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  • 1.
    Lindberg, Magnus
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Bäckström-Andersson, Helena
    Gävle sjukhus.
    Lindström, Rosmarie
    Gävle sjukhus.
    Lindberg, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Dry weight from the haemodialysis patient perspective2013In: Renal Society of Australasia Journal, ISSN ISSN 1832-3804, Vol. 9, no 2, p. 68-73Article in journal (Refereed)
    Abstract [en]

    Background

    The concept of dry weight is central to fluid control in patients on haemodialysis (HD). Few studies have explored the concept from the patient perspective. Thus, the aim of the present study was to explore how patients on HD perceive the concept of dry weight and how they act in relation to it.

    Methods

    A purposive sample of 10 HD patients was interviewed once during a dialysis session in May–June 2009. The narratives were analysed using manifest qualitative content analysis.

    Findings

    The findings indicated that the concept was regarded as either an aid to securing treatment-related health, as indicating the fluid surplus volume or as a reminder of the daily fluid allotment. Some informants, however, did not report any specific perception. Plans for dealing with the perceptions were expressed in terms of using self-care strategies to control fluid balance, transferring responsibility to the HD team, and managing the physical consequences or social and psychological concerns.

    Conclusion

    Four ways in which HD patients perceived the dry weight concept were demonstrated. It is important that HD patients understand the significance of dry weight, both for their own wellbeing and for treatment adequacy. Prevalent misunderstandings about the dry weight concept have to be addressed by the dialysis team in order to prevent further suffering. By acknowledging the patient’s perspective of the dry weight concept, the dialysis team could help the patient to successfully develop self-care strategies for dealing with the consequences of chronic renal failure.

  • 2.
    Lindberg, Magnus
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gävle, Sweden.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gävle, Sweden.
    Wågström, B-M
    Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gävle, Sweden.
    Arvidsson, L.
    Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gävle, Sweden.
    Lindberg, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gävle, Sweden.
    Risk behaviours for organism transmission in daily care activities: a longitudinal observational case study2018In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 100, no 3, p. e146-e150, article id S0195-6701(18)30406-7Article in journal (Refereed)
    Abstract [en]

    Background: To understand healthcare personnel's infection prevention behaviour has long been viewed as a key factor in preventing healthcare-associated infections. Suboptimal hand hygiene compliance and handling of materials, equipment, and surfaces present the main risks for potential organism transmission. Further exploration is needed regarding the role of context-specific conditions and the infection prevention behaviours of healthcare personnel. Such knowledge could enable the development of new intervention strategies for modifying behaviour.

    Aim: To describe risk behaviours for organism transmission in daily care activities over time.

    Methods: Unstructured observations of healthcare personnel carrying out patient-related activities were performed on 12 occasions over a period of 18 months.

    Findings: Risk behaviours for organism transmission occur frequently in daily care activities and the results show that the occurrence is somewhat stable over time. Interruptions in care activities contribute to an increased risk for organism transmission that could lead to subsequent healthcare-associated infection.

    Conclusion: Interventions aimed at reducing the risks of healthcare-associated infections need to focus on strategies that address: hand hygiene compliance; the handling of materials, equipment, work clothes and surfaces; the effects of interruptions in care activities if they are to alter healthcare personnel's infection prevention behaviour sufficiently.

  • 3.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Fac Hlth & Occupat Studies, Dept Caring Sci, SE-80176 Gavle, Sweden.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Fac Hlth & Occupat Studies, Dept Caring Sci, SE-80176 Gavle, Sweden;Lishui Univ, Fac Med & Hlth, Dept Nursing Sci, Lishui, Zhejiang, Peoples R China.
    Kristofferzon, Marja-Leena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Fac Hlth & Occupat Studies, Dept Caring Sci, SE-80176 Gavle, Sweden.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Fac Hlth & Occupat Studies, Dept Caring Sci, SE-80176 Gavle, Sweden.
    Nursing student's expectations for their future profession and motivating factors - A longitudinal descriptive study from Sweden2020In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 84, article id 104218Article in journal (Refereed)
    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.

