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Munck, B., Vikingur, H., Smoljan, M. & Björklund, M. (2023). District nurses’ experiences of advanced medical technology in home care: A qualitative interview study. Nordic journal of nursing research, 43(1)
Open this publication in new window or tab >>District nurses’ experiences of advanced medical technology in home care: A qualitative interview study
2023 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 43, no 1Article in journal (Refereed) Published
Abstract [en]

The escalation in the number of medical devices in home care increases the demands on district nurses’ knowledge and skills. This qualitative interview study with 13 district nurses from Sweden aimed to describe their experiences of advanced medical technology in home care. The COREQ checklist for qualitative studies was applied. The results showed two categories: district nurses’ experiences of collaborating in teams and district nurses’ experiences of performing safe care. The safe use of advanced medical technology in home care required good collaboration between all the parties involved. This resulted in a certain amount of freedom and increased quality of life for the patients. District nurses needed time, continuity, practical training, and repeated education to be able to provide safe care. Distinct leadership was important at all organizational levels. The results can generate a safe and sustainable work environment for district nurses, almost independent of their technical background.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
adult, article, clinical competence, education, home care, human, intersectoral collaboration, interview, leadership, medical technology, nurse, patient safety, quality of life, risk management, work environment
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-58662 (URN)10.1177/20571585221127344 (DOI)2-s2.0-85139052831 (Scopus ID)GOA;;837976 (Local ID)GOA;;837976 (Archive number)GOA;;837976 (OAI)
Available from: 2022-10-18 Created: 2022-10-18 Last updated: 2024-01-15Bibliographically approved
Gustavsson, K., Börjesson, E., Björklund, M. & Munck, B. (2021). Interprofessional collaboration in connection with a medical ship: nurses' experiences. Journal of Clinical Nursing, 30(23-24), 3506-3516
Open this publication in new window or tab >>Interprofessional collaboration in connection with a medical ship: nurses' experiences
2021 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 30, no 23-24, p. 3506-3516Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To describe nurses´ experiences of interprofessional collaboration (IPC) in connection with a medical ship offering primary health care in Papua New Guinea.

BACKGROUND: More than a third of the population in Papua New Guinea are living in severe poverty, resulting in serious and fatal diseases. Due to rough terrain and lack of infrastructure, most of them cannot benefit from health care in the cities. Thus, a medical ship is used since the sea route is one of the few possible ways to reach the people.

DESIGN: A qualitative study with an inductive and descriptive approach was performed, and content analysis of the data was used.

METHODS: In January 2018, eleven nurses from seven countries were interviewed onboard the medical ship assessing their experiences when performing IPC. The COREQ checklist for qualitative studies was applied in the conduct and reporting of this study.

RESULTS: Three generic categories emerged: Nurses' motivation to achieve the common goal of doing good using IPC; Nurses' view of performing IPC within special conditions; and Nurses' perception of their role in IPC. Overall, the IPC was perceived by the nurses as well functioning. Having a common goal, positive mindset and effective communication improved the team's collaboration. When these aspects were accomplished, the chances of overcoming the challenge of working in new circumstances and limited space with a newly formed team were increased.

CONCLUSION: Good collaboration within an interprofessional team required repeated sharing of information. This demonstrates the importance of communication and engagement to overcome existing challenges when working interprofessionally.

RELEVANCE TO CLINICAL PRACTICE: This study recommends the establishment of IPC for similar contexts such as onboard Youth With a Mission and ashore, as well as in disaster situations or home care where the healthcare professional must collaborate and adapt to new circumstances and prevailing situations.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
communication, interprofessional collaboration, interview study, nurse core competence, papua new guinea, volunteer ​
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-52556 (URN)10.1111/jocn.15853 (DOI)000652757900001 ()34021657 (PubMedID)2-s2.0-85106287795 (Scopus ID)HOA;;1557865 (Local ID)HOA;;1557865 (Archive number)HOA;;1557865 (OAI)
Available from: 2021-05-27 Created: 2021-05-27 Last updated: 2021-12-12Bibliographically approved
Wåhlin, M., Stjernman, H. & Munck, B. (2019). Disease-related worries in persons with Crohn disease: An interview study. Gastroenterology Nursing, 42(5), 435-442
Open this publication in new window or tab >>Disease-related worries in persons with Crohn disease: An interview study
2019 (English)In: Gastroenterology Nursing, ISSN 1042-895X, E-ISSN 1538-9766, Vol. 42, no 5, p. 435-442Article in journal (Refereed) Published
Abstract [en]

