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Knutsson, Susanne
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Publications (10 of 34) Show all publications
Mårtensson, S., Knutsson, S., Hodges, E. A., Sherwood, G., Broström, A. & Björk, M. (2023). Development of caring behaviour in undergraduate nursing students participating in a caring behaviour course. Scandinavian Journal of Caring Sciences
Open this publication in new window or tab >>Development of caring behaviour in undergraduate nursing students participating in a caring behaviour course
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2023 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: In today's complex healthcare organisations there is an increasing recognition of the need to enhance care quality and patient safety. Nurses' competence in demonstrating caring behaviour during patient encounters affects how patients experience and participate in their care. Nurse educators are faced with the challenge of balancing the demand for increasingly complex knowledge and skills with facilitating students' abilities essential to becoming compassionate and caring nurses.

AIM: The aim was to describe undergraduate nursing students' development of caring behaviour while participating in a caring behaviour course.

METHOD: This pilot study used a quantitative observational design. At a university in Sweden, video-recorded observational data from twenty-five students were collected in the first and last weeks of a full-time five-week Caring Behaviour Course (the CBC). In total, 56-min video-recorded simulation interactions between a student and a standardised patient were coded by a credentialed coder using a timed-event sequential continuous coding method based on the Caring Behaviour Coding Scheme (the CBCS). The CBCS maps the five conceptual domains described in Swanson's Theory of Caring with related sub-domains that align with Swanson's qualities of the Compassionate Healer and the Competent Practitioner. The CBCS contains seventeen verbal and eight non-verbal behavioural codes, categorised as caring or non-caring.

RESULTS: Between the two simulations, most verbal caring behaviours increased, and most non-verbal caring behaviours decreased. Statistically significant differences between the simulations occurred in the sub-domains Avoiding assumptions and Performing competently/skilfully in the quality of the Competent Practitioner. Most observed caring behaviours aligned with the Compassionate Healer.

CONCLUSION: Generally, the students' development of caring behaviours increased while participating in the CBC. Using a structured observational behavioural coding scheme can assist educators in assessing caring behaviour both in education and in practice, supporting caring as the universal foundation of nursing and a key to patient safety.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
Swanson's theory of caring, caring behaviour, nursing education, observational coding scheme, observational method, simulation, standardised patient
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-61667 (URN)10.1111/scs.13189 (DOI)001019278500001 ()37350361 (PubMedID)2-s2.0-85162910262 (Scopus ID)HOA;intsam;888183 (Local ID)HOA;intsam;888183 (Archive number)HOA;intsam;888183 (OAI)
Available from: 2023-06-27 Created: 2023-06-27 Last updated: 2023-08-14
Mårtensson, S., Knutsson, S., Hodges, E. A., Sherwood, G., Broström, A. & Björk, M. (2022). Undergraduate Nursing Students' Experiences of Learning Caring Using a Variety of Learning Didactics. International journal for human caring, 26(3), 145-158
Open this publication in new window or tab >>Undergraduate Nursing Students' Experiences of Learning Caring Using a Variety of Learning Didactics
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2022 (English)In: International journal for human caring, ISSN 1091-5710, Vol. 26, no 3, p. 145-158Article in journal (Refereed) Published
Abstract [en]

This study examines undergraduate nursing students' experiences of participating in a Caring Behavior Course using various learning didactics. Twenty-five students participated in one of five focus group interviews with data analyzed according to qualitative content analysis. The main theme to emerge, an insightful and sudden awakening that caring is not only theoretical words, was further explained with three themes and nine subthemes. The Caring Behavior Course demonstrates effective learning didactics to develop awareness of values that influence caring behaviors and can contribute to patient well-being, particularly relevant for the care challenges in the time of COVID-19 and beyond.

