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  • 1.
    Ahlgren, Gustaf
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Anheller, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Anestesisjuksköterskans möjlighet att övervaka awareness med hjälp av bispectral index: En litteraturstudie med systematisk ansats2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
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  • 2.
    Ajdert, Caroline
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Hakim, Farzad
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Följsamhet till kontroll inför op-start enligt checklista för säker kirurgi: Observationsstudie2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: World Health Organization gör tydligt att patientsäkerhet är av högsta prioritet för att kunna bedriva säker kirurgi. Kirurgi bedrivs i komplexa miljöer och det föreligger alltid risk för vårdskada. Operationssjuksköterskan kan med sin unika kompetens bidra till att säkerställa patientsäkerheten genom att använda ett säkerhetsmedvetet arbetssätt. Checklista för säker kirurgi är ett säkerhetsverktyg som främjar och optimerar samverkan och kommunikation vid kirurgi. Internationell forskning pekar på att det finns brister i användningen av den.

    Syftet: Att undersöka följsamheten till checklista för säker kirurgi med avseende på delen kontroll inför op-start med specifikt fokus på operationssjuksköterskans punkter.

    Metod: Datainsamling genomfördes på två universitetssjukhus i mellansverige på två operationsverksamheter genom 24 strukturerade icke-deltagande observationer under kontroll inför op-start. Som teoretisk referensram användes Schweizerostmodellen.

    Resultat: Visade att kontroll inför op-start genomfördes på alla observationer, att följsamheten för den personal som skulle initiera checklistan var låg och att följsamheten till punkterna varierade mellan operationsverksamheterna. Vidare påvisades att operationssjuksköterskans följsamhet till kontroll inför op-start har brister.

    Slutsats: Kontroll inför op-start genomfördes i samtliga fall. Dock påvisades sämre följsamhet till punkterna och utförandet samt att följsamheten till punkterna skiljde sig åt mellan operationsverksamheterna. Dessutom påvisades att operationssjuksköterskan följsamhet till kontroll inför op-start har brister, vilket kan äventyra patientsäkerheten. Att dessa brister synliggörs kan bidra till ytterligare forskning och därmed förhoppningsvis leda till förbättrad patientsäkerhet.

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    Följsamhet till kontroll inför op-start enligt checklista för säker kirurgi
  • 3.
    Andersson, Caroline
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Ajanovic, Elma
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Patientens upplevelse av de första timmarna på en kirurgisk vårdavdelning efter ankomst från akutmottagningen: En intervjustudie2023Independent thesis Advanced level (degree of Master (One Year)), 40 credits / 60 HE creditsStudent thesis
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  • 4.
    Andersson, Fia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Eriksson, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Patientens upplevelse av lindrat lidande vid akut omhändertagande i prehospital miljö: En litteraturöversikt2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING

    Bakgrund: Varje år utförs cirka en miljon ambulansuppdrag i Sverige. Vanliga uppdrag är bröstsmärta, stroke, buksmärta och trauma. Akut prehospitalt omhändertagande innebär ofta lidande som är förknippat med smärta, rädsla, ångest och oro. Att identifiera lidande är en viktig del vid akut omhändertagande och det är av vikt ur ett vårdetiskt perspektiv och ur professionens roll att ambulanssjuksköterskan ser patientens lidande och kan ge den lindring som krävs. Tidigare forskning visar att patienten inte får adekvat lindring vid det akuta omhändertagandet och att det finns en kunskapslucka om hur patientens upplever sitt lidande. Den teoretiska utgångspunkten i detta arbete är lindra lidande utifrån Maria Armans vidareutveckling av Katie Eriksson teori.

    Syfte:  Belysa patientens upplevelse av lindrat lidande vid akut omhändertagande i prehospital miljö.

    Metod: En litteraturöversikt bestående av 18 artiklar med kvalitativ ansats. Avsikten var att skapa en tydlig bild av aktuell sammanställd forskning inom valt kunskapsområde. Innehållsanalys enligt Friberg (2022) användes för resultatsammanställning. Artiklarnas kvalitét granskades utifrån SBU:s kvalitets mall för artiklar med kvalitativa ansatser. 

    Resultat: Resultatanalysen resulterade i två huvudkategorier; beroende omvårdnadsåtgärder vid akut omhändertagande och oberoende omvårdnadsåtgärder vid akut omhändertagande. Faktorer som belystes av vikt för studiens syfte var ambulanssjuksköterskans kompetens och förmågan att ge god omvårdnad. 

    Slutsats: Av resultatet framkommer att det är en kombination av kompetens hos ambulanspersonalen och omvårdande åtgärder som leder till att patienten upplever sitt lidande lindrat i det akuta omhändertagandet.

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    fulltext
  • 5.
    Andersson, Mandus
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Pedersen, Mattias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Upplevelser av teamarbete och dess effekter på patientsäkerheten inom ambulanssjukvården.: En kvalitativ intervjustudie2023Independent thesis Advanced level (professional degree), 40 credits / 60 HE creditsStudent thesis
    Abstract [en]

    Introduction: The ambulance service has undergone significant changes, from a transport service to treating advanced and life-threatening conditions. This places great demands on the ambulance team responsible for patient care, and the specialist-trained ambulance nurse has a responsibility for ensuring effective teamwork. Previous research has shown that teamwork is strongly related to patient safety, but there is limited research on the ambulance nurses' own experiences of teamwork and how they perceive that teamwork affects patient safety. Aim: The aim of the study was to investigate ambulance nurses' experiences of collaboration in teams and their experiences of how teamwork affects patient safety. Method: Qualitative interview study with an inductive approach was used. Ten interviews were conducted with practicing ambulance nurses. The interviews were transcribed and analyzed according to Graneheim and Lundman's method for qualitative content analysis. Results: The results showed that there were factors that influenced how ambulance nurses experienced collaboration in the team, such as situational awareness, communication, competence and experience were identified. Shortcomings in one or more of these factors negatively affected the team and patient care. The team was positively affected when roles in the team were clear, and communication worked well. When team members had the same level of education, safety increased because they had similar pre-understanding and similar ways to care for the patients. Conclusion: This study has shown that patient care is affected by how teamwork works. The study can, therefore, be used for improving teamwork, which in turn would improve patient safety.

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  • 6.
    Avallin, Therese
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Achieving person-centred pain management for the patient with acute abdominal pain: Guided by the Fundamentals of Care framework2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis is to explore how to achieve and measure person-centred pain management (PCPM) for the patient with acute abdominal pain (AAP) in acute surgical care. The Fundamentals of Care (FoC) framework guides all studies.

    The methods: In Study I, focused ethnography is used with 92h of participant observations (n=34) at the emergency department (n=1) and surgical wards (n=2), including 261 patient–provider interactions. In Study II, case study is used for secondary analysis of 20 observations from Study I. In Study III, a questionnaire is developed in a systematic process to measure PCPM, performed by combining; a validated questionnaire, theoretical and empirical evidence. The questionnaire is tested by question appraisal, theoretical experts (n=2), patients (n=5) and providers (n=5), and thereafter by patients (n=100) at surgical wards (n=4). In Study IV, a qualitative systematic review is performed with a synthesis by thematic analysis, to test and refine a model for PCPM from Study I. The synthesis includes 15 qualitative studies representing patients (n=495) and/or nurses (n=259) from n= 3 emergency departments and n=17 hospital wards in n=9 countries. The patients are ≥ 18 years old, with AAP (Studies I-IV), or acute pain from surgery (Study IV). The results confirms that the patient still suffer from unmanaged pain in acute surgical care, and presents actions on behalf of the patient and provider, and contextual factors including the organizational culture, to achieve and measure PCPM. The studies presents a model for PCPM from the patient perspective (Study I), patient-provider communications contributing to meeting fundamental care needs (Study II), an initially feasible and valid questionnaire to measure PCPM (Study III), and a tested and refined model for PCPM from the patient and nurse perspective (Study IV). 

