical implications from nursing and psychosocial research within Swedish pediatric oncology2015In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 30, no 4, p. 550-559Article in journal (Refereed)
    Abstract [en]

    The purpose of this manuscript is to analyze researchers' suggestions for clinical implications of their findings as stated in recent published articles on nursing and psychosocial research within the setting of Swedish pediatric oncology. Identified categories included staff awareness of the effects of child illness on families; systems for care improvement; provision of quality of care, education and support; and empowerment of children and families. In order to be able to realize these clinical suggestions, expanded research is needed as well as continued education and support for staff.

  • 13.
    Enskär, Karin
    et al.
    Jönköping University, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Huus, Karina
    Jönköping University, Sweden.
    Granlund, Mats
    Jönköping University, Sweden.
    Darcy, Laura
    Jönköping University, Sweden.
    Björk, Maria
    Jönköping University, Sweden.
    A literature review of the results from nursing and psychosocial research within Swedish pediatric oncology2014In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 3, no 6, p. 1-8Article, review/survey (Refereed)
    Abstract [en]

    The body of research-based knowledge in paediatric caring science has been increasing leading to dramaticimprovements in treatment. The purpose of this manuscript was to analyze results as stated by the researchers', inrecently published articles on nursing and psychosocial research, within Swedish pediatric oncology setting. Thiswas done through a review of 137 published articles about paediatric oncology related to caring science in Sweden.The result shows that the illness has affected, in both positive and negative ways, the wellbeing of everyone cominginto contact with the child. The cancer also causes distress related to all aspects of life including physical,psychological, existential and social. Mediating factors for the experience of distress and wellbeing are: disease andtreatment severity, age, gender and ethnicity of the participant, time since diagnosis, the use of internal and externalsupport, and the identity of the person reporting the data. Health promoting aspects frequently reported are: familytogetherness, coping strategies, engaging in normal life and activities, and quality of care which includes emotionalsupport, information and family participation in care. The hospital staff has to be aware of the psychosocial issuesexperienced by children with cancer and their families, and they have to acknowledge the value of formalinterventions, reporting benefits for children, families, and themselves.

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  • 14.
    Golsäter, Marie
    et al.
    Jönköping University, Sweden;Region Jönköping County, Sweden.
    Enskär, Karin
    Jönköping University, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Contributing to making the school a safe place for the child: School nurses’ perceptions of their assignment when caring for children having parents with serious physical illness2017In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 4, p. 267-273Article in journal (Refereed)
    Abstract [en]

    Aim: To explore how school nurses perceive their assignment when caring for children having parents with serious physical illness.

    Design: An explorative inductive qualitative design.

    Method: The study is based on interviews with 16 school nurses. The interviews were subjected to qualitative content analysis.

    Results: The main category, “Contribute in making the school a safe place for the child”, reveals how the school nurses try to contribute to making the school a safe place for a child when his/her parent has a serious physical illness. They support children through individual support, as well as at an overall level in the school health team to make the school, as an organization, a safe place. Routines and collaboration to recognize the child when his/her parent has become ill is described as crucial to accomplishing this assignment

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  • 15.
    Golsäter, Marie
    et al.
    Jönköping University, Sweden;Region Jönköping County, Sweden.
    Enskär, Karin
    Jönköping University, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Parents’ perceptions of how nurses care for children as relatives of an ill patient: Experiences from an oncological outpatient department2019In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 39, p. 35-40Article in journal (Refereed)
    Abstract [en]

    Purpose:

    Research has shown that a child's knowledge about what is happening to a parent when he/she has a cancer disease is crucial to the child's health and wellbeing. Therefore the purpose of this study was to explore parents’ perceptions of how nurses in clinical practice care for children as relatives when one parent in the family has a cancer disease.

    Method:

    A qualitative explorative design with interviews was used. Altogether 28 parents (17 patients and 11 partners) were interviewed. The transcripts from the interviews were subjected to qualitative content analysis.

    Results:

    The parents perceive that the nurses make efforts to support the child as well as them as parents, but feel that the care needs to be more tailored to the specific child and his/her situation. The children are initially invited, generally informed and seen by the nurses, but the parents perceive that they themselves need repeated support and advice over time to uphold their parental responsibility for caring for their children during the illness trajectory.

    Conclusion:

    The parents argue for the importance of receiving repeated advice and support for how to talk to their children about the disease and treatment. The parents describe how the nurses were helpful by asking after the children and explaining the value of their visiting the hospital.

  • 16.
    Golsäter, Marie
    et al.
    Jönköping University, Sweden;Region Jönköping County, Sweden.
    Henricson, Maria
    Jönköping University, Sweden.
    Enskär, Karin
    Jönköping University, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Are children as relatives our responsibility?: How nurses perceive their role in caring for children as relatives of seriously ill patients2016In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 25, p. 33-39Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to elucidate how nurses perceive their role in caring for children as relatives to a parent with a serious physical illness.

    Method: A qualitative explorative design with focus group interviews was used. In total, 22 nurses working at one neurological, one haematological and two oncological wards were interviewed. The transcripts from the interviews were analysed in steps in accordance with inductive qualitative content analysis.

    Results: This study revealed six variations in how nurses perceived their role in the encounter with child relatives, ranging from being convinced that it is not their responsibility to being aware of the children's situation and working systematically to support them.

    Conclusion: Nurses should consider whether their patients have children who might be affected by their parent's illness. The nurses' self-confidence when meeting these children must be increased by education in order to strengthen their professional role. Furthermore, guidelines on how to encounter child relatives are required.

  • 17.
    Golsäter, Marie
    et al.
    Jönköping University, Sweden;Region Jönköping County, Sweden;Linköping University, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Enskär, Karin
    Jönköping University, Sweden;Malmö University, Sweden.
    Children's experiences of information, advice and support from healthcare professionals when their parent has a cancer disease: experiences from an oncological outpatient department2021In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 50, no February, article id 101893Article in journal (Refereed)
    Abstract [en]

    Purpose

    This study was carried out in order to evaluate children's experiences after taking part in the pilot clinical intervention “See Me” aimed at supporting children as relatives.

    Method

    A qualitative explorative design with interviews was chosen, with analyses using an inductive approach. Interviews were conducted with 19 children (9 aged 7–12 years and 10 aged 13–18 years). The younger children were asked to draw a picture of a person in hospital, using the Child Drawing: hospital (CD:H) instrument to measure the child's level of anxiety. The older children completed the Caring Professional Scale (CPS) as a measure of the caring approach in their encounter with the nurse.

    Results

    The interviews with the children show that: they felt expected and welcomed at the hospital; they needed knowledge about their parent's situation; they needed information and participation based on their individual situation; and they needed the nurse to offer them information and support. The results from the pictures showed that one child had above-average levels of anxiety. The older children reported that the nurses were Competent Practitioners, but to a lesser degree that they were Compassionate Healers.

