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Muntlin Athlin, Åsa, DocentORCID iD iconorcid.org/0000-0002-7221-2876
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Feo, R., Donnelly, F., Muntlin Athlin, Å. & Jangland, E. (2019). Providing high-quality fundamental care for patients with acute abdominal pain: A qualitative study of patients' experiences in acute care. Journal of Health Organisation & Management, 33(1), 110-123
Åpne denne publikasjonen i ny fane eller vindu >>Providing high-quality fundamental care for patients with acute abdominal pain: A qualitative study of patients' experiences in acute care
2019 (engelsk)Inngår i: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 33, nr 1, s. 110-123Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Purpose Globally, acute abdominal pain (AAP) is one of the most common reasons for emergency admissions, yet little is known about how this patient group experiences the delivery of fundamental care across the acute care delivery chain. The purpose of this paper is to describe how patients with AAP experienced fundamental care across their acute care presentation, and to explicate the health professional behaviours, reported by patients, that contributed to their positive experiences. Design/methodology/approach A qualitative descriptive study, using repeated reflective interviews, was analysed thematically (n=10 patients). Findings Two themes were identified: developing genuine, caring relationships with health professionals and being informed about one's care. Patients reported that health professionals established genuine professional-patient relationships despite the busy care environment but perceived this environment as impeding information-provision. Patients were typically accepting of a lack of information, whereas poor professional-patient relationships were seen as inexcusable.

sted, utgiver, år, opplag, sider
EMERALD GROUP PUBLISHING LTD, 2019
Emneord
Healthcare, Hospitals, Patient care, Interviews, Qualitative research, Nursing
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-380438 (URN)10.1108/JHOM-02-2018-0037 (DOI)000460932000009 ()30859914 (PubMedID)
Tilgjengelig fra: 2019-03-28 Laget: 2019-03-28 Sist oppdatert: 2019-03-28bibliografisk kontrollert
Donnelly, F., Feo, R., Jangland, E. & Muntlin Athlin, Å. (2019). The management of patients with acute abdominal pain in the emergency department: A qualitative study of nurse perceptions. AUSTRALASIAN EMERGENCY CARE, 22(2), 97-102
Åpne denne publikasjonen i ny fane eller vindu >>The management of patients with acute abdominal pain in the emergency department: A qualitative study of nurse perceptions
2019 (engelsk)Inngår i: AUSTRALASIAN EMERGENCY CARE, ISSN 2588-994X, Vol. 22, nr 2, s. 97-102Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Acute abdominal pain is a common reason for presentation to the emergency department. Understanding the role of nurses involved in management of acute abdominal pain is important for improving patient care and outcomes. The aim of this study was to understand the perceptions of emergency nurses in the management of acute abdominal pain. Methods: Using a qualitative design, a purposeful sample (n=9) of experienced registered nurses was recruited from the emergency department of a large tertiary public hospital in South Australia. Semi-structured interviews, informed by literature describing the management of acute abdominal pain, were used to identify the perceptions of emergency nurses when caring for patients with acute abdominal pain. Results: Thematic analysis of interviews identified four themes: Centrality of Diagnosis; Busyness and Patient Management; Systems Issues; and Communication Challenges. Of the four themes, the Centrality of Diagnosis was especially important to the nurses' sense of contribution to patient care. Care was also affected by the busyness of the environment, the systems and processes in place to manage patients and communication in the emergency department. Conclusions: The management of patients with acute abdominal pain is influenced by how nurses participate in the diagnostic process. Nurses identified their role in this process and described how this role impacted their delivery of fundamental care. Further studies of the nursing contribution to diagnosis, communication, and the systems that affect care delivery in the emergency department are required.

