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  • 1. Abdelrazek, Fathya
    et al.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Aly, Magda
    El-Sabour, Mona Abd
    Ibrahim, Naglaa
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Leadership and management skills of first-line managers of elderly care and their work environment2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 6, p. 736-745Article in journal (Refereed)
    Abstract [en]

    Aim To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries.

  • 2.
    Athlin, Åsa Muntlin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Univ Uppsala Hosp, Dept Emergency Care & Internal Med, Entrance 40, S-75185 Uppsala, Sweden.;Univ Adelaide, Sch Nursing, Adelaide, SA, Australia..
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gavle, Sweden.;Lishui Univ, Sch Med & Hlth, Dept Nursing, Lishui, Peoples R China..
    Gunningberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Uppsala Hosp, Qual Dept, Uppsala, Sweden..
    Baath, Carina
    Karlstad Univ, Fac Hlth Sci & Technol, Dept Hlth Sci, Karlstad, Sweden.;Cty Council Varmland, Karlstad, Sweden..
    Heel pressure ulcer, prevention and predictors during the care delivery chain - when and where to take action?: A descriptive and explorative study2016In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 24, article id 134Article in journal (Refereed)
    Abstract [en]

    Background: Hazardous healthcare settings, for example acute care, need to focus more on preventing adverse events and preventive actions across the care delivery chain (i.e pre-hospital and emergency care, and further at the hospital ward) should be more studied. Pressure ulcer prevalence is still at unreasonably high levels, causing increased healthcare costs and suffering for patients. Recent biomedical research reveals that the first signs of cell damage could arise within minutes. However, few studies have investigated optimal pressure ulcer prevention in the initial stage of the care process, e.g. in the ambulance care or at the emergency department. The aim of the study was to describe heel pressure ulcer prevalence and nursing actions in relation to pressure ulcer prevention during the care delivery chain, for older patients with neurological symptoms or reduced general condition. Another aim was to investigate early predictors for the development of heel pressure ulcer during the care delivery chain. Methods: Existing data collected from a multi-centre randomized controlled trial investigating the effect of using a heel prevention boot to reduce the incidence of heel pressure ulcer across the care delivery chain was used. Totally 183 patients participated. The settings for the study were five ambulance stations, two emergency departments and 16 wards at two hospitals in Sweden. Results: A total of 39 individual patients (21 %) developed heel pressure ulcer at different stages across the care delivery chain. Findings revealed that 47-64 % of the patients were assessed as being at risk for developing heel pressure ulcer. Preventive action was taken. However, all patients who developed pressure ulcer during the care delivery chain did not receive adequate pressure ulcer prevention actions during their hospital stay. Discussion and Conclusions: In the ambulance and at the emergency department, skin inspection seems to be appropriate for preventing pressure ulcer. However, carrying out risk assessment with a validated instrument is of significant importance at the ward level. This would also be an appropriate level of resource use. Context-specific actions for pressure ulcer prevention should be incorporated into the care of the patient from the very beginning of the care delivery chain.

  • 3.
    Bjorkman, Annica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Caring Sci Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Caring Sci Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden; Lishui Univ, Med & Hlth Coll, Nursing Dept, Lishui, Peoples R China.
    Olsson, Annakarin
    Caring Sci Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Wahlberg, Anna Carin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Identified obstacles and prerequisites in telenurses' work environment: a modified Delphi study2017In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, no 1, article id 357Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Telenursing is an expanding part of healthcare, staffed with registered nurses whose work environment is typical of a call centre. Work-related stress has been shown to be a major problem in nurses' work environments and of importance to the outcome of care, patient safety, nurse job satisfaction and burnout. Today, however, we have a limited understanding of and knowledge about the work environment for telenurses. The aim of the present study is to explore and reach consensus on perceived important obstacles and prerequisites in telenurses' work environment.

    METHODS: A modified Delphi design, using qualitative as well as quantitative data sequentially through three phases, was taken. Data were initially collected via semi-structured interviews (Phase I) and later using a web survey (Phase II-III) between March 2015 and March 2016.

    RESULTS: The findings present a consensus view of telenurses' experiences of important obstacles and prerequisites in their work environment. Central to the findings are the aspects of telenurses having a demanding work, cognitive fatigue and having no opportunity for recovery during the work shift was ranked as important obstacles. Highly ranked prerequisites for managing were being able to focus on one caller at a time, working in a calm and pleasant environment and having technical support 24/7.

    CONCLUSIONS: Managers need to enable telenurses to experience control in their work, provided with possibilities to control their work and to recover during work; shortening work time could improve their work environment. Limited possibilities to perform work might contribute to feelings of stress and inability to perform work.

  • 4.
    Blanck, Susanne
    et al.
    Baldersnäs Din Hälsocent, S-82143 Bollnäs, Sweden..
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Dept Hlth & Caring Sci, Fac Hlth & Occupat Studies, Gavle, Sweden..
    District nurses' prescribing practice and its link to structural conditions2015In: Journal of the American Association of Nurse Practitioners, ISSN 2327-6886, E-ISSN 2327-6924, Vol. 27, no 10, p. 568-575Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe district nurses' (DNs') prescribing practice and examine associations between DNs' self-reported prescribing frequency, opinions about prescribing, and structural conditions/empowerment. Data sources: A cross-sectional and correlational design was employed. Data were collected during 2012 using questionnaires and a prescribing register. A random sample of 150 DNs from 32 primary care centers in Sweden was invited. Conclusions: DNs' ability to prescribe is used to a relatively small extent and access to "opportunities" and "informal power" seems to be the most important structural empowerment conditions for increased prescribing frequency and positive opinions about prescribing. The results support Kanter's theory of structural empowerment. Implications for practice: This article regarding restricted prescribing shows how important structural conditions/empowerment is to DNs' prescribing and employers have to enhance nurses' access to especially the structures "opportunities" and "informal power" to increase nurse prescribing. More targeted support and training are needed in different prescribing areas to make use of DNs' prescription qualification to a greater extent.

  • 5.
    Bååth, Carina
    et al.
    Karlstad Univ, Fac Hlth Sci & Technol, Dept Hlth Sci, Univ Gatan 2, S-65188 Karlstad, Sweden.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Uppsala Hosp, Surg & Oncol Div, Uppsala, Sweden.
    Gunningberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Uppsala Hosp, Surg & Oncol Div, Uppsala, Sweden.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Univ Adelaide, Sch Nursing, Adelaide, SA, Australia.; Univ Uppsala Hosp, Dept Emergency Care, Uppsala, Sweden.
    Prevention of heel pressure ulcers among older patients - from ambulance care to hospital discharge: A multi-centre randomized controlled trial.2016In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 30, p. 170-175Article in journal (Refereed)
    Abstract [en]

    UNLABELLED: The aim was to investigate the effect of an early intervention, a heel suspension device boot, on the incidence of heel pressure ulcers among older patients (aged 70+).

    BACKGROUND: Pressure ulcers are a global healthcare issue; furthermore, the heel is an exposed location. Research indicates that preventive nursing interventions starting during the ambulance care and used across the acute care delivery chain are seldom used.

    METHODS: A multi-centre randomized control study design was used. Five ambulance stations, two emergency departments and 16 wards at two Swedish hospitals participated. Altogether, 183 patients were transferred by ambulance to the emergency department and were thereafter admitted to one of the participating wards.

    RESULTS: Significantly fewer patients in the intervention group (n=15 of 103; 14.6%) than the control group (n=24 of 80; 30%) developed heel pressure ulcers during their hospital stay (p=0.017).

    CONCLUSIONS: Pressure ulcer prevention should start early in the acute care delivery chain to increase patient safety.

