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Skytt, B., Högberg, H. & Engström, M. (2023). An explorative and confirmative factor analysis of the Leadership and Management Inventory-II among staff working in elderly care. Leadership in Health Services, 37(5), 66-83
Open this publication in new window or tab >>An explorative and confirmative factor analysis of the Leadership and Management Inventory-II among staff working in elderly care
2023 (English)In: Leadership in Health Services, ISSN 1751-1879, E-ISSN 1751-1887, Vol. 37, no 5, p. 66-83Article in journal (Refereed) Published
Abstract [en]

Purpose

The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.

Design/methodology/approach

Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061).

Findings

The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results.

Originality/value

The instrument measures both leadership and management performance and can be used to continually measure managers’ performances as perceived by staff to identify areas for development.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2023
Keywords
Statistical analysis, Health leadership competencies, Leadership, Management, Nurses
National Category
Nursing Business Administration Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-522461 (URN)10.1108/LHS-01-2023-0004 (DOI)001101160900001 ()37962108 (PubMedID)
Available from: 2024-02-07 Created: 2024-02-07 Last updated: 2024-02-07Bibliographically approved
Pålsson, Y., Engström, M., Leo Swenne, C. & Mårtensson, G. (2022). A peer learning intervention in workplace introduction - managers’ and new graduates’ perspectives. BMC Nursing, 21, Article ID 12.
Open this publication in new window or tab >>A peer learning intervention in workplace introduction - managers’ and new graduates’ perspectives
2022 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 21, article id 12Article in journal (Refereed) Published
Abstract [en]

Background: Evaluation of a complex intervention are often described as being diminished by difficulties regarding acceptability, compliance, delivery of the intervention, recruitment and retention. Research of peer learning for nursing students have found several positive benefits while studies of peer learning for newly graduated nurses are lacking. This study aimed (1) to investigate the study process in terms of (a) first-line managers' perspectives on the intervention study, the difficulties they face and how they handle these and (b) new graduates' fidelity to the intervention and (2) to examine the effect of the peer learning intervention in workplace introduction for newly graduated nurses.

Methods: A mixed-methods approach using semi-structured interviews with eight managers, repeated checklist for fidelity and questionnaires conducted with 35 new graduates from June 2015 and January 2018, whereof 21 in the intervention group. The peer learning intervention's central elements included pairs of new graduates starting their workplace introduction at the same time, working the same shift and sharing responsibility for a group of patients for 3 weeks. The intervention also included 3 months of regular peer reflection.

Results: Managers offered mostly positive descriptions of using peer learning during workplace introduction. The intervention fidelity was generally good. Because of recruitment problems and thereby small sample size, it was difficult to draw conclusions about peer learning effects and, thus, the study hypothesis could either be accepted or rejected. Thereby, the study should be regarded as a pilot.

Conclusions: The present study found positive experiences of, from managers, and fidelity to the peer learning intervention; regarding the experimental design, there were lessons learned.

Place, publisher, year, edition, pages
BioMed Central (BMC)BMC, 2022
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-398695 (URN)10.1186/s12912-021-00791-0 (DOI)000738633200001 ()34983518 (PubMedID)
Note

Title in dissertation list of papers: A PEER LEARNING INTERVENTION IN WORKPLACE INTRODUCTION - FIRST-LINE MANAGERS’ AND NEWLY GRADUATED NURSES’ PERSPECTIVES: A MIXED-METHODS STUDY GUIDED BY THE MEDICAL RESEARCH COUNCIL FRAMEWORK.

Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2024-01-15Bibliographically approved
Högstedt, D., Engström, M., Jansson, I. & Eriksson, E. (2021). Attending a bridging program to obtain a Swedish nursing license: An interview study with internationally educated nurses. Nurse Education Today, 99, Article ID 104744.
Open this publication in new window or tab >>Attending a bridging program to obtain a Swedish nursing license: An interview study with internationally educated nurses
2021 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 99, article id 104744Article in journal (Refereed) Published
Abstract [en]

Background: Bridging programs have been created to facilitate internationally educated nurses? integration process. Thus far, studies on bridging programs have been few and have only been conducted in English-speaking countries. Due to language barriers, it may be a greater challenge to attend a bridging program in a non-Englishspeaking country. Objectives: The aim was to examine internationally educated nurses? experience of attending a one-year bridging program to obtain a Swedish nursing license. Design: A qualitative study with a descriptive design was applied. Settings: The study setting was the five universities offering the one-year, full-time Swedish bridging program. Participants: Purposive sampling was used. Eighteen nurses participated in the study at the end of the program. Methods: Semi-structured interviews were conducted and analyzed using qualitative content analysis. Results: Studying in a new environment and language was challenging and intensive, as were adapting to a new healthcare system and relearning some nursing practices. However, attending the bridging program was also rewarding and gave feelings of happiness and pride; the nurses developed their nursing skills as well as their language and academic skills. Moreover, they became familiar with Sweden?s nursing practices, healthcare system, and culture. Good support was important, but not always enough. Conclusions: By attending a bridging program, nurses can become familiar with the country?s healthcare system and nursing practices. Moreover, develop their language skills and attain skills important to lifelong learning. Although the program may not eliminate all difficulties nurses often experience in a new country, it can offer the support nurses need to handle the challenges. However, for some nurses, due to different backgrounds and prerequisites, the support offered may need to be more individualized.

Place, publisher, year, edition, pages
ElsevierCHURCHILL LIVINGSTONE, 2021
Keywords
Bridging program, Competency-based education (MeSH), Education nursing (MeSH), Nurses international (MeSH), Licensure nursing (MeSH), Overseas nurse program, Qualitative research (MeSH)
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-443048 (URN)10.1016/j.nedt.2021.104744 (DOI)000634957300008 ()33549959 (PubMedID)
Available from: 2021-06-03 Created: 2021-06-03 Last updated: 2024-01-15Bibliographically approved
Sjolund, B.-M., Olsson, A. & Engström, M. (2021). Factors associated with improvement in depressive symptoms among older persons after hospitalisation - a prospective design with two follow-ups. Scandinavian Journal of Caring Sciences, 35(3), 923-928
Open this publication in new window or tab >>Factors associated with improvement in depressive symptoms among older persons after hospitalisation - a prospective design with two follow-ups
2021 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 3, p. 923-928Article in journal (Refereed) Published
Abstract [en]

Background Depression is a common disorder in old age and increases with hospitalisation. The aim was to investigate whether improvement in depressive symptoms after hospitalisation is associated with education level, age, gender, living situation, self-efficacy, activities in daily living and quality of life by (1) examining the prevalence of depressive symptoms at baseline and at 1st and 2nd follow-up (2) examining different factors' association with depressive symptoms at baseline and (3) examining different factors' association with improvement in depressive symptoms at baseline and at 1st and 2nd follow-up. Methods The study consisted of 145 patients, 65 years and older. Data were collected between February 2015 and September 2016 through interviews conducted using structured protocols. The instrument used was Katz index of ADL, Geriatric Depression Scale-20, Life Satisfaction Questionnaire and the General Self-Efficacy Scale. The participants were interviewed before discharge from hospital, after 1.5 month and after 3 months. Results The prevalence of depressive symptoms in older persons was high after hospitalisation. Factors associated with improvement of depressive symptoms after hospitalisation were higher educational level, improvement in activities in daily living and quality of life. Non-significant results were found for improvement of depressive symptoms and gender, age, living situation or self-efficacy. Conclusions Depression is a common health problem in older persons, especially after hospitalisation. It is therefore important that healthcare staff screen older persons for depression during hospitalisation, as this allows identification of those in need and a possibility to help them in an appropriate manner. Persons with lower educational level and depressive symptoms need special attention.