sted, utgiver, år, opplag, sider
ELSEVIER SCI LTD, 2019
Emneord
Abdominal pain, Diagnosis, Nursing, Emergency department, Hospital, Fundamentals of care
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-390030 (URN)10.1016/j.auec.2019.04.002 (DOI)000471239500006 ()31056349 (PubMedID)
Tilgjengelig fra: 2019-08-07 Laget: 2019-08-07 Sist oppdatert: 2019-08-07bibliografisk kontrollert
Ahlstedt, C., Eriksson Lindvall, C., Holmström, I. & Muntlin Athlin, Å. (2019). What makes registered nurses remain in work? An ethnographic study. International Journal of Nursing Studies, 89, 32-38
Åpne denne publikasjonen i ny fane eller vindu >>What makes registered nurses remain in work? An ethnographic study
2019 (engelsk)Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 89, s. 32-38Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Registered nurses' work-related stress, dissatisfaction and burnout are some of the problems in the healthcare and that negatively affect healthcare quality and patient care. A prerequisite for sustained high quality at work is that the registered nurses are motivated. High motivation has been proved to lead to better working results. The theory of inner work life describes the dynamic interplay between a person's perceptions, emotions and motivation and the three key factors for a good working life: nourishment, progress and catalysts. Objectives: The aim of the study was to explore registered nurses' workday events in relation to inner work life theory, to better understand what influences registered nurses to remain in work. Design: A qualitative explorative study with an ethnographic approach. Methods: Participant observation over four months; in total 56 h with 479 events and 58 informal interviews during observation; all registered nurses employed at the unit (n = 10) were included. In addition, individual interviews were conducted after the observation period (n = 9). The dataset was analysed using thematic analysis and in the final step of the analysis the categories were reflected in relation to the three key factors in theory of inner work life. Results: Nourishment in a registered nurse context describes the work motivation created by the interpersonal support between colleagues. It was important to registered nurses that physicians and colleagues respected and trusted their knowledge in the daily work, and that they felt comfortable asking questions and supporting each other. Progress in the context of registered nurses' work motivation was the feeling of moving forward with a mix of small wins and the perception of solving more complex challenges in daily work. It was also fundamental to the registered nurses' development through new knowledge and learning during daily work. Catalysts, actions that directly facilitate the work, were highlighted as the possibility to work independently along with the opportunity to work together with other registered nurses. Conclusion: This study has a number of implications for future work and research on creating an attractive workplace for registered nurses. Working independently, with colleagues from the same profession, integrated with learning, visible progress, and receiving feedback from the work itself, contribute to work motivation.

HSV kategori
Forskningsprogram
Hälso- och sjukvårdsforskning
Identifikatorer
urn:nbn:se:uu:diva-364722 (URN)10.1016/j.ijnurstu.2018.09.008 (DOI)000454965700006 ()30339953 (PubMedID)
Tilgjengelig fra: 2018-10-31 Laget: 2018-10-31 Sist oppdatert: 2019-01-28bibliografisk kontrollert
Jeffs, L., Muntlin Athlin, Å., Needleman, J., Jackson, D. & Kitson, A. (2018). Building the Foundation to Generate a Fundamental Care Standardized Data Set. Journal of Clinical Nursing, 27(11-12), 2481-2488
Åpne denne publikasjonen i ny fane eller vindu >>Building the Foundation to Generate a Fundamental Care Standardized Data Set
Vise andre…
2018 (engelsk)Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 11-12, s. 2481-2488Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Considerable transformation is occurring in healthcare globally with organizations focusing on achieving the quadruple aim of improving the experience of care, the health of populations, and the experience of providing care while reducing per capita costs of health care. In response, health care organizations are employing performance measurement and quality improvement methods to achieve the quadruple aim. Despite the plethora of measures available to health managers, there is no standardized data set and virtually no indicators reflecting how patients actually experience the delivery of fundamental care, such as nutrition, hydration, mobility, respect, education, and psychosocial support. Given the linkages of fundamental care to safety and quality metrics, efforts to build the evidence base and knowledge that captures the impact of enacting fundamental care across the health care continuum and lifespan should include generating a routinely collected data set of relevant measures. This paper provides an overview of the current state of performance measurement, key trends, and a methodological approach to leverage in efforts to generate a standardized data set for fundamental care.

HSV kategori
Forskningsprogram
Omvårdnadsforskning med medicinsk inriktning
Identifikatorer
urn:nbn:se:uu:diva-342067 (URN)10.1111/jocn.14308 (DOI)000434127600025 ()29446500 (PubMedID)
Tilgjengelig fra: 2018-02-19 Laget: 2018-02-19 Sist oppdatert: 2019-01-25bibliografisk kontrollert
Muntlin Athlin, Å., Brovall, M., Wengström, Y., Conroy, T. & Kitson, A. (2018). Descriptions of fundamental care needs in cancer care: an exploratory study. Journal of Clinical Nursing, 27(11-12), 2322-2332
Åpne denne publikasjonen i ny fane eller vindu >>Descriptions of fundamental care needs in cancer care: an exploratory study
Vise andre…
2018 (engelsk)Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 11-12, s. 2322-2332Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Aims and objectives

To explore the experiences of the fundamentals of care for people with a cancer diagnosis, from diagnosis to after adjuvant treatment.