Place, publisher, year, edition, pages
Springer Publishing Company, 2022
Keywords
caring, content analysis, focus group, reflective practice, simulation, undergraduate nursing education
National Category
Nursing Didactics
Identifiers
urn:nbn:se:hj:diva-56262 (URN)10.20467/HumanCaring-D-21-00012 (DOI)2-s2.0-85138724469 (Scopus ID)
Available from: 2022-04-25 Created: 2022-04-25 Last updated: 2022-10-10Bibliographically approved
Mårtensson, S., Hodges, E. A., Knutsson, S., Hjelm, C., Broström, A., Swanson, K. M. & Björk, M. (2021). Caring Behavior Coding Scheme based on Swanson’s Theory of Caring – development and testing among undergraduate nursing students. Scandinavian Journal of Caring Sciences, 35(4), 1123-1133
Open this publication in new window or tab >>Caring Behavior Coding Scheme based on Swanson’s Theory of Caring – development and testing among undergraduate nursing students
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2021 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 4, p. 1123-1133Article in journal (Refereed) Published
Abstract [en]

Rationale: To maintain patients’ dignity and well-being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers’ non-caring behaviours. Defining and measuring both verbal and nonverbal caring and non-caring behaviour in healthcare delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients.

Aim: The aim was to develop and test a Caring Behavior Coding Scheme based on Swanson’s Theory of Caring.

Method: An instrument development process was used for behavioural coding including observational data from thirty-eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient.

Result: The Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non-caring in accordance with Swanson’s Theory of Caring. Content and face validity were assessed. Timed-event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter-rater reliability (k = 0.82). All domains in Swanson’s Theory of Caring were observed and coded in the interaction.

Discussion/Conclusion: The CBCS is a theory-based instrument that contributes to research on healthcare providers’ behavioural encounters. It uses verbal and nonverbal caring and non-caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers’ caring behaviour with the intended outcome of patient well-being.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
behavioural coding, caring behaviour, healthcare providers, observational methods, simulation, Swanson’s Theory of Caring, undergraduate nursing student, adult, article, care behavior, face validity, gold standard, health care delivery, human, interrater reliability, nursing student, observational method, outcome assessment, software, theoretical study, videorecording, wellbeing
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-50952 (URN)10.1111/scs.12927 (DOI)000585037300001 ()33124708 (PubMedID)2-s2.0-85094639968 (Scopus ID)HOA;intsam;1499568 (Local ID)HOA;intsam;1499568 (Archive number)HOA;intsam;1499568 (OAI)
Available from: 2020-11-09 Created: 2020-11-09 Last updated: 2022-09-16Bibliographically approved
Golsäter, M., Knutsson, S. & Enskär, K. (2021). Children's experiences of information, advice and support from healthcare professionals when their parent has a cancer disease: experiences from an oncological outpatient department. European Journal of Oncology Nursing, 50, Article ID 101893.
Open this publication in new window or tab >>Children's experiences of information, advice and support from healthcare professionals when their parent has a cancer disease: experiences from an oncological outpatient department
2021 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 50, article id 101893Article in journal (Refereed) Published
Abstract [en]

Purpose

This study was carried out in order to evaluate children's experiences after taking part in the pilot clinical intervention “See Me” aimed at supporting children as relatives.

Method

A qualitative explorative design with interviews was chosen, with analyses using an inductive approach. Interviews were conducted with 19 children (9 aged 7–12 years and 10 aged 13–18 years). The younger children were asked to draw a picture of a person in hospital, using the Child Drawing: hospital (CD:H) instrument to measure the child's level of anxiety. The older children completed the Caring Professional Scale (CPS) as a measure of the caring approach in their encounter with the nurse.

Results

The interviews with the children show that: they felt expected and welcomed at the hospital; they needed knowledge about their parent's situation; they needed information and participation based on their individual situation; and they needed the nurse to offer them information and support. The results from the pictures showed that one child had above-average levels of anxiety. The older children reported that the nurses were Competent Practitioners, but to a lesser degree that they were Compassionate Healers.