  • 4.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Högman, Marieann
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Suffering from meticillin-resistant Staphylococcus aureus: experiences and understandings of colonisation2009In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 73, no 3, p. 271-277Article in journal (Refereed)
    Abstract [en]

    The objective was to explore individuals' experiences and understandings of meticillin-resistant Staphylococcus aureus (MRSA) colonisation. Thirteen interviews were performed and processed using content analysis, resulting in the theme 'Invaded, insecure and alone'. The participants experienced fears and limitations in everyday life and expressed a need to protect others from contagion. Moreover, they experienced encounters with, and information from, healthcare workers differently: some were content, whereas others were discontent. The described fears, limitations and inadequate professional-patient relationship generated unacceptable distress for MRSA-colonised persons. Thus, the healthcare sector should assume responsibility for managing MRSA, and healthcare workers must improve their professionalism and information skills, so as to better meet MRSA-colonised persons' needs.

  • 5.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    MRSA-colonized persons' and healthcare personnel's experiences of patient-professional interactions in and responsibilities for infection prevention in Sweden2014In: Journal of infection and public health, ISSN 1876-035X, Vol. 7, no 5, p. 427-435Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Patient-professional interactions and adherence to infection control measures are central to the quality of care and patient safety in healthcare. Persons colonized with methicillin-resistant Staphylococcus aureus (MRSA) describe insufficient support and unprofessional behavior among healthcare personnel.

    METHODS:

    A descriptive qualitative study was conducted to investigate managers', physicians', registered nurses' and MRSA-colonized persons' experiences of patient-professional interactions in relation to and responsibilities for infection prevention in the care of colonized patients. Five persons with MRSA colonization and 20 healthcare personnel employed within infection, hematology, nephrology or primary healthcare settings participated. The data were collected using open-ended semi-structured individual interviews with the MRSA-colonized persons and semi-structured focus group interviews with the healthcare personnel.

    RESULTS:

    The participants perceived MRSA as an indefinable threat and described that the responsibility for infection prevention is important, but such adherence was a neglected and negotiable issue. The described actions that were acknowledged as unprofessional and inappropriate adherence to infection prevention resulted in stigmatized patients.

    CONCLUSION:

    Colonized persons' and healthcare personnel's understanding of MRSA determines whether the personnel's behavior is perceived as proper or improper. Individual responsibility for patient-professional interactions in relation to MRSA colonization and adherence to infection control measures should be more stringent.

  • 6.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Performance and acting in care relations: experiences of MRSA-colonized persons and healthcare personnel2012Article in journal (Other academic)
  • 7.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindberg, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Risk behaviours for organism transmission in health care delivery-A two month unstructured observational study.2017In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 70, p. 38-45Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Errors in infection control practices risk patient safety. The probability for errors can increase when care practices become more multifaceted. It is therefore fundamental to track risk behaviours and potential errors in various care situations.

    OBJECTIVE: The aim of this study was to describe care situations involving risk behaviours for organism transmission that could lead to subsequent healthcare-associated infections.

    DESIGN & SETTING: Unstructured nonparticipant observations were performed at three medical wards.

    PARTICIPANTS & METHODS: Healthcare personnel (n=27) were shadowed, in total 39h, on randomly selected weekdays between 7:30 am and 12 noon. Content analysis was used to inductively categorize activities into tasks and based on the character into groups. Risk behaviours for organism transmission were deductively classified into types of errors. Multiple response crosstabs procedure was used to visualize the number and proportion of errors in tasks. One-Way ANOVA with Bonferroni post Hoc test was used to determine differences among the three groups of activities.

    RESULTS: The qualitative findings gives an understanding of that risk behaviours for organism transmission goes beyond the five moments of hand hygiene and also includes the handling and placement of materials and equipment. The tasks with the highest percentage of errors were; 'personal hygiene', 'elimination' and 'dressing/wound care'. The most common types of errors in all identified tasks were; 'hand disinfection', 'glove usage', and 'placement of materials'. Significantly more errors (p<0.0001) were observed the more multifaceted (single, combined or interrupted) the activity was.

