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  • 1. Elgán, C
    et al.
    Fridlund, Bengt
    Lunds universitet.
    Bone mineral density in relation to body mass index among young women: a prospective cohort study2006In: International Journal of Nursing Studies, ISSN 0020-7489, Vol. 43, no 6, 663-672 p.Article in journal (Refereed)
  • 2.
    Eriksson, Kerstin
    et al.
    Jönköping University, School of Health and Welfare. Department of Anaesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
    Wikström, Lotta
    Jönköping University, School of Health and Welfare. Department of Anaesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Årestedt, Kristofer
    School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Clinical Neurophysiology, University Hospital, Linköping, Sweden.
    Patients’ experiences and actions when describing pain after surgery – A critical incident technique analysis2016In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 56, 27-36 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Pain is a common postoperative symptom, and length of hospital stay after surgery is short which highlights the importance of pain assessments. Experiences of assessing pain are mainly described from the perspective of nurses. In postoperative care, enrolled nurses and physicians also assess pain. It is therefore important to take note of their experiences to improve postoperative pain assessments.

    OBJECTIVES:

    The aim of this study was, through considering critical incidents, to describe care experiences and actions taken by healthcare professionals when assessing postoperative pain.

    METHODS:

    An explorative design employing critical incidents technique analysis was used. A total of 24 strategically selected enrolled nurses, nurses and physicians employed at orthopaedic or general surgery wards in four Swedish hospitals were interviewed. The intention was to reach variation in age, sex, profession and professional experience.

    FINDINGS:

    In pain assessments, patient-related facilitators were patients' verbal and emotional expressions including pain ratings, while lack of consistency with observed behaviours was a barrier. Clinical competence, continuity in care and time were healthcare-related facilitators. The actions healthcare professionals took were gathering facts about patients' pain manifestations and adapting to patients' communication abilities. Patient observations, either passive or active were used to confirm or detect pain. Collaboration between healthcare professionals, including consultations with pain experts, social workers and relatives, strengthened understanding of pain.

    CONCLUSIONS:

    Communication skills and working conditions have an impact on performance of pain assessment. Patient comfort without compromising safety is reached by including healthcare professionals' dissimilar responsibilities when collecting patients' and relatives' perspectives on current pain.

  • 3. Gustafsson, Margareta
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Emotional distress and coping in the early stage of recovery following acute traumatic hand injury: a questionnaire survey.2006In: International Journal of Nursing Studies, ISSN 0020-7489, Vol. 43, no 5, 557-565 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Emotional distress is frequent in patients with acute traumatic hand injury during the first weeks after the accident. Knowledge of coping in relation to emotional distress could help to identify those who need support. OBJECTIVES: To describe the different kinds of coping used by patients in the early stage of recovery following an acute traumatic hand injury and to investigate differences in coping patterns in patients with and without symptoms of emotional distress. DESIGN: Questionnaire survey with a descriptive and comparative design. Setting/participants: A total of 112 patients with acute traumatic hand injury requiring inpatient treatment at the hand surgical clinic. Those with injuries caused by a suicide attempt or with known drug abuse were excluded. Method/main outcome measures: The patients answered a postal questionnaire at home 1-2 weeks after the accident. Emotional distress was assessed with the Hospital Anxiety and Depression scale. Coping was measured with the Jalowiec Coping Scale-40. RESULTS: Coping by "trying to keep the situation under control" and "trying to look at the problems objectively and see all sides" were most frequent. These strategies are typical for the confrontive coping style, which dominated in the actual illness-situation. Symptoms of emotional distress occurred in 32% of the patients. These patients used significantly more kinds of coping strategies and used confrontive and emotive coping strategies more often than the others. Coping by "hoping for improvement", "working tension off with physical activity", "trying to put the problem out of one's mind", "worrying", "getting nervous or angry" and "taking off by one self" were associated with emotional distress. Coping by "accepting the situation as it is" and "thinking that it is nothing to worry about" were more frequent in patients without emotional distress. CONCLUSIONS: Observations of the coping strategies associated with emotional distress in this study could help to identify patients in clinical practice that need nursing support. Coping associated with less emotional distress should be encouraged.