Place, publisher, year, edition, pages
John Wiley & SonsWILEY, 2021
Keywords
depression, hospitalisation, older persons
National Category
Nursing Geriatrics
Identifiers
urn:nbn:se:uu:diva-454396 (URN)10.1111/scs.12910 (DOI)000565704500001 ()32885891 (PubMedID)
Funder
University of Gävle
Available from: 2021-09-29 Created: 2021-09-29 Last updated: 2024-01-15Bibliographically approved
Pålsson, Y., Mårtensson, G., Leo Swenne, C., Mogensen, E. & Engström, M. (2021). First-year nursing students’ collaboration using peer learning during clinical practice education: an observational study. Nurse Education in Practice, 50, Article ID 102946.
Open this publication in new window or tab >>First-year nursing students’ collaboration using peer learning during clinical practice education: an observational study
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2021 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 50, article id 102946Article in journal (Refereed) Published
Abstract [en]

The purpose of this observational study was to describe the collaboration between first-year nursing students using peer learning during their first clinical practice education. In earlier, predominantly interview studies, peer learning has been described as a model with several positive outcomes. However, no studies on how students act in collaboration in a real-life context have been found. The present study observed sixteen arbitrarily paired nursing students (eight pairs) on three to five occasions per pair, in total 164 h from September 2015 to March 2016. Repeated unstructured observations including informal conversations were used. Using qualitative content analysis, one theme 'Involuntary collaboration leads to growth in different competencies' emerged and three categories 'Practising nursing skills and abilities when working together', 'Establishing knowledge by helping each other to understand' and 'Sharing thoughts, feelings, and knowledge and put them into words'. In conclusion, nursing students using peer learning were observed practising several competencies, some of them not so easily elicited according to earlier research as organization, nursing leadership, teaching, and supervision.

Place, publisher, year, edition, pages
Elsevier, 2021
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-398692 (URN)10.1016/j.nepr.2020.102946 (DOI)000614932700018 ()33310510 (PubMedID)
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2024-01-15Bibliographically approved
Adel, E., Lofmark, A., Pålsson, Y., Mårtensson, G., Engström, M. & Lindberg, M. (2021). Health-promoting and -impeding aspects of using peer-learning during clinical practice education: A qualitative study. Nurse Education in Practice, 55, Article ID 103169.
Open this publication in new window or tab >>Health-promoting and -impeding aspects of using peer-learning during clinical practice education: A qualitative study
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2021 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 55, article id 103169Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of the present study was to elucidate health-promoting and -impeding aspects of peer-learning by examining nursing students' descriptions of learning together as peers, and how this might interact with their health. Background: Peer-learning is a useful strategy for teaching and learning in nursing students' clinical practice education. In the research, benefits such as improved cooperation and increased self-confidence have been described and labelled as health-promoting. Design: A qualitative descriptive approach Method: Thirteen first-year nursing students aged 22-45 years, who had completed their first clinical practice education on a medical or surgical hospital ward, participated in one-on-one semi-structured interviews. The interviews were analyzed using qualitative content analysis. Result: Working as a pair was primarily described as positive, as the peers felt basic support from each other, even though they described negative experiences that limited their own development and challenged their patience. Conclusion: Peer-learning as a model for supervision in clinical practice incorporates valuable health-promoting aspects, as the students felt safe, supported, increased self-confidence, and participation. The interaction between peers helped them grow as human beings, and the mutual support the peers felt was a vital health-promoting aspect that limited the impact of the described health-impeding aspects, which included sometimes finding peer-learning trying, stressful and irritating.