  • 6. Candell, A.
    et al.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Dental hygienists' work environment: motivating, facilitating, but also trying2010In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 8, no 3, p. 204-212Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to describe dental hygienists' experiences of their physical and psychosocial work environment. The study was descriptive in design and used a qualitative approach. Eleven dental hygienists participated in the study and data were collected during spring 2008 using semi-structured interviews. The material was analysed using qualitative content analysis. The results showed that the dental hygienists experienced their work environment as motivating and facilitating, but at the same time as trying. The three categories revealed a theme: Being controlled in a modern environment characterized by good relationships. Motivating factors were the good relationship with co-workers, managers and patients, seeing the results of your work, having your own responsibility and making your own decisions. The new, pleasant and modern clinics, good cooperation between co-workers and varying duties were described as facilitating factors. The trying factors, as described by the dental hygienists, were above all being controlled by time limits or by some elements of the work, such as teamwork. The dental hygienists also felt stress because appointments were too-short. To conclude, the participants described their work environment as trying in several ways, despite the modern clinics and good relationships.

  • 7.
    Chen, Jian Hua
    et al.
    Lishui Univ, Med & Hlth Coll, Dept Nursing, Lishui 323000, Zhejiang, Peoples R China.
    Björkman, Annica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Univ Gavle, Fac Hlth & Occupat Studies, Kungsbacksvagen 47, S-80176 Gavle, Sweden.
    Zou, Ji Hua
    Lishui Univ, Med & Hlth Coll, Dept Nursing, Lishui 323000, Zhejiang, Peoples R China.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Kungsbacksvagen 47, S-80176 Gavle, Sweden.
    Self-regulated learning ability, metacognitive ability, and general self-efficacy in a sample of nursing students: A cross-sectional and correlational study2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 37, p. 15-21Article in journal (Refereed)
    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.

  • 8.
    Dahlkvist, Eva
    et al.
    Faculty of Health and Occupational Studies, University of Gävle, Sweden Department of Health and Medicine, Örebro University, Sweden.
    Hartig, Terry
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Institute for Housing and Urban Research.
    Nilsson, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle, Sweden.
    Högberg, Hans
    Faculty of Health and Occupational Studies, University of Gävle, Sweden.
    Skovdahl, Kirsti
    Faculty of Health Sciences, Buskerud University College, Tønsberg, Norway.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle, Sweden.
    Garden greenery and the health of older people in residential care facilities: a multi-level cross-sectional study2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 9, p. 2065-2076Article in journal (Refereed)
    Abstract [en]

    Aims. To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden. Background. Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health. Design. A multi-level, cross-sectional, correlational design. Methods. Questionnaires were administered June–August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial mediation model was tested with multiple linear regression analysis. Results. The total indirect effect of greenery on self-perceived health was positive and significant. Garden greenery appears to affect health by enhancing a sense of being away, affording possibilities to experience the outdoor environment as interesting and encouraging visitation. Among residents in homes with multiple barriers, only fascination mediated the relationship between greenery and selfperceived health. Conclusion. Ample greenery in outdoor space at residential facilities for older people appears to promote experiences of being away and fascination, more frequent visitation and better health.

  • 9. Dahlkvist, Eva
    et al.
    Nilsson, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Skovdahl, Kirsti
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Is There a Caring Perspective in Garden/Patio Design in Elderly Care?: A Description and a Comparison of Residents’ and Staff Members’ Perceptions of These Outdoor Spaces2014In: Journal of Housing for the Elderly, ISSN 0276-3893, E-ISSN 1540-353X, Vol. 28, no 1, p. 85-106Article in journal (Refereed)
    Abstract [en]

    This article aims to describe the characteristics of and design elements in gardens/patios at 87 residential living homes for older people and to describe and compare residents’ and staff members’ perceptions of outdoor spaces. The aim was also to investigate factors related to residents' satisfaction with and stays in the garden/patio. The result showed that many gardens/patios had several recommended design elements and, at the same time, obvious deficiencies. The residents (n = 415) valued various aspects of the garden/patio more highly than did the staff (n = 667). Managers responsible for residential living homes for elderly people should take measures to ameliorate deficiencies and deficient elements in design and accessibility that are lacking so that the garden/patio can be used as an important health promotion resource in the care of elderly people. Residents and staff are important actors in such development work.

  • 10.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindqvist, Ragny
    Ljunggren, Birgitta
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Relatives' opinions of IT support, perceptions of irritations and life satisfaction in dementia care2006In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 12, no 5, p. 246-250Article in journal (Refereed)
    Abstract [en]

    We studied relatives' opinions of IT support at a residential home for persons with dementia. We also investigated the relatives' perceptions of irritations and life satisfaction before and after increased IT support. This was accomplished using an experimental group (n = 14) and a control group (n = 8) of subjects in dementia care. The design was quasi-experimental with baseline assessments and three follow-ups. Data were collected using two questionnaires measuring opinions of the IT support: irritations in care (the Nursing Home Hassles Scale) and life satisfaction (the Life Satisfaction Questionnaire). Results showed that relatives' opinions of IT support were generally positive. In the experimental group, relatives' perceptions of practical/logistical irritations decreased between baseline and 12-month follow-up. In the control group, there was an increase in the total Nursing Home Hassles score between baseline and three-month follow-up. This difference did not persist at seven- and 12-month follow-ups. No significant differences were found for life satisfaction. We conclude that relatives had positive opinions of IT support, and their perceptions of practical/logistical irritations decreased after implementation of the IT support package.

  • 11.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindqvist, Ragny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ljunggren, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Staff members' perceptions of a ICT support package in dementia care during the process of implementation2009In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 17, no 7, p. 781-789Article in journal (Refereed)
    Abstract [en]

    AIM

    The aim of the present study was to describe staff members' perceptions of an information and communication technology (ICT) support package during the process of implementation.

    BACKGROUND

    ICT in dementia care will likely increase in the future. The diffusion of new innovations can be better understood through diffusion research.

    METHODS

    Fourteen staff members in dementia care were interviewed, in groups, once before the new ICT, twice during its implementation and once after. Data were analysed using qualitative content analyses. The ICT included monitors/alarms: passage alarms, fall detectors, sensor-activated night-time illumination of the lavatory, and communication technology: Internet communication and additional computers.

    RESULTS

    The results showed two themes 'Moving from fear of losing control to perceived increase in control and security' and 'Struggling with insufficient/deficient systems'.

    CONCLUSIONS

    Staff perceptions of ICT were diverse and changed during the implementation. Benefits were more pronounced than disadvantages, and improvements were described both in care and in staff job situation.

    IMPLICATIONS FOR NURSING MANAGEMENT

    Functioning and use of ICT may relate to design as well as by application and the surrounding structure, and the whole system: the organizational structure, the employers and the new product needs to be taken into consideration when implementing new technology.

  • 12.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ljunggren, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindqvist, Ragny
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Staff perceptions of job satisfaction and life situation before and 6 and 12 months after increased information technology support in dementia care2005In: Journal of Telemedicine and Telecare, ISSN 1357-633X, Vol. 11, no 6, p. 304-309Article in journal (Refereed)
    Abstract [en]

    We measured staff members' satisfaction with their work before and after increased information technology (IT) support in dementia care. Comparisons were also performed of perceived life satisfaction and sense of coherence; Data were collected before, and 6 and 12 months after implementation of the first part of an IT support project. Instruments used were the Satisfaction with Work Questionnaires, the Life Satisfaction Questionnaire (LSQ) and the Sense of Coherence (SOC) scale. The study was performed in a residential home for persons with dementia. The participants were 33 staff members. The IT technology included general and individualized passage alarms, sensor-activated night-time illumination, fall detectors and Internet communication. Results showed that staff members' job satisfaction and perceived quality of care improved in comparison with the control group. Personal development, workload, expectations and demands, internal motivation and documentation, as well as the total scores for 'psychosocial aspects of job satisfaction' and 'quality of care aspects', increased in the experimental group. There were significant interaction effects for the factors family relation, close friend relation (LSQ), the total SOC scale and the meaningfulness subscale. The study showed that IT support in dementia care increased staff members' satisfaction with their work in several ways.