Conclusions

The results of this pilot study indicate that the structure of “See Me” could be used as a starting point to ensure that children as relatives receive information, advice, and support. Further the results indicate that both CD:H and CPS could be used to evaluated children's experiences of support when a parent has a long-term illness.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Children as relatives, Cancer, Clinical intervention, Support, Sweden
National Category
Pediatrics Nursing
Identifiers
urn:nbn:se:hj:diva-51519 (URN)10.1016/j.ejon.2020.101893 (DOI)000632612300006 ()33465701 (PubMedID)2-s2.0-85099401929 (Scopus ID)PPembargo12;;1518957 (Local ID)PPembargo12;;1518957 (Archive number)PPembargo12;;1518957 (OAI)
Available from: 2021-01-18 Created: 2021-01-18 Last updated: 2022-01-21Bibliographically approved
Abelsson, A., Gustafsson, M., Petersèn, C. & Knutsson, S. (2021). Physical stress triggers in simulated emergency care situations. Nursing Open, 8(1), 156-162
Open this publication in new window or tab >>Physical stress triggers in simulated emergency care situations
2021 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 8, no 1, p. 156-162Article in journal (Refereed) Published
Abstract [en]

Aim

To practise emergency care situations during the education can be stressful. The aim of this study is to identify factors that cause stress in simulated emergency care.

Design

A descriptive observational study.

Methods

Video recordings (N = 26) subjected to observation with written field notes in turn subjected to interpretive qualitative content analysis.

Results

To assess the patient's condition and decide what measures to take trigger stress reactions. If the students failed to connect the correct and relevant information in the conversation with the physician, the students showed signs of stress. Also, to calculate medication dosages stress the students.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
education, electrodermal activity, galvanic skin response, intervention, nurse, simulation
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-50468 (URN)10.1002/nop2.614 (DOI)000564564100001 ()33318823 (PubMedID)2-s2.0-85089976395 (Scopus ID)GOA;;1462893 (Local ID)GOA;;1462893 (Archive number)GOA;;1462893 (OAI)
Available from: 2020-09-01 Created: 2020-09-01 Last updated: 2022-01-20Bibliographically approved
Koldestam, M., Broström, A. & Knutsson, S. (2021). Supervisors’ experiences of undergraduate nursing students’ learning in clinical practice when applying caring and learning as parallel processes in a caritative caring conceptual learning model (Part 2). Nurse Education in Practice, 52, Article ID 103004.
Open this publication in new window or tab >>Supervisors’ experiences of undergraduate nursing students’ learning in clinical practice when applying caring and learning as parallel processes in a caritative caring conceptual learning model (Part 2)
2021 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 52, article id 103004Article in journal (Refereed) Published
Abstract [en]

The Model for Improvements in Learning Outcomes (MILO) is theoretically grounded and designed to intertwine didactics, pathophysiology and medicine with specific concepts important for learning. The aim was to describe supervisors' experiences of undergraduate nursing students' learning during clinical practice when using MILO. A qualitative and explorative design was used. Seventeen supervisors, thirteen women and four men from different departments at three hospitals in southern Sweden participated. After using the model, data were collected through four focus group interviews with open unstructured interview questions and analysed using inductive latent content analysis. Twelve subcategories, four generic subcategories and one main category emerged. The students developed a questioning approach and were more reflective, open and compliant. Twosomes enhanced learning. Specific documents generated structure and feelings of participation. The supervisors felt that taking the students' pre-understanding into account and a caring approach in the learning environment were valuable for enhanced learning. The students established a caring relationship with the patients and the patients’ perspective became emphasized. Using MILO, intertwining between the natural and the professional became possible; enhanced learning in nursing skills together with a more caritative caring approach towards the patient was revealed. The need of compassion is discussed.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Caring, Clinical practice, Learning, Models educational, adult, article, care behavior, clinical article, content analysis, female, human, interview, learning environment, male, multicenter study, nursing competence, nursing student, outcome assessment, Sweden
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-52050 (URN)10.1016/j.nepr.2021.103004 (DOI)000651644500017 ()33684871 (PubMedID)2-s2.0-85101980826 (Scopus ID)HOA;;729854 (Local ID)HOA;;729854 (Archive number)HOA;;729854 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2021-03-19 Created: 2021-03-19 Last updated: 2021-06-11Bibliographically approved
Knutsson, S., Golsäter, M. & Enskär, K. (2021). The meaning of being a visiting child of a seriously ill parent receiving care at the ICU. International Journal of Qualitative Studies on Health and Well-being, 16(1), Article ID 1999884.
Open this publication in new window or tab >>The meaning of being a visiting child of a seriously ill parent receiving care at the ICU
2021 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 16, no 1, article id 1999884Article in journal (Refereed) Published
Abstract [en]

Purpose

Children's visits to the ICU are still restricted, and more focus on the child's own needs and experiences are needed. The aim of this study is to illustrate the meaning of being a visiting child of a seriously ill parent receiving care at the ICU.