Place, publisher, year, edition, pages
ElsevierELSEVIER SCI LTD, 2021
Keywords
Nursing students, Nursing clinical education, Peer learning, Qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-457569 (URN)10.1016/j.nepr.2021.103169 (DOI)000701903200024 ()34388617 (PubMedID)
Available from: 2021-11-04 Created: 2021-11-04 Last updated: 2024-01-15Bibliographically approved
Sjölund, B.-M., Mamhidir, A.-G. & Engström, M. (2021). Pain prevalence among residents living in nursing homes and its association with quality of life and well-being. Scandinavian Journal of Caring Sciences, 35(4), 1332-1341
Open this publication in new window or tab >>Pain prevalence among residents living in nursing homes and its association with quality of life and well-being
2021 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 4, p. 1332-1341Article in journal (Refereed) Published
Abstract [en]

Background: Pain is common and often more complex to assess among nursing homes residents with cognitive impairments. Thus, more research is needed of different pain assessment methods in elderly care and how these assessments outcomes are related to quality of life, as there mostly should be a negative relationship. There is a risk that pain are under diagnosed among persons with cognitive impairment.

Aim: The aim was to describe and compare pain prevalence among nursing home residents (1) using different pain assessment methods (2) in relation to cognitive status and to (3) examine associations between pain and quality of life or well-being.

Methods: A cross-sectional correlational design was used, participants were 213 nursing home residents and data were collected through interviews using standardised protocols. Instrument used were Katz index of ADL, Mini-Mental-State-Examination, Quality of Life in Late-Stage Dementia scale, WHO-5 well-being index, Numeric Rating Scale and Doloplus-2 scale.

Results: The results showed high pain prevalence, but no significant difference based on cognitive level. Pain classification at the individual level varied somewhat when different instruments are used. The results indicated that use of a single-item proxy-measure for pain tends to show higher pain prevalence and was not statistically significant related to quality of life. The relationship with quality of life was statistically significant when self-rated pain instruments or multi-component observation were used.

Conclusions: The study shows that it is difficult to estimate pain in residents living at nursing homes and that it continues to be a challenge to solve. Self-rated pain should be used primarily to assess pain, and a multi-component observation scale for pain should be used when residents are cognitively impaired. Both self-rated pain and multi-component observation also support the well-known link between pain and quality of life. Single-item proxy assessments should only be used in exceptional cases.

Place, publisher, year, edition, pages
John Wiley & SonsWiley, 2021
Keywords
pain assessment, quality of life, nursing homes, older residents
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-469694 (URN)10.1111/scs.12955 (DOI)000605177200001 ()33410189 (PubMedID)
Funder
Alzheimerfonden
Available from: 2022-03-14 Created: 2022-03-14 Last updated: 2024-01-15Bibliographically approved
Engström, M., Högberg, H., Strömberg, A., Hagerman, H. & Skytt, B. (2021). Staff Working Life and Older Persons' Satisfaction With Care: A Multilevel, Correlational Design. Journal of Nursing Care Quality, 36(1), E7-E13
Open this publication in new window or tab >>Staff Working Life and Older Persons' Satisfaction With Care: A Multilevel, Correlational Design
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2021 (English)In: Journal of Nursing Care Quality, ISSN 1057-3631, E-ISSN 1550-5065, Vol. 36, no 1, p. E7-E13Article in journal (Refereed) Published
Abstract [en]

Background: 

The importance of staff working life for staff well-being has been demonstrated in several studies; less research has focused on staff working life and older persons' satisfaction with care.

Purpose: 

The study aim was to study relationships between 1) staff assessments of their structural conditions/empowerment in elderly care, psychological empowerment, and job satisfaction and (2) older persons' satisfaction with care.

Methods: 

A multilevel, cross-sectional, and correlational design was applied using questionnaire data on working life (1021 staff members) and unit-level data (40 elderly care units) on older persons' satisfaction with care.

Results: 

Statistically significant relationships were found between all 3 working life variables and older persons' satisfaction with care. Furthermore, the results revealed an indirect/mediating effect of job satisfaction between structural empowerment and satisfaction with care, but not for psychological empowerment.