    Conclusion: This thesis presents scientific evidence providing an in-depth understanding of what is important for successful pain management from the patient’s and nurses’ perspectives, how these parts are interconnected, and how they can be achieved and measured. The results also show the feasible role of communication in meeting the patient’s fundamental care needs. This evidence is suggested to be tested and evaluated in clinical practice to perform PCPM, relieving the patient from pain. 

    List of papers
    1. Person-centred pain management for the patient with acute abdominal pain: An ethnography informed by the Fundamentals of Care framework
    Open this publication in new window or tab >>Person-centred pain management for the patient with acute abdominal pain: An ethnography informed by the Fundamentals of Care framework
    Show others...
    2018 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 11, p. 2596-2609Article in journal (Refereed) Published
    Abstract [en]

    Aims: To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contributes to or detract from successful pain management for the patient with acute abdominal pain (AAP) across the acute care pathway.

    Background: Although pain management is a recognized human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance.

    Design: Focused ethnography, applying the Developmental Research Sequence and the Fundamentals of Care framework.

    Methods: Participant observation and informal interviews (92hr) were performed at one emergency department (ED) and two surgical wards at a University Hospital during April-November 2015. Data include 261 interactions between patients, aged 18years seeking care for AAP at the ED and admitted to a surgical ward (N=31; aged 20-90years; 14 men, 17 women; 9 with communicative disabilities) and healthcare practitioners (N=198).

    Results: The observations revealed an organizational culture with considerable impact on how well pain was managed. Well-managed pain presupposed the patient and practitioners to connect in a holistic pain management including a trustful relationship, communication to share knowledge and individualized analgesics.

    Conclusions: Person-centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management.

    National Category
    Nursing
    Research subject
    Caring Sciences in Medical Sciences
    Identifiers
    urn:nbn:se:uu:diva-364720 (URN)10.1111/jan.13739 (DOI)000447551800013 ()29893491 (PubMedID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Research Council
    Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2022-05-11Bibliographically approved
    2. Using communication to manage missed care: A case study applying the Fundamentals of Care framework
    Open this publication in new window or tab >>Using communication to manage missed care: A case study applying the Fundamentals of Care framework
    2020 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 28, no 8, p. 2091-2102Article in journal (Refereed) Published
    Abstract [en]

    AimTo explore, through the patient's perspective, how patient–provider communication is linked to missed nursing care vs. meeting patients’ fundamental care needs.BackgroundMissed nursing care causes severe consequences for patients. Person-centred fundamental care, in which communication is central, provides an approach to manage this challenge. However, the specific patient–provider communications linked to care outcomes are unknown.MethodsCase study using secondary analysis of observations and interviews. A purposeful sample of 20 patients with acute abdominal pain collected using ethnographic methodology at one emergency department and two surgical wards. The Fundamentals of Care framework guided the analysis.ResultsCommunications that included the patient as an equal member of the care team were observed to make a difference between adequate and missed nursing care. Four categories were identified: interpersonal respect, humanized context of care, available and accessible communication channels, and mutual holistic understanding of the care needs and care plan.ConclusionCommunication can be an essential tool to avoid missed nursing care and address the critical need for nursing managers to restore the fundamentals of care.Implications for Nursing ManagementNursing managers can use this new knowledge of communication to facilitate person-centred fundamental care and thereby avoid missed nursing care.

    National Category
    Nursing
    Research subject
    Caring Sciences in Medical Sciences
    Identifiers
    urn:nbn:se:uu:diva-427489 (URN)10.1111/jonm.12963 (DOI)000526662700001 ()31985109 (PubMedID)
    Funder
    Swedish Research Council, 2013:1992Forte, Swedish Research Council for Health, Working Life and WelfareRegion Uppsala
    Available from: 2020-12-08 Created: 2020-12-08 Last updated: 2022-05-11Bibliographically approved
    3. Measuring person-centred pain management: Development of a questionnaire using the Fundamentals of Care framework
    Open this publication in new window or tab >>Measuring person-centred pain management: Development of a questionnaire using the Fundamentals of Care framework
    2023 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 79, no 10, p. 3923-3934Article in journal (Refereed) Published
    Abstract [en]

    Aim: To develop and test a questionnaire using the Fundamentals of Care framework to measure person-centred pain management.

    Design: Cross-sectional exploratory descriptive design.

    Methods: Development in three phases: (a) literature search for questionnaires measuring person-centred pain management, (b) seven-step process developing items using thematic analysis, (c) initial feasibility and validity testing. Theoretical and empirical evidence was used, including the 'Strategic and Clinical Quality Indicators in Postoperative Pain management' questionnaire, the Fundamentals of Care framework and person-centredness principles. Theoretical experts (n = 2) reviewed the questionnaire, further evaluated by providers (n = 5) and patients (n = 5) using a think-aloud process, and by additional questions in the questionnaire answered by n = 100 patients. The questionnaire was tested February to March 2021, at four surgical wards in a university hospital.

    Results: The evaluation showed initial support for feasibility and validity, and the questionnaire was found to represent and be sensitive to capture the patients' experiences of person-centred pain management and being easy to answer. The 100 patients with acute abdominal pain who answered the questionnaire (aged 18-89 years, 46 women and 54 men), identified missing elements of fundamental care in their pain management, indicating that the questionnaire is sensitive to capture specific areas for improvement.

    Conclusion: This first attempt at transforming the essential components of person-centred pain management into measurable items in a questionnaire was found promising. The questionnaire is suggested to be further tested for psychometric properties and patient benefit to provide clinical guidance in acute surgical care to meet the patient care need of pain management.

    Implications for the profession and/or patient care: The developed questionnaire addresses the need of nurses and nursing leaders to evaluate the delivery of person-centred pain management in acute surgical care, to relieve the patient from pain.

    Patient or public contribution: Patients and providers were involved in testing the questionnaire.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2023
    Keywords
    Acute abdominal pain, Fundamentals of care, Instrument development, Measurement, Nursing, Pain management, Person-centredness, Person-centred-care, Questionnaire, Surgical care
    National Category
    Nursing
    Research subject
    Caring Sciences
    Identifiers
    urn:nbn:se:uu:diva-474276 (URN)10.1111/jan.15697 (DOI)000993170500001 ()
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare
    Available from: 2022-05-11 Created: 2022-05-11 Last updated: 2024-01-08Bibliographically approved
    4. Testing a model for person-centred pain management: A systematic review and synthesis guided by the Fundamentals of Care framework
    Open this publication in new window or tab >>Testing a model for person-centred pain management: A systematic review and synthesis guided by the Fundamentals of Care framework
    2023 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 32, no 19-20, p. 6811-6832Article in journal (Refereed) Published
    Abstract [en]

      Aims

    To test a model for person-centred pain management using qualitative evidence in the literature and refine it based on the results.

    Design

    A qualitative systematic review with thematic synthesis using the Fundamentals of Care framework.

    Methods and Data Sources

    A literature search in February 2021 in six scientific databases: CINAHL, PsycInfo, Pubmed, Scopus, Social Science Premium Collection and Web of Science, reported using ENTREQ and PRISMA. Quality assessment was performed for the individual studies. Thematic analysis and the GRADE-CERQual approach were used in the synthesis including the assessment of confidence in the evidence.

    Results

    The model was tested against the evidence in 15 studies appraised with moderate or high quality and found represented in the literature but needed to be expanded. A refined model with a moderate/high confidence level of evidence presents elements to be used in a holistic care process; The nurse is guided to establish a trusting relationship with the patient and enable communication to identify and meet pain management needs using pharmacological and non-pharmacological management. Nurse leaders are guided to support this process by providing the right contextual conditions.

    Conclusions

    The strengths of the confidence level in the refined model, and that it is represented from the nurse and patient perspectives in nursing research across countries and cultures, support our recommendation for empirical evaluation.

    Implications for the Profession and/or Patient Care

    The model links the knowledge of pain management elements from individual studies together into actions to be performed in clinical practice. It also outlines the organizational support needed to make this happen. Nurses and nursing leaders are suggested to test the model to implement person-centred pain management in clinical practice.