Method

A qualitative descriptive design was used, with open-ended interviews with seven children (6-18 years) performed and analysed using a phenomenological research approach.

Findings

Being a visiting child of a seriously ill parent receiving care at the ICU is described as a life situation taking place in an unfamiliar environment, characterized by a heartfelt, genuine desire to be there, in an interdependence entailing offering a loved one the help they need while at the same time being seen in a compassionate way and being able to share, revealing a sudden awakening of an inner truth of reality and a sense of a healing wisdom of understanding.

Conclusions

The children felt good when they visited their ill parent, but at the same time not fully involved, and desired a more compassionate, caring approach by the nurses. Improvements are needed in how to approach visiting children in a more individual and caring way.

Place, publisher, year, edition, pages
Taylor & Francis, 2021
Keywords
Visiting, child, intensive care, information, caring
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-55151 (URN)10.1080/17482631.2021.1999884 (DOI)000718608500001 ()34775932 (PubMedID)2-s2.0-85119260069 (Scopus ID)GOA;;778863 (Local ID)GOA;;778863 (Archive number)GOA;;778863 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2021-11-25 Created: 2021-11-25 Last updated: 2021-12-03Bibliographically approved
Enskär, K., Darcy, L., Björk, M., Knutsson, S. & Huus, K. (2020). Experiences of young children with cancer and their parents with nurses' caring practices during the cancer trajectory. Journal of Pediatric Oncology Nursing, 37(1), 21-34
Open this publication in new window or tab >>Experiences of young children with cancer and their parents with nurses' caring practices during the cancer trajectory
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2020 (English)In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 37, no 1, p. 21-34Article in journal (Refereed) Published
Abstract [en]

Children with cancer require repeated hospitalizations and the family's everyday life and routines undergo change. Concrete descriptions of how nurses act when caring for children with cancer throughout the various phases of care and treatment are sparsely highlighted in the literature. The aim of this study was to describe young children with cancer and their parents' experiences of nurses' caring practices over a 3-year period, from diagnosis to follow-up. This study is based on semistructured interviews with 25 children newly diagnosed with cancer, aged 1 to 6 years, and their parents, connected to a pediatric oncology unit in Sweden. Child and parent data were analyzed with a deductive content analysis using Swanson's theory of caring. The result shows that nurse care practices directed toward young children with cancer and their parents are to some extent similar across a 3-year period from diagnosis to follow-up but also differ in some ways. Nurses' caring practices aim to support children and parents in the transition to a "new normal." Child- and family-friendly care processes include the following: creating hope and a trustful relationship, asking rather than assuming, providing knowledge and information, performing tasks skillfully, displaying an interest in the child's and parents' life outside the hospital, and helping the family to trust in the future and other health care providers. Based on these results, we recommend the development of a standardized and structured nursing care plan or clinical guideline with detailed information on how to carry out clinical nurse care practices in the different phases.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
Swanson caring theory, cancer, caring, children
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-46751 (URN)10.1177/1043454219874007 (DOI)000488438000001 ()31526068 (PubMedID)2-s2.0-85074264023 (Scopus ID)
Available from: 2019-10-30 Created: 2019-10-30 Last updated: 2020-01-07Bibliographically approved
Desai, P. P., Flick, S. L., Knutsson, S. & Brimhall, A. S. (2020). Practices and perceptions of nurses regarding child visitation and child life role in adult intensive care units practices and perceptions of nurses regarding child visitation and child life role in adult intensive care units. American Journal of Critical Care, 29(3), 195-203
Open this publication in new window or tab >>Practices and perceptions of nurses regarding child visitation and child life role in adult intensive care units practices and perceptions of nurses regarding child visitation and child life role in adult intensive care units
2020 (English)In: American Journal of Critical Care, ISSN 1062-3264, E-ISSN 1937-710X, Vol. 29, no 3, p. 195-203Article in journal (Refereed) Published
Abstract [en]

Background

Provision of developmentally appropriate support for child visitors in adult intensive care units (ICUs) would benefit patients and young visitors. Research on best practices for child visitation in adult ICUs is limited.

