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Bjurling-Sjöberg, P., Wadensten, B., Pöder, U., Jansson, I. & Nordgren, L. (2017). Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice. Journal of Interprofessional Care, 31(2), 233-244.
Open this publication in new window or tab >>Balancing intertwined responsibilities: A grounded theory study of teamwork in everyday intensive care unit practice
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2017 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 31, no 2, 233-244 p.Article in journal (Refereed) Published
Abstract [en]

This study aimed to describe and explain teamwork and factors that influence team processes in everyday practice in an intensive care unit (ICU) from a staff perspective. The setting was a Swedish ICU. Data were collected from 38 ICU staff in focus groups with registered nurses, assistant nurses, and anaesthetists, and in one individual interview with a physiotherapist. Constant comparative analysis according to grounded theory was conducted, and to identify the relations between the emerged categories, the paradigm model was applied. The core category to emerge from the data was balancing intertwined responsibilities. In addition, eleven categories that related to the core category emerged. These categories described and explained the phenomenon's contextual conditions, causal conditions, and intervening conditions, as well as the staff actions/interactions and the consequences that arose. The findings indicated that the type of teamwork fluctuated due to circumstantial factors. Based on the findings and on current literature, strategies that can optimise interprofessional teamwork are presented. The analysis generated a conceptual model, which aims to contribute to existing frameworks by adding new dimensions about perceptions of team processes within an ICU related to staff actions/interactions. This model may be utilised to enhance the understanding of existing contexts and processes when designing and implementing interventions to facilitate teamwork in the pursuit of improving healthcare quality and patient safety.

Keyword
Grounded theory, intensive care unit, interprofessional care, interviews, practice, roles, teamwork
National Category
Health Sciences
Identifiers
urn:nbn:se:uu:diva-317286 (URN)10.1080/13561820.2016.1255184 (DOI)000395098400017 ()28140715 (PubMedID)
Available from: 2017-03-13 Created: 2017-03-13 Last updated: 2017-04-26Bibliographically approved
Nordgren, L. & Söderlund, A. (2016). Associations between socio-demographic factors, encounters with healthcare professionals and perceived ability to return to work in people sick-listed due to heart failure in Sweden: a cross-sectional study. Disability and Rehabilitation, 38(2), 168-173.
Open this publication in new window or tab >>Associations between socio-demographic factors, encounters with healthcare professionals and perceived ability to return to work in people sick-listed due to heart failure in Sweden: a cross-sectional study
2016 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 2, 168-173 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim of this study was to investigate associations between socio-demographic factors, experiences of positive/negative encounters with healthcare professionals, and the encounters' impact on the ability to return to work in a population of people on sick leave due to heart failure.

METHODS: This was a cross-sectional study. Data were collected from two official registries in Sweden and from a postal questionnaire. In all, 590 people with heart failure responded to the questionnaire. Associations between variables were calculated with bivariate correlation analyses and logistic regression analyses.

RESULTS: For people on sick leave due to heart failure, positive encounters with healthcare professionals are associated with being Swedish-born, female gender, and high income. People with high income are more likely to be supported back to work by positive encounters with healthcare professionals. To perceive that healthcare professionals believe in person's ability to return to work can be facilitating.

CONCLUSIONS: Women, people who are not foreign-born, and people with high income are more likely to perceive encounters with healthcare professionals as positive. Healthcare professionals who work with rehabilitation for people with heart failure need to be aware of social inequalities and that being on sick leave is a process of change. Implications for Rehabilitation A failing heart limits everyday life implying risk for long-term sick leave. Even though there are rehabilitation programs for people with heart failure, vocational rehabilitation is often over-looked. The knowledge about factors associated with sick leave due to heart failure is scarce. Experiences of positive encounters with healthcare professionals were associated with being Swedish-born, female gender, and high income. People with high income were more likely to be supported back to work by positive encounters with healthcare professionals. Healthcare professionals who work with rehabilitation for people with heart failure can support patients with heart failure by showing them confidence and trust. However, they need to be aware that sick leave implies a process of change.

