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Lindberg, M., Carlsson, M., Engström, M., Kristofferzon, M.-L. & Skytt, B. (2020). Nursing student's expectations for their future profession and motivating factors - A longitudinal descriptive study from Sweden. Nurse Education Today, 84, Article ID 104218.
Open this publication in new window or tab >>Nursing student's expectations for their future profession and motivating factors - A longitudinal descriptive study from Sweden
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2020 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 84, article id 104218Article in journal (Refereed) Published
Abstract [en]

Background: The shortage of registered nurses is a global concern. Motives to become registered nurses can be to help others, altruism, personal development and career security. Motives in combination with student expectations regarding the role are not explored. Objective: To describe students' motives to become registered nurses and their expectations regarding their future profession. Design: A longitudinal descriptive design with a qualitative approach was used to follow nursing students in the beginning, during and at the end of their education. Participants and setting A purposive sampling of a group with initially 75 students starting a three-year nursing program at a university in Sweden. Methods: A study specific questionnaire with open-ended questions was used in the beginning, during and the end of the students' education. At data collection two and three, a copy of the earlier answers was attached. Data were analysed using manifest and latent content analysis. Results: An important profession with career opportunities, interesting duties and team work were described. Students expected diversified duties, possibilities for development and work satisfaction. Increased concerns regarding their upcoming work life was described at the end of the education. Conclusion: The students had a positive understanding of the profession and perceived their forthcoming role as interesting. The leading role of coordinating patient care was more comprehensive than expected. Supportive conditions and well planned transition periods could strengthen newly graduated nurses in their professional role and could be an important aspect in the future retention of RNs.

Place, publisher, year, edition, pages
CHURCHILL LIVINGSTONE, 2020
Keywords
Expectations, Longitudinal qualitative study, Nursing students, Professional role
National Category
Nursing Pedagogy
Identifiers
urn:nbn:se:uu:diva-400737 (URN)10.1016/j.nedt.2019.104218 (DOI)000501643800026 ()31698292 (PubMedID)
Available from: 2020-01-02 Created: 2020-01-02 Last updated: 2020-01-23Bibliographically approved
Jarnulf, T., Skytt, B., Mårtensson, G. & Engström, M. (2019). District nurses experiences of precepting district nurse students at the postgraduate level. Nurse Education in Practice, 37, 75-80
Open this publication in new window or tab >>District nurses experiences of precepting district nurse students at the postgraduate level
2019 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 37, p. 75-80Article in journal (Refereed) Published
Abstract [en]

District nurses are preceptors of district nurse students at the postgraduate level. These district nurse students are already registered nurses who have graduated and are now studying to become district nurses; this training is at the postgraduate level. As preceptors at the postgraduate level, district nurses play an important role in helping these students to achieve the learning outcomes of the clinical practice part of their education. However, there is a lack of studies on precepting at this level. Thus, the aim was to describe district nurses' experiences of precepting district nurse students at the postgraduate level. The study was descriptive in design and used a qualitative approach. Purposive sampling was used and nine district nurses from seven primary health care units in Sweden were interviewed. Data were analysed using qualitative content analysis. An overall theme "Fluctuating between transferring knowledge and striving for reflective learning" and two subthemes emerged. The preceptors' views on precepting and performance varied depending on the situation. The conclusions is that given the current learning outcomes for clinical practice education at the postgraduate level, district nurses need to be more influenced by preception focused on reflective learning.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2019
Keywords
Postgraduate level, Clinical practice education, District nurses, Preceptor
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-390530 (URN)10.1016/j.nepr.2019.05.004 (DOI)000473840000011 ()31128519 (PubMedID)
Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2020-01-23Bibliographically approved
Stromberg, A., Engström, M., Hagerman, H. & Skytt, B. (2019). First-line managers dealing with different management approaches. Leadership in Health Services, 32(4), 543-557
Open this publication in new window or tab >>First-line managers dealing with different management approaches
2019 (English)In: Leadership in Health Services, ISSN 1751-1879, E-ISSN 1751-1887, Vol. 32, no 4, p. 543-557Article in journal (Refereed) Published
Abstract [en]

Purpose

The purpose of this paper is to contribute new knowledge about how first line managers (FLMs) in elderly care perceive their situation, with a focus on differences in management approaches at the intersection of the central and local parts of the organization.