Background

More focus is needed on the experience of people living with cancer, as current cancer care more emphasises on independence and resilience without fully acknowledging that there will be moments in the cancer journey where patients will need ‘basic nursing care’ to manage their symptoms and care pathways.

Design

Secondary analysis of qualitative data.

Method

Secondary thematic analysis of interview data from 30 people with a diagnosis of breast (n=10), colorectal (n=10) or prostate (n=10) cancer was undertaken.

Results

The findings revealed vivid descriptions of the fundamentals of care (i.e. basic needs) and participants described physical, psychosocial and relational aspects of the delivery of care. Both positive (e.g. supportive and kind) and negative (e.g. humiliating) experiences related to the relationship with the healthcare professionals were re-counted and affected the participants' experiences of the fundamentals of care. Participants' accounts of their fundamental care needs were provided without them identifying who, within the health care system, was responsible for providing these needs. Specific nursing interventions were seldom described.

Conclusion

Some people with a cancer diagnosis have to strive for help and support from the nursing staff to manage to regain control over their recovery. Nurses in cancer care need to focus on the patients' fundamental care needs to optimise their patients' recovery.

Relevance to clinical practice

Cancer patients require support with their fundamental care needs and nurses need to be more aware of this and integrate it into the caring relationship. It is imperative that the complexity of the nurse–patient relationship is acknowledged and that models of care which honour this complexity are used.

Emneord
cancer care, fundamentals of care, nursing care, person-centred care, qualitative study, secondary analysis
HSV kategori
Forskningsprogram
Omvårdnadsforskning med medicinsk inriktning
Identifikatorer
urn:nbn:se:uu:diva-342064 (URN)10.1111/jocn.14251 (DOI)000434127600012 ()29292542 (PubMedID)
Tilgjengelig fra: 2018-02-19 Laget: 2018-02-19 Sist oppdatert: 2019-06-28bibliografisk kontrollert
Jangland, E., Teodorsson, T., Molander, K. & Muntlin Athlin, Å. (2018). Inadequate environment, resources, and values lead to missed nursing care: A focused ethnographic study on the surgical ward using the Fundamentals of Care framework. Journal of Clinical Nursing, 27(11-12), 2311-2321
Åpne denne publikasjonen i ny fane eller vindu >>Inadequate environment, resources, and values lead to missed nursing care: A focused ethnographic study on the surgical ward using the Fundamentals of Care framework
2018 (engelsk)Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 11-12, s. 2311-2321Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

AIMS AND OBJECTIVES: The purpose was to explore the delivery of care from the perspective of patients with acute abdominal pain focusing on the contextual factors at system level using the Fundamentals of Care framework.

BACKGROUND: The Fundamentals of Care framework describes several contextual and systemic factors that can impact the delivery of care. To deliver high- quality, person-centred care it is important to understand how these factors affect patients' experiences and care needs.

DESIGN: A focused ethnographic approach.

METHOD: A total of 20 observations were performed on two surgical wards at a Swedish university hospital. Data were collected using participant observation and informal interviews and analysed using deductive content analysis.

RESULTS: The findings, presented in four categories, reflect the value patients place on the caring relationship and a friendly atmosphere on the ward. Patients had concerns about the environment, particularly the high-tempo culture on the ward and its impact on their integrity, rest and sleep, access to information and planning, and need for support in addressing their existential thoughts. The observers also noted that missed nursing care had serious consequences for patient safety.

CONCLUSION: Patients with acute abdominal pain were cared for in the high-tempo culture of a surgical ward with limited resources, unclear leadership, and challenges to patients' safety. The findings highlight the crucial importance of prioritizing and valuing the patients' fundamental care needs for recovery.

RELEVANCE TO CLINICAL PRACTICE: Nursing leaders and nurses need to take the lead to re-conceptualize the value of fundamental care in the acute care setting. To improve clinical practice the value of fundamentals of care must be addressed regardless of patient's clinical condition. Providing a caring relationship is paramount to ensure a positive impact on patient's well-being and recovery.