  • 13.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Ljunggren, Birgitta
    Lindqvist, Ragny
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Staff satisfaction with work, perceived quality of care and stress in elderly care: psychometric assessments and associations2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 4, p. 318-328Article in journal (Refereed)
    Abstract [en]

    Aims To evaluate validity and reliability of three questionnaires measuring 'work satisfaction', 'patient care' and 'staff health' for staff in elderly care and to study the relationship between staff members' satisfaction with work and perceived stress.

    Background Increased workload, difficulties in recruiting and retaining nurses are reported in elderly care. Valid and reliable instruments measuring staffs' perceptions of work are needed.

    Methods A convenience sample of 299 staff answered the questionnaires.

    Results Factor analysis of 'work satisfaction' gave eight factors, 'patient care' four factors and 'staff health' two factors, explaining 52.2%, 56.4% and 56.8% of the variance. Internal consistency was mostly satisfactory. Multiple regression analysis revealed a model that explained 41% of the variance in perceived stress symptoms.

    Conclusions There was support for the instruments' validity and reliability. Older age, higher scores/satisfaction with workload, cooperation, expectations and demands, personal development and lower scores on internal motivation contributed to less stress.

  • 14.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle, Sweden; Nursing Department, Medicine and Health College, Lishui University, China.
    Löfmark, Anna
    Vae, Karen Johanne Ugland
    Mårtensson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle, Sweden.
    Nursing students' perceptions of using the Clinical Education Assessment tool AssCE and their overall perceptions of the clinical learning environment: A cross-sectional correlational study2017In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 51, p. 63-67Article in journal (Refereed)
    Abstract [en]

    Background: Clinical education is a vital part of nursing students' learning; the importance of assessment tools and feedback in stimulating student learning has been stressed, but this needs to be studied in more detail.

    Objectives: To examine relationships between nursing students' perceptions of using an Assessment tool in Clinical Education (AssCE) during their mid-course discussion and final assessment, the content discussed during these meetings between the student, preceptor and nurse teacher and the students' overall perception of the clinical learning environment.

    Design: A cross-sectional, correlational design was used.

    Setting and Participants: A convenience sample of 110 nursing students from one Norwegian university college with two campuses.

    Methods: Data were collected with self-developed questionnaires and analysed using logistic regression with SASS and the PROCESS macro for mediation analysis.

    Results: There was a positive relationship between nursing students' perceptions of using the assessment tool AssCE and their overall perception of the clinical learning environment. This relationship was, in turn, mediated by the content discussed during the formative mid-course discussion and summative final assessment.

    Conclusions: Our conclusion is that the assessment tool AssCE supported students' clinical learning and that this relationship, in turn, was mediated by the degree to which the conversation during the assessment meeting focused on the student's knowledge, skills and professional judgement.

  • 15.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Scandurra, Isabella
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Ljunggren, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindqvist, Ragny
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Koch, Sabine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Evaluation of OLD@HOME virtual health record staff opinions of the system and satisfaction with work2009In: Telemedicine journal and e-health, ISSN 1530-5627, E-ISSN 1556-3669, Vol. 15, no 1, p. 53-61Article in journal (Refereed)
    Abstract [en]

    The aim of the present research was to study outcomes of use of the OLD@HOME Virtual Health Record with regard to staff opinions about information, communication technology, and satisfaction with work. A quasi-experimental design was used. Staff opinions about the information and communication technology were assessed using a study-specific questionnaire at the test site (n =22) and at other settings in the municipality (n =172). Staff (n =22) job satisfaction, perceived quality of care, and psychosomatic health were assessed using the Satisfaction with Work Questionnaires before and after a 5-month period of testing the technology in an intervention and a comparison group. Staff opinions about the information and communication technology were significantly more positive at the test site compared to other settings in the municipality. For the total scale of quality of care and the factor documentation, there were significant differences in change scores between intervention and comparison groups, with improvements for the comparison group. For job satisfaction and psychosomatic health, there were no differences in change scores between the groups. Participatory design enhances staff opinions about information and communication technology. However, a 5-month test period showed no benefits regarding staff satisfaction with work when compared to a comparison group. On the contrary, the comparison group improved in documentation, and for the intervention group, there was a trend toward deterioration, which may be due to their knowing how to document, but not having time when using both paper-based and electronic systems.

  • 16.
    Engström, Maria
    et al.
    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.
    Ernesater, Annica
    Flackman, Birgitta
    Mamhidir, Anna-Greta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    District nurses' self-reported clinical activities, beliefs about and attitudes towards obesity management2013In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 26, no 4, p. 198-203Article in journal (Refereed)
    Abstract [en]

    Aim: To describe district nurses' self-reported clinical activities, beliefs about and attitudes towards obesity management; and to examine associations between the variables. Background: Obesity is increasing worldwide and primary care could play a central role in the management. Methods: Questionnaire data were collected from 247 nurses in 33 centres. Results: The most common activities performed weekly were; advice about physical activity (40.1%) and general lifestyle advice (34.8%). However, nearly one third seldom/never performed these activities. Approximately half seldom/never performed BMI assessment and even fewer waist circumference (78.1%). Values for the factors Importance of obesity and Personal effectiveness were skewed towards a positive view and Negative view close to neutral. Multivariate analysis revealed that nurses with specialized tasks, longer working experience and higher perceived personal effectiveness performed more clinical activities. Conclusion: Managers need to make efforts to engage all personnel in obesity management; and strategies to increase self-efficacy are called for.

  • 17.
    Engström, Maria
    et al.
    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.
    Nilsson, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Working life and stress symptoms among caregivers in elderly care with formal and no formal competence2011In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 19, no 6, p. 732-741Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the present study was to describe and compare caregivers with formal and no formal competence on job satisfaction, psychosomatic health, structural and psychological empowerment and perceptions of care quality. A further aim was to study relationships among study variables.

    Methods: A convenience sample of 572 caregivers in elderly care participated.

    Results: Caregivers with no formal competence perceived higher workload, more communication obstacles, less competence, poorer sleep and more stress symptoms than did their colleagues. Linear regression analyses revealed that the factor self-determination was an explanatory variable of stress levels among caregivers with no formal competence, and self-determination and impact among caregivers with formal competence. Linear regression analysis revealed that different dimensions in structural and psychological empowerment explained the variance in staff job satisfaction, perceived stress symptoms and quality of care.

    Conclusions: No formal competence seems to be a risk factor for psychosomatic health problems.

    Implications for nursing management: Managers need to have a strategic plan for how to create a working environment for caregivers with no formal competence. Caregivers’ self-determination seems to be important for stress symptoms. Meaning, self-determination, impact and opportunities appear to be important for job satisfaction and competence, opportunities, resources and formal power for quality of care.

  • 18.
    Engström, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Wadensten, Barbro
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Häggström, Elisabeth
    Caregivers' job satisfaction and empowerment before and after an intervention focused on caregiver empowerment.2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 1, p. 14-23Article in journal (Refereed)
    Abstract [en]

    Aims

    To evaluate a training programme aimed at strengthening caregivers' self-esteem and empowering them, and also to study correlations between psychological empowerment and job satisfaction.

    Background

    Structural and psychological empowerment have received increased attention in nursing management, yet few intervention studies on this topic, based on theoretical assumptions, have been conducted in elderly care.

    Method

    Data on self-assessed psychological empowerment and job satisfaction were collected in an intervention (n = 14) and a comparison group (n = 32), before and after the intervention.

    Results

    When compared over time in the respective groups, there were significant improvements in the intervention group regarding the factor criticism (job satisfaction scale). There were no statistically significant differences in the comparison group. Total empowerment and all factors of empowerment correlated positively with total job satisfaction. Six out of eight factors of job satisfaction correlated positively with total empowerment.

    Conclusions

    Caregivers' perception of criticism can improve through an intervention aimed at strengthening their self-esteem and empowering them.

    Implications for nursing management

    Intervention focused on psychological empowerment and especially caregivers' communication skills seems to be beneficial for caregivers. Recommendations are to increase the programme's length and scope and to include all staff at the unit. However, these recommendations need to be studied further.