Crohn disease, a chronic inflammatory bowel disease, affects everyday life, impairs quality of life, and creates worries. This study explored disease-related worries in persons with Crohn disease to gain deeper insight into how this worry is experienced and handled. Eight women and 4 men with Crohn disease who reported their disease-related worries as high or very high in a questionnaire were interviewed. The interviews were evaluated by qualitative content analysis, generating 3 categories: worries about the disease itself; feelings related to the worries; and management of the worries. The unpredictable course of the disease, impaired function due to fatigue, and lack of bowel control were the most prominent causes of worry. The worries created feelings of stress, guilt, and frustration. The participants expressed a need to talk about their worries, to make them visible and recognized, and to be understood. The participants found individual ways to handle the worries. Actively gaining control by changing focus, performing relaxation exercises, and seeking information were important self-care strategies. In addition, a strong and partially unmet need for expressing and venting concerns to one's caregiver was identified.

Place, publisher, year, edition, pages
Wolters Kluwer, 2019
National Category
Gastroenterology and Hepatology Nursing
Identifiers
urn:nbn:se:hj:diva-46551 (URN)10.1097/SGA.0000000000000395 (DOI)000501816300006 ()31574072 (PubMedID)2-s2.0-85072847736 (Scopus ID)
Available from: 2019-10-14 Created: 2019-10-14 Last updated: 2025-02-11Bibliographically approved
Wahlström, S., Björklund, M. & Munck, B. (2019). The professional role of skilled birth attendants’ in Nepal – A phenomenographic study. Sexual & Reproductive HealthCare, 21, 60-66
Open this publication in new window or tab >>The professional role of skilled birth attendants’ in Nepal – A phenomenographic study
2019 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 21, p. 60-66Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to describe the Nepali Skilled Birth Attendants’ (SBAs) perceptions of their professional role.

Methods: Fifteen Nepalese SBAs were interviewed using a semi-structured interview guide. A phenomenographic approach was chosen to describe their qualitatively different and unreflective conceptions of the professional role. Data was analysed in a seven-step process and three description categories and six conceptions emerged.

Results: The SBAs described the role as provider, the role as counsellor and the role as educator. As provider, the SBA maintained midwifery nursing and prevented maternal deaths. As counsellor, the SBA advocated and empowered women and facilitated family planning. As educator, the SBA promoted health of families and health in the society. She also tutored students and colleagues about skills and human rights.

Conclusion: The SBAs’ vulnerability emerged especially in rural areas while preventing complications and newborn and maternal death in rural areas where she often worked alone with lack of proper equipment and access to other medical professionals. The SBAs perceived that their professional roles required knowledge and experiences, were safety was closely linked to health education. Ethical dilemma could arose when they had to relate to the families' cultural decisions. Education was a key factor connected to close life-saving procedures and to retain good quality and safety in newborn and maternal healthcare. The SBAs switched between their three roles, always striving to be aware of compliance with the Sustainable Development Goals policy. 

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Education, Nepalese culture, Skilled birth attendant, Vulnerability
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-45331 (URN)10.1016/j.srhc.2019.05.003 (DOI)000485335500011 ()31395235 (PubMedID)2-s2.0-85068054015 (Scopus ID)
Available from: 2019-07-11 Created: 2019-07-11 Last updated: 2021-05-27Bibliographically approved
Munck, B., Björklund, A., Jansson, I., Lundberg, K. & Wagman, P. (2018). Adulthood transitions in health and welfare: a literature review. Nursing Open, 5(3), 254-260
Open this publication in new window or tab >>Adulthood transitions in health and welfare: a literature review
Show others...
2018 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 3, p. 254-260Article, review/survey (Refereed) Published
Abstract [en]

Aim

The aim of the literature review was to describe how adulthood transition is used in health and welfare.

Design

A qualitative design with a deductive approach were used.