Design/methodology/approach

The present study has a qualitative approach and is part of a larger project on FLMs in elderly care. The results presented here are based on a secondary analysis of 15 of the total of 28 interviews carried out in the project.

Findings

The main results are twofold: the majority of FLMs perceived differences in management approaches between local and central management; the differences caused some struggle because FLMs perceived that the management system did not support the differences. The two main aspects that caused the FLMs to struggle were differences in the foci of the management levels and difficulties in influencing the conditions of management.

Originality/value

The results contribute to the debate on what aspects are important to sustainable management of elderly care. It is common knowledge that FLMs have a complex position, intermediate to the central, upper level management and their subordinates at the local level - levels with different foci and interests. The study contributes new knowledge about what these differences consist of and the dilemmas they cause and offers suggestions as to what can be done to reduce both energy waste and the risk of low job satisfaction.

Keywords
Leadership, Elderly care, Management, Value-orientation, First-line manager, Production-orientation
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-396663 (URN)10.1108/LHS-09-2018-0046 (DOI)000491144600004 ()31612787 (PubMedID)
Available from: 2019-11-12 Created: 2019-11-12 Last updated: 2020-01-24Bibliographically approved
Hagerman, H., Engström, M., Wadensten, B. & Skytt, B. (2019). How do first-line managers in elderly care experience their work situation from a structural and psychological empowerment perspective?: An interview study. Journal of Nursing Management, 27(6), 1208-1215
Open this publication in new window or tab >>How do first-line managers in elderly care experience their work situation from a structural and psychological empowerment perspective?: An interview study
2019 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1208-1215Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The work situation for first-line managers in elderly care is complex and challenging. Little is known about these managers' work situation from a structural and psychological empowerment perspective.

AIM: To describe first-line managers' experiences of their work situation in elderly care from a structural and psychological empowerment perspective.

METHOD: Interviews from 14 female first-line managers were analysed using qualitative content analysis.

RESULTS: The theme described the managers' work situation as "It's not easy, but it's worth it." In the four subthemes, the managers described their work in terms of "Enjoying a meaningful job," "A complex and demanding responsibility that allows great authority within set boundaries," "Supported by other persons, organisational preconditions and confidence in their own abilities" and "Lacking organisational preconditions, but developing strategies for dealing with the situations."

CONCLUSION: The managers described having various amounts of access to structural empowerment and experienced a feeling of meaning, competence, self-determination and impact, that is, psychological empowerment in their work.

IMPLICATIONS FOR NURSING MANAGEMENT: It is vital that first-line managers have access to organisational support. Therefore, upper management and first-line managers need to engage in continuous dialogue to customize the support given to each first-line manager.

Keywords
elderly care, empowerment, first-line manager, structures of proportions, work situation
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-394229 (URN)10.1111/jonm.12793 (DOI)000486018500019 ()31102540 (PubMedID)
Funder
AFA InsuranceUniversity of Gävle
Available from: 2019-10-05 Created: 2019-10-05 Last updated: 2020-01-24Bibliographically approved
Kaltenbrunner, M., Mathiassen, S. E., Bengtsson, L. & Engström, M. (2019). Lean maturity and quality in primary care. Journal of Health Organisation & Management, 33(2), 141-154
Open this publication in new window or tab >>Lean maturity and quality in primary care
2019 (English)In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 33, no 2, p. 141-154Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this paper is twofold: first, to describe Lean maturity in primary care using a questionnaire based on Liker’s description of Lean, complemented with observations; and second, to determine the extent to which Lean maturity is associated with quality of care measured as staff-rated satisfaction with care and adherence to national guidelines (NG). High Lean maturity indicates adoption of all Lean principles throughout the organization and by all staff.

Design/methodology/approach: Data were collected using a survey based on Liker’s four principles, divided into 16 items (n=298 staff in 45 units). Complementary observations (n=28 staff) were carried out at four units.

Findings: Lean maturity varied both between and within units. The highest Lean maturity was found for “adhering to routines” and the lowest for “having a change agent at the unit.” Lean maturity was positively associated with satisfaction with care and with adherence to NG to improve healthcare quality.

Practical implications: Quality of primary care may benefit from increasing Lean maturity. When implementing Lean, managers could benefit from measuring and adopting Lean maturity repeatedly, addressing all Liker’s principles and using the results as guidance for further development.