  • 19. Eriksson, Annelie
    et al.
    Engström, Maria
    Högskolan i Gävle, Sweden.
    Distriktssköterskors beskrivningar av sjukdomsförebyggande arbete i daglig verksamhet och strukturella förutsättningar för detta arbete: District nurses' perceptions of their preventive work and structural conditions for this work2015In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, no 2, p. 77-84Article in journal (Refereed)
    Abstract [en]

    Background:There is much research about district nurses’ preventive work, effects of it and their perceptions of the preventivework. Less is known about how district nurses perceive their preventive work in relation to structural conditions for this work.Aim:The aim was to describe district nurses’ perceptions of their preventive work in daily practice; and structural conditionsfor this using Kanter’s theory of structural empowerment.Methods:Interviews were conducted 2012 with nine Swedish district nurses. Data were analysed using qualitative contentanalysis.Findings:The analysis resulted in one theme; ‘To experience stimulation versus frustration; a consistency versus a discrepancybetween will and structural conditions’. District nurses who worked with specialized tasks felt that they mostly had thestructural conditions required to work in a preventive manner and that they could prioritize which unhealthy living habits todiscuss with their patients. District nurses without specialized tasks described that their structural conditions for preventivework was limited in the present streamlined organization. This in turn led to a feeling of frustration.Conclusion:Preventive work is described as stimulating when district nurses have the conditions required, yet the conditionsrequired are sometimes lacking and especially for district nurses without specialized tasks. There is a will to work in a preventivemanner but structural conditions need to be improved.

  • 20.
    Eriksson, Elisabet
    et al.
    Univ Gävle, Dept Hlth & Caring Sci, Gävle, Sweden.
    Berg, Sören
    Linköping Univ, Cty Council Östergötland, Dept Cardiothorac Surg, Dept Med & Hlth Sci, Linköping, Sweden.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gävle, Dept Hlth & Caring Sci, Gävle, Sweden; Lishui Univ, Med & Hlth Coll, Nursing Dept, Lishui, Peoples R China.
    Internationally educated nurses' and medical graduates' experiences of getting a license and practicing in Sweden - a qualitative interview study.2018In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 18, article id 296Article in journal (Refereed)
    Abstract [en]

    Background: The Swedish healthcare system has an increased need for nurses and physicians, and the number of International Educated Nurses (IENs) and International Medical Graduates (IMGs) seeking job opportunities and a license to practice in Sweden is rising. This study explored how IENs and IMGs describe their experience of getting a license to practice, their perceptions of working in Sweden and of how their intercultural competence is utilized.

    Method: A qualitative study based on semi-structured interviews with 11 IENs and 11 IMGs. The interviews were conducted between 2015 and 2017. The data were analyzed using qualitative content analysis.

    Results: Three main themes were identified: ‘Getting a license – a different story,’ ‘The work is familiar, yet a lot is new,’ ‘Trying to master a new language.’ The time to obtain a license to practice and finding a job was shorter for IENs and IMGs coming from European countries than for those from non-European countries. Some of the experiences of getting a license to practice and of entering a new workplace in another country were the same for nurses and physicians. In general, both IENs and IMGs felt welcomed and used their intercultural competence at work. Lack of language skills was regarded as the main problem for both professions, while workplace introduction was shorter for IMGs than for IENs.

    Conclusions: Problems related to language and culture are often underestimated, therefore organizations and managers employing IENs and IMGs should provide longer workplace introduction to facilitate the acculturation process. More time-efficient language courses specifically adapted to IENs and IMGs could make the transition easier and shorten the time to obtain a license to practice for both professions.

  • 21.
    Ernesäter, Annica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Incident reporting within nurse-led national telephone triage in Sweden: reported errors reveal a pattern that needs to be broken2010In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 16, no 5, p. 243-247Article in journal (Refereed)
    Abstract [en]

    We conducted a retrospective study of incident reports concerning the national, nurse-led telephone triage system in Sweden. The Swedish Health Care Direct organization (SHD) is staffed by registered nurses who act as telenurses and triage the callers' need for care, using a computerized decision support system. Data were collected during 2007 from all county councils that participated in the SHD and were analysed using content analysis. Incident reports were then compared concerning differences in reported categories and who reported the errors. The 426 incident reports included 452 errors. Of the analysed incident reports, 41% concerned accessibility problems, 25% incorrect assessment, 15% routines/guidelines, 13% technical problems and 6% information and communication. The most frequent outgoing incident reports (i.e. sent from SHD to other health-care providers) concerned accessibility problems and the most frequently incoming reports (i.e. sent to SHD from other health-care providers) concerned incorrect assessment. There was a significant difference (P <  0.001) between outgoing and incoming reports regarding the main category. Telenurses have limited possibilities for referring the caller to their primary health-care provider or specialist, which may cause them to over-triage or under-triage the callers' need for care. This over-triage or under-triage may in turn cause other health-care providers to report incorrect assessment to SHD. The implications for practice are that poor accessibility is a matter that should be addressed and that the reasons for incorrect assessment should be explored.

  • 22.
    Ernesäter, Annica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Gävle University.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Rahmqvist, Mikael
    Linköping University.
    Holmström, Inger K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Telephone nurses’ communication and response to callers’ concern: a mixed methods study2016In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 23, p. 116-121Article in journal (Refereed)
    Abstract [en]

    Aims

    To describe telephone nurses’ and callers’ communication, investigate relationships within the dyad and explore telephone nurses’ direct response to callers’ expressions of concern

    Background

    Telephone nurses assessing callers’ need of care is a rapidly growing service. Callers with expectations regarding level of care are challenging.

    Method

    RIAS-and content analysis was performed on a criterion sampling of calls (n=25) made by callers who received a recommendation from telephone nurses of a lower level of care than expected.

    Results

    Telephone nurses mainly ask close-ended questions, whilst open-ended questions are sparsely used. Relationships between callers’ expressions of Concern and telephone nurses responding with Disapproval were found. Telephone nurses mainly responded to concern with close-ended medical questions whilst exploration of callers’ reason for concern was sparse.

    Conclusion

    Telephone nurses’ reluctance to use open-ended questions and to follow up on callers’ understanding might be a threat to concordance, and a potential threat to patient safety.

  • 23.
    Ernesäter, Annica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Telenurses' experiences of working with computerized decision support: supporting, inhibiting and quality improving2009In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 5, p. 1074-1083Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study conducted to describe telenurses' experiences of working with computerized decision support systems and how such systems could influence their work. BACKGROUND: Telenursing is an expanding service in many Western countries, and in recent years centralization of telenursing services has occurred in Sweden. In connection with this, the use of computerized decision support has increased. METHOD: Eight Registered Nurses from three telephone advice call centres in Sweden who were using computerized decision support took part in semi-structured interviews in 2006. The data were analysed using qualitative content analysis. FINDINGS: The findings are presented as one theme and three categories. Telenurses experienced their work with a decision support system as supporting, inhibiting and quality improving. Based on two of the categories - 'supporting' and 'inhibiting' - a theme was revealed: being strengthened, but simultaneously controlled and inhibited. This theme represents the individual level. The telenurses found that the decision support system simplified their work, complemented their knowledge, gave them security and enhanced their credibility. They also described experiencing the system as incomplete, sometimes in conflict with their own opinions and controlling. The third category referred to the organizational level: the decision support system ensured the quality of telenursing. CONCLUSIONS: Although the telenurses experienced computerized decision support as both supporting and inhibiting, they preferred working with it. They also described how a computerized decision support system cannot replace telenurses' knowledge and competence, and that it should be considered as complementary.