    CONCLUSION: The numbers and types of errors as well as the character of activities performed in care situations described in this study confirm the need to improve current infection control practices. It is fundamental that healthcare personnel practice good hand hygiene however effective preventive hygiene is complex in healthcare activities due to the multifaceted care situations, especially when activities are interrupted. A deeper understanding of infection control practices that goes beyond the sense of security by means of hand disinfection and use of gloves is needed as materials and surfaces in the care environment might be contaminated and thus pose a risk for organism transmission.

  • 8.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Högman, Marieann
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    The Multidrug-Resistant Bacteria Attitude Questionnaire: validity and understanding of responsibility for infection control in Swedish registered district, haematology and infection nurses2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 3-4, p. 424-436Article in journal (Refereed)
    Abstract [en]

    Aim. To assess the discriminative and construct validity of the Multidrug-Resistant Bacteria Attitude Questionnaire and to study registered nurses knowledge of, behaviour toward and emotional responses to patients with multidrug-resistant bacteria in relation to how they understand their own, managers and politicians responsibility for adherence to preventive measures for infection control.

    Background. Multidrug-resistant organisms are a global problem and an essential topic in healthcare regarding patient safety improvement.

    Design. Descriptive and correlational cross-sectional survey.

    Method. Data were collected in a non-random sample consisting of 397 registered nurses; district, haematology or infection registered nurses. One-way analysis of variance and independent t-tests were used for comparisons and a principal component analysis was performed.

    Results. Discriminative and construct validity were supported, as the infection registered nurses generally had higher scores on knowledge, behaviour and emotional response, compared with district registered nurses and haematology registered nurses and the three-factor solution was confirmed. Registered nurses with higher scores on knowledge and emotional response attributed greater responsibility to themselves and to politicians. The Multidrug-Resistant Bacteria Attitude Questionnaire was translated using a forward-back translation process.

    Conclusion. The questionnaire has adequate psychometric properties. Insufficient knowledge of, behaviour toward and emotional response to patients with multidrug-resistant bacteria were described, but the registered nurses did estimate their own responsibility for adherence to preventive measures for infection control as being great or very great.

    Relevance to clinical practice. There is a considerable need to improve knowledge, behaviour and emotional response regarding infection prevention measures among healthcare workers. The hospital management are responsible for such improvements and the Multidrug-Resistant Bacteria Attitude Questionnaire is useful in identifying such needs, as it has adequate psychometric properties and is able to discriminate between groups. Evaluation among healthcare workers may indicate where to situate additional training, as this is of clinical significance for safe care.

  • 9.
    Lindberg, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gavle, Sweden.
    Lindberg, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gavle, Sweden.
    Perceptions of Infection Control Practices and the use of Vignettes to Alter Infection Control Behavior: A Feasibility Study2019In: FLORENCE NIGHTINGALE JOURNAL OF NURSING-FLORENCE NIGHTINGALE HEMSIRELIK DERGISI, ISSN 2147-4923, Vol. 27, no 3, p. 231-240Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the perceptions of infection control practices among healthcare personnel and evaluate the use of authentic vignettes as a means to alter infection control behavior.

    Method: Four authentic vignettes were used as a part of reflective dialogues with healthcare personnel. An evaluation of the dialogues was performed with six healthcare personnel using the focus group technique. Qualitative content analysis was used to analyze the data.

    Results: The mind-set to help one another and do one's best in every situation was described as a core aspect in preventing the transmission of microorganisms. Having support, taking personal responsibility, being knowledgeable about infection control practices, and having a reasonable workload were seen to play decisive roles in controlling the spread of infection. Discussing authentic comprehensible vignettes with colleagues during the allotted time was considered a valuable method for improving infection control practices.

    Conclusion: Meaningful insights on how best to use vignettes as a means to improve infection control practice were gained. These findings should be considered when designing theory-driven interventions in different contexts, which are aimed at improving infection control practices in health care.

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