    Patient or Public Contribution

    No patient or public contribution.

    Impact

    What Problem Did the Study Address? There is a need to transfer available evidence of person-centred pain management into practice to relieve the patient from pain. What Were the Main Findings? Person-centred pain management is of high priority for patients and nurses around the world and can be performed in a holistic care process including patient–nurse trust and communication, supported by contextual conditions to deliver timely pharmacological and non-pharmacological pain management addressing the patient's physical, psychosocial and relational care needs. Where and on Whom will the Research Have an Impact? The model is to be tested and evaluated in clinical practice to guide the providers to relieve the patient from pain.

    Reporting Method

    Relevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2023
    Keywords
    Acute pain, Fundamentals of care, Nursing care, Nursing leadership, Pain management, Patient-centred care, Person-centred fundamental care, Person-centred care, Systematic review, Qualitative synthesis
    National Category
    Nursing
    Research subject
    Caring Sciences
    Identifiers
    urn:nbn:se:uu:diva-474277 (URN)10.1111/jocn.16770 (DOI)000994533600001 ()
    Available from: 2022-05-11 Created: 2022-05-11 Last updated: 2024-01-08Bibliographically approved
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    UUThesis_T-Avallin-2022
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  • 7.
    Avallin, Therese
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Kitson, Alison
    College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia;Caring Futures Institute Flinders University Adelaide South Australia Australia.
    Muntlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia;Caring Futures Institute Flinders University Adelaide South Australia Australia.
    Measuring person-centred pain management: Development of a questionnaire using the Fundamentals of Care framework2023In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 79, no 10, p. 3923-3934Article in journal (Refereed)
    Abstract [en]

    Aim: To develop and test a questionnaire using the Fundamentals of Care framework to measure person-centred pain management.

    Design: Cross-sectional exploratory descriptive design.

    Methods: Development in three phases: (a) literature search for questionnaires measuring person-centred pain management, (b) seven-step process developing items using thematic analysis, (c) initial feasibility and validity testing. Theoretical and empirical evidence was used, including the 'Strategic and Clinical Quality Indicators in Postoperative Pain management' questionnaire, the Fundamentals of Care framework and person-centredness principles. Theoretical experts (n = 2) reviewed the questionnaire, further evaluated by providers (n = 5) and patients (n = 5) using a think-aloud process, and by additional questions in the questionnaire answered by n = 100 patients. The questionnaire was tested February to March 2021, at four surgical wards in a university hospital.

    Results: The evaluation showed initial support for feasibility and validity, and the questionnaire was found to represent and be sensitive to capture the patients' experiences of person-centred pain management and being easy to answer. The 100 patients with acute abdominal pain who answered the questionnaire (aged 18-89 years, 46 women and 54 men), identified missing elements of fundamental care in their pain management, indicating that the questionnaire is sensitive to capture specific areas for improvement.

    Conclusion: This first attempt at transforming the essential components of person-centred pain management into measurable items in a questionnaire was found promising. The questionnaire is suggested to be further tested for psychometric properties and patient benefit to provide clinical guidance in acute surgical care to meet the patient care need of pain management.

    Implications for the profession and/or patient care: The developed questionnaire addresses the need of nurses and nursing leaders to evaluate the delivery of person-centred pain management in acute surgical care, to relieve the patient from pain.

    Patient or public contribution: Patients and providers were involved in testing the questionnaire.

    Download full text (pdf)
    fulltext
  • 8.
    Avallin, Therese
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Nursing, University of Adelaide, Australia.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Using communication to manage missed care: A case study applying the Fundamentals of Care framework2020In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 28, no 8, p. 2091-2102Article in journal (Refereed)
    Abstract [en]

    AimTo explore, through the patient's perspective, how patient–provider communication is linked to missed nursing care vs. meeting patients’ fundamental care needs.BackgroundMissed nursing care causes severe consequences for patients. Person-centred fundamental care, in which communication is central, provides an approach to manage this challenge. However, the specific patient–provider communications linked to care outcomes are unknown.MethodsCase study using secondary analysis of observations and interviews. A purposeful sample of 20 patients with acute abdominal pain collected using ethnographic methodology at one emergency department and two surgical wards. The Fundamentals of Care framework guided the analysis.ResultsCommunications that included the patient as an equal member of the care team were observed to make a difference between adequate and missed nursing care. Four categories were identified: interpersonal respect, humanized context of care, available and accessible communication channels, and mutual holistic understanding of the care needs and care plan.ConclusionCommunication can be an essential tool to avoid missed nursing care and address the critical need for nursing managers to restore the fundamentals of care.Implications for Nursing ManagementNursing managers can use this new knowledge of communication to facilitate person-centred fundamental care and thereby avoid missed nursing care.

  • 9.
    Avallin, Therese
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Muntlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia;Department of Emergency Care and Internal Medicine Uppsala University Hospital, Uppsala Sweden.
    Kitson, Alison
    College of Nursing and Health Sciences Flinders University Adelaide South Australia Australia;Caring Futures Institute Flinders University Adelaide South Australia Australia.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Testing a model for person-centred pain management: A systematic review and synthesis guided by the Fundamentals of Care framework2023In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 32, no 19-20, p. 6811-6832Article in journal (Refereed)
    Abstract [en]

      Aims

    To test a model for person-centred pain management using qualitative evidence in the literature and refine it based on the results.

    Design

    A qualitative systematic review with thematic synthesis using the Fundamentals of Care framework.

    Methods and Data Sources

    A literature search in February 2021 in six scientific databases: CINAHL, PsycInfo, Pubmed, Scopus, Social Science Premium Collection and Web of Science, reported using ENTREQ and PRISMA. Quality assessment was performed for the individual studies. Thematic analysis and the GRADE-CERQual approach were used in the synthesis including the assessment of confidence in the evidence.

    Results

    The model was tested against the evidence in 15 studies appraised with moderate or high quality and found represented in the literature but needed to be expanded. A refined model with a moderate/high confidence level of evidence presents elements to be used in a holistic care process; The nurse is guided to establish a trusting relationship with the patient and enable communication to identify and meet pain management needs using pharmacological and non-pharmacological management. Nurse leaders are guided to support this process by providing the right contextual conditions.

    Conclusions

    The strengths of the confidence level in the refined model, and that it is represented from the nurse and patient perspectives in nursing research across countries and cultures, support our recommendation for empirical evaluation.

    Implications for the Profession and/or Patient Care

    The model links the knowledge of pain management elements from individual studies together into actions to be performed in clinical practice. It also outlines the organizational support needed to make this happen. Nurses and nursing leaders are suggested to test the model to implement person-centred pain management in clinical practice.

    Patient or Public Contribution

    No patient or public contribution.

    Impact

    What Problem Did the Study Address? There is a need to transfer available evidence of person-centred pain management into practice to relieve the patient from pain. What Were the Main Findings? Person-centred pain management is of high priority for patients and nurses around the world and can be performed in a holistic care process including patient–nurse trust and communication, supported by contextual conditions to deliver timely pharmacological and non-pharmacological pain management addressing the patient's physical, psychosocial and relational care needs. Where and on Whom will the Research Have an Impact? The model is to be tested and evaluated in clinical practice to guide the providers to relieve the patient from pain.

    Reporting Method

    Relevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.

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  • 10.
    Bergström, Rikard
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Sjögren, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Strategier för att lindra lidandet vid såromläggningar av brännskador: En litteraturstudie med kvantitativ ansats2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Burn wound dressing is associated with great suffering for the patient in the form of pain and anxiety. There is research that investigates strategies to alleviate this suffering, however there is a lack of research compiles these strategies.  

    Purpose: The purpose of the essay was to compile and evaluate different strategies, which can be used by specialist nurses in intensive care to relieve pain and anxiety in burn patients during wound dressing.  

    Method: The essay was a descriptive literature review that included 20 quantitative articles. Article review was performed using templates from SBU and GRADE. Katie Eriksson’s theory of suffering was the essay’s theoretical outset.  