  • 24.
    Ernesäter, Annica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Engström, Maria
    Högskolan i Gävle.
    Holmström, Inger
    Örebro Universitet.
    Malpractice claims regarding calls to Swedish telephone advice nursing: what went wrong and why?2012In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 18, no 7, p. 379-383Article in journal (Refereed)
    Abstract [en]

    We analysed the characteristics of all malpractice claims arising out of telephone calls to Swedish Healthcare Direct (SHD) during 2003–2010 (n = 33). The National Board of Health and Welfare's (NBHW) investigations describing the causes of the malpractice claims and the healthcare providers' reported measures were analysed using Qualitative Content Analysis. The original telephone calls themselves, which had been recorded, were analysed using the Roter Interaction Analysis System (RIAS). Among the 33 cases, 13 patients died and 12 were admitted to intensive care. Failure to listen to the caller (n = 12) was the most common reason for malpractice claims, and work-group discussion (n = 13) was the most common measure taken to prevent future re-occurrence. Male patients (n = 19) were in the majority, and females (n = 24) were the most common callers. The most common symptoms were abdominal (n = 11) and chest pain (n = 6). Telenurses followed up on caller understanding in six calls, and mainly used closed-ended questions. Despite the severity of these malpractice claims, the measures taken mainly addressed active failure, rather than the latent conditions. Third-party communication should be regarded as a risk. When callers make repeated contacts, telenurses need to re-evaluate their need for care.

  • 25.
    Forsberg, Markus
    et al.
    Cty Council Gavleborg, Dept Anaesthesia, Gavleborg, Sweden.
    Björn, Catrine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Cty Council Gavleborg, Dept Anaesthesia, Gavleborg, Sweden.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gavle, Sweden.
    Nilsson, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gavle, Sweden.
    Nurse Anesthetists' Reflections on Caring for Patients With Previous Substance Dependence: Balancing Between Professionalism and Preconceptions2018In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 1, p. 69-77Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The study aim was to describe nurse anesthetists' reflections on the provision of perioperative care to patients with previous substance dependence.

    DESIGN: A qualitative approach with a descriptive design.

    METHODS: Semistructured interviews based on clinical vignettes were conducted with 10 nurse anesthetists.

    FINDINGS: The perioperative care provided to patients with previous substance dependence was perceived as balancing between professionalism and preconceptions for this specific patient group. The nurse anesthetists felt that anesthetizing this group of patients constituted a challenge with regard to knowledge, experience, and time. However, the nurses also had feelings of distrust and uncertainty because of lack of knowledge.

    CONCLUSIONS: The nurse anesthetists strove to uphold the principle that patients who are/have been substance dependent have the same right to adequate treatment and care as all patients. If guidelines were developed for this patient group, care could be made safer and nurses' sense of uncertainty minimized.

  • 26.
    Hagerman, Heidi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Wadensten, Barbro
    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.
    How do female first-line managers in elderly care experience their work situation? – an interview studyIn: Article in journal (Refereed)
  • 27.
    Hagerman, Heidi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle; Nursing Department, Medicine and Health College, Lishui University, Lishui, China.
    Wadensten, Barbro
    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. Faculty of Health and Occupational Studies, University of Gävle.
    How do first-line managers in elderly care experience their work situation from a structural and psychological empowerment perspective?: An interview study2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 6, p. 1208-1215Article in journal (Refereed)
    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.

  • 28.
    Hagerman, Heidi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Högberg, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Wadensten, Barbro
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.; Lishui Univ, Nursing Dept, Med & Hlth Coll, Lishui, Peoples R China.
    Empowerment and performance of managers and subordinates in elderly care: A longitudinal and multilevel study2017In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 25, no 8, p. 647-656Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate relationships between first-line managers' ratings of structural and psychological empowerment, and the subordinates' ratings of structural empowerment, as well as their ratings of the managers' leadership-management performance.

    BACKGROUND: Work situations in elderly care are complex. To date, few studies have used a longitudinal, correlational and multilevel design to study the working life of subordinates and managers.

    METHOD: In five Swedish municipalities, questionnaires were answered twice during 2010-12 by 56 first-line managers and 769 subordinates working in nursing homes or home-help services.

    RESULTS: First-line managers' empowerment at Time 1 partially predicted subordinate's structural empowerment and ratings of their managers' leadership-management performance at Time 2. Changes over time partially revealed that the more access managers had to structural empowerment, i.e. increase over time, the higher the ratings were for structural empowerment and managerial leadership-management performance among subordinates.

    CONCLUSIONS: Findings strengthen research and theoretical suggestions linking first-line managers' structural empowerment to their subordinates' structural empowerment and ratings of their manager's leadership-management performance.

    IMPLICATIONS FOR NURSING MANAGEMENT: Managers with high access to structural empowerment are more likely to provide subordinates access to structural empowerment.

  • 29.
    Hagerman, Heidi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden..
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden..
    Wadensten, Barbro
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Högberg, Hans
    Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden..
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden..
    A longitudinal study of working life among first-line managers in the care of older adults2016In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 32, p. 7-13Article in journal (Refereed)
    Abstract [en]

    Aim: To study whether the number of subordinates plays a role in first-line managers' and subordinates' ratings of empowerment, stress symptoms, and leadership-management performance. The aim was also to study relationships between managers' empowerment and stress symptoms and leadership-management performance. Methods: A longitudinal and correlational design was used. All first-line managers (n = 98) and their subordinates (n = 2085) working in the care of older adults in five municipalities were approached. Results: With fewer (<= 30) subordinates per manager, there were higher ratings of structural empowerment among managers and subordinates and lower stress symptoms among subordinates, than with >= 31 subordinates. Furthermore, structural empowerment was related to the managers' stress symptoms and leadership management performance, mediated through psychological empowerment Moreover, structural empowerment can control/adjust for large numbers of subordinates in relation to stress symptoms. Conclusion: The higher FLMs rated their access to empowerment, the lower stress symptoms and higher leadership-management performance they rated over time.

  • 30.
    Häggström, Elisabeth
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Barbro, Barbro Wadensten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    A nine-month intervention programme focusing on empowerment: caregivers' descriptions of changed behaviour and increased room for acting2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 6, p. 866-873Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe public nursing home Enrolled Nurses' and Nurses Aides' view of their work and their perceptions of themselves in their professional role while they were receiving a serious of role awareness sessions focusing on empowerment for nine months.

    BACKGROUND: According to several studies, it is typical that women may experience problems and injustices at work. The main focus of the intervention was to help enrolled nurses' and nurses aides' in developing their self-image and professional role.

    DESIGN: This study was descriptive and qualitative in design.

    METHODS: The present study comprises semi-structured interviews conducted with enrolled nurses and nurses aides (n = 14) from public nursing homes at start of the intervention and again nine months following the intervention. The text from the interviews was analysed using latent content analysis.

    RESULTS: The main findings primarily show an improved professional role for the caregivers, as described in the following themes: the move from passivity to activity, the move from complaining to understanding, the move from expectations to frustration and the move from being silent to speaking loud.

    CONCLUSIONS: For caregivers working with older people within public nursing home care, it seems to be a good form of clinical supervision to implement a serious of role awareness sessions in order to improve their professional role.

    RELEVANCE TO CLINICAL PRACTICE: The findings showed that an intervention providing opportunities with focus on empowerment improved the enrolled nurses' and nurses aides' professional role in working with older people. This can be useful information for managers and educators and they may want to adapt it when working in a public nursing home.

  • 31.
    Jarnulf, Therese
    et al.
    Univ Gavle, Fac Hlth & Occupat Studies, Kungsbacksvagen 47, S-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. Univ Gavle, Fac Hlth & Occupat Studies, Kungsbacksvagen 47, S-80176 Gavle, Sweden.
    Mårtensson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Kungsbacksvagen 47, S-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. Univ Gavle, Fac Hlth & Occupat Studies, Kungsbacksvagen 47, S-80176 Gavle, Sweden;Lishui Univ, Med & Hlth Coll, Nursing Dept, 1 Xueyuan Rd, Lishui 323000, Zhejiang, Peoples R China.
    District nurses experiences of precepting district nurse students at the postgraduate level2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 37, p. 75-80Article in journal (Refereed)
    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.