  • 4. Hansson, Birgitta
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Coping with chronic illness: a qualitative study of coping with postpolio syndrome.1999In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 36, no 3, 255-262 p.Article in journal (Refereed)
    Abstract [en]

    The study describes how 24 people with postpolio syndrome (PPS) cope with their problems. Two qualitative interviews were conducted, 6 weeks apart. The interviews were analysed inductively. It was found that the participants experienced many types of illness-related problems in their everyday lives. Furthermore, they describe the progressive deterioration in terms of a general weakness, fatigue and pain--these adding to the emotional stress. A variety of coping strategies are employed and the result of the analysis shows it to be impossible to carry out a clearly differentiated grouping into problem-focused and emotion-focused. By and large the participants have learnt to live with the changes and feel that they have 'a good life in spite of everything'.

  • 5. Hildingh, C
    et al.
    Fridlund, Bengt
    Högskolan i Halmstad.
    Segesten, K
    Social support in self-help groups, as experienced by persons having coronary heart disease and their next of kin1995In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 32, no 3, 224-232 p.Article in journal (Refereed)
  • 6. Johansson, P
    et al.
    Oléni, M
    Fridlund, Bengt
    Högskolan i Halmstad.
    Nurses' assessments and patients' perceptions: development of the Night Nursing Care Instrument (NNCI), measuring nursing care at night2005In: International Journal of Nursing Studies, ISSN 0020-7489, Vol. 42, no 5, 569-578 p.Article in journal (Refereed)
  • 7. Rytterström, Patrik
    et al.
    Cedersund, Elisabet
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Arman, Maria
    Care and caring culture as experienced by nurses working in different care environments: a phenomenological-hermeneutic study.2009In: International Journal of Nursing Studies, ISSN 0020-7489, Vol. 46, no 5, 689-698 p.Article in journal (Refereed)
    Abstract [en]

    AIM: The aim is to understand and develop the concept of care and caring culture and to do so based on the empirical/phenomenological standpoint of nurses' lived experiences of working in different environments. BACKGROUND: Culture, care and caring are significant concepts mentioned and used in connection with nursing practice. In the nursing literature, the 'caring culture' as a concept is mostly taken for granted, and it is up to the reader to determine what caring culture means. METHOD: A phenomenological-hermeneutic method was used to uncover the meaning of lived experiences though interpretation of interviews transcribed as text. Seventeen nurses working on different wards were interviewed in 2006. A follow-up focus-group discussion was conducted with seven of the nurses 1 year later for validation of the findings. FINDINGS: Thematic analyses revealed five themes: you have to adapt to the existing care culture; seeing the invisible; being yourself; the strong personalities; the patients must adapt themselves to the circumstances. Adaptation to unwritten routines entails adaptation to the culture and the common value system. On wards described as "homelike", nurses may act in a way that reflects their own values. DISCUSSION: The care and caring culture can be understood from the perspective of what it means to care and from the perspective of how care provision is accomplished. To attain a caring culture founded on certain values, for example caritas, love and charity, we must first understand how the organization and personnel understand caring.

  • 8. Sandberg, Jonas
    et al.
    Lundh, Ulla
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Nolan, Mike
    Moving into a care home: The role of adult children in the placement process2002In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 39, no 3, 353-362 p.Article in journal (Refereed)
    Abstract [en]

    Admission of an older person to a care home is widely recognised as a very stressful period for the family and one which, despite community care policy, is likely to be an increasingly common experience. Although there is a growing research base in this area, there have been few studies on the role of adult children in supporting their parents during this difficult transition. This paper reports on the third stage of a grounded theory study conducted in Sweden which explored the part played by adult children in the placement process. Data were collected from 13 adult children using in-depth semi-structured interviews and the results are compared with themes previously derived from interviews with 26 spouse carers. The analysis reveals important overlaps and differences and suggests the need for further research exploring the dynamics of the placement process.

  • 9. Sandberg, Jonas
    et al.
    Nolan, Mike
    Lundh, Ulla
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    ’Entering a new world’: Emphatic awareness as the key to positive family/staff relationships in care homes2002In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 39, no 5, 507-515 p.Article in journal (Refereed)
    Abstract [en]

    Despite an almost universal policy of community care, placing a relative in a care home will be an increasingly common event as population ageing continues. Studies suggest that most families wish to remain involved in care following placement but that they often experience difficulties in establishing relationships with staff. This paper reports on the fifth phase of a Swedish study exploring the experience of placement from a temporal perspective and including the views of all the key actors (relatives, staff in the community, staff in care homes). The focus here is placed on the perceptions of care home staff and their perceived role in relation to spouses who have recently placed a partner. The study adopted a grounded theory approach and data were collected from in-depth interviews with 16 staff members of varying grades and positions. Analysis of the data suggested 3 levels of awareness amongst staff: empathic awareness, guarded awareness and limited awareness. The characteristics of empathic awareness are outlined and its implications briefly considered.