    Results: Different categories for the relief of pain, anxiety and pain-related anxiety during dressing change of burn wounds emerged. These were complementary and medicinal strategies. Complementary strategies was the category that showed the greatest potential to reduce pain, anxiety and pain-related anxiety.  

    Conclusion: Complementary and certain medical strategies significantly alleviate suffering in combination with opioids and achieve the greatest possible relief when repeated over several consecutive days. In order to alleviate suffering when performing dressing changes of burn wounds, the specialist nurse in intensive care needs to adapt the care to the patient's needs and wishes. 

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  • 11.
    Björk, Elin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Boel Berner, Strange blood: The rise and fall of lamb blood transfusion in 19th century medicine and beyond (Bielefeld: Columbia University Press 2020). 200 s.2021In: Historisk Tidskrift, ISSN 0345-469X, E-ISSN 2002-4827, Vol. 141, no 4, p. 758-760Article, book review (Other academic)
  • 12.
    Bremberg, Nikolina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Muñoz, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Att hålla patienten varm: En kvalitativ studie om specialistsjuksköterskans värmebevarande åtgärder inom dagkirurgi2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Previous research shows that 32–90% of patients who have undergone some sort of surgery develop accidental perioperative hypothermia. Often, patients already have mild hypothermia upon arrival at the operating room. The perioperative specialist nurses have a shared responsibility to prevent and treat unintended cooling of the patient. Despite a lot of research on hypothermia and its consequences, studies show that there are knowledge gaps within the subject in specialist nurses who are part of the surgical team. Furthermore, there are currently no Swedish national guidelines for perioperative heat conservation measures during surgery, but more general recommendations on the importance of maintaining the patient’s temperature.

    Aim: To describe how specialist nurses in ambulatory surgery work to maintain normothermia in the patient.

    Method: Qualitative interview with inductive approach. Semi-structured interviews with ten specialist nurses at two ambulatory surgery departments. The data were analyzed with manifest content analysis according to Graneheim and Lundman. 

    Results: The results revealed three categories: decisions on heat conservation measures, conditions for preventing perioperative hypothermia and a desire to do good. The categories had a total of eight associated subcategories. 

    Conclusion: The specialist nurse’s work to maintain normothermia in the patient was complex in which many different factors came into play. There was a good knowledge of perioperative hypothermia and heat conservation measures in the surgical team. However, the results showed that the work in preventing perioperative hypothermia was not always based on evidence and that there was not enough basis for decision for perioperative heat conservation measures.

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  • 13.
    Bui-Quy, Sara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Saellström, Johanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Transpersoner upplever att de bär ansvaret för sin vård på grund av kunskapsbrist hos vårdgivaren: En litteraturstudie med tillämpning inom operationssjukvård2021Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Transgendered individuals are a growing minority group in society who generally have poor confidence in health care. They experience shortcomings in the contact with health services that affect the experience of their interaction with health care staff. There is currently limited knowledge about how transgendered individuals wants to be encountered and treated in health care. 

    Aim: The aim was to study the collective knowledge regarding how transgendered people experience the interaction with health care. 

    Method: A literature study with a systematic approach where studies were compiled using content analysis according to Evans with an inductive approach. The theoretical framework Fundamentals of Care (FoC) was used throughout the literature study. 

    Results: Three themes emerged: (1) To be addressed with the right pronoun to be met with insensitivity, tactlessness and open dissatisfaction, (2) To bear responsibility for their care due to lack of knowledge on the part of the caregiver, (3) To feel trust or mistrust in the treatment. Five sub-themes were found: (Ia) from correct address to inappropriate questions and the experience of poorer care when the transidentity was announced. (Ib) Unnecessary physical examination to a reluctance to provide care. (IIa) To meet competent or incompetent caregivers. (IIb)To be responsible for training the caregiver. (IIa) from feeling welcome to not wanting to seek care. 

    Conclusions: The interaction with health care worries transgender individuals and needs improvement. Normalizing reactions that support rather than condemn are desired in the meeting of health care. The theoretical framework FoC can be used as a guide for person- centered care in the meeting of health care staff with transgendered individuals in the operating room. 

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  • 14.
    Caroline, Sasse
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Wegar, Johanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Föräldrars upplevelser då deras barn har vårdats i livets slut på neonatal intensivvårdsavdelning: Ur ett familjecentrerat perspektiv2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: I Sverige har ca 10% av de nyfödda barnen behov av neonatalvård där vanligaste dödsorsaken är asfyxi, infektioner, underburenhet samt fosterskador. Oavsett ålder ska välbefinnandet främjas till livets slut. Familjecentrerad Vård (FCV) är en arbetsmodell kring ett sjukt barn och dennes familj där vården planeras efter hela familjens behov i samråd med familjen för hela familjens bästa.

    Syfte: Undersöka föräldrars upplevelser av vårdtiden då deras barn vårdats i livets slut på en neonatal intensivvårdsavdelning ur ett familjecentrerat perspektiv.

    Metod: Kvalitativ litteraturöversikt med systematisk ansats med riktad innehållsanalys.

    Resultat: Resultatet visar att det var viktigt att få spendera tid med sitt barn både före och efter döden. Föräldrarna önskade få ge normal omsorg som att hålla om, mata och trösta. Det fanns ett stort behov av information och kommunikation kring barnets situation. I efterhand värdesatte de högt att de fått hjälp att insamla minnessaker. Föräldrarna menade på att vårdtiden var svår men värdefull.

    Slutsats: FCV kan vara ett verktyg som får föräldrarna att spendera mer tid med sitt barn vilket kan leda till minskad prevalens av depression efter barnets död. Det är av stor vikt att se varje familjs individuella behov för en så bra vårdtid som möjligt för familjen.

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  • 15.
    Drott, Jenny
    et al.
    Linköpings universitet .
    Engström, My
    Göteborgs universitet .
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Fomichov, Viktoria
    Linköpings universitet .
    Malmström, Marlene
    Malmö universitet .
    Jakobsson, Jenny
    Malmö universitet .
    Factors related to a successful professional development for specialist nurses in surgical care: a cross-sectional study2023In: BMC Nursing, E-ISSN 1472-6955, Vol. 22, article id 79Article in journal (Refereed)
    Abstract [en]

    Background

    A high level of competence among staff is necessary for providing patient-safe surgical care. Knowledge regarding what factors contribute to the professional development of specialist nurses in surgical care and why they choose to remain in the workplace despite high work requirements is needed. To investigate and describe the organizational and social work environment of specialist nurses in surgical care as part of studying factors that impact on professional development.

    Method

    This was a cross-sectional study with a strategic convenience sampling procedure that recruited 73 specialist nurses in surgical care in Sweden between October to December 2021. The study was guided by STROBE Statement and checklist of cross-sectional studies. The validated Copenhagen Psychosocial Questionnaire was used, and additional demographic data. Descriptive statistics were performed and the comparison to the population benchmarks was presented as the mean with a 95% confidence interval. To study potential differences among the demographic and professional characteristics, pairwise t tests were used with Bonferroni adjustment for multiple comparisons with a significance level of 5%.

    Results

    Five domains were identified as factors related to success, as they received higher scores in relation to population benchmarks: quality of leadership, variation of work, meaning of work and work engagement as well as job insecurity. There was also a significant association between a having a manager with low nursing education and job insecurity (p = 0.021).

    Conclusions

    Quality of leadership is important for the professional development of specialist nurses in surgical care. Strategic work seems to include managers with a higher nursing education level to prevent insecure professional working conditions.