Methods

As material, 283 articles published in scientific journals, between 2011–August 2013, were selected. The search was conducted August 2013. The data were analysed and sorted in a categorization matrix.

Results

Transition was identified as a process mainly related to the four types previously identified; developmental, situational, health-illness and organizational transitions. Another one transition was also identified, lifestyle transition.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
developmental transition, health illness transition, life style transition, literature review, nurse education, organizational transition, situational transition
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-38968 (URN)10.1002/nop2.136 (DOI)000439858900003 ()30062017 (PubMedID)2-s2.0-85062113855 (Scopus ID)
Available from: 2018-03-07 Created: 2018-03-07 Last updated: 2023-02-21Bibliographically approved
Munck, B. & Sandgren, A. (2017). The impact of medical technology on sense of security in the palliative home care setting. British Journal of Community Nursing, 22(3), 130-135
Open this publication in new window or tab >>The impact of medical technology on sense of security in the palliative home care setting
2017 (English)In: British Journal of Community Nursing, ISSN 1462-4753, E-ISSN 2052-2215, Vol. 22, no 3, p. 130-135Article in journal (Refereed) Published
Abstract [en]

The increase in the use of medical devices in palliative home care requires that patients and next-of-kin feel secure. Therefore, the aim was to describe medical technology's impact on the sense of security for patients, next-of-kin and district nurses. Deductive content analysis was conducted on data from three previous studies, using the theoretical framework 'palliative home care as a secure base'. The use of medical technology was shown to have an impact on the sense of security for all involved. A sense of control was promoted by trust in staff and their competence in managing the technology, which was linked to continuity. Inner peace and being in comfort implied effective symptom relief facilitated by pain pumps and being relieved of responsibility. Health care professionals need to have practical knowledge about medical technology, but at the same time have an awareness of how to create and maintain a sense of security. 

Place, publisher, year, edition, pages
Mark Allen Healthcare, 2017
Keywords
Deductive content analysis, Medical technology, Palliative home care, Secure base, Security
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-35353 (URN)10.12968/bjcn.2017.22.3.130 (DOI)28252328 (PubMedID)2-s2.0-85016178861 (Scopus ID)
Available from: 2017-04-11 Created: 2017-04-11 Last updated: 2017-11-29Bibliographically approved
Munck, B., Sandgren, A., Fridlund, B. & Mårtensson, J. (2012). Next-of-kin's conceptions of medical technology in palliative homecare. Journal of Clinical Nursing, 21(13/14), 1868-1877
Open this publication in new window or tab >>Next-of-kin's conceptions of medical technology in palliative homecare
2012 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 13/14, p. 1868-1877Article in journal (Refereed) Published
Abstract [en]

Aims and objectives.  Describe next-of-kin’s conceptions of medical technology in palliative homecare.

Background.  Next-of-kin to palliative patients are in an exposed position with increasing responsibility. The more involved they are in the care, the greater caregiver burden they describe. Medical technology has become increasingly common in palliative homecare, and previous research suggests that the devices transform the homes to a hospital ward, thus shifting responsibility from the personnel to the next-of-kin.

Design.  An explorative descriptive design with a phenomenographic approach was chosen to describe qualitatively different conceptions of the phenomenon medical technology.

Method.  Interviews with 15 next-of-kin to patients in palliative homecare were analysed in a seven-step process where 10 conceptions emerged in five description categories.

Results.  Medical technology in palliative homecare required next-of-kin’s responsibility in monitoring or providing practical help. It also implied uncertainty among the next-of-kin because of worries about its safety or because of an improper handling. The technology trespassed on daily life because it restricted and affected the private sphere. Medical technology enabled comfort as it implied security and was a prerequisite for the patient to be cared for at home. It also required an adjustment to comprehend and manage the medical technology.

Conclusions.  Medical technology resulted in an increased caregiver burden and uncertainty among the next-of-kin. Although it meant restrictions and affected their social life, they had great confidence in its possibilities.

Relevance to clinical practice.  It is important to limit the amount of personnel and materials in the home to avoid trespassing on the family’s daily life. Medical personnel also have to be sensitive to what next-of-kin have the strength to do and not use them as informal caregivers.