  • 32.
    Kaltenbrunner, Monica
    et al.
    Univ Gavle, Fac Hlth & Occupat Studies, S-80176 Gavle, Sweden..
    Bengtsson, Lars
    Univ Gavle, Fac Engn & Sustainable Dev, S-80176 Gavle, Sweden..
    Mathiassen, Svend Erik
    Univ Gavle, Fac Hlth & Occupat Studies, S-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. Univ Gavle, Fac Hlth & Occupat Studies, S-80176 Gavle, Sweden.; Lishui Univ, Dept Nursing, Med & Hlth Coll, Lishui Shi, Peoples R China..
    A questionnaire measuring staff perceptions of Lean adoption in healthcare: development and psychometric testing2017In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, no 1, article id 235Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: During the past decade, the concept of Lean has spread rapidly within the healthcare sector, but there is a lack of instruments that can measure staff's perceptions of Lean adoption. Thus, the aim of the present study was to develop a questionnaire measuring Lean in healthcare, based on Liker's description of Lean, by adapting an existing instrument developed for the service sector.

    METHODS: A mixed-method design was used. Initially, items from the service sector instrument were categorized according to Liker's 14 principles describing Lean within four domains: philosophy, processes, people and partners and problem-solving. Items were lacking for three of Liker's principles and were therefore developed de novo. Think-aloud interviews were conducted with 12 healthcare staff from different professions to contextualize and examine the face validity of the questionnaire prototype. Thereafter, the adjusted questionnaire's psychometric properties were assessed on the basis of a cross-sectional survey among 386 staff working in primary care.

    RESULTS: The think-aloud interviews led to adjustments in the questionnaire to better suit a healthcare context, and the number of items was reduced. Confirmatory factor analysis of the adjusted questionnaire showed a generally acceptable correspondence with Liker's description of Lean. Internal consistency, measured using Cronbach's alpha, for the factors in Liker's description of Lean was 0.60 for the factor people and partners, and over 0.70 for the three other factors. Test-retest reliability measured by the intra-class correlation coefficient ranged from 0.77 to 0.88 for the four factors.

    CONCLUSIONS: We designed a questionnaire capturing staff's perceptions of Lean adoption in healthcare on the basis of Liker's description. This Lean in Healthcare Questionnaire (LiHcQ) showed generally acceptable psychometric properties, which supports its usability for measuring Lean adoption in healthcare. We suggest that further research focus on verifying the usability of LiHcQ in other healthcare settings, and on adjusting the instrument if needed.

  • 33.
    Kaltenbrunner, Monica
    et al.
    Department of Occupational Health Sciences and Psychology, Faculty of Health and Occupational Studies, University of Gävle, 801 76, Gävle, Sweden.
    Bengtsson, Lars
    Department of Industrial Management, Industrial Design and Mechanical Engineering, Faculty of Engineering and Sustainable Development, University of Gävle, 801 76, Gävle, Sweden.
    Mathiassen, Svend Erik
    Department of Occupational Health Sciences and Psychology, Faculty of Health and Occupational Studies, University of Gävle, 801 76, Gävle, Sweden.
    Högberg, Hans
    Department of Caring Science, Faculty of Health and Occupational Studies, University of Gävle, 801 76, Gävle, Sweden.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Department of Caring Science, Faculty of Health and Occupational Studies, University of Gävle, 801 76, Gävle, Sweden; Nursing Department, Medicine and Health College, Lishui University, Lishui, China.
    Staff perception of Lean, care-giving, thriving and exhaustion: a longitudinal study in primary care2019In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, no 1, article id 652Article in journal (Refereed)
    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.

  • 34.
    Kaltenbrunner, Monica
    et al.
    Univ Gävle, Fac Hlth & Occupat Studies, Gävle, Sweden.
    Mathiassen, Svend Erik
    Univ Gävle, Fac Hlth & Occupat Studies, Gävle, Sweden.
    Bengtsson, Lars
    Univ Gävle, Fac Engn & Sustainable Dev, Gävle, Sweden.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gävle, Fac Hlth & Occupat Studies, Gävle, Sweden; Lishui Univ, Med & Hlth Coll, Nursing Dept, Lishui, Peoples R China.
    Lean maturity and quality in primary care2019In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 33, no 2, p. 141-154Article in journal (Refereed)
    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.

  • 35.
    Kristofferzon, Marja-Leena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Kungsbacksvagen 47, S-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. Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Kungsbacksvagen 47, S-80176 Gavle, Sweden;Lishui Univ, Dept Nursing, Med & Hlth Coll, Lishui, Peoples R China.
    Nilsson, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Kungsbacksvagen 47, S-80176 Gavle, Sweden.
    Coping mediates the relationship between sense of coherence and mental quality of life in patients with chronic illness: a cross-sectional study2018In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 27, no 7, p. 1855-1863Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus' and Folkman's stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status. The study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS. The test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL. Self-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus' and Folkman's stress and coping theory.

  • 36.
    Lian, Zhengmei
    et al.
    Lishui Univ, Fac Med & Hlth, Dept Nursing Sci, Lishui, Zhejiang, Peoples R China.
    Skytt, Bernice
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Li, Caifu
    Lishui Univ, Fac Med & Hlth, Dept Nursing Sci, Lishui, Zhejiang, Peoples R China.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Lishui Univ, Fac Med & Hlth, Dept Nursing Sci, Lishui, Zhejiang, Peoples R China;Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Nursing students' reflections on caring for end-of-life patients in a youth volunteer association2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 34, p. 204-209Article in journal (Refereed)
    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.

  • 37.
    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.

  • 38.
    Löfmark, Anna
    et al.
    Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden;Western Norway Univ Appl Sci, Fac Hlth & Social Sci, Bergen, Norway.
    Mårtensson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden.
    Vae, Karen Johanne Ugland
    Western Norway Univ Appl Sci, Fac Hlth & Social Sci, Bergen, Norway.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden;Lishui Univ, Dept Nursing, Med & Hlth Coll, Lishui, Peoples R China.
    Lecturer's reflection on the three-part assessment discussions with students and preceptors during clinical practice education: A repeated group discussion study2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 36, p. 1-6Article in journal (Refereed)
    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.

  • 39. Mamhidir, Anna-Greta
    et al.
    Lindberg, Maria
    Larsson, Rigmor
    Fläckman, Birgitta
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Deficient knowledge of multidrug-resistant bacteria and preventive hygiene measures among primary healthcare personnel2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 4, p. 756-762Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study conducted to describe primary healthcare personnel's knowledge of multidrug-resistant and preventive hygiene measures. Background. The group of patients at risk for multi-drug resistant bacteria is largely cared for in primary care. Knowledge of multidrug-resistant and hygiene preventive measures among primary healthcare personnel is therefore essential. Method. A descriptive and comparative questionnaire survey among primary healthcare personnel was performed in 2008. In total, five urban and rural primary healthcare centres situated in one county in central Sweden were included. Convenient sampling was used and 10 physicians, 38 district nurses and 10 nursing assistants participated. Knowledge/medical facts concerning multidrug-resistant and hygiene preventive measures were investigated and data were analysed using a quantitative approach. Results. Knowledge/medical facts concerning several aspects of multidrug-resistant bacteria, particularly Extended-Spectrum-Beta-Lactamase producing bacteria, were deficient as was knowledge of different aspects of hygiene preventive measures. Physicians showed significantly better results than district nurses and nursing assistants did. Awareness of proper hand-washing as an effective preventive method and use of aprons in nursing care was high among all participants. Staff who knew they had cared for these patients had significantly better results than the others did. Conclusion. Our findings suggest that evidence-based education of multidrug-resistant and hygiene preventive measures, in primary health with subsequent follow-ups should become a prioritized clinician and management concern. Research is needed that focus implementation of evidence-based educations, staff attitudes and responsibilities related to the work with patients at risk of multidrug-resistant bacteria.