    Conclusions

    The results of this pilot study indicate that the structure of “See Me” could be used as a starting point to ensure that children as relatives receive information, advice, and support. Further the results indicate that both CD:H and CPS could be used to evaluated children's experiences of support when a parent has a long-term illness.

  • 18.
    Hellström, Amanda
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Pakpour, Amir
    Jönköping University, Sweden.
    Odzakovic, Elzana
    Jönköping University, Sweden.
    Björk, Maria
    Jönköping University, Sweden.
    Ulander, Martin
    Linköping University Hospital, Sweden;Linköping University, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandlund, Christina
    Karolinska Institutet, Sweden;Region Stockholm, Sweden.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden;Western Norway Univ Appl Sci, Norway.
    The psychometric properties of the Pearlin Mastery Scale in persons living with restless legs syndrome2024In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 10, article id e0311259Article in journal (Refereed)
    Abstract [en]

    Introduction

    Restless Legs Syndrome (RLS) is a neurological disorder characterized by an urge to move arms and legs, commonly combined with distress, pain and motor restlessness. It can cause fragmented sleep, daytime symptoms, and decreased quality of life. Pharmacological treatment can suppress symptoms, but not cure. When challenged with illness, people may turn to their inner psychological resources such as self-esteem and mastery. The Pearlin Mastery scale was developed to study stress and coping, is commonly used in people with chronic illnesses, however, not yet validated in people with RLS.

    Aim

    The aim was to test reliability and construct validity of the Pearlin Mastery Scale in persons with RLS.

    Methods

    A cross-sectional postal survey including the Pearlin Mastery Scale, Restless Legs Syndrome-6 Scale, Pittsburgh Sleep Quality Index and Patient Health Questionnaire was sent out to members (n = 1500) of the national RLS association and 788 (52.5%) agreed to participate. Data were analyzed using classical test theory, Confirmatory factor analysis and Rasch measurement theory analysis. Hypothesis testing for construct validity was done by bivariate correlation analyses.

    Results

    Most respondents were women (65%), retired (71%) and had a mean-age of 70.8 years (SD 11.4). The 7-item version of the Pearlin Mastery Scale showed poor fit to the one factor model. After omitting the two positively worded items (i.e., item 4 and 6), the 5-item version was found to be unidimensional, with satisfactory internal consistency. However, all items showed considerable ceiling effects. No measurement variance was seen regarding age-groups or sex. Higher level of mastery was moderately correlated with less depressive symptoms but only weakly correlated to RLS-related sleep problems.

    Conclusion

    The 5-item version of the Pearlin Mastery Scale is suggested to be used in persons with RLS due to its acceptable psychometric properties. The instrument could be applied as an outcome measure for behavioral change interventions aiming to support mastery in RLS.

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  • 19.
    Johansson, Lotta
    et al.
    University of Gothenburg, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Bergbom, Ingegerd
    University of Gothenburg, Sweden;University of Borås, Sweden.
    Lindahl, Berit
    University of Borås, Sweden.
    Noise in the ICU patient room: Staff knowledge and clinical improvements2016In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 35, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Introduction: The acoustic environment in the intensive care unit patient room, with high sound levels and unpredictable sounds, is known to be poor and stressful. Therefore, the present study had two aims: to investigate staff knowledge concerning noise in the intensive care unit and: to identify staff suggestions for improving the sound environment in the intensive care unit patient room.

    Method: A web-based knowledge questionnaire including 10 questions was distributed to 1047 staff members at nine intensive care unit. Moreover, 20 physicians, nurses and enrolled nurses were interviewed and asked to give suggestions for improvement.

    Results: None of the respondents answered the whole questionnaire correctly; mean value was four correct answers. In the interview part, three categories emerged: improving staff's own care actions and behaviour; improving strategies requiring staff interaction; and improving physical space and technical design.

    Conclusion: The results from the questionnaire showed that the staff had low theoretical knowledge concerning sound and noise in the intensive care unit. However, the staff suggested many improvement measures, but also described difficulties and barriers. The results from this study can be used in the design of future interventions to reduce noise in the intensive care unit as well as in other settings.

  • 20.
    Johansson, Lotta
    et al.
    University of Gothenburg, Sweden.
    Lindahl, Berit
    University of Borås, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Ögren, Mikael
    University of Gothenburg, Sweden.
    Persson Waye, Kerstin
    University of Gothenburg, Sweden.
    Ringdal, Mona
    University of Gothenburg, Sweden.
    Evaluation of a sound environment intervention in an ICU: A feasibility study2018In: Australian Critical Care, ISSN 1036-7314, E-ISSN 1878-1721, Vol. 31, no 2, p. 59-70Article in journal (Refereed)
    Abstract [en]

    Background: Currently, it is well known that the sound environment in intensive care units (ICU) is substandard. Therefore, there is a need of interventions investigating possible improvements. Unfortunately, there are many challenges to consider in the design and performance of clinical intervention studies including sound measurements and clinical outcomes.

    Objectives: (1) explore whether it is possible to implement a full-scale intervention study in the ICU concerning sound levels and their impact on the development of ICU delirium; (2) discuss methodological challenges and solutions for the forthcoming study; (3) conduct an analysis of the presence of ICU delirium in the study group; and (4) describe the sound pattern in the intervention rooms.

    Methods: A quasi-randomized clinical trial design was chosen. The intervention consisted of a refurbished two-bed ICU patient room (experimental) with a new suspended wall-to-wall ceiling and a low frequency absorber. An identical two-bed room (control) remained unchanged.

    Inclusion criteria: Patients >18 years old with ICU lengths of stay (LoS) >48. h. The final study group consisted of 31 patients: six from the rebuilt experimental room and 25 from the control room. Methodological problems and possible solutions were continuously identified and documented.

    Results: Undertaking a full-scale intervention study with continuous measurements of acoustic data in an ICU is possible. However, this feasibility study demonstrated some aspects to consider before start. The randomization process and the sound measurement procedure must be developed. Furthermore, proper education and training are needed for determining ICU delirium.

    Conclusion: This study raises a number of points that may be helpful for future complex interventions in an ICU. For a full-scale study to be completed a continuously updated cost calculation is necessary. Furthermore, representatives from the clinic need to be involved in all stages during the project. 