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  • 16.
    Eckerberg, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Samvårdssjuksköterskan från intensivvårdsavdelningen: En litteraturöversikt över dess roll och omvårdnadsåtgärder2022Independent thesis Advanced level (degree of Master (One Year)), 40 credits / 60 HE creditsStudent thesis
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  • 17.
    Edberg, Jacob
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Lundqvist, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Anestesisjuksköterskans åtgärder vid preoperativ oro2021Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
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  • 18.
    Edfeldt, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Hellman, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
    Granberg, Dan
    Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden.
    Lagergren, Pernilla
    Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden.
    Thiis‐Evensen, Espen
    Department of Transplantation Medicine Oslo University Hospital Oslo Norway.
    Sundin, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Andersson, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Improved health‐related quality of life during peptide receptor radionuclide therapy in patients with neuroendocrine tumours2023In: Journal of neuroendocrinology, ISSN 0953-8194, E-ISSN 1365-2826, Vol. 35, no 10Article in journal (Refereed)
    Abstract [en]

    Neuroendocrine tumours (NETs) can arise in different locations in the body, and may give rise to hormonal symptoms, which amongst other factors may affect patients' health-related quality of life (HRQoL). Up to four cycles of peptide receptor radionuclide therapy (PRRT) have been shown effective for symptom alleviation and prolonging progression-free survival. The aim of this study was to assess the patient's perspective regarding changes in their HRQoL during PRRT. HRQoL was assessed using the questionnaires for cancer in general, EORTC QLQ-C30, and the gastrointestinal NET-specifically EORTC QLQ-GINET21. Patients with NET (n = 204) rated their HRQoL before PRRT cycles one and four. The medical records of patients were reviewed and their HRQoL was compared to a matched reference population (n = 4910). HRQoL was found to improve during PRRT in aspects of global quality of life; role, social, and emotional functioning, and multiple symptom relief. Potential risk groups for worse HRQoL during PRRT were patients with overweight (BMI >25) who completed four cycles of PRRT and older patients (>65 years old). In conclusion, we found that PRRT improves HRQoL in patients with NETs. The results of this study may be used to improve person-centred care.

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  • 19.
    Edfeldt, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Larsson Ingwall, Linn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Wistedt, Sandra‐Marie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Gunnarsson, Anna-Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Fröjd, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Oral health and oral care in patients in a surgical context: A quantitative study comparing patients' and nurses' assessments2023In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 33, no 6, p. 2201-2208Article in journal (Refereed)
    Abstract [en]

      Aims

    To investigate fundamental care delivery regarding oral care in a surgical context, and to compare patients' self-reported oral health with registered nurse assessments.

    Design

    A descriptive and comparative study, with a consecutive selection.

    Methods

    A patient oral health rating tool, including questions about performed oral care, was distributed to patients (n = 50), at four surgical wards in Sweden. The response rate was 72%. Oral health status was assessed by a registered nurse using the Revised Oral Assessment Guide (ROAG), and a comparison between patient and registered nurse assessment was performed by calculating Cohen's kappa coefficient and percentage agreement.

    Results

    Patients (38%) reported severe oral symptoms, mostly dry lips and not an adequate amount of saliva, and 80% were not offered help with oral care. ROAG assessments revealed that 74% had problems with oral health. Almost half of the patients (48%) needed assistance with oral care but only 10% received help. Registered nurses assessed the patient's oral health as worse than the patient's self-assessment did.

    Conclusion

    There are deficiencies in fundamental care delivery regarding oral care in a surgical care context. Oral health assessments need to be performed by registered nurses. Routines for systematic oral assessments and for oral care need to be implemented by nurse managers to ensure that patients' fundamental care needs are fulfilled.

    Implications for the Profession and Patient Care

    Oral health assessments need to be performed regularly by registered nurses since it is insufficient that patients self-assess their oral health. Nurse managers need

    to provide and implement routines for nurse assessments and oral care in surgical care contexts.

    Impact

    There are deficiencies in patients' oral health and oral care, and registered nurses need to perform oral health assessments. Nurse managers need to implement routines for registered nurse assessments and oral care.

    Patient Contribution

    Patients admitted to a surgical ward were included in the study after being screened for inclusion criteria. After participants signed informed consent, they filled in a questionnaire about oral health and oral care, and a registered nurse performed an oral health assessment.

    Reporting Method

    This study was carried out according to the STROBE checklist.

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  • 20.
    Edfeldt, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Nyholm, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Gunnarsson, Anna-Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Fröjd, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Hauffman, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Missed nursing care in surgical care– a hazard to patient safety: a quantitative study within the inCHARGE programme2024In: BMC Nursing, E-ISSN 1472-6955, Vol. 23, no 1, article id 233Article in journal (Refereed)
    Abstract [en]

    Background

    Missed nursing care occurs globally, and the consequences are severe for the patients when fundamental care needs are not fulfilled, nor delivered in a person-centred way. This study aimed to investigate the occurrence and cause of missed nursing care, and the relationship between registered nurses’ and nursing assistants’ perceptions of missed nursing care, in a surgical care context.

    Methods

    A quantitative study was performed using the MISSCARE survey, measuring missed nursing care and associated reasons, in three surgical wards with registered nurses and nursing assistants as the participants (n = 118), during May-November in 2022. The MISSCARE survey also covers background data such as job satisfaction and intention to leave. The survey was distributed paper-based and the response rate was 88%.

    Results

    Aspects of nursing care rated to be missed the most were ‘attending interdisciplinary care conferences’, ‘turning patient every 2 h’, ‘ambulation 3 times per day or as ordered’, and ‘mouth care’. Differences between registered nurse and nursing assistant ratings were detected for eight out of 24 items, where registered nurses rated more missed nursing care. The uppermost reasons for missed nursing care were ‘inadequate number of staff’ and ‘unexpected rise in patient volume and/or acuity on the unit’. Registered nurses and nursing assistants rated differently regarding six of 17 items. Almost every fourth staff member (24.6%, n = 29) had the intention to leave within a year in the present department.

    Conclusions

    The occurrence of missed nursing care is frequent in the surgical context, and in combination with a high number of staff members intending to leave their employment, poses a hazard to patient safety. Registered nurses, holding higher educational levels, reported more missed care compared with the nursing assistants. The main reason for missed nursing care was an inadequate number of staff. These findings support a warranted investment in nursing within the organisation. The results can be used to form strategies and interventions, to reduce nurse attrition and optimise competence utilisation, and to achieve safe person-centered fundamental care.

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  • 21.
    Einholt, Andreas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Wilhelmsson, Viktoria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Vilka munvårdsåtgärder är effektiva som prevention mot ventilatorassocierad pneumoni?: En litteraturöversikt2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The oral hygiene in intubated patients successively deteriorates during the period of care. The risk of contracting a VAP increases daily and VAP is considered to be one of the most common complications related to mechanical ventilation. The patients who are afflicted require a prolonged hospital stay. Oral hygiene is a part of VAP-prevention but it remains unclear as to which specific oral care measures are effective. 

     

    Aim: The aim of this study is to describe which oral care measures are the most effective in the prevention of VAP and therefore should be used by the intensive care nurse in the daily working routine. 

     

    Method: A systematic literature study with a qualitative inductive approach was used. A total of 17 studies were included in this essay.

     

    Results: Two main categories were identified as well as two subcategories. The adoption of oral care protocols showed a statistically significant decrease of VAP, and chlorhexidine can be effective against VAP however there are also other antibacterial solutions which effectively prevent VAP.

     

    Conclusion: In order to contribute to increased patient safety intensive care nurses should use an oral care protocol to prevent VAP. In addition to the protocol toothbrushes should be replaced regularly, and the ward should oversee the possibility of including dentists to optimize the oral care. Oral care requires additional research so that in the future it is possible to use only the oral care procedures that have been proven to be effective. 

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  • 22.
    Ekerby, Anton
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Danielsson, Viktor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Ambulanssjuksköterskans erfarenheter av förflyttning under pågående A-HLR2024Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
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    Ambulanssjuksköterskans erfarenheter av förflyttning under pågående A-HLR
  • 23.
    Engström, Matilda
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Grönqvist, Hampus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Vilka åtgärder kan förbättra kommunikationen mellan intensivvårdssjuksköterskor och patienter med nedsatt verbal förmåga på IVA?: En litteraturstudie2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Many patients who receive care in the ICU suffer from a reduced verbal ability due to mechanical ventilation or sedation. It can also make it difficult for the patients to communicate with the intensive care nurse, which might affect the nurse-patient relationship.