Conclusions: 

Staff structural empowerment, psychological empowerment, and job satisfaction are linked to older persons' satisfaction with care.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2021
Keywords
elderly care, empowerment, job satisfaction, nurses, quality of care
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-430194 (URN)10.1097/NCQ.0000000000000463 (DOI)000595905000004 ()32079960 (PubMedID)
Funder
AFA Insurance
Available from: 2021-01-08 Created: 2021-01-08 Last updated: 2024-01-15Bibliographically approved
Olsson, A., Skovdahl, K. & Engström, M. (2021). Strategies used by people with Alzheimer's disease for outdoor wayfinding: A repeated observational study. Dementia, 20(2), 505-517
Open this publication in new window or tab >>Strategies used by people with Alzheimer's disease for outdoor wayfinding: A repeated observational study
2021 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 20, no 2, p. 505-517Article in journal (Refereed) Published
Abstract [en]

This study aimed to describe the wayfinding strategies used during outdoor walks by people with Alzheimer's disease. Inspired by an ethnographic approach, observations and conversations during repeated outdoor walks with five people with Alzheimer's disease living in their own homes were conducted. Data were analyzed using qualitative content analysis. The wayfinding strategies the participants described were: (1) landmarks, (2) used their senses, (3) stopped, looked around, and thought, (4) walking the same way or loop and in familiar areas, and (5) only walked in places and on routes where they could see other people and houses. Using wayfinding strategies might help people with Alzheimer's disease to be independent during outdoor walks, and discussing these strategies with relatives and nursing care staff may help finding people with Alzheimer's disease if lost outdoors. Wayfinding during the winter might be facilitated if temporary and changeable objects are avoided in people with Alzheimer's disease's walking route.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
Alzheimer’s disease, observation, outdoors, qualitative research, wayfinding
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-402187 (URN)10.1177/1471301219896453 (DOI)000506777700001 ()31874572 (PubMedID)
Available from: 2020-01-11 Created: 2020-01-11 Last updated: 2023-07-13Bibliographically approved
Forsman, H., Jansson, I., Leksell, J., Lepp, M., Sundin Andersson, C., Engström, M. & Nilsson, J. (2020). Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students. Journal of Advanced Nursing, 76(1), 199-208
Open this publication in new window or tab >>Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students
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2020 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 76, no 1, p. 199-208Article in journal (Refereed) Published
Abstract [en]

AIMS: To identify clusters based on graduating nursing students' self-reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students' perceptions of overall quality of the nursing programme and students' general self-efficacy.

DESIGN: A cross-sectional study combining survey data and results from a national examination.

METHODS: Data were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the General Self-Efficacy scale and results from the National Clinical Final Examination. A Two-Step Cluster Analysis was used to identify competence profiles, followed by comparative analyses between clusters.

RESULTS: Three clusters were identified illustrating students' different competence profiles. Students in Cluster 1 and 2 passed the examination, but differed in their self-assessments of competence, rating themselves under and above the overall median value respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.

CONCLUSION: The study illustrates how nursing students' self-assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self-evaluation is a key learning outcome and is, in the long run, essential to patient safety.

IMPACT: The study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their general self-efficacy lower than other students. The findings illuminate the need for student-centered strategies in nursing education, including elements of self-assessment in relation to examination to make the students more aware of their clinical competence.

Keywords
cluster analysis, nursing education, nursing students, professional competence, questionnaires, self-assessment, survey
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-394225 (URN)10.1111/jan.14222 (DOI)000492752500001 ()31576579 (PubMedID)
Available from: 2019-10-05 Created: 2019-10-05 Last updated: 2021-03-26Bibliographically approved
Projects
Arbetsmiljö och hälsa bland personal i äldreomsorgen: en modell för validering och lärande med stöd av IKT hos personal som saknar formell kompetens [100062]; University of GävleÄldreomsorgens vårdare och ledare; samspelet mellan strukturella förutsättningar, chef- ledarskap, arbetssituation och personalens hälsa [110043]; University of GävleThe Intervention CAN-Work-S: Facilitating Work Participation among Cancer Survivors During their Entire Professional Career [2021-01546_Forte]; University of Gävle
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9912-5350

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