  • 21.
    Knutsson, Susanne
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Green Sustainable Development.
    Axelsson, Johanna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lindqvist, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    An application of the caritative caring approach - nursing students' experiences of practising caring and uncaring encounters by simulation at a clinical training centre2022In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 17, no 1, article id 2100610Article in journal (Refereed)
    Abstract [en]

    Purpose Nurses' lack of competence to be caring affects patients' health and patients describe a desire for more individual and compassionate care. Nursing education tends, however, to focus less on the caring approach in nursing practice and more on developing knowledge in psychomotor skills. The aim of this study was to describe nursing students' experiences of simulating caring and uncaring encounters founded on the caritative perspective at a Clinical Training Centre (CTC). Method A qualitative, inductive approach using a qualitative latent content analysis. Written reflections of 49 students were analysed. Findings By intertwining reflection with acting and observation, the students experienced that they achieved an open mind and gained an understanding of how important it was to treat the patient based on a caring approach. To act, first uncaring and thereafter caring, gave them an awakening. The students were touched and an overwhelming feeling of suddenly understanding human uniqueness and vulnerability appeared. Conclusions To simulate caritative caring and uncaring encounters at the CTC enhanced students' knowledge and understanding about caring and strengthened their prerequisites to acquire a caritative ontological basic view and attitude which in the long run may lead to an increased feeling of patient well-being in the encounter.

  • 22.
    Knutsson, Susanne
    et al.
    Borås Hospital, Sweden.
    Bergbom Engberg, Ingegerd
    Karlstad University, Sweden.
    An evaluation of patients' quality of life before, 6 weeks and 6 months after total hip replacement surgery1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 30, no 6, p. 1349-59Article in journal (Refereed)
    Abstract [en]

    Annually, throughout the world, more than 800,000 primary total hip replacement surgery procedures are performed on patients suffering from hip joint arthrosis. Since 1991, approximately 11,000 of these procedures are performed annually in Sweden. This study aimed to investigate any changes in the patients' life quality 6 weeks and 6 months after their total hip replacement surgery had been performed, compared to that immediately prior to the operation. It also aimed to examine the reason for surgery, the types of prostheses used, postoperative pain, complications and the actual usage of ambulation support. The Sickness Impact Profile self-appraisal instrument, together with personal patient interviews have been used as the basis of the research. A total of 51 patients responded to the quality of life instrument prior to their operation, 47 of these participated 6 weeks after the operation, and 40 patients 6 months after the operation. Significant differences in patients' total, physical and psychosocial quality of life 6 months postoperatively compared to the situation prior to the operation were found, but not between the situation before and 6 weeks after the total hip replacement surgery. The majority of patients were of the opinion that it was more important that the pain had disappeared or decreased, than any overall increase in the quality of life. Postoperative complications occurred within 6 weeks, and even after 6 months some patients still suffered from these.

  • 23.
    Knutsson, Susanne
    et al.
    Jönköping University, Sweden.
    Bergbom, Ingegerd
    University of Gothenburg, Sweden.
    Children's thoughts and feelings related to visiting critically ill relatives in an adult ICU: A qualitative study2016In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 32, p. 33-41Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    To describe and understand children's thoughts and feelings related to visiting critically ill relatives or family members in an adult intensive care unit.

    DESIGN:

    A qualitative descriptive study.

    METHOD:

    Twenty-eight children (14 girls; 14 boys) that had visited a critically ill relative or family member in an adult intensive care unit were invited to participate in an interview. The material was analysed inspired by Gadamer's hermeneutic philosophy and Doverborg and Pramling Samuelsson's method about interviews and dialogues with children.

    RESULTS:

    Children with a seriously ill/injured relative suffer. However, visiting seems to alleviate suffering. Visiting and being present as a part of the situation brought positive feelings of involvement and made it possible to show that they wanted to care for the relative. The sick relative was always on the child's mind and seeing and being with them in the intensive care unit resulted in relief and calmness, even if the relative's situation sometimes evoked feelings of despair and fear.

    CONCLUSION:

    Knowledge and awareness of the fact that children are affected by the relative's condition and for their wellbeing needs to visit, caring actions must focus on helping the child become involved in the relative's situation in order to alleviate suffering.

  • 24.
    Knutsson, Susanne
    et al.
    Jönköping University, Sweden.
    Bergbom, Ingegerd
    Nurses' and physicians' viewpoints regarding children visiting/not visiting adult ICUs.2007In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 12, no 2, p. 64-73Article in journal (Refereed)
    Abstract [en]

    Allowing children to visit adult intensive care units (ICUs) has been an area of controversy. There is a lack of recent research dealing with visits by children and physicians' views and whether differences exist between the views held by nurses and physicians regarding visits by children. The aim of this study was to describe and compare reasons given by nurses and physicians for restricting visits by children to a relative hospitalized in an adult ICU. This was a quantitative, descriptive multicentre study. Nurses and physicians (n = 291) at 72 general adult ICUs participated, each completing a questionnaire. A majority of the nurses and physicians were positive to children visiting patients in ICU, but they also imposed restrictions. The most common reasons were: severity of the patient's injury (50%); the environment was frightening for the child (50%); the infection risk for the child (36%) and the patient (56%). Children <7 years were restricted more than those >7 years. Nurses were more positive than physicians to visits by younger children. Physicians were more positive to visits if the patient was tired and critically ill/injured or was a friend/cousin. More physicians refused visits due to the fact that children are too noisy for the staff. Risks of negative effects on the children's health by visiting patients were also stated. Nurses and physicians still restrict children's visits to adult ICUs for a number of reasons, and nurses' and physicians' views on children visiting differ and so also the views within each professional group. The differences in views show that the dynamics are complicated and this could be attributed to a lack of a common view of care, which prevents family-centred care that includes children from being practised.

  • 25.
    Knutsson, Susanne
    et al.
    University of Gothenburg, Sweden.
    Bergbom, Ingegerd L.
    University of Gothenburg, Sweden.
    Custodians’ viewpoints and experiences from their child’s visit to an ill or injured nearest being cared for at an adult intensive care unit2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 2, p. 362-371Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe custodians' experiences of their child's visit to an ill/injured nearest being cared for at an adult intensive care unit (ICU), their thoughts about the visit in relation to the child's health/well being and who initiated the visit.

    BACKGROUND: Custodians can feel undecided about whether to allow their children to visit the ICU or not. They wonder how important it is for the child to visit, as well as the consequences, and attempt to protect the child from information/experiences that could provoke anxiety or threaten the child's health.

    DESIGN: Quantitative and descriptive.

    METHOD: Thirty custodians answered a questionnaire.

    RESULTS: It was mainly custodians and their children and not staff who initiated the children's visits. Many children were not informed by staff and the responsibility lay instead with the custodians. The importance of giving children adequate information before, during and after the visit was pointed out. The custodians reported that their child's reactions to the visit differed, i.e. reactions reflecting happiness but also sadness; the visit was good for the child, increased awareness of the nearest's condition and appreciation of the hospital staff and their work; if the visit did not take place the child would be left with thoughts and conjectures; their children were not frightened when they saw the equipment and instead they became curious; older children were more focused on the patient while younger children were interested in both the equipment and the patient. Many children asked questions/made comments during the visit. Many custodians were of the opinion that visiting is not a risk to future health and well being.

    CONCLUSIONS: This issue must be addressed and discussed and strategies need to be developed to improve the nurses' obligation to involve visiting children in the care that is/should be provided to a member of the patient's family.