    Aim: To explore the scientific basis for measures that can be used to improve the communication between the intensive care nurse and patients with reduced verbal ability in the ICU.

    Method: A literature study with systematic approach based on research with quantitative design. PICO was used for the search and selection of studies. The studies that answered this study's aim were then reviewed for risk of bias before a narrative analysis was used for the result.

    Results: 17 articles were included. Three main themes emerged after analysis: ‘training in communication measures for intensive care patients with a reduced verbal ability’, ‘electronic measures and aids to improve communication’ and ‘non-electronic measures and aids to improve communication’. The two last themes had three respectively two sub themes. All studies were assessed to have a moderate or high risk of bias.

    Conclusion: Training intensive care nurses in communication techniques and aids as well as the use of a communication board to facilitate communication has shown statistically significant improvements for patients with reduced verbal abilities in the ICU. Because of the poor quality of the included studies and the insufficient scientific basis it is however not possible to draw a definitive conclusion based on the results of this literature study.

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    Hampus Grönqvist_Matilda Engström_examensarbete_version1
  • 24.
    Eriksson Borg, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Bohlin, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Anestesisjuksköterskors vårdande kommunikation i preanestesifasen: En Fokuserad etnografi2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING

    Bakgrund – Vårdande kommunikation är komplext och viktigt att studera eftersom den kan påverka vårdens kvalitet och patientens upplevelse av kvalitet.

    Syfte - Syftet med denna studie är att beskriva anestesisjuksköterskors vårdande kommunikation med patienter i preanestesifasen

    Metod – Metoden var kvalitativ, induktiv och beskrivande fokuserad etnografi. Fem fokuserade deltagandeobservationer med fältanteckningar och skisser av vårdandetgenomfördes. Analysen utfördes enligt kvalitativ konventionell innehållsanalys.

    Resultat –Anestesisjuksköterskors vårdande kommunikation sker genom att; Skapa förtroende och agera medmänskligt genom att använda ett situationsspecifikt och lämpligt kommunikationsmönster. Skapa förståelse för procedurerna i förloppet genom information och instruktioner. Skapa försäkran tillsammans med patienten genom att fokusera på säkerhet i miljön.

    Slutsats - Anestesisjuksköterskor bedömer patientens kliniska behov och vårdar genom att skapa förtroende, skapa förståelse, skapa försäkran. Vårdande kommunikation har sin särskilda betydelse i den här kliniska kontexten och är förankrad i anestesisjuksköterskans mycket praktiska arbete och dennes förutsättningar för vårdande.

    Nyckelord: Vårdande relation, Vårdande kommunikation, Personcentrerad vård, Anestesisjuksköterska, Etnografi

    ABSTRACT

    Background – Caring communication is an important object of study since the care provided may have impact on quality of care and the perceived quality of care.

    Aim - The purpose of this study is to describe anaesthetic nurses' caring communication with patients in the pre-anaesthetic phase

    Method - The method was qualitative, inductive, and descriptive focused ethnography. To describe situation-specific patterns of Caring communication, data collection was performed with sampling of field notes and hand-drawn sketches. Data analysis was performed with conventional qualitative content analysis.

    Results – Anaesthetic nurses caring communication was provided through; Create trust and act compassionately by communicating with care and good judgement. Create comprehension of important procedures with information and instruction. Create assurance in cooperation with the patient by focusing on safety in the environment. 

    Conclusion – Anaesthetic nurses assess patient´s needs and work to provide a caring communication. Create trust, create comprehension, create assurance are contextual and unique caring communication. Further interpretative research can enlighten a deeper understanding of important perspectives from patient and nurses in the preanesthetic context.

    Keywords: Caring Relationship, Caring Communication, Person-Centred Care, Anaesthesia Nurse, Ethnography

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  • 25.
    Falck, Sofia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Seka, Mimmi
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Faktorer som påverkar perioperativ överrapportering: En litteraturstudie med systematisk ansats2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background 

    Handover in perioperative care is increasingly associated with safe care, quality and efficiency.  Lack of handover entails an increased risk of delayed and incorrect measures, complications and extended care time for the patient. Fundamentals of care is used as theoretical support to understand and explain the care context and its impact on the handover as well as highlight the responsibility of the individual nurse anesthetist. 

     

    Aim  

    The purpose is to investigate the anesthesia nurse's perception of factors that influence handovers during perioperative care.  

     

    Methods 

    The study is a systematic review. The method was chosen as it was considered suitable for overview of published research in the field. The PEO model was used to design the study's search strategies and guided keywords was also central to the search process. 18 articles were analyzed using manifest qualitative content analysis according to Graneheim and Lundman (2004).  

     

    Results 

    The factors that influence the handover process according to the perception of anesthesia nurses formed three categories with associated subcategories. Factors related to work environment, factors related to work culture and factors related to the content of the handover. Factors that affect the handover process are mainly derived from the organization and its ability to create an environment that promotes detailed handover. Further some factors are derived from the individual nurse anesthetists and their responsibilities. 

     

    Conclusion 

    Handover is a complex process where several factors might affect the quality of the process. Knowledge regarding which factors that influence the handover process creates awareness, highlights areas for improvement within peri-operative handover and thereby contributes to safe care.

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  • 26.
    Feo, Rebecca
    et al.
    University of Adelaide/Adelaide Nursing School.
    Conroy, Tiffany
    School of Nursing, University of Adelaide, Australia.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research. Uppsala Univ Hosp, Dept Surg, 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. School of Nursing, University of Adelaide.
    Brovall, Maria
    Högskolan i Skövde/Institutionen för hälsa och lärande.
    Parr, Jenny
    Department of Health Care Practice, Auckland University of Technology, New Zealand.
    Blomberg, Karin
    Örebro universitet/Institutionen för hälsovetenskaper .
    Kitson, Alison
    School of Nursing, University of Adelaide, Australia; Centre for Evidence based Practice South Australia, School of Nursing, The University of Adelaide, Australia;Green Templeton College, University of Oxford, United Kingdom .
    Towards a standardised definition for fundamental care: A modified Delphi study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 11-12, p. 2285-2299Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To generate a standardised definition for fundamental care and identify the discrete elements that constitute such care.

    BACKGROUND:

    There is poor conceptual clarity surrounding fundamental care. The Fundamentals of Care Framework aims to overcome this problem by outlining three core dimensions underpinning such care. Implementing the Framework requires a standardised definition for fundamental care that reflects the Framework's conceptual understanding, as well as agreement on the elements that comprise such care (i.e., patient needs, such as nutrition, and nurse actions, such as empathy). This study sought to achieve this consensus.

    DESIGN:

    Modified Delphi study.

    METHODS:

    Three phases: (i) engaging stakeholders via an interactive workshop; (ii) using workshop findings to develop a preliminary definition for, and identify the discrete elements that constitute, fundamental care; and (iii) gaining consensus on the definition and elements via a two-round Delphi approach (Round 1 n = 38; Round 2 n = 28).

    RESULTS:

    Delphi participants perceived both the definition and elements generated from the workshop as comprehensive, but beyond the scope of fundamental care. Participants questioned whether the definition should focus on patient needs and nurse actions, or more broadly on how fundamental care should be delivered (e.g., through a trusting nurse-patient relationship), and the outcomes of this care delivery. There were also mixed opinions whether the definition should be nursing specific.

    CONCLUSIONS:

    This study has initiated crucial dialogue around how fundamental care is conceptualised and defined. Future work should focus on further refinements of the definition and elements with a larger, international group of practising nurses and service users.

    RELEVANCE TO CLINICAL PRACTICE:

    The definition and elements, through ongoing refinement, will contribute to a robust evidence base that will underpin policy development and the systematic and effective teaching, delivery, measurement and evaluation of fundamental care.