  • 40.
    Mamhidir, Anna-Greta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gavle, Sweden.
    Sjölund, Britt-Marie
    Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gavle, Sweden; Stockholm Univ, Aging Res Ctr ARC, Dept Neurobiol Care Sci & Soc NVS, Stockholm, Sweden.
    Fläckman, Birgitta
    Skondal Univ Coll, Dept Hlth Care Sci Ersta, Stockholm, Sweden.
    Wimo, Anders
    Stockholm Univ, Aging Res Ctr ARC, Dept Neurobiol Care Sci & Soc NVS, Stockholm, Sweden;Karolinska Inst, Div Neurogeriatr, Dept Neurobiol Care Sci & Soc NVS, Stockholm, Sweden.
    Sköldunger, Anders
    Stockholm Univ, Aging Res Ctr ARC, Dept Neurobiol Care Sci & Soc NVS, Stockholm, Sweden; Karolinska Inst, Div Neurogeriatr, Dept Neurobiol Care Sci & Soc NVS, Stockholm, Sweden.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Dept Hlth & Caring Sci, Gavle, Sweden; Lishui Univ, Dept Nursing Med & Hlth Coll, Lishui, Peoples R China.
    Systematic pain assessment in nursing homes: a cluster-randomized trial using mixed-methods approach2017In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, no 1, article id 61Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Chronic pain affects nursing home residents' daily life. Pain assessment is central to adequate pain management. The overall aim was to investigate effects of a pain management intervention on nursing homes residents and to describe staffs' experiences of the intervention.

    METHODS: A cluster-randomized trial and a mixed-methods approach. Randomized nursing home assignment to intervention or comparison group. The intervention group after theoretical and practical training sessions, performed systematic pain assessments using predominately observational scales with external and internal facilitators supporting the implementation. No measures were taken in the comparison group; pain management continued as before, but after the study corresponding training was provided. Resident data were collected baseline and at two follow-ups using validated scales and record reviews. Nurse group interviews were carried out twice. Primary outcome measures were wellbeing and proxy-measured pain. Secondary outcome measures were ADL-dependency and pain documentation.

    RESULTS: Using both non-parametric statistics on residential level and generalized estimating equation (GEE) models to take clustering effects into account, the results revealed non-significant interaction effects for the primary outcome measures, while for ADL-dependency using Katz-ADL there was a significant interaction effect. Comparison group (n = 66 residents) Katz-ADL values showed increased dependency over time, while the intervention group demonstrated no significant change over time (n = 98). In the intervention group, 13/44 residents showed decreased pain scores over the period, 14/44 had no pain score changes ≥ 30% in either direction measured with Doloplus-2. Furthermore, 17/44 residents showed increased pain scores ≥ 30% over time, indicating pain/risk for pain; 8 identified at the first assessment and 9 were new, i.e. developed pain over time. No significant changes in the use of drugs was found in any of the groups. Nursing pain related documentation was sparse. In general, nurses from the outset were positive regarding pain assessments. Persisting positive attitudes seemed strengthened by continued assessment experiences and perceptions of improved pain management.

    CONCLUSION: The implementation of a systematic work approach to pain issues in nursing homes indicates that an increased awareness, collaboration across and shared understanding among the team members of the pain assessment results can improve pain management and lead to decreased physical deterioration or the maintenance of physical and functional abilities among NH residents. However, pain (proxy-measured) and wellbeing level did not reveal any interaction effects between the groups over time.

    TRIAL REGISTRATION: The study was registered in ISRCTN71142240 in September 2012, retrospectively registered.

  • 41.
    Mårtensson, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Mamhidir, Anna-Greta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Kristofferzon, Marja-Leena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    What are the structural conditions of importance to preceptors' performance?2013In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 33, no 5, p. 444-449Article in journal (Refereed)
    Abstract [en]

    Background: Preceptors play a critical role in the process of developing nursing students' knowledge, skills and ability to make independent and critical judgments, however relatively little is known about what aspects are associated with nurses' performance as preceptors. Objectives: To investigate structural conditions and professional aspects of potential importance to nurses' perceptions of their performance as preceptors, and to evaluate the validity and reliability of a questionnaire measuring nurses' perceptions of being a preceptor. Methods: The study had a correlational design. Total population sampling (N = 1720) in a county council district in central Sweden was used to screen for nurses with recent preceptor experience, 933 nurses responded (response rate 54%), of those 323 nurses fulfilled the inclusion criteria. The present findings are based on data from 243 of these subjects. Data were collected with a questionnaire and analyzed using multiple regressions analyses, exploratory factor analyses and reliability coefficients. Results: The results show that aspects such as receiving feedback on the function as a preceptor, being able to plan and prepare the clinical education period, receiving support from unit managers and having specific supervision education explain 31% of nurses' overall view of their performance as preceptors. However, structural conditions and professional experiences could not explain preceptors' use of reflection and critical thinking when acting as preceptors. These findings are discussed within the framework of Kanter's structural theory of power in organizations. Further, the psychometric evaluation showed that the questionnaire is a valid and reliable instrument for measuring nurses' structural conditions for and perceptions of their performance as preceptors. Conclusions: Structural conditions such as feedback and support seemed to strengthen nurses' general view of their performance as preceptors but did not seem to facilitate nurses' work toward the aim of higher education and helping nursing students develop critical thinking. 

  • 42.
    Nilsson, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Andren, Marianne
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    E-assessment of prior learning: a pilot study of interactive assessment of staff with no formal education who are working in Swedish elderly care2014In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 14, article id 52Article in journal (Refereed)
    Abstract [en]

    Background

    The current paper presents a pilot study of interactive assessment using information and communication technology (ICT) to evaluate the knowledge, skills and abilities of staff with no formal education who are working in Swedish elderly care.

    Methods

    Theoretical and practical assessment methods were developed and used with simulated patients and computer-based tests to identify strengths and areas for personal development among staff with no formal education.

    Results

    Of the 157 staff with no formal education, 87 began the practical and/or theoretical assessments, and 63 completed both assessments. Several of the staff passed the practical assessments, except the morning hygiene assessment, where several failed. Other areas for staff development, i.e. where several failed (>50%), were the theoretical assessment of the learning objectives: Health, Oral care, Ergonomics, hygiene, esthetic, environmental, Rehabilitation, Assistive technology, Basic healthcare and Laws and organization. None of the staff passed all assessments. Number of years working in elderly care and staff age were not statistically significantly related to the total score of grades on the various learning objectives.

    Conclusion

    The interactive assessments were useful in assessing staff members' practical and theoretical knowledge, skills, and abilities and in identifying areas in need of development. It is important that personnel who lack formal qualifications be clearly identified and given a chance to develop their competence through training, both theoretical and practical. The interactive e-assessment approach analyzed in the present pilot study could serve as a starting point.

  • 43.
    Nilsson, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    E-assessment and an e-training program among elderly care staff lacking formal competence: results of a mixed-methods intervention study2015In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 15, article id 189Article in journal (Refereed)
    Abstract [en]

    Background: Among staff working in elderly care, a considerable proportion lack formal competence for their work. Lack of formal competence, in turn, has been linked to higher staff ratings of stress symptoms, sleep disturbances and workload. Objectives: 1) To describe the strengths and weaknesses of an e-assessment and subsequent e-training program used among elderly care staff who lack formal competence and 2) to study the effects of an e-training program on staff members' working life (quality of care and psychological and structural empowerment) and well-being (job satisfaction and psychosomatic health). The hypothesis was that staff who had completed the e-assessment and the e-training program would rate greater improvements in working life and well-being than would staff who had only participated in the e-assessments. Methods: An intervention study with a mixed-methods approach using quantitative (2010-2011) and qualitative data (2011) was conducted in Swedish elderly care. Participants included a total of 41 staff members. To describe the strengths and weaknesses of the e-assessment and the e-training program, qualitative data were gathered using semi-structured interviews together with a study-specific questionnaire. To study the effects of the intervention, quantitative data were collected using questionnaires on: job satisfaction, psychosomatic health, psychological empowerment, structural empowerment and quality of care in an intervention and a comparison group. Results: Staff who completed the e-assessments and the e-training program primarily experienced strengths associated with this approach. The results were also in line with our hypotheses: Staff who completed the e-assessment and the e-training program rated improvements in their working life and well-being. Conclusion: Use of the e-assessments and e-training program employed in the present study could be one way to support elderly care staff who lack formal education by increasing their competence; increased competence, in turn, could improve their self-confidence, working life, and well-being.