    RELEVANCE TO CLINICAL PRACTICE: Nurses need to take more initiative when discussing children's visits with the custodians. Nurses also need to discuss how to meet, inform, support and care for visiting children and their custodians in relation to health and well being. Recommendations/guidelines about children visiting that take both the patient's and child's needs into consideration needs to be developed based on scientific knowledge. Findings from this study may draw attention to children visiting ICUs and encourage nurses to discuss children visiting with custodians and to develop family-centred care at the ICU that includes children.

  • 26.
    Knutsson, Susanne
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bjork, Maria
    Jönköping University, Sweden.
    Odzakovic, Elzana
    Jönköping University, Sweden.
    Hellström, Amanda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandlund, Christina
    Karolinska Institutet, Sweden;Region Stockholm, Sweden.
    Ulander, Martin
    Linköping University, Sweden;Linköping University Hospital, Sweden.
    Lind, Jonas
    Linköping University, Sweden;County Hospital Ryhov, Sweden.
    Fridlund, Bengt
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Pakpour, Amir
    Jönköping University, Sweden.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden;Western Norway Univ Appl Sci, Norway.
    The ethos brief index-validation of a brief questionnaire to evaluate wellness based on a holistic perspective in patients with restless legs syndrome2024In: Sleep and Breathing, ISSN 1520-9512, E-ISSN 1522-1709, Vol. 28, no 4, p. 1781-1791Article in journal (Refereed)
    Abstract [en]

    Purpose

    The aim of this study was to validate the Ethos Brief Index (EBI) in patients with Restless Legs Syndrome (RLS).

    Methods

    A cross-sectional design, including 788 subjects with RLS (65% women, 70.8 years, SD 11.3) from the Swedish RLS Association, was used. A postal survey was sent out to collect data regarding socio demographics, comorbidities, and RLS-related treatment data. Questionnaires included were EBI, the Restless Legs Syndrome-6 Scale (RLS-6), Restless Legs Syndrome-Quality of Life questionnaire (RLSQoL), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). The validity and reliability of the EBI were investigated using Rasch and confirmatory factor analysis (CFA) models. Measurement invariance, unidimensionality, and differential item functioning (DIF) across age and gender groups, as well as insomnia, daytime sleepiness, RLS-related QoL and RLS severity were assessed.

    Results

    The results supported the unidimensionality of the EBI in the CFA (i.e., explaining 61.5% of the variance) and the Rasch model. The reliability of the EBI was confirmed using composite reliability and Cronbach's alpha. No DIF was identified for gender, age, insomnia, daytime sleepiness, RLS severity or RLS-related QoL.

    Conclusion

    The EBI showed good validity and reliability and operated equivalently for male and female patients with RLS. Accordingly, healthcare professionals can use the EBI as a psychometrically sound tool to explore and identify patient-centered problems related to the whole life situation.

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  • 27.
    Knutsson, Susanne
    et al.
    Jönköping University, Sweden.
    Enskär, Karin
    Jönköping University, Sweden.
    Andersson-Gäre, Boel
    Region Jönköping County, Sweden;Jönköping University, Sweden.
    Golsäter, Marie
    Jönköping University, Sweden;Region Jönköping County, Sweden.
    Children as relatives to a sick parent: Healthcare professionals’ approaches2017In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 37, no 2, p. 61-69Article in journal (Refereed)
    Abstract [en]

    An illness or injury sustained by a family member affects all family members. It is consequently important that a child’s need to be involved in a family member’s care is clearly recognized by healthcare professionals. The aim of this study was to describe healthcare professionals’ approaches to children as relatives of a parent being cared for in a clinical setting. A web-based study-specific questionnaire was sent and responded to by 1052 healthcare professionals in Sweden. Data were analysed using descriptive statistics and qualitative analysis. The results show that guidelines and routines are often lacking regarding involving children in the care of a parent. Compared to other areas, psychiatric units seem to have enacted routines and guidelines to a greater extent than other units. The results indicate that structured approaches based on an awareness of the children’s needs as well as a child-friendly environment are vital in family-focused care. These aspects need to be prioritized by managers in order to support children’s needs and promote health and wellbeing for the whole family.

  • 28.
    Knutsson, Susanne
    et al.
    Jönköping University, Sweden.
    Enskär, Karin
    Jönköping University, Sweden.
    Golsäter, Marie
    Jönköping University, Sweden;Jönköping Region, Sweden.
    Nurses' experiences of what constitutes the encounter with children visiting a sick parent at an adult ICU2017In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 39, p. 9-17Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Despite a cultural change in visitation policies for children (0-17 years) in the intensive care unit (ICU) to a more open approach, children are still restricted from visiting for various reasons. To overcome these obstacles, it is vital to determine what is needed while encountering a child.

    AIM:

    To elucidate nurses' experiences of what constitutes the encounter with children visiting a sick parent in an adult ICU.

    METHOD:

    An explorative inductive qualitative design was used, entailing focus group interviews with 23 nurses working at a general ICU. The interviews were analysed according to inductive content analysis.

    RESULTS:

    The findings show components that constitute the encounter with children as relatives at the ICU, as experienced by ICU nurses: nurses need to be engaged and motivated; parents need to be motivated; the child needs individual guidance; and a structured follow-up is needed. This reflects a child-focused encounter.

    CONCLUSIONS:

    Nurses need to adopt a holistic view, learn to see and care for the child individually, and be able to engage parents in supporting their children. To accomplish this the nurses need engagement and motivation, and must have knowledge about what constitutes a caring encounter, in order to achieve a caring child-focused encounter.

  • 29.
    Knutsson, Susanne
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Golsäter, Marie
    Region Jönköping County, Sweden;Linköping University, Sweden.
    Enskär, Karin
    Malmö University, Sweden.
    The meaning of being a visiting child of a seriously ill parent receiving care at the ICU2021In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 16, no 1, article id 1999884Article in journal (Refereed)
    Abstract [en]

    Purpose

    Children's visits to the ICU are still restricted, and more focus on the child's own needs and experiences are needed. The aim of this study is to illustrate the meaning of being a visiting child of a seriously ill parent receiving care at the ICU.

    Method

    A qualitative descriptive design was used, with open-ended interviews with seven children (6-18 years) performed and analysed using a phenomenological research approach.

    Findings

    Being a visiting child of a seriously ill parent receiving care at the ICU is described as a life situation taking place in an unfamiliar environment, characterized by a heartfelt, genuine desire to be there, in an interdependence entailing offering a loved one the help they need while at the same time being seen in a compassionate way and being able to share, revealing a sudden awakening of an inner truth of reality and a sense of a healing wisdom of understanding.

    Conclusions

    The children felt good when they visited their ill parent, but at the same time not fully involved, and desired a more compassionate, caring approach by the nurses. Improvements are needed in how to approach visiting children in a more individual and caring way.