  • 10.
    Sidenvall, Birgitta
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Fjellström, C
    Ek, AC
    Cultural perspectives of meals expressed by patients in geriatric care1996In: International Journal of Nursing Studies, ISSN 0020-7489, Vol. 33, no 2, 212-222 p.Article in journal (Refereed)
  • 11. Sjöström-Strand , A
    et al.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Women's descriptions of symptoms and delay reasons in seeking medical care at the time of a first myocardial infarction: a qualitative study2008In: International Journal of Nursing Studies, ISSN 0020-7489, Vol. 45, no 7, 1003-1010 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Coronary heart disease (CHD) is a major cause of mortality in women. Women have also been identified as late presenters in seeking medical care. AIM: The aim of this study was to explore and describe women's symptoms and the reasons for delay in seeking medical care at the time of the first myocardial infarction (MI). METHODS: The study had an explorative and descriptive design based on content analysis approach. Nineteen women were interviewed at the hospital 2 or 3 days after hospitalisation. RESULTS: The result showed that the women had difficulties interpreting, understanding and linking the symptoms to CHD. They tried to handle the discomfort and even the chest pain, rather then ask for professional help. The women had problems with making the final decision. CONCLUSION: Women need to be made aware of the clinical symptoms of CHD, in order to understand the consequences of delay in seeking medical care following an MI.

  • 12. Skärsäter, I
    et al.
    Dencker, K
    Häggström, L
    Fridlund, Bengt
    Högskolan i Halmstad.
    A salutogenetic perspective on how men cope with major depression in daily life, with the help of professional and lay support2003In: International Journal of Nursing Studies, ISSN 0020-7489, Vol. 40, no 2, 153-162 p.Article in journal (Refereed)
  • 13. Stenwall, Ewa
    et al.
    Eriksdotter Jönhagen, Maria
    Sandberg, Jonas
    Fagerberg, Ingegerd
    The older patient's experience of encountering professional carers and close relatives during a confusional state: an interview study2008In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, no 11, 1577-1585 p.Article in journal (Refereed)
  • 14.
    Unbeck, Maria
    et al.
    Karolinska Institutet.
    Sterner, Eila
    Karolinska Institutet.
    Elg, Mattias
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare. Linköping University.
    Fossum, Bjöörn
    Sophiahemmet University College.
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare. Karolinska Institutet.
    Pukk Härenstam, Karin
    Karolinska Institutet.
    Design, application and impact of quality improvement 'theme months' in orthopaedic nursing: A mixed method case study on pressure ulcer prevention2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 4, 527-535 p.Article in journal (Refereed)
    Abstract [en]

    Background: While there is growing awareness of quality problems in healthcare systems, it remains uncertain how best to accomplish and sustain improvement over time.

    Objective: To report on the design and application of quality improvement theme months in orthopaedic nursing, and evaluate the impact on pressure ulcer as an example.

    Design: Retrospective mixed method case study with time series diagrams.

    Setting: An orthopaedic department at a Swedish university hospital.

    Method: The interventions were led by nursing teams and focused on one improvement theme at a time in two-month cycles, hence the term 'improvement theme months'. These included defined objectives, easy-to-use follow-up measurement, education, changes to daily routines, "reminder months" and data feedback. The study draws on retrospective record data regarding one of the theme topics, pressure ulcer risk assessment and prevalence, in 2281 orthopaedic admissions during January 2007-October 2010 through point prevalence measurement one-day per month. Data were analysed in time series diagrams and through comparison to annual point prevalence data from mandatory county council-wide measurements prior to, during and after interventions from 2003 to 2010. By using document analysis we reviewed concurrent initiatives at different levels in the healthcare organisation and related them to the improvement theme months and their impact.

    Results: The 46 monthly point prevalence samples ranged from 28 to 66 admissions. Substantial improvements were found in risk assessment rates for pressure ulcers both in the longitudinal follow-up (p<0.001) and in the annual county council-wide measurements. A reduction in pressure ulcer rate was observed in the annual county council-wide measurements. In the longitudinal data, wider variation in the pressure ulcer rate was seen (p<0.067); however, there was a significant decrease in pressure ulcer rates during the final ten-month period in 2010, compared to the baseline period in 2007 (p=0.004). Improvements were moderate the first years and needed reinforcement to be maintained.

    Conclusions: The theme month design and the way it was applied in this case showed potential, contributing to reduced pressure ulcer prevalence, as a way to conduct quality improvement initiatives in nursing. For sustainable improvement, multi component interventions are needed with regular monitoring and reminder efforts.

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