Keyword
Adults; heart diseases; return to work; sick leave
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-262353 (URN)10.3109/09638288.2015.1031289 (DOI)000364971000005 ()25835330 (PubMedID)
Available from: 2015-09-14 Created: 2015-09-14 Last updated: 2017-12-04Bibliographically approved
Nordgren, L. & Söderlund, A. (2016). Emotions and encounters with healthcare professionals as predictors for the self-estimated ability to return to work: A cross-sectional study of people with heart failure. BMJ Open, 6(11), Article ID e009896.
Open this publication in new window or tab >>Emotions and encounters with healthcare professionals as predictors for the self-estimated ability to return to work: A cross-sectional study of people with heart failure
2016 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 11, e009896Article in journal (Refereed) Published
Abstract [en]

Objectives: To live with heart failure means that life is delimited. Still, people with heart failure can have a desire to stay active in working life as long as possible. Although a number of factors affect sick leave and rehabilitation processes, little is known about sick leave and vocational rehabilitation concerning people with heart failure. This study aimed to identify emotions and encounters with healthcare professionals as possible predictors for the self-estimated ability to return to work in people on sick leave due to heart failure. Design: A population-based cross-sectional study design was used. Setting: The study was conducted in Sweden. Data were collected in 2012 from 3 different sources: 2 official registries and 1 postal questionnaire. Participants: A total of 590 individuals were included. Statistics: Descriptive statistics, correlation analysis and linear multiple regression analysis were used. Results: 3 variables, feeling strengthened in the situation (beta=-0.21, p=0.02), feeling happy (beta=-0.24, p=0.02) and receiving encouragement about work (beta=-0.32, p <= 0.001), were identified as possible predictive factors for the self-estimated ability to return to work. Conclusions: To feel strengthened, happy and to receive encouragement about work can affect the return to work process for people on sick leave due to heart failure. In order to develop and implement rehabilitation programmes to meet these needs, more research is needed.

National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-307309 (URN)10.1136/bmjopen-2015-009896 (DOI)000391303400145 ()28186921 (PubMedID)
Available from: 2016-11-11 Created: 2016-11-11 Last updated: 2017-11-29Bibliographically approved
Nordgren, L. & Söderlund, A. (2016). Heart failure clients' encounters with professionals and self-rated ability to return to work. Scandinavian Journal of Occupational Therapy, 23(2), 115-126.
Open this publication in new window or tab >>Heart failure clients' encounters with professionals and self-rated ability to return to work
2016 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 2, 115-126 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: People with heart failure are sick listed for long periods and disability pension is common. Healthcare professionals need knowledge about factors that can enhance their return to work processes.

AIMS: This study focus on people on sick leave due to heart failure and their encounters with healthcare professionals/social insurance officers. Specifically, it aimed to investigate associations between: (1) encounters and socio-demographic factors and, (2) encounters and self-rated ability to return to work.

MATERIAL AND METHODS: A cross-sectional study based on registry data and a postal questionnaire to people on sick leave due to heart failure (n = 590). Bivariate correlation analyses and logistic regression analyses were used.

RESULTS: Gender, income, and age were strongly associated with encounters with both social insurance officers and healthcare professionals. Self-rated ability to return to work was associated with the encounters 'Made reasonable demands', 'Gave clear and adequate information/advice' and 'Did not keep our agreements'.

CONCLUSION AND SIGNIFICANCE: To enhance clients' abilities to return to work demands should be reasonable, information and advice need to be clear, and agreements should be kept. These results can be used by healthcare professionals as occupational therapists involved in vocational rehabilitation for people on sick leave due to heart failure.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-262348 (URN)10.3109/11038128.2015.1078840 (DOI)000369768000005 ()26337863 (PubMedID)
Available from: 2015-09-14 Created: 2015-09-14 Last updated: 2017-12-04Bibliographically approved
Nordgren, L. & Söderlund, A. (2016). Impact of encounters with healthcare professionals on perceived ability to return to work in people on sick leave due to heart failure. European Journal of Cardiovascular Nursing, 15, S48-S49.
Open this publication in new window or tab >>Impact of encounters with healthcare professionals on perceived ability to return to work in people on sick leave due to heart failure
2016 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, S48-S49 p.Article in journal, Meeting abstract (Other academic) Published
National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-299387 (URN)000374486500093 ()
Available from: 2016-07-18 Created: 2016-07-18 Last updated: 2017-11-28Bibliographically approved
Skålén, C., Nordgren, L. & Annerbäck, E.-M. (2016). Patient complaints about healthcare in a Swedish county: Characteristics and satisfaction after handling. Nursing Open, 3(4), 203-211.
Open this publication in new window or tab >>Patient complaints about healthcare in a Swedish county: Characteristics and satisfaction after handling
2016 (English)In: Nursing Open, ISSN 2054-1058, Vol. 3, no 4, 203-211 p.Article in journal (Refereed) Published
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Identifiers
urn:nbn:se:uu:diva-301505 (URN)10.1002/nop2.54 (DOI)000386117200003 ()
Available from: 2016-08-23 Created: 2016-08-23 Last updated: 2016-12-08Bibliographically approved
Dean, E., Nordgren, L. & Söderlund, A. (2015). An Exploration of the Scientific Writing Experience ofNon-native English-speaking Doctoral Supervisors and Students Using a Phenomemngraphic Approach. Journal of Biomedical Education, 2015, Article ID 542781.
Open this publication in new window or tab >>An Exploration of the Scientific Writing Experience ofNon-native English-speaking Doctoral Supervisors and Students Using a Phenomemngraphic Approach
2015 (English)In: Journal of Biomedical Education, ISSN 2314-503X, Vol. 2015, 542781Article in journal (Refereed) Published
Abstract [en]