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  • 30.
    Knutsson, Susanne
    et al.
    Jönköping University, Sweden;University of Borås, Sweden.
    Jarling, Aleksandra
    University of Borås, Sweden.
    Thorén, Ann-Britt
    University of Borås, Sweden.
    It has given me tools to meet patients’ needs’: students' experiences of learning caring science in reflection seminars2015In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 16, no 4, p. 459-471Article in journal (Refereed)
    Abstract [en]

    This qualitative study aims to describe nursing students’ experiences of learning caring science by using reflection seminars as a didactic model. A reflective lifeworld research approach according to Husserl’s phenomenological philosophy was used. Findings suggest that reflective seminars increased understanding of caring science, other people and one’s self. Moreover, substance-oriented reflection and lifeworld perspectives provided a good learning environment. Learning prerequisites were found to be openness, honesty, respect, trust, security, justice, parity and shared responsibilities along with having a common platform and a clear framework. These findings highlight conditions for a culture conducive to learning and for gaining embodied knowledge, but also present concerns regarding the difficulty and importance of establishing a good learning environment. A need to create meaningfulness, establish caring as conscious, reflective acts and show the value in personal differences were also found. These findings offer an important perspective necessary for preparing nurses to perform good quality care.

  • 31.
    Knutsson, Susanne
    et al.
    Jönköping university, Sweden.
    Lundvall, Maria
    University of Borås, Sweden.
    Lindberg, Elisabeth
    University of Borås, Sweden.
    Participating in reflection seminars: Progressing towards a deeper understanding of caring science described by nursing students2018In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, no 2, p. 111-116Article in journal (Refereed)
    Abstract [en]

    Few studies focus on how reflection seminars can support the learning of knowledge in caring science when inserted throughout the curriculum. The aim of this study was to describe students’ experiences of participating in reflection seminars, using lifeworld theory and focusing on caring science. A qualitative descriptive study based on interviews was carried out, and ten students between 21 and 33 years of age volunteered to participate. A reflective lifeworld research approach was used. Reflection seminars contribute to developing students’ ability to relate to caring and life. A deeper understanding is obtained when reflection sessions are spread over a longer period and when reflection becomes a process. The process helps caring science to become more natural and useful. Reflective seminaries based on a theoretical foundation contribute to facilitate learning more readily. A good atmosphere pervaded by a lifeworld perspective characterized by openness and thoughtfulness contributes to learning.

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  • 32.
    Knutsson, Susanne
    et al.
    University of Gothenburg, Sweden.
    Otterberg, Cecilia L.
    Sahlgrenska University Hospital, Sweden.
    Bergbom, Ingegerd L.
    University of Gothenburg, Sweden.
    Visits of children to patients being cared for in adult ICUs: policies, guidelines and recommendations2004In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 20, no 5, p. 264-274Article in journal (Refereed)
    Abstract [en]

    Little is known about the frequency of children visiting their nearest relatives in adult ICUs or if there are any policies/guidelines or recommendations regarding these. The aims of this multi-centre descriptive study were to survey Swedish ICUs policies/guidelines or recommendations, and examine the reasons given both for and against restricting child visits; if parents/guardians sought advice in connection with such visits, and if any differences in demographic data could be ascertained. Fifty-six Lead Nurse Managers (LNM), representing as many general adult ICUs, participated by answering a questionnaire. Only one ICU had written policy/guidelines concerning child visits; most ICUs (70%) had no policies/guidelines at all. All LNMs reported that their ICU was positive to child visits, but only two actively encouraged these. Nineteen (34%) of the ICUs restricted child visits. More than 50% of the LNMs reported that only about half of their patients ever had visits from children. Seventy percent of the ICUs had no restrictions on visiting hours, but 30% imposed some form of restriction. Twenty LNMs reported that 75% of the parents/guardians of children 0-6 years old asked for advice about child visits. However, those responsible for children >12 years of age seldom asked for any advice at all.

  • 33.
    Knutsson, Susanne
    et al.
    University of Gothenburg, Sweden.
    Samuelsson, Ingrid Pramling
    University of Gothenburg, Sweden.
    Hellström, Anna-Lena
    University of Gothenburg, Sweden.
    Bergbom, Ingegerd
    University of Gothenburg, Sweden.
    Children's experiences of visiting a seriously ill/injured relative on an adult intensive care unit2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 61, no 2, p. 154-162Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study of children's experiences of visiting a seriously ill/injured relative in an intensive care unit.

    BACKGROUND: Little attention has been paid to children's experiences and needs when visiting a relative being cared for at a high technological adult intensive care unit. Instead, the focus has been on adult's experiences and needs.

    METHOD: In 2004, 28 children (14 girls, 14 boys) aged 4-17 years who had visited an adult relative were interviewed 3 months after the visit. A hermeneutic approach was used when interpreting and analysing the text.

    FINDINGS: Four themes were generated from the data: It meant waiting, It was strange, It was white and It was good. Waiting was experienced as difficult, increasing the feeling of uncertainty, exclusion and separation, which in turn led to tension and concern. 'It was strange' was perceived as unfamiliar but also with interest and curiosity. The experience of the intensive care unit was that it was white. Everything in the patient's room was experienced as white and gloomy. It lacked joy. 'It was good' was stated about the outcome of the visit because through this they were given the opportunity to meet and see the relative by themselves. This evoked feelings of relief and joy. The visit did not seem to frighten the child; instead it generated feelings of release and relief.

    CONCLUSION: Children's experiences of visiting an adult intensive care unit seem to support theories that emphasize the involvement and participation of children in family matters.

  • 34.
    Koldestam, Maria
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Jönköping, Sweden;Linköping University, Sweden.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Supervisors’ experiences of undergraduate nursing students’ learning in clinical practice when applying caring and learning as parallel processes in a caritative caring conceptual learning model (Part 2)2021In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 52, no March, article id 103004Article in journal (Refereed)
    Abstract [en]

    The Model for Improvements in Learning Outcomes (MILO) is theoretically grounded and designed to intertwine didactics, pathophysiology and medicine with specific concepts important for learning. The aim was to describe supervisors’ experiences of undergraduate nursing students’ learning during clinical practice when using MILO. A qualitative and explorative design was used. Seventeen supervisors, thirteen women and four men from different departments at three hospitals in southern Sweden participated. After using the model, data were collected through four focus group interviews with open unstructured interview questions and analysed using inductive latent content analysis. Twelve subcategories, four generic subcategories and one main category emerged. The students developed a questioning approach and were more reflective, open and compliant. Twosomes enhanced learning. Specific documents generated structure and feelings of participation. The supervisors felt that taking the students’ pre-understanding into account and a caring approach in the learning environment were valuable for enhanced learning. The students established a caring relationship with the patients and the patients’ perspective became emphasized. Using MILO, intertwining between the natural and the professional became possible; enhanced learning in nursing skills together with a more caritative caring approach towards the patient was revealed. The need of compassion is discussed. 