Objectives

To explore the perceptions and practices of nurses working in adult ICUs in the United States regarding child visitation and the role of child life specialists in this setting.

Methods

Data were collected from 446 adult ICU nurses via a cross-sectional survey. The survey explored perceptions and practices regarding child visitation, access to child-friendly resources, and the feasibility of having a child life specialist in adult ICUs.

Results

Several participants (303, 67.9%) felt that children were at risk for psychological trauma from visiting an adult ICU. Some participants (122, 27.4%) reported that their ICUs did not have policies for child visitation. Logistic regression showed that nurses with a master’s degree were 1.8 times (P < .05) more likely to believe that young children (0-5 years) should visit. Nurses (105 of 197, 53.3%) were more likely to allow young children to visit if the patient was the child’s parent or if the patient was dying. Child-friendly resources were not routinely available. Nurses expressed that adult ICUs could benefit from child life specialists facilitating child visitation.

Conclusions

Nurses were inconsistently open to child visitation. Exceptions for older children (> 6 years), children whose parent was the patient, patients’ illness severity, and end of life allowed more child visitation. Ways to facilitate child-friendly visitation in adult ICUs are discussed.

Place, publisher, year, edition, pages
American Association of Critical-Care Nurses, 2020
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-47185 (URN)10.4037/ajcc2020370 (DOI)000569375600012 ()32355965 (PubMedID)2-s2.0-85084909313 (Scopus ID);HHJCHILDIS (Local ID);HHJCHILDIS (Archive number);HHJCHILDIS (OAI)
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2020-12-18Bibliographically approved
Golsäter, M., Enskär, K. & Knutsson, S. (2019). Parents’ perceptions of how nurses care for children as relatives of an ill patient: Experiences from an oncological outpatient department. European Journal of Oncology Nursing, 39, 35-40
Open this publication in new window or tab >>Parents’ perceptions of how nurses care for children as relatives of an ill patient: Experiences from an oncological outpatient department
2019 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 39, p. 35-40Article in journal (Refereed) Published
Abstract [en]

Purpose:

Research has shown that a child's knowledge about what is happening to a parent when he/she has a cancer disease is crucial to the child's health and wellbeing. Therefore the purpose of this study was to explore parents’ perceptions of how nurses in clinical practice care for children as relatives when one parent in the family has a cancer disease.

Method:

A qualitative explorative design with interviews was used. Altogether 28 parents (17 patients and 11 partners) were interviewed. The transcripts from the interviews were subjected to qualitative content analysis.

Results:

The parents perceive that the nurses make efforts to support the child as well as them as parents, but feel that the care needs to be more tailored to the specific child and his/her situation. The children are initially invited, generally informed and seen by the nurses, but the parents perceive that they themselves need repeated support and advice over time to uphold their parental responsibility for caring for their children during the illness trajectory.

Conclusion:

The parents argue for the importance of receiving repeated advice and support for how to talk to their children about the disease and treatment. The parents describe how the nurses were helpful by asking after the children and explaining the value of their visiting the hospital.

Place, publisher, year, edition, pages
Churchill Livingstone, 2019
Keywords
Children as relatives, Co-production, Nursing, Parents, Qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-43114 (URN)10.1016/j.ejon.2019.01.004 (DOI)000462419500005 ()30850136 (PubMedID)2-s2.0-85060543265 (Scopus ID)
Available from: 2019-02-21 Created: 2019-02-21 Last updated: 2019-04-11Bibliographically approved
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