Originality/value: This is one of the first studies to evaluate Lean maturity in primary care, addressing all Liker’s principles from the perspective of quality of care. The results suggest that repeated actions based on evaluations of Lean maturity may help to improve quality of care.

Keywords
Lean principles, Observations, Qualitative, Healthcare, Liker
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-382657 (URN)10.1108/JHOM-04-2018-0118 (DOI)000463633800002 ()30950305 (PubMedID)
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-05-07Bibliographically approved
Löfmark, A., Mårtensson, G., Vae, K. J. & Engström, M. (2019). Lecturer's reflection on the three-part assessment discussions with students and preceptors during clinical practice education: A repeated group discussion study. Nurse Education in Practice, 36, 1-6
Open this publication in new window or tab >>Lecturer's reflection on the three-part assessment discussions with students and preceptors during clinical practice education: A repeated group discussion study
2019 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 36, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Assessment of students' learning and achievement requires active involvement of participating students, preceptors and lecturers. The lecturers have overall responsibility for both the content of the assessment and students' learning. The aim of the present study was to investigate lecturer's reflections on the mid-course discussion and final assessment that are part of nursing students' clinical practice education. The design was descriptive and had a qualitative approach. Repeated group discussions were undertaken with 14 lecturers at two university campuses in Norway. Five categories were identified: preparing for the three-part discussion, creating a collaborative atmosphere, facilitating student learning, verifying student learning, using the assessment tool to create the assessment discussion; one theme emerged: 'being able to see and justify students' learning processes'. Lecturers' reflections on both assessment discussions and students' learning proceeded from a clear pedagogical viewpoint.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2019
Keywords
University lecturer, Clinical practice education, Assessment, Nursing student, Preceptor
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-387977 (URN)10.1016/j.nepr.2019.02.010 (DOI)000470041900001 ()30826626 (PubMedID)
Available from: 2019-06-27 Created: 2019-06-27 Last updated: 2019-06-27Bibliographically approved
Lian, Z., Skytt, B., Li, C. & Engström, M. (2019). Nursing students' reflections on caring for end-of-life patients in a youth volunteer association. Nurse Education in Practice, 34, 204-209
Open this publication in new window or tab >>Nursing students' reflections on caring for end-of-life patients in a youth volunteer association
2019 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 34, p. 204-209Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to describe nursing students' reflections on caring for end-of-life patients in a youth volunteer service. A purposive sample of 11 nursing students in one province in China were interviewed and diaries were collected. The data were analysed using qualitative content analysis. The students described the service as "an empowering care that makes a difference - but not without challenges on different levels". The service was said to provide devoted caring adjusted to the person's need, condition and wishes. According to the students, the service had an impact on them; the internal and/or external support was stimulating and rewarding, whereas deficient support was frustrating and made them feel helpless. They emphasized the need for improvements at different levels. In conclusions, the youth volunteer service empowers both patients and students and can be seen as person-centred care. The students' professional knowledge, skills and ability improved, while these aspects were still perceived as deficient. Appropriate curriculum and training for nursing students are necessary and should be tailored to improving students' caring ability and confidence. Expanding the service was emphasized and suggestions for improvements were identified.

Keywords
End-of-life care, Nursing students, Nursing education, Reflections, Volunteers
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-379237 (URN)10.1016/j.nepr.2018.12.006 (DOI)000459841600031 ()30605789 (PubMedID)
Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2020-01-23Bibliographically approved
Silén, M., Skytt, B. & Engström, M. (2019). Relationships between structural and psychological empowerment, mediated by person-centred processes and thriving for nursing home staff. Geriatric Nursing, 40(1), 67-71
Open this publication in new window or tab >>Relationships between structural and psychological empowerment, mediated by person-centred processes and thriving for nursing home staff
2019 (English)In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 40, no 1, p. 67-71Article in journal (Refereed) Published
Abstract [en]

Person-centred care has been shown to have positive outcomes for patients and for staff. However, the complexity of the link between structural conditions, work in a person-centred manner and outcomes for staff is insufficiently described. We tested the relationship between structural empowerment and psychological empowerment, as mediated by nursing home staff members' self-ratings of working in a person-centred manner, the person-centred climate and thriving. Questionnaires were distributed to staff working in 12 nursing homes in Sweden. A serial mediation model was tested. The results showed that higher access to structural empowerment was related to higher psychological empowerment mediated by staff working in a more person-centred manner, improved person-centred climate, and improved staff ratings of thriving. These results point to the importance of strengthening the preconditions for staff to work in a person-centred manner and nursing home managers play an important role in this.