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  • 35.
    Koldestam, Maria
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Jönköping, Sweden.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden.
    Petersson, Christina
    Jönköping University, Sweden;Region Jönköping, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Model for Improvements in Learning Outcomes (MILO): Development of a conceptual model grounded in caritative caring aimed to facilitate undergraduate nursing students’ learning during clinical practice (Part 1)2021In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 55, no August, article id 103144Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to describe the development of a caritative caring conceptual model aimed to facilitate undergraduate nursing students’ learning during clinical practice.

    Design: An explorative design was used.

    Methods: The Delphi method with a panel of 12 experts together with a literature search with a systematic approach were used and data were analysed according to content analysis.

    Results: The Model for Improvements in Learning Outcomes (MILO) consists of eight core concepts divided into four intrapersonal concepts (nursing, a reflective approach, a critical approach, quality and safety) and four contextual concepts (peer learning, co-clinical teachers, student-centred and student-active supervision, a good learning environment). MILO is grounded in the theory of caritative caring with a hermeneutic approach and the understanding of caring and learning as parallel processes. Tools such as reflection, structure and guiding pm are used to intertwine caring, nursing, pathophysiology and medicine.

    Conclusions: MILO intertwines didactics with concepts important for nursing students’ learning with a foundation in caritative caring and may facilitate undergraduate nursing students’ learning in clinical practice.

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  • 36.
    Koldestam, Maria
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Jönköping county, Sweden;Linköping University, Sweden.
    Rolander, Bo
    Region Jönköping county, Sweden;Jönköping University, Sweden.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden;Western Norway University of Applied Sciences, Norway.
    Lindqvist, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Undergraduate nursing student's attitudes to learning during clinical practice in different semesters when using a conceptual learning model grounded in a caritative caring perspective – A cross-sectional study2024In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 38, no 2, p. 294-305Article in journal (Refereed)
    Abstract [en]

    Aim:To describe undergraduate nursing students' attitudes to learning during clinical practice in different semesters when using the conceptual learning model, Model for Improvements in Learning Outcomes (MILO) grounded in a caritative caring perspective.

    Background: With the intention to support interlinking between theory and praxis and offer understanding and structure to facilitate learning, MILO, theoretically grounded in hermeneutics and a caritative caring perspective based on ethical values, was implemented. MILO consists of four contextual concepts (peer learning, co-clinical teachers, student-centred and student-active supervision) and four intrapersonal concepts (nursing, a reflective approach, a critical approach, quality and safety).

    Methods: A descriptive comparative quantitative study design was applied at a Swedish university, 3 hospitals and 13 municipalities in one county. Cross-sectional data collected via a questionnaire developed to assess attitudes to learning related to MILO's contextual and intrapersonal concepts and their applications were used.

    Results: 209 students in semester 3, 4 and 6 participated in 6 different clinical practice courses. In comparison, intrapersonal concepts, that is, the student's own characteristics and abilities were viewed to be of greater value for learning than contextual, that is, organisational-related concepts in all semesters. Understanding the needs of others and reflective learning were rated to be of major importance. Students in semester 3 valued the use of the applications the highest. To be supervised in pairs was rated the lowest in semester 6. Some of the concepts and their applications were to great extent not applied.

    Conclusions: In all semesters, fundamentals in caritative caring and characteristics and abilities related to the individual student were rated to be of greater importance for learning than environmental support. Providing students opportunities to develop independency seems essential. Use of a learning model such as MILO is dependent on a bearing of a caritative caring culture and a shared understanding between all involved in student learning during clinical practice.

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  • 37.
    Lindberg, Elisabeth
    et al.
    University of Borås, Sweden.
    Karlsson, Pernilla
    University of Borås, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Reflective seminaries grounded in caring science and lifeworld theory: A phenomenological study from the perspective of nursing students2018In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 61, p. 60-65Article in journal (Refereed)
    Abstract [en]

    Background

    Creative strategies are needed in nurse education to integrate theory, practice and lived experiences. Towards that end, reflective seminars, conducted in congruence with reflective lifeworld theory and caring science, were implemented during a three-year nursing programme. The reflection seminars took place during the theoretical parts of education and the clinical placements. Each reflection group consisted of six to nine students, and the seminars were led by a lecturer from the university.

    Objectives

    This article aims to describe the experiences of learning about caring science by participating in reflective seminars that were integrated into courses during a three-year nursing education programme.

    Design

    A phenomenological approach was used, and qualitative group interviews were conducted.

    Setting

    The study was conducted at a university in southern Sweden.

    Participants

    Twenty three students, 19 women and four men, volunteered to participate. All participants were at the end of a three-year nurse education programme. Data were collected through four group interviews with five to seven participants in each group.

    Methods

    This study used a reflective lifeworld research approach based on phenomenological philosophy.

    Results

    The findings reveal that nursing students experience reflective seminars as being valuable for their professional development. The result is described in more detail via four meaning units: An obtained awareness of the value of reflection in clinical practice; Reflection contributes to an approach of thoughtfulness; Caring science has become second nature, and Reflection as a strength and a challenge at the threshold of a profession.

    Conclusions

    This study contributes to the understanding of reflective seminars grounded in lifeworld theory as a didactic strategy that enables students to increase their knowledge of caring science and develop their reflective skills.

  • 38.
    Lindqvist, Gunilla
    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.
    Rolander, Bo
    Region Jönköping County, Sweden;Jönköping University, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Nursing students' experiences of clinical practice at a clinical training centre during the Covid-19 pandemic2024In: Nordisk sygeplejeforskning, ISSN 1892-2678, E-ISSN 1892-2686, Vol. 14, no 3, article id 2Article in journal (Refereed)
    Abstract [en]

    Background: To stimulate the learning process for nursing students, theory and practice need to be integrated by means of practice at a clinical training centre (CTC). The Covid-19 pandemic was a challenge in relation to this. The aim of this study was to describe and compare the experiences of clinical practice at the CTC among nursing students during the Covid-19 pandemic. Methods: It is a crosssectional study using both quantitative and qualitative design. Data were analysed using both descriptive statistics and qualitative analysis. Results: Due to the pandemic restrictions and distance education the students reported frustration over the lack of materials and 15.1% of the students reported poor/very poor experience of clinical training. The results point out the importance of being able to link caring theory with nursing practice at the CTC, no matter the circumstances, and how unity among the teachers regarding what to learn, conditions and goals is vital.