  • 44. Nilsson, Jan
    et al.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Florin, Jan
    Gardulf, Ann
    Carlsson, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    A short version of the nurse professional competence scale for measuring nurses' self-reported competence.2018In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 71, p. 233-239Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Nurse Professional Competence (NPC) Scale with 88-items has been used to measure self-reported competence among nursing students and registered nurses in many national and international nursing research projects. However, a shorter version of the scale with maintained quality has been requested to further enhance its usability.

    OBJECTIVES: To develop and evaluate the construct validity and internal consistency of a shorter version of the NPC Scale.

    DESIGN: A developmental and methodological design.

    PARTICIPANTS AND SETTINGS: The study was based on a sample of 1810 nursing students at the point of graduation from 12 universities in Sweden.

    METHODS: The number of items in the original NPC Scale was reduced using several established research steps and then evaluated for data quality and construct validity using principal component analysis and confirmatory factor analysis. Reliability was measured as internal consistency using Cronbach's alpha.

    RESULTS: The extensive process of reducing the number of items resulted in a version with 35 items. Principal component analysis resulted in six factors explaining 53.6% of the variance: "Nursing Care", "Value-based Nursing Care", "Medical and Technical Care", "Care Pedagogics", "Documentation and Administration of Nursing Care", and "Development, Leadership, and Organization of Nursing Care". All factors showed Cronbach's alpha values of >0.70. The confirmative factor analysis goodness-of-fit indexes were for root mean square error of approximation 0.05 and for comparative fit index 0.89.

    CONCLUSIONS: The NPC Scale Short Form (NPC Scale-SF) 35-items revealed promising results with a six-factor structure explaining 53.6% of the total variance. This 35-item scale can be an asset when used alone and together with other instruments it can provide the possibility of more complex analyses of self-reported competence among nursing students and registered nurses.

  • 45. Olsson, Annakarin
    et al.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lampic, Claudia
    Skovdahl, Kirsti
    A passive positioning alarm used by persons with dementia and their spouses: a qualitative intervention study2013In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 13, p. 11-Article in journal (Refereed)
    Abstract [en]

    Background: Increasingly, information and communication technology is being used to support persons with dementia living at home and their relatives. The aim of the present intervention study was to describe and explore the use and experiences of using a passive positioning alarm, over time, in daily life among persons with dementia and their spouses. Methods: Using an ethnographically inspired approach, five couples, each including a person with Alzheimer's disease and his/her spouse living in their own home, were repeatedly observed and interviewed regarding their experiences of using a passive positioning alarm. Interview text transcripts and field notes were analyzed using qualitative content analysis. Results: The main findings show changes over time, where testing and checking the passive positioning alarm successively led to trust in the alarm and in one own's ability to use it. These components were a prerequisite for the couples to perceive the value of the alarm. Conclusions: A passive positioning alarm for persons with dementia and their spouses needs to be packaged as a "service" with flexibility for each user and based on user needs, abilities, knowledge and skills. Using a passive positioning alarm can be a valuable support that allows persons with dementia to be alone outdoors and can increase safety and security for them and their spouses. The present study contributes to our understanding of what prerequisites need to be in place and what barriers need to be dealt with before successful implementation can occur.

  • 46. Olsson, Annakarin
    et al.
    Lampic, Claudia
    Skovdahl, Kirsti
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Persons with early-stage dementia reflect on being outdoors: a repeated interview study2013In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 17, no 7, p. 793-800Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to describe how persons with early-stage dementia reflect on being outdoors. Method: Data were collected through repeated interviews with a purposive sample of 11 persons with early-stage dementia in Sweden during the period 2009-2010 and were analysed using qualitative content analysis. Results: Informants described being outdoors as a confirmation of the self. Confirmation of their ability to maintain desired activities, despite the dementia disease, was important to the informants. However, some confirmations were not positive; the realisation that one could no longer perform certain activities could be devastating. Two sub-themes emerged: shifting between still being part of it all' and a sense of grief and loss and striving to keep on despite perceived barriers. Past, but no longer possible, outdoor activities were greatly missed and the informants longed to be able to perform these activities once again. To resolve possible difficulties associated with being outdoors, the informants used various adaptation strategies. Despite the described barriers, being outdoors was of great value to them. Conclusion: Independent outdoor activities seem to contribute to the well-being and feelings of self-worth among persons with early-stage dementia who want to be and are able to be outdoors. If a person with dementia, despite cognitive limitations, wants and is able to engage in outdoor activities, it is important for relatives and health-care staff to encourage and facilitate this, for example, by discussing adaptation strategies to deal with orientation problems.

  • 47. Olsson, Annakarin
    et al.
    Skovdahl, Kirsti
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, S-80176 Gavle, Sweden.
    Using diffusion of innovation theory to describe perceptions of a passive positioning alarm among persons with mild dementia: a repeated interview study2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 3Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Problems with memory and decline in cognitive abilities are common during development of dementia. Different kinds of technologies may be useful in supporting persons with dementia and their relatives in daily life. Tracking technologies have the potential to improve independence among persons with dementia. Consequently, the aim of the present study was to describe perceptions of a passive positioning alarm (PPA) among persons with mild dementia.

    METHODS: A repeated interview study was conducted in Sweden with a strategic sample of 11 persons with mild dementia. Roger's Diffusion of Innovation Theory was used to deductively analyse the data.

    RESULTS: Regarding the advantages of the PPA, participants described perceived safety and security for, both themselves, and their relatives, as well as freedom and independence. However, they also expressed concern about the cost of the PPA, reflected on who might be the receiver of the alarm from the PPA, emphasized the importance of opportunities to test the device before becoming a user and early introduction before their problems start, thus allowing them to decide for themselves.

    CONCLUSIONS: Supporting persons with dementia in their own homes using, e.g., a PPA may enable them and their relatives to remain longer in their own homes and be safer in their own neighbourhoods.

  • 48.
    Pålsson, Ylva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Leo Swenne, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Mårtensson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    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.Manuscript (preprint) (Other academic)
  • 49.
    Pålsson, Ylva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden; Nursing Department, Medicine and Health College, Lishui University, Zhejiang Sheng, China.
    Swenne, Christine Leo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Mårtensson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    A peer learning intervention targeting newly graduated nurses: A feasibility study with a descriptive design based on the Medical Research Council framework2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 5, p. 1127-1138Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to describe the feasibility of a peer learning intervention targeting newly graduated nurses. Feasibility was tested concerning consistency of the theoretical description of peer learning with empirical findings in a new context, compliance and acceptability, as well as usability of a questionnaire measuring the intended future outcome variables.

    Background: Newly graduated nurses who meet, socialize and share experiences have described supporting each other's ability to cope with stress. Peer learning involves individuals in a similar situation learning from and with each other through interaction. When implementing new interventions, feasibility studies are used to minimize problems in future evaluation studies.

    Design: Quasi‐experimental design with an intervention group, followed over time using descriptive methods. The study was based on the Medical Research Council framework.

    Methods: Repeated semi‐structured interviews, a checklist for fidelity and a questionnaire were conducted with 10 newly graduated nurses from January to March 2015. The intervention's main component included pairs of newly graduated nurses working the same shift and having joint responsibility for a group of patients for a period of 3 weeks. The intervention also included 3 months of regular reflection by the pair.

    Findings: Using deductive analysis, the peer learning intervention was found to be consistent with the theoretical description. Due to the compliance and acceptability, there were lessons learnt. The tested questionnaire was found to be useful.

    Conclusions: This peer learning intervention seems to be feasible in this context. This study will serve as the basis for a future full‐scale evaluation study.

  • 50.
    Pålsson, Ylva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Mårtensson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Leo Swenne, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Mogensen, Ester
    Karolinska Institutet.
    Engström, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    FIRST-YEAR NURSING STUDENTS’ COLLABORATION USING PEER LEARNING DURING CLINICAL PRACTICE EDUCATION: AN OBSERVATIONAL STUDYManuscript (preprint) (Other academic)
12 1 - 50 of 66
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