Keywords
Nursing home staff, Outcomes, Person-centred processes, Structural conditions
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-371636 (URN)10.1016/j.gerinurse.2018.06.016 (DOI)000459952500010 ()30120010 (PubMedID)
Available from: 2018-12-21 Created: 2018-12-21 Last updated: 2020-01-23Bibliographically approved
Chen, J. H., Björkman, A., Zou, J. H. & Engström, M. (2019). Self-regulated learning ability, metacognitive ability, and general self-efficacy in a sample of nursing students: A cross-sectional and correlational study. Nurse Education in Practice, 37, 15-21
Open this publication in new window or tab >>Self-regulated learning ability, metacognitive ability, and general self-efficacy in a sample of nursing students: A cross-sectional and correlational study
2019 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 37, p. 15-21Article in journal (Refereed) Published
Abstract [en]

The healthcare sector is fast-growing and knowledge-intensive, and to meet the demands associated with it, nursing students must have high levels of self-regulated learning (SRL), metacognition, and general self-efficacy (GSE). In this cross-sectional, correlational study, data were collected from 216 nursing students through a questionnaire. The aims were: 1) to describe the levels of SRL ability, metacognitive ability and GSE among second- and third-year nursing students; 2) to explore the relationships between the SRL ability, metacognitive ability and GSE of second- and third-year nursing students; 3) and to compare SRL ability, metacognitive ability and GSE between second- and third-year nursing students. Nursing students had moderate levels of SRL ability and metacognitive ability, but lower levels of GSE. Positive relationships between SRL ability, metacognitive ability, and GSE were observed. Third-year nursing students had a higher level of SRL ability but lower levels of GSE, compared to second-year students. In terms of metacognitive ability, no significant differences were observed between the student batches. Interventions are required for the improvement of nursing students' SRL ability, metacognitive ability, and GSE.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2019
Keywords
Nursing students, Self-regulated learning ability, Metacognitive ability, General self-efficacy, Self-directed learning
National Category
Learning Nursing
Identifiers
urn:nbn:se:uu:diva-390529 (URN)10.1016/j.nepr.2019.04.014 (DOI)000473840000003 ()31035075 (PubMedID)
Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-08-13Bibliographically approved
Kaltenbrunner, M., Bengtsson, L., Mathiassen, S. E., Högberg, H. & Engström, M. (2019). Staff perception of Lean, care-giving, thriving and exhaustion: a longitudinal study in primary care. BMC Health Services Research, 19(1), Article ID 652.
Open this publication in new window or tab >>Staff perception of Lean, care-giving, thriving and exhaustion: a longitudinal study in primary care
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2019 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, no 1, article id 652Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Lean is commonly adopted in healthcare to increase quality of care and efficiency. Few studies of Lean involve staff-related outcomes, and few have a longitudinal design. Thus, the aim was to examine the extent to which changes over time in Lean maturity are associated with changes over time in care-giving, thriving and exhaustion, as perceived by staff, with a particular emphasis on the extent to which job demands and job resources, as perceived by staff, have a moderated mediation effect.

METHOD: A longitudinal study with a correlational design was used. In total, 260 staff at 46 primary care units responded to a web survey in 2015 and 2016. All variables in the study were measured using staff ratings. Ratings of Lean maturity reflect participants' judgements regarding the entire unit; ratings of care-giving, thriving, exhaustion and job demands and resources reflect participants' judgements regarding their own situation.

RESULTS: First, over time, increased Lean maturity was associated with increased staff satisfaction with their care-giving and increased thriving, mediated by increased job resources. Second, over time, increased Lean maturity was associated with decreased staff exhaustion, mediated by decreased job demands. No evidence was found showing that job demands and job resources had a moderated mediation effect.

CONCLUSION: The results indicate that primary care staff may benefit from working in organizations characterized by high levels of Lean maturity and that caregiving may also be improved as perceived by staff.

Keywords
COPSOQ, Exhaustion, JD-R theory, LiHcQ Lean in healthcare questionnaire, Linear mixed model, Quality of care, Thriving
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-394227 (URN)10.1186/s12913-019-4502-6 (DOI)000484951700004 ()31500624 (PubMedID)
Available from: 2019-10-05 Created: 2019-10-05 Last updated: 2019-10-22Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9912-5350

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