  • 39.
    Magnusson, Carl
    et al.
    Ambulans- och Prehospital Akutsjukvård, Göteborg.
    Ekebergh, Margaretha
    University of Borås, Sweden.
    Jutengren, Göran
    University of Borås, Sweden.
    Knutsson, Susanne
    Jönköping university, Sweden.
    Patientnärmre vård: En observationsstudie av sjuksköterskans tid för patientnära vård2014In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 34, no 4, p. 4-9Article in journal (Refereed)
    Abstract [en]

    The aim: To conduct a follow up study to measure registered nurses’ time of direct patientcare after implementation of patientfocused care(PFC).

    Background: PFC is an organizational model with the objective to increase both patient participation and health care effectiveness. After areconstruction of wards to single bedrooms in a hospital south of Sweden. PFC was implemented to increase time for direct patientcare inorder to better meet patients’ needs.

    Method: Time measured observations were conducted. 20 registered nurses were observed in four different wards at a 525-bed hospital insouth of Sweden after implementation of PFC.

    Findings: In a workday of 8,5 hrs, registered nurses spend 6,8 hrs (79,8 %) with work related to patients. Time for directcare was 2 hrs(23,8 %) and time for indirect care was 4,8 hrs (56 %). Indirect care consists of categories such as documentation, report and medical round.

    Conclusion: In comparison before implementation of PFC, time for patientrelated care increased by 10,8 %. However, time is spent mainlyat patient indirectcare activities. It is important to also focus on a change of culture in the organization to succeed with an implementationof PFC.

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  • 40.
    Magnusson, Carl
    et al.
    Sahlgrenska University Hospital, Sweden.
    Källenius, Christofer
    Kungälv Ambulance Service, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Axelsson, Christer
    Sahlgrenska University Hospital, Sweden.
    Pre-hospital assessment by a single responder: The Swedish ambulance nurse in a new role: A pilot study2016In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 26, p. 32-37Article in journal (Refereed)
    Abstract [en]

    When a person with vague symptoms calls 112, the dispatchers often have difficulty prioritising the severity of the call. Their only alternative has been to send an ambulance. In Gothenburg, Sweden, a nurse-manned single responder (SR) was initiated to assess this patient group. The study aims to describe patient characteristics and assessment level made by the SR nurse among patients assessed by the dispatcher as low priority and/or vague symptoms. A consecutive journal review was conducted. During six months, 529 patients were assessed; 329 (62%) attended the emergency department (ED) or inpatient care (IC). Of these, 85 patients (26%) were assessed as high priority. Only 108 were assessed as being in need of ambulance transport. ED/IC patients were significantly older. Two hundred (38%) stayed at the scene (SS) (n = 142) or were referred to primary care (PC) (n  = 58). Of the 200 SS/PC patients, 38 (19%) attended the ED within 72 hrs with residual symptoms, 20 of whom were admitted to a ward. Nine patients (4% of 200 SS/PC patients) required inpatient treatment and 11 patients stayed overnight for observation. These results suggest a relatively high level of patient safety and the usefulness of an SR among patients assessed by the dispatcher as low priority.

  • 41.
    Mårtensson, Sophie
    et al.
    Jönköping university, Sweden.
    Hodges, Eric A.
    Univ N Carolina, USA.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Carina
    Linköping University, Sweden.
    Broström, Anders
    Jönköping university, Sweden;Linköping University Hospital, Sweden.
    Swanson, Kristen M.
    Seattle Univ, USA.
    Björk, Maria
    Jönköping university, Sweden.
    Caring Behavior Coding Scheme based on Swanson's Theory of Caring - development and testing among undergraduate nursing students2021In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 4, p. 1123-1133Article in journal (Refereed)
    Abstract [en]

    Rationale To maintain patients' dignity and well-being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers' non-caring behaviours. Defining and measuring both verbal and nonverbal caring and non-caring behaviour in healthcare delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients. Aim The aim was to develop and test a Caring Behavior Coding Scheme based on Swanson's Theory of Caring. Method An instrument development process was used for behavioural coding including observational data from thirty-eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient. Result The Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non-caring in accordance with Swanson's Theory of Caring. Content and face validity were assessed. Timed-event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter-rater reliability (k = 0.82). All domains in Swanson's Theory of Caring were observed and coded in the interaction. Discussion/Conclusion The CBCS is a theory-based instrument that contributes to research on healthcare providers' behavioural encounters. It uses verbal and nonverbal caring and non-caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers' caring behaviour with the intended outcome of patient well-being.

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  • 42.
    Mårtensson, Sophie Kjerstin
    et al.
    Jönköping University, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Hodges, Eric A.
    University of North Carolina at Chapel Hill, USA.
    Sherwood, Gwen
    University of North Carolina at Chapel Hill, USA.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden.
    Björk, Maria
    Jönköping University, Sweden.
    Undergraduate Nursing Students’ Experiences of Learning Caring Using a Variety of Learning Didactics2022In: International journal for human caring, ISSN 1091-5710, Vol. 26, no 3, p. 145-158Article in journal (Refereed)
    Abstract [en]

    This study examines undergraduate nursing students’ experiences of participatingin a Caring Behavior Course using various learning didactics. Twenty-five studentsparticipated in one of five focus group interviews with data analyzed according to qualitativecontent analysis. The main theme to emerge, an insightful and sudden awakeningthat caring is not only theoretical words, was further explained with three themes andnine subthemes. The Caring Behavior Course demonstrates effective learning didacticsto develop awareness of values that influence caring behaviors and can contribute topatient well-being, particularly relevant for the care challenges in the time of COVID-19and beyond.

  • 43.
    Mårtensson, Sophie
    et al.
    University of Skövde, Sweden;Jönköping University, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Hodges, Eric A.
    Univ North Carolina Chapel Hill, USA.
    Sherwood, Gwen
    Univ North Carolina Chapel Hill, USA.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden.
    Björk, Maria
    Jönköping University, Sweden.
    Development of caring behaviour in undergraduate nursing students participating in a caring behaviour course2024In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 38, no 1, p. 47-56Article in journal (Refereed)
    Abstract [en]

    Background: In today's complex healthcare organisations there is an increasing recognition of the need to enhance care quality and patient safety. Nurses' competence in demonstrating caring behaviour during patient encounters affects how patients experience and participate in their care. Nurse educators are faced with the challenge of balancing the demand for increasingly complex knowledge and skills with facilitating students' abilities essential to becoming compassionate and caring nurses. Aim: The aim was to describe undergraduate nursing students' development of caring behaviour while participating in a caring behaviour course. Method: This pilot study used a quantitative observational design. At a university in Sweden, video-recorded observational data from twenty-five students were collected in the first and last weeks of a full-time five-week Caring Behaviour Course (the CBC). In total, 56-min video-recorded simulation interactions between a student and a standardised patient were coded by a credentialed coder using a timed-event sequential continuous coding method based on the Caring Behaviour Coding Scheme (the CBCS). The CBCS maps the five conceptual domains described in Swanson's Theory of Caring with related sub-domains that align with Swanson's qualities of the Compassionate Healer and the Competent Practitioner. The CBCS contains seventeen verbal and eight non-verbal behavioural codes, categorised as caring or non-caring. Results: Between the two simulations, most verbal caring behaviours increased, and most non-verbal caring behaviours decreased. Statistically significant differences between the simulations occurred in the sub-domains Avoiding assumptions and Performing competently/skilfully in the quality of the Competent Practitioner. Most observed caring behaviours aligned with the Compassionate Healer. Conclusion: Generally, the students' development of caring behaviours increased while participating in the CBC. Using a structured observational behavioural coding scheme can assist educators in assessing caring behaviour both in education and in practice, supporting caring as the universal foundation of nursing and a key to patient safety.