Nonnative English-speaking scholars and trainees are increasingly submitting their work to English journals. The study’s aim was to describe their experiences regarding scientific writing in English using a qualitative phenomenographic approach. Two focus groups (5 doctoral supervisors and 13 students) were conducted. Participants were nonnative English-speakers in a Swedish health sciences faculty. Group discussion focused on scientific writing in English, specifically, rewards, challenges, facilitators, and barriers. Participants were asked about their needs for related educational supports. Inductive phenomenographic analysis included extraction of referential (phenomenon as a whole) and structural (phenomenon parts) aspects of the transcription data. Doctoral supervisors and students viewed English scientific writing as challenging but worthwhile. Both groups viewed mastering English scientific writing as necessary but each struggles with the process differently. Supervisors viewed it as a long-term professional responsibility (generating knowledge, networking, and promotion eligibility). Alternatively, doctoral students viewed its importance in the short term (learning publication skills). Both groups acknowledged they would benefit from personalized feedback on writing style/format, but in distinct ways. Nonnative English-speaking doctoral supervisors and students in Sweden may benefit from on-going writing educational supports. Editors/reviewers need to increase awareness of the challenges of international contributors and maximize the formative constructiveness of their reviews.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-268011 (URN)10.1155/2015/542781 (DOI)
Available from: 2015-12-01 Created: 2015-12-01 Last updated: 2015-12-29
Palesjö, C., Nordgren, L. & Asp, M. (2015). Being in a critical illness-recovery process: A phenomenological hermeneutical study. Journal of Clinical Nursing, 24(23-24), 3494-3502.
Open this publication in new window or tab >>Being in a critical illness-recovery process: A phenomenological hermeneutical study
2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 23-24, 3494-3502 p.Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVE: The aim of this study was to describe and interpret the essential meaning of the lived experiences of being in a critical illness-recovery process after a life-threatening condition.

BACKGROUND: The critical illness-recovery process after a life-threatening condition takes several years and does not only include patients' experiences during intensive care. Previous research has mainly focused on what critically ill patients recall. However, from a phenomenological point of view, experiences are more than memories alone. To plan and perform relevant health care and social support for patients who have survived a life-threatening condition, a more profound understanding about their lived experiences is needed.

DESIGN AND METHOD: In this qualitative study, a phenomenological hermeneutical approach was used. Interviews were conducted with seven patients, two to four years after they had received care in an intensive care unit in Sweden.

RESULTS: The comprehensive understanding of the results shows that the critical illness-recovery process after a life-threatening condition means an existential struggle to reconcile with an unfamiliar body and with ordinary life. This can be understood as an 'unhomelikeness' implying a struggle to create meaning and coherence from scary and fragmented memories. The previous life projects, such as work and social life become unfamiliar when the patient's fragile and weak body is disobedient and brings on altered sensations.

CONCLUSIONS: Patients who survive a life-threatening condition have an immense need for care and support during the entire critical illness-recovery process, and also after the initial acute phase. They need a coherent understanding of what happened, and support to be able to perform their changed life projects.

RELEVANCE TO CLINICAL PRACTICE: Supporting and caring for patients' recovery from a life- threatening condition involves recognising the patients' struggle and responding to their existential concerns.