Emneord
Fundamentals of Care, acute abdominal pain, acute care, focused ethnography, organization, surgical nursing
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-333982 (URN)10.1111/jocn.14095 (DOI)000434127600011 ()28960702 (PubMedID)
Forskningsfinansiär
Swedish Research Council, 2013:1992Forte, Swedish Research Council for Health, Working Life and Welfare
Tilgjengelig fra: 2017-11-20 Laget: 2017-11-20 Sist oppdatert: 2019-06-28bibliografisk kontrollert
Muntlin Athlin, Å. (2018). Methods, metrics and research gaps around minimum data sets for nursing practice and fundamental care: A scoping literature review. Journal of Clinical Nursing, 27(11/12), 2230-2247
Åpne denne publikasjonen i ny fane eller vindu >>Methods, metrics and research gaps around minimum data sets for nursing practice and fundamental care: A scoping literature review
2018 (engelsk)Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 11/12, s. 2230-2247Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Aims and objectives

To examine and map research on minimum data sets linked to nursing practice and the fundamentals of care. Another aim was to identify gaps in the evidence to suggest future research questions to highlight the need for standardisation of terminology around nursing practice and fundamental care.

Background

Addressing fundamental care has been highlighted internationally as a response to missed nursing care. Systematic performance measurements are needed to capture nursing practice outcomes.

Design

Overview of the literature framed by the scoping study methodology.

Method

PubMed and CINAHL were searched using the following inclusion criteria: peer‐reviewed empirical quantitative and qualitative studies related to minimum data sets and nursing practice published in English. No time restrictions were set. Exclusion criteria were as follows: no available full text, reviews and methodological and discursive studies. Data were categorised into one of the fundamentals of care elements.

Results

The review included 20 studies published in 1999–2016. Settings were mainly nursing homes or hospitals. Of 14 elements of the fundamentals of care, 11 were identified as measures in the included studies, but their frequency varied. The most commonly identified elements concerned safety, prevention and medication (n = 11), comfort (n = 6) and eating and drinking (n = 5).

Conclusion

Studies have used minimum data sets and included variables linked to nursing practices and fundamentals of care. However, the relations of these variables to nursing practice were not always clearly described and the main purpose of the studies was seldom to measure the outcomes of nursing interventions. More robust studies focusing on nursing practice and patient outcomes are warranted.

HSV kategori
Forskningsprogram
Omvårdnadsforskning med medicinsk inriktning
Identifikatorer
urn:nbn:se:uu:diva-342058 (URN)10.1111/jocn.14155 (DOI)000434127600005 ()29119641 (PubMedID)
Tilgjengelig fra: 2018-02-19 Laget: 2018-02-19 Sist oppdatert: 2018-11-12bibliografisk kontrollert
Avallin, T., Muntlin Athlin, Å., Elgaard Sörensen, E., Kitson, A., Björck, M. & Jangland, E. (2018). Person-centred pain management for the patient with acute abdominal pain: An ethnography informed by the Fundamentals of Care framework. Journal of Advanced Nursing, 74(11), 2596-2609
Åpne denne publikasjonen i ny fane eller vindu >>Person-centred pain management for the patient with acute abdominal pain: An ethnography informed by the Fundamentals of Care framework
Vise andre…
2018 (engelsk)Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, nr 11, s. 2596-2609Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Aims: To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contributes to or detract from successful pain management for the patient with acute abdominal pain (AAP) across the acute care pathway.

Background: Although pain management is a recognized human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance.

Design: Focused ethnography, applying the Developmental Research Sequence and the Fundamentals of Care framework.

Methods: Participant observation and informal interviews (92hr) were performed at one emergency department (ED) and two surgical wards at a University Hospital during April-November 2015. Data include 261 interactions between patients, aged 18years seeking care for AAP at the ED and admitted to a surgical ward (N=31; aged 20-90years; 14 men, 17 women; 9 with communicative disabilities) and healthcare practitioners (N=198).

Results: The observations revealed an organizational culture with considerable impact on how well pain was managed. Well-managed pain presupposed the patient and practitioners to connect in a holistic pain management including a trustful relationship, communication to share knowledge and individualized analgesics.

Conclusions: Person-centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management.

HSV kategori
Forskningsprogram
Omvårdnadsforskning med medicinsk inriktning
Identifikatorer
urn:nbn:se:uu:diva-364720 (URN)10.1111/jan.13739 (DOI)000447551800013 ()29893491 (PubMedID)
Forskningsfinansiär
Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Research Council
Tilgjengelig fra: 2018-10-31 Laget: 2018-10-31 Sist oppdatert: 2018-12-13bibliografisk kontrollert
Feo, R., Conroy, T., Jangland, E., Muntlin Athlin, Å., Brovall, M., Parr, J., . . . Kitson, A. (2018). Towards a standardised definition for fundamental care: A modified Delphi study. Journal of Clinical Nursing, 27(11-12), 2285-2299
Åpne denne publikasjonen i ny fane eller vindu >>Towards a standardised definition for fundamental care: A modified Delphi study
Vise andre…
2018 (engelsk)Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, nr 11-12, s. 2285-2299Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

AIMS AND OBJECTIVES:

To generate a standardised definition for fundamental care and identify the discrete elements that constitute such care.