  • 44.
    Mårtensson, Sophie
    et al.
    Jönköping University, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Linnaeus Knowledge Environments, Green Sustainable Development. Univ N Carolina, USA.
    Hodges, Eric A.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sherwood, Gwen
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden.
    Björk, Maria
    Jönköping University, Sweden.
    Undergraduate nursing students' experiences of practicing caring behaviours with standardised patients2023In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 37, no 1, p. 271-281Article in journal (Refereed)
    Abstract [en]

    Rationale Undergraduate nursing students' learning opportunities to practice caring behaviours to assure compassionate and competent nursing practice with standardised patients are few. Earlier studies primarily focused on practicing communication skills in relation to mental health or developing psychomotor skills while caring for a patient with a specific diagnosis. Aim The study aim was to describe undergraduate nursing students' experiences of practicing caring behaviours with a standardised patient. Method A sample of forty-eight undergraduate nursing students in semester four at a school of nursing in southern Sweden, enrolled in a full-time, 5-week, on-campus elective caring behaviour course, were at the first and last week individually video-recorded during two caring behaviour simulations encountering a standardised patient. After observing each of their video-recordings, students completed written reflections focusing on their own compassionate and competent verbal and nonverbal caring behaviour. In total, 96 individual written reflections were analysed using qualitative content analysis to describe the experience. Results One main theme emerged: The challenge of being mindfully present in patient encounters. Four themes further described the experience: A challenging but realistic learning experience, learning the impact of nonverbal behaviour, recognising the complexity of verbal behaviour, and learning to be with the patient instead of only doing for the patient. Conclusion When caring is intertwined with visible and realistic nursing practice in simulations using standardised patients it facilitates undergraduate nursing students learning compassionate and competent caring behaviour. The learning experience opened the students' eyes to the impact of practicing caring, recognising that being with is not the same as doing for the patient, and thus, how challenging it is to be mindfully present in patient encounters. Designing caring behaviour simulations with standardised patients is a feasible and efficacious educational learning didactic to facilitate students' learning caring behaviour and enhancing patients' experiences.

  • 45.
    Nygårdh, Annette
    et al.
    Jönköping University, Sweden.
    Sherwood, Gwen
    University of North Carolina at Chapel Hill, USA.
    Sandberg, Therese
    Värnamo Hospital, Sweden.
    Rehn, Jeanette
    Värnamo Hospital, Sweden.
    Knutsson, Susanne
    Jönköping University, Sweden.
    The visibility of QSEN competencies in clinical assessment tools in Swedish nurse education2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 59, p. 110-117, article id S0260-6917(17)30207-1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Prospective nurses need specific and sufficient knowledge to be able to provide quality care. The Swedish Society of Nursing has emphasized the importance of the six quality and safety competencies (QSEN), originated in the US, in Swedish nursing education.

    PURPOSE: To investigate the visibility of the QSEN competencies in the assessment tools used in clinical practice

    METHOD: A quantitative descriptive method was used to analyze assessment tools from 23 universities.

    RESULTS AND CONCLUSION: Teamwork and collaboration was the most visible competency. Patient-centered care was visible to a large degree but was not referred to by name. Informatics was the least visible, a notable concern since all nurses should be competent in informatics to provide quality and safety in care. These results provide guidance as academic and clinical programs around the world implement assessment of how well nurses have developed these essential quality and safety competencies.

  • 46.
    Odzakovic, Elzana
    et al.
    Jönköping University, Sweden.
    Sandlund, Christina
    Karolinska Institutet, Sweden;Academic Primary Health Care Centre, Sweden.
    Hellström, Amanda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Ulander, Martin
    Linköping University, Sweden;Linköping University Hospital, Sweden.
    Blom, Kerstin
    Karolinska Institutet, Sweden;Stockholm Health Care Services, Sweden.
    Jernelöv, Susanna
    Karolinska Institutet, Sweden;Stockholm Health Care Services, Sweden.
    Kaldo, Viktor
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Karolinska Institutet, Sweden;Stockholm Health Care Services, Sweden.
    Björk, Maria
    Jönköping University, Sweden.
    Knutsson, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lind, Jonas
    Linköping University, Sweden; County Hospital Ryhov, Sweden.
    Pakpour, Amir
    Jönköping University, Sweden.
    Broström, Anders
    Jönköping University, Sweden;Linköping University Hospital, Sweden; Western Norway University of Applied Sciences, Norway.
    Self-care behaviours in patients with restless legs syndrome (RLS): development and psychometric testing of the RLS-Self-care Behaviour questionnaire2024In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, article id e14390Article in journal (Refereed)
    Abstract [en]

    Restless legs syndrome (RLS) is a highly prevalent condition that significantly disrupts sleep and causes reduced quality of life. While previous RLS research has mainly focused on the pharmacological treatment, this study presents the first instrument to measure self-care, the RLS-Self-care Behaviour questionnaire (RLS-ScBq). Self-care, defined as an active decision-making process, can empower patients to effectively participate in their own healthcare through awareness, self-control, and self-reliance to cope with their disease. Self-care can in a RLS context include actions such as physical exercise, meditation, and massage. Hence, the aim of this study is to explore the psychometric properties of the RLS-ScBq in patients with RLS. A cross-sectional design, including 788 patients with RLS (65% women, mean age 70.8 years, [standard deviation (SD) =11.4]) was used. Sociodemographics, comorbidities, and RLS-related treatment data, including insomnia symptoms (i.e., Insomnia Severity Index), daytime sleepiness (i.e., Epworth Sleepiness Scale) and RLS symptoms (i.e., RLS-6 scale) were collected. The validity and reliability of the RLS-ScBq were investigated using exploratory factor analysis and Rasch models. The two-factor solution (i.e., physical, and mental actions) showed an explained variance of 32.33% for The Self-care Behaviour Frequency part and 36.28% for The Benefit of Self-care Behaviour part. The internal consistency measured by Cronbach's alpha was 0.57 and 0.60, and McDonald's omega was 0.60 and 0.67, respectively. No differential item functioning was identified for gender, age, insomnia, daytime sleepiness, or RLS severity. The eight-item RLS-ScBq can serve as a tool enabling healthcare personnel to explore use and benefit of self-care activities in patients with RLS.

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