Keyword
caring science; critical illness; Heidegger; life-threatening; lived body; lived experiences; phenomenological hermeneutics; recovery; Ricoeur
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-264800 (URN)10.1111/jocn.13002 (DOI)000368277900017 ()26435292 (PubMedID)
Available from: 2015-10-19 Created: 2015-10-19 Last updated: 2017-12-01Bibliographically approved
Nordgren, L. & Söderlund, A. (2015). Being on sick leave due to heart failure: Self-rated health, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work. Psychology, Health & Medicine, 20(5), 582-593.
Open this publication in new window or tab >>Being on sick leave due to heart failure: Self-rated health, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work
2015 (English)In: Psychology, Health & Medicine, ISSN 1354-8506, E-ISSN 1465-3966, Vol. 20, no 5, 582-593 p.Article in journal (Refereed) Published
Abstract [en]

Younger people with heart failure often experience poor self-rated health. Furthermore, poor self-rated health is associated with long-term sick leave and disability pension. Socio-demographic factors affect the ability to return to work. However, little is known about people on sick leave due to heart failure. The aim of this study was to investigate associations between self-rated health, mood, socio-demographic factors, sick leave compensation, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work, for people on sick leave due to heart failure. This population-based investigation had a cross-sectional design. Data were collected in Sweden in 2012 from two official registries and from a postal questionnaire. In total, 590 subjects, aged 23-67, responded (response rate 45.8%). Descriptive statistics, correlation analyses (Spearman bivariate analysis) and logistic regression analyses were used to investigate associations. Poor self-rated health was strongly associated with full sick leave compensation (OR  =  4.1, p < .001). Compared self-rated health was moderately associated with low income (OR  =  2.6, p  =  .003). Good self-rated health was strongly associated with positive encounters with healthcare professionals (OR  =  3.0, p  =  .022) and to the impact of positive encounters with healthcare professionals on self-estimated ability to return to work (OR  =  3.3, p  < .001). People with heart failure are sicklisted for long periods of time and to a great extent receive disability pension. Not being able to work imposes reduced quality of life. Positive encounters with healthcare professionals and social insurance officers can be supportive when people with heart failure struggle to remain in working life.

National Category
Health Sciences
Identifiers
urn:nbn:se:uu:diva-244832 (URN)10.1080/13548506.2015.1007148 (DOI)000354114200008 ()25652183 (PubMedID)
Available from: 2015-02-21 Created: 2015-02-21 Last updated: 2017-12-04Bibliographically approved
Bjurling-Sjöberg, P., Wadensten, B., Pöder, U., Nordgren, L. & Jansson, I. (2015). Factors affecting the implementation process of clinical pathways: A mixed method study within the context of Swedish intensive care. Journal of Evaluation In Clinical Practice, 21(2), 255-261.
Open this publication in new window or tab >>Factors affecting the implementation process of clinical pathways: A mixed method study within the context of Swedish intensive care
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2015 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 21, no 2, 255-261 p.Article in journal (Refereed) Published
Abstract [en]

RATIONALE, AIMS AND OBJECTIVES: Clinical pathways (CPs) can improve quality of care on intensive care units (ICUs), but are infrequently utilized and of varying quality. Knowledge regarding factors that facilitate versus hinder successful implementation of CPs is insufficient and a better understanding of the activities and individuals involved is needed. The aim of this study was to explore the implementation process of CPs within the context of ICUs.

METHODS: An exploratory design with a sequential mixed method was used. A CP survey, including all Swedish ICUs, was used to collect quantitative data from ICUs using CPs (n = 15) and interviews with key informants (n = 10) were used to collect qualitative data from the same ICUs. Descriptive statistics and qualitative content analysis were used, and the quantitative and qualitative findings were integrated.

RESULTS: The CP implementation was conceptualized according to two interplaying themes: a process to realize the usefulness of CPs and create new habits; and a necessity of enthusiasm, support and time. Multiple factors affected the process and those factors were organized in six main categories and 14 subcategories.

CONCLUSIONS: Bottom-up initiatives, interprofessional project groups and small ICUs seem to enhance successful implementation of CPs while inadequate electronic health record systems, insufficient support and time constrains can be barriers. Support regarding the whole implementation process from centralized units at the local hospitals, as well as cooperation between ICUs and national guidance, has the potential to raise the quality of CPs and benefit the progress of CP implementation.

National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-244833 (URN)10.1111/jep.12301 (DOI)000351871200013 ()25678495 (PubMedID)
Available from: 2015-02-21 Created: 2015-02-21 Last updated: 2017-12-04Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-0667-7111

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