BACKGROUND:

There is poor conceptual clarity surrounding fundamental care. The Fundamentals of Care Framework aims to overcome this problem by outlining three core dimensions underpinning such care. Implementing the Framework requires a standardised definition for fundamental care that reflects the Framework's conceptual understanding, as well as agreement on the elements that comprise such care (i.e., patient needs, such as nutrition, and nurse actions, such as empathy). This study sought to achieve this consensus.

DESIGN:

Modified Delphi study.

METHODS:

Three phases: (i) engaging stakeholders via an interactive workshop; (ii) using workshop findings to develop a preliminary definition for, and identify the discrete elements that constitute, fundamental care; and (iii) gaining consensus on the definition and elements via a two-round Delphi approach (Round 1 n = 38; Round 2 n = 28).

RESULTS:

Delphi participants perceived both the definition and elements generated from the workshop as comprehensive, but beyond the scope of fundamental care. Participants questioned whether the definition should focus on patient needs and nurse actions, or more broadly on how fundamental care should be delivered (e.g., through a trusting nurse-patient relationship), and the outcomes of this care delivery. There were also mixed opinions whether the definition should be nursing specific.

CONCLUSIONS:

This study has initiated crucial dialogue around how fundamental care is conceptualised and defined. Future work should focus on further refinements of the definition and elements with a larger, international group of practising nurses and service users.

RELEVANCE TO CLINICAL PRACTICE:

The definition and elements, through ongoing refinement, will contribute to a robust evidence base that will underpin policy development and the systematic and effective teaching, delivery, measurement and evaluation of fundamental care.

HSV kategori
Forskningsprogram
Omvårdnadsforskning med medicinsk inriktning
Identifikatorer
urn:nbn:se:uu:diva-342060 (URN)10.1111/jocn.14247 (DOI)000434127600009 ()29278437 (PubMedID)
Tilgjengelig fra: 2018-02-19 Laget: 2018-02-19 Sist oppdatert: 2018-08-24bibliografisk kontrollert
Athlin, Å. M., Juhlin, C. & Jangland, E. (2017). Lack of existing guidelines for a large group of patients in Sweden: a national survey across the acute surgical care delivery chain. Journal of Evaluation In Clinical Practice, 23(1), 89-95
Åpne denne publikasjonen i ny fane eller vindu >>Lack of existing guidelines for a large group of patients in Sweden: a national survey across the acute surgical care delivery chain
2017 (engelsk)Inngår i: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 23, nr 1, s. 89-95Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Rationale, aims and objectivesEvidence-informed healthcare is the fundament for prac-tice, whereby guidelines based on the best available evidence should assist health profes-sionals in managing patients. Patients seeking care for acute abdominal pain form acommon group in acute care settings worldwide, for whom decision-making and timelytreatment are of paramount importance. There is ambiguity about the existence, use andcontent of guidelines for patients with acute abdomen. The objective was to describe andcompare guidelines and management of patients with acute abdomen in different settingsacross the acute care delivery chain in Sweden.MethodA national cross-sectional design was used. Twenty-nine ambulance stations, 17emergency departments and 33 surgical wards covering all six Swedish health regions wereincluded, and 23 guidelines were quality appraised using the validated Appraisal of Guide-lines for Research & Evaluation II tool.ResultsThere is a lack of guidelines in use for the management of this large group of pa-tients between and within different healthcare areas across the acute care delivery chain.The quality appraisal identified that several guidelines were of poor quality, especiallythe in-hospital ones. Further, range orders for analgesics are common in the ambulance ser-vices and the surgical wards, but are seldom present in the emergency departments. Also,education in pain management is more common in the ambulance services. Thesefindingsare noteworthy as, hypothetically, the same patient could be treated in three different waysduring the same care episode.ConclusionsThere is an urgent need to develop high-quality evidence-based clinicalguidelines for this patient group, with the entire care process in focus

Emneord
abdominal pain, acute care delivery chain, ambulance, emergency care, guidelines, surgical care
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-304033 (URN)10.1111/jep.12607 (DOI)000395024900012 ()27491471 (PubMedID)
Tilgjengelig fra: 2016-09-29 Laget: 2016-09-29 Sist oppdatert: 2018-01-10bibliografisk kontrollert
Organisasjoner
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-7221-2876