  • 27.
    Framming, Maja
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Lise, Björlin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Miljön på en intensivvårdsavdelning - patienternas perspektiv: En litteraturstudie2021Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
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  • 28.
    Fröjd, Camilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Gunnarsson, Anna-Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Employers' requests when advertising for nurses: A national mapping of recruitment advertising for nurses in Sweden2024In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 7, article id e0303255Article in journal (Refereed)
    Abstract [en]

    Introduction: There is a shortage of nurses and many are leaving the profession. Maintaining sufficient nursing staff is a major healthcare challenge for societies worldwide. Work conditions, job orientation, and career opportunities all factor into nurses' rates of attrition, exit, and turnover. Newly graduated nurses have requested structured introductory and/or mentoring programmes to ease their transition from education to work life and develop the skills and knowledge necessary in their particular work setting. Nurses also seek opportunities to continue learning and developing professionally.

    Aims: To map and describe the content of recruitment advertisements for nurses. Research questions were: 'What qualifications do healthcare employers request when recruiting nurses?' and 'What sorts of professional development do healthcare employers offer nurses?

    Materials and methods: A comprehensive national mapping of recruitment advertisements for nurses in Sweden where all advertisements, N = 450, on 20 of the 21 regional hospital websites were collected. A qualitative and a quantitative content analysis was performed.

    Results: Personal characteristics dominated requested competence in recruitment advertisements. Employers offered general nursing opportunities with unspecific work content and focused more on recruiting newly registered, rather than experienced, nurses. In only a few advertisements, employers asked for a master's degree. No employer requested nurses with a PhD or research experience.

    Conclusion: While the World Health Organization stresses the need for a sustainable recruitment and attainment of nurses to secure health care, employers' recruitment of mostly newly graduated nurses and offering little professional development and few career opportunities may be one explanation for the difficulties in securing safe nurse staffing.

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  • 29.
    Giernalczyk, Martina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Nöjd, Barbara Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Prevention av perioperativ hypotermi. Metoder och deras effektivitet: En litteraturstudie2024Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: All patients who undergo surgery under general anesthesia are at risk of perioperative hypothermia. Untreated hypothermia can lead to physiological complications and cause suffering for the patient, thereby posing a risk to the patient's safety, as well as increased healthcare costs. According to the Perioperative Patient Focus Model the operating room (OR) nurse must provide safe care and thereby prevent and treat perioperative hypothermia. There are various methods to prevent hypothermia, however, there is a lack of sufficient knowledge about these among healthcare personnel and therefore there is a need to compile and evaluate the current evidence of perioperative hypothermia prevention.

    Aim: To compile different methods and their effectiveness for the prevention of perioperative hypothermia in adult patients under general anesthesia. 

    Method: Descriptive literature study with a systematic approach based on 22 quantitative randomized control trials analyzed using narrative synthesis.

    Results: Active methods of hypothermia prevention are more effective than passive methods, forced air blanket being the most effective method. Other effective methods, especially when the upper body cannot be covered intraoperatively, are heating mattresses and warmed infusion fluids. At the same time, the results indicate that several different methods should be used together, of which at least one active method, and all patients, regardless of surgery intervention, benefit from preoperative warming.

    Conclusion: Although it is difficult to completely prevent perioperative hypothermia in all patients, it is possible to prevent and limit the extent by combining different existing methods based on the operating nurse's perioperative assessment of the patient. 

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  • 30.
    Gustavsson, Henrietta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Neurosurgery. Uppsala University Hospital, Uppsala, Sweden.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Nyholm, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Neurosurgery.
    Daily life without cranial bone protection while awaiting cranioplasty: a qualitative study2024In: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 166, no 1, article id 330Article in journal (Refereed)
    Abstract [en]

    Purpose

    Decompressive craniectomy is occasionally performed as a life-saving neurosurgical intervention in patients with acute severe brain injury to reduce refractory intracranial hypertension. Subsequently, cranioplasty (CP) is performed to repair the skull defect. In the meantime, patients are living without cranial bone protection, and little is known about their daily life. This study accordingly explored daily life among patients living without cranial bone protection after decompressive craniectomy while awaiting CP.

    Methods

    A multiple-case study examined six purposively sampled patients, patients’ family members, and healthcare staff. The participants were interviewed and the data were analyzed using qualitative content analysis.

    Results

    The cross-case analysis identified five categories: “Adapting to new ways of living,” “Constant awareness of the absence of cranial bone protection,” “Managing daily life requires available staff with adequate qualifications,” “Impact of daily life depends on the degree of recovery,” and “Daily life stuck in limbo while awaiting cranioplasty.” The patients living without cranial bone protection coped with daily life by developing new habits and routines, but the absence of cranial bone protection also entailed inconveniences and limitations, particularly among the patients with greater independence in their everyday living. Time spent awaiting CP was experienced as being in limbo, and uncertainty regarding planning was perceived as frustrating.

    Conclusion

    The results indicate a vulnerable group of patients with brain damage and communication impairments struggling to find new routines during a waiting period experienced as being in limbo. Making this period safe and reducing some problems in daily life for those living without cranial bone protection calls for a person-centered approach to care involving providing contact information for the correct healthcare institution and individually planned scheduling for CP.

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  • 31.
    Haakseth, Linda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Recovery after complex endovascular aortic repair: a person-centred approach2024Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Objective: There is limited knowledge about patients’ recovery after complex endovascular aortic repair (EVAR). The overall aim of this thesis was to explore patients’ recovery after complex EVAR, with a focus on patients’ experiences.

    Methods: Study I explored patients’ (n=6) lived experiences of recovery after complex staged EVAR, through interviews and descriptive phenomenology. Study II investigated health and quality of life effects of complex EVAR in relation to patients’ (n=25) health and demographic characteristics, through questionnaires preoperative, one and six months postoperative. Study III explored patients’ (n=10) and healthcare professionals’ (n=12) experiences of what can improve patient recovery after EVAR, through thematic analysis of three consecutive data collection stages building on each other. Study IV explored healthcare professionals’ (n=12) descriptions of contextual factors affecting care provision towards patients’ recovery, in a secondary analysis of transcripts from study III, using the Fundamentals of Care framework.

    Results: In study I the patients’ experienced a necessary, overwhelming, hard, and prolonged recovery process with life changing consequences. Study II showed patients’ health disability were significantly greater at one month postoperative, compared to preoperative. Some individuals showed impaired recovery continuing six months postoperative. In study III patients and healthcare professionals describe adequate information, patient involvement and continuity and follow-up could improve recovery. Due to influence of contextual factors, only establishing information routines were reviewed a feasible intervention by the participants. In study IV a dynamic integration of contextual factors, at an individual, system and policy level, were described to have a role to play in the patients’ recovery.

    Conclusion: This thesis provides an understanding of patients’ recovery after undergoing complex EVAR, and what the healthcare services could do to support it. The results show the importance of enabling communication with the patient. Healthcare professionals and leaders need to better understand how contextual factors integrate and affect patient recovery, and take their responsibility towards common goals with the patient. Future studies should aim to better understand who is at risk of impaired recovery, and where and how in the context of care the goals of care should be set and upheld.