Keywords
medical technology, next-of-kin, nurses, nursing, palliative homecare, phenomenography
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-17022 (URN)10.1111/j.1365-2702.2012.04123.x (DOI)000304821100010 ()22582763 (PubMedID)2-s2.0-84862166949 (Scopus ID)
Available from: 2012-01-09 Created: 2012-01-09 Last updated: 2019-03-07Bibliographically approved
Munck, B., Sandgren, A., Fridlund, B. & Mårtensson, J. (2012). Patients' understanding of medical technology in palliative home care: a qualitative analysis. Journal of Hospice and Palliative Nursing, 14(3), 191-198
Open this publication in new window or tab >>Patients' understanding of medical technology in palliative home care: a qualitative analysis
2012 (English)In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 14, no 3, p. 191-198Article in journal (Refereed) Published
Abstract [en]

Healthcare reforms and reductions in the number of hospital beds are leading to an increasing amount of medical technology moving from hospitals into home care, affecting the daily lives of patients. The aim of this study was therefore to describe the ways patients understand medical technology in palliative home care. With use of a phenomenographic approach, 15 patients with medical technology were interviewed, and data were analyzed in a 7-step process. Three ways of understanding the phenomenon emerged: a masterful patient, an adjustable patient, and a restricted patient. Masterful patients took control over the medical technology and were mostly independent of assistance from personnel. Adjustable patients accepted and adapted their lives to the medical technology and were satisfied with assistance from the personnel. Restricted patients were reminded daily of the medical technology and dependent on assistance from personnel. Depending on the patients’ health conditions, the support from the personnel, and the impact of medical technology, a transfer between the different ways of understanding occurred with a simultaneous movement between independence and dependence. The patient exhibited various ways of understanding, although one way of understanding was more dominant.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-17024 (URN)10.1097/NJH.0b013e3182404b71 (DOI)000302770200004 ()2-s2.0-84859731861 (Scopus ID)
Available from: 2012-01-09 Created: 2012-01-09 Last updated: 2019-03-07Bibliographically approved
Munck, B., Fridlund, B. & Mårtensson, J. (2011). District nurses´ conceptions of medical technology in palliative home care. Journal of Nursing Management, 19(7), 845-854
Open this publication in new window or tab >>District nurses´ conceptions of medical technology in palliative home care
2011 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 19, no 7, p. 845-854Article in journal (Refereed) Published
Abstract [en]

Aim  The aim of this study was to describe district nurses’ conceptions of medical technology in palliative homecare.

Background  Medical technology has, in recent years, been widely used in palliative homecare. Personnel with varying degrees of training and knowledge must be able to handle the new technology.

Methods  A descriptive design with a phenomenographic approach was chosen to describe qualitatively different conceptions of the phenomenon medical technology. Interviews with 16 district nurses working with palliative homecare were analysed and five descriptive categories emerged.

Results  Medical technology in palliative homecare led to vulnerability because of increasing demands and changing tasks. When medical technology was used in the home it demanded collaboration between all involved actors. It also demanded self-reliance and an awareness of managing medical technology in a patient-safe way. Medical technology provided freedom for the palliative patients.

Conclusions  To maintain patient safety, more education and collaboration with palliative care teams is needed. Next-of-kin are considered as an important resource but their participation must be based on their own conditions.

Implications for nursing management  District nurses need regular training on medical devices, must be more specialized in this kind of care and must not fragment their working time within other specialities.

Keywords
district nurses, medical technology, palliative homecare, phenomenography
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-16150 (URN)10.1111/j.1365-2834.2011.01231.x (DOI)000296250000003 ()
Available from: 2011-09-22 Created: 2011-09-22 Last updated: 2021-04-05Bibliographically approved
Munck, B. (2011). Medical technology and its impact on palliative home care as a secure base experienced by patients, next-of-kin and district nurses. (Doctoral dissertation). Jönköping: School of Health Sciences
Open this publication in new window or tab >>Medical technology and its impact on palliative home care as a secure base experienced by patients, next-of-kin and district nurses
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2011. p. 148
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 21
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-17026 (URN)
Public defence
2011-12-02, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-01-09 Created: 2012-01-09 Last updated: 2017-11-28Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8563-750x

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