    List of papers
    1. Understanding patients' experiences of recovery after staged complex aortic repair: A phenomenological study
    Open this publication in new window or tab >>Understanding patients' experiences of recovery after staged complex aortic repair: A phenomenological study
    2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 11, p. 2834-2844Article in journal (Refereed) Published
    Abstract [en]

    Aim To explore patients' with complex aortic diseases lived experiences of recovery between and after staged endovascular aortic repair (EVAR) procedures, including adjunctive open surgery. Design Qualitative descriptive phenomenological design, applying person-centred care and lifeworld-led health care. Methods Patients operated on in a staged fashion between 2012-2017 were invited to participate. Six participants underwent in-depth interviews 1-5 years postoperatively. The interviews were analysed using descriptive phenomenological method. Findings The essence of the patients' experiences was described as: a necessary, overwhelming, hard, and prolonged process with life changing consequences. Between the operations: expected tiredness where life goes on as usual and insufficient time for recovery. Short-term after all operations: overwhelming tiredness, pain and complications, mostly from neurological deficits. Losing 'yourself' and struggling to manage daily life one day to another. Long-term after all operations: gradually recovering back to 'yourself' and having to accept life with permanent setbacks and limitations. Conclusion Patients with complex aortic diseases struggle with physical and psychological setbacks, continuing years after their operations. There is a need to prospectively assess different aspects of these patients' recovery, identify those with impaired recovery and establish preventive and supporting strategies. Impact Patients' experience of recovery after staged aortic repair has not previously been investigated. The findings indicate that these patients struggle with various physical and psychological setbacks continuing years after their operations. These results will inform further research on this group of patients and guide healthcare professionals in the care of these patients in their transition back to recovery.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2019
    Keywords
    Aortic disease, Interviews, Lifeworld-led health care, Nursing, Person-centred care, Phenomenology, Postoperative, Postoperative recovery, Vascular surgery
    National Category
    Nursing Surgery
    Research subject
    Surgery; Caring Sciences
    Identifiers
    urn:nbn:se:uu:diva-398704 (URN)10.1111/jan.14103 (DOI)000477539900001 ()31222821 (PubMedID)
    Available from: 2019-12-12 Created: 2019-12-12 Last updated: 2024-05-30
    2. Patients' health and quality of life after complex endovascular aortic repair: A prospective cohort study
    Open this publication in new window or tab >>Patients' health and quality of life after complex endovascular aortic repair: A prospective cohort study
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    2023 (English)In: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 41, no 3, p. 132-143Article in journal (Refereed) Published
    Abstract [en]

    Rationale

    Complex endovascular aortic repair often involves multiple major procedures over time with a high risk of complications and little time for recovery. This exposes patients to great stress, both physically and mentally, with potentially long-lasting effects. There is limited knowledge about these effects and who is most at risk – information on this could help vascular nurses and other healthcare professionals anticipate and meet care needs.

    Aim

    To investigate the health and quality of life effects of complex endovascular aortic repair, in relation to patients’ demographic and health characteristics.

    Design

    A prospective cohort study.

    Methods

    Patients undergoing elective complex endovascular aortic repair were consecutively recruited from one university hospital during one year (n=25). Self-report questionnaires on health disability (WHODAS 2.0), quality of life (WHOQoL-BREF) and symptoms of anxiety and depression (HADS) were filled out preoperatively and repeated one and six months postoperatively. Prospective changes in health and quality of life, and associations with patient demographics and preoperative health characteristics, were assessed. Ethical approval was obtained prior to study performance.

    Results

    Overall, patients had significantly greater health disability at one month (WHODAS 2.0 score median 31.5, range 1.1–63.0) than preoperatively (median 13.6, range 0.0–41.3) (n=22, p=.017); the majority had recovered at six months (median 11.4, range 3.3–58.7) (n=18, p=.042). No significant effects were seen in quality of life and symptoms of anxiety and depression (p>.05). However, the participants showed heterogeneity, with certain individuals not recovered at six months (n=8). Factors associated with worse six-month outcomes were being female, age < 70 years, postoperative complications, and history of anxiety or depression.

    Conclusions

    Complex endovascular aortic repair have limited long-term negative effects on patients’ health and quality of life. However, some patients are not recovered at six months postoperatively, which could be explained by individual characteristics. To improve recovery outcomes, vascular nurses and other health care professionals should be aware of the possible recovery trajectories and factors associated with impaired recovery, and use them to anticipate and meet the patients’ individual care needs.

    Place, publisher, year, edition, pages
    Elsevier, 2023
    Keywords
    Quality of life, Postoperative recovery, Person-centred care, Complex endovascular aortic repair, Complex EVAR, Aortic surgery, Endovascular aortic surgery, Vascular nursing, Elective surgery, ERAS
    National Category
    Surgery Cardiac and Cardiovascular Systems Nursing
    Identifiers
    urn:nbn:se:uu:diva-514451 (URN)10.1016/j.jvn.2023.05.010 (DOI)001076498600001 ()37684091 (PubMedID)
    Available from: 2023-10-17 Created: 2023-10-17 Last updated: 2024-05-30Bibliographically approved
    3. How to improve patient recovery after complex endovascular aortic repair: the experiences of patients and healthcare professionals
    Open this publication in new window or tab >>How to improve patient recovery after complex endovascular aortic repair: the experiences of patients and healthcare professionals
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    2025 (English)In: Patient Education and Counceling, ISSN 0738-3991, Vol. 130, p. 108460-Article in journal (Other academic) Published
    Abstract [en]

    Objective: Complex endovascular aortic repair (EVAR) involves tertiary surgical care, with short in-hospital recovery. This study aimed to explore patients’ and healthcare professionals’ experiences of what can improve patient recovery after complex EVAR.Methods: Three qualitative data collection stages building on each other were analysed with thematic analysis. Stages 1 and 2 separately explored patients’ and healthcare professionals’ experiences of what works well and what can be improved with current care. In stage 3, participants reviewed the relevance and feasibility of intervention suggestions.Results: Three matching themes were identified in stages 1 and 2: Adequate information; Patient involvement; Continuity and follow-up. In stage 3: Individual care plan, Team meetings, and Contact nurse were all found relevant, while only Information routines was found both relevant and feasible.Conclusion: What patients and healthcare professionals experienced could improve patients recovery after complex EVAR seem universal for complex surgical patients, and relevant interventions were identified. However, the feasibility of person-centred interventions seem affected by various contextual factors, like current routines and availability of staff.Practice implications: Interventions that facilitate communication, both involving and supporting the patient, should be tested to strengthen patients’ ability to self-care, and ensure access to care and support when needed.

    National Category
    Surgery Nursing
    Research subject
    Medical Science
    Identifiers
    urn:nbn:se:uu:diva-528752 (URN)10.1016/j.pec.2024.108460 (DOI)
    Available from: 2024-05-27 Created: 2024-05-27 Last updated: 2024-10-22
    4. Healthcare professionals’ descriptions of contextual factors affecting patients’ postoperative recovery: an analysis using the Fundamentals of Care framework
    Open this publication in new window or tab >>Healthcare professionals’ descriptions of contextual factors affecting patients’ postoperative recovery: an analysis using the Fundamentals of Care framework
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Surgery Nursing
    Identifiers
    urn:nbn:se:uu:diva-528751 (URN)
    Available from: 2024-05-27 Created: 2024-05-27 Last updated: 2024-05-30
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  • 32.
    Haakseth, Linda
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Wanhainen, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Björck, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
    Jangland, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Education in Nursing. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Nursing Research.
    Understanding patients' experiences of recovery after staged complex aortic repair: A phenomenological study2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 11, p. 2834-2844Article in journal (Refereed)
    Abstract [en]

    Aim To explore patients' with complex aortic diseases lived experiences of recovery between and after staged endovascular aortic repair (EVAR) procedures, including adjunctive open surgery. Design Qualitative descriptive phenomenological design, applying person-centred care and lifeworld-led health care. Methods Patients operated on in a staged fashion between 2012-2017 were invited to participate. Six participants underwent in-depth interviews 1-5 years postoperatively. The interviews were analysed using descriptive phenomenological method. Findings The essence of the patients' experiences was described as: a necessary, overwhelming, hard, and prolonged process with life changing consequences. Between the operations: expected tiredness where life goes on as usual and insufficient time for recovery. Short-term after all operations: overwhelming tiredness, pain and complications, mostly from neurological deficits. Losing 'yourself' and struggling to manage daily life one day to another. Long-term after all operations: gradually recovering back to 'yourself' and having to accept life with permanent setbacks and limitations. Conclusion Patients with complex aortic diseases struggle with physical and psychological setbacks, continuing years after their operations. There is a need to prospectively assess different aspects of these patients' recovery, identify those with impaired recovery and establish preventive and supporting strategies. Impact Patients' experience of recovery after staged aortic repair has not previously been investigated. The findings indicate that these patients struggle with various physical and psychological setbacks continuing years after their operations. These results will inform further research on this group of patients and guide healthcare professionals in the care of these patients in their transition back to recovery.

  • 33.