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  • 1.
    Lundberg, Kristina
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Borås.
    Conflicting values - everyday ethical and leadership challenges related to care in combat zones within a military organization2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Introduction: Licensed medical personnel (henceforth LMP) experience ethical problems related to undertaking care duties in combat zones. When employed in the Armed Forces they are always under the command of tactical officers (henceforth TOs).

    Aim: The overall aim was to explore everyday ethical problems experienced by military medical personnel, focusing on licensed medical personnel in combat zones from a descriptive and normative perspective. A further aim was to explore leadership challenges in leading licensed medical personnel.

    Methods: For the research descriptive, explorative (inductive and abductive) and normative designs were used. Data collection was undertaken by using different methods. Altogether 12 physicians, 15 registered nurses, seven combat lifesavers and 15 tactical officers were individually interviewed. The participants were selected by strategic (I), purposive (II) and theoretical sampling (III). The interviews were analyzed by using qualitative content analysis. Study III used classic grounded theory and study IV was a normative analysis of an ethical problem based on the idea of a wide reflective equilibrium.

    Results: We found that LMP experience ethical problems related to dual loyalty when serving in combat zones. They give reasons for undertaking, or not, military duties that can be seen as combat duties. Sometimes they have restricted reasons for undertaking these military duties. Furthermore, LMP are under the command of TOs who found it challenging when leading LMP, since TOs have to unify LMP in the unit. The unifying makes it difficult since LMP experience dual loyalty.

    Conclusions: LMP experience dual loyalty in combat zones. The reason maybe that humanitarian law and the medical ethical codes are not clear-cut or explicit about how to be interpreted around these everyday ethical problems in internal military operations. In order to fit in todays context humanitarian law needs to be revised. Furthermore, LMP need further training in parallel with reflections on ethical problems in order to adapt to the combat zones of today.

  • 2.
    Lundberg, Kristina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Borås University.
    Kjellström, Sofia
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Jonsson, Anders
    School of Health Sciences, University of Borås, SE-50190 Borås, Sweden.
    Sandman, Lars
    School of Health Sciences, University of Borås, SE-50190 Borås, Sweden.
    Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties2014Ingår i: Military medicine, ISSN 0026-4075, E-ISSN 1930-613X, Vol. 179, nr 8, s. 821-826Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES:

    The aim of this qualitative study is to explore the Swedish military personnel's experience of what it means to perform a caring role in a combat zone. This study assesses the challenges faced by military medical personnel in the context of a combat zone.

    METHODS:

    The design was descriptive with a qualitative inductive approach. Twenty military medical personnel (physicians, nurses, and combat lifesavers) were interviewed individually. They had been involved in international military operations between 2009 and 2012. This study was analyzed using qualitative content analysis.

    RESULTS:

    The analysis produced four categories: being in a primarily noncaring organization, caring in emotionally charged relationships, lacking an open dialog about expectations of killing and having to prioritize scarce resources.

    CONCLUSIONS:

    This study shows that medical personnel easily adapt to a military setting. They care but also perform other tasks when they are in a combat zone. The medical personnel want to give care to host nation but use drugs they can spare.

  • 3.
    Lundberg, Kristina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Borås.
    Kjellström, Sofia
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Jonsson, Anders
    Sandman, Lars
    Gathering intelligence or providing medical care on military operations: an ethical problem for Swedish licensed medical personnel (LMP)in combat zones2017Ingår i: Journal of Military Ethics, ISSN 1502-7570, E-ISSN 1502-7589Artikel i tidskrift (Refereegranskat)
  • 4.
    Lundberg, Kristina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Borås.
    Kjellström, Sofia
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Sandgren, Anna
    Unifying loyalty: a grounded theory about tactical officers’ (TOs) challengewhen leading licensed medical personnel (LMP) in combat zonesManuskript (preprint) (Övrigt vetenskapligt)
  • 5.
    Lundberg, Kristina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. University of Borås, Sweden.
    Kjellström, Sofia
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Sandman, Lars
    University of Borås, Sweden.
    Dual loyalties: Everyday ethical problems of registered nurses and physicians in combat zones2019Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 26, nr 2, s. 480-495Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    When healthcare personnel take part in military operations in combat zones, they experience ethical problems related to dual loyalties, that is, when they find themselves torn between expectations of doing caring and military tasks, respectively.

    Aim:

    This article aims to describe how Swedish healthcare personnel reason concerning everyday ethical problems related to dual loyalties between care and military tasks when undertaking healthcare in combat zones.

    Design:

    Abductive qualitative design.Participants and research context:Individual interviews with 15 registered nurses and physicians assigned for a military operation in Mali.

    Ethical considerations:

    The participants signed up voluntarily, and requirements for informed consent and confidentiality were met. The research was approved by the Regional Ethics Review Board in Gothenburg (D no. 816-14; 24 November 2014).

    Findings:

    Three main categories emerged: reasons for not undertaking combat duties, reasons for undertaking combat duties and restricted loyalty to military duties, and 14 subcategories. Reasons for not undertaking combat duties were that it was not in their role, not according to ethical codes or humanitarian law or a breach towards patients. Reasons for undertaking combat duties were that humanitarian law does not apply or has to be treated pragmatically or that it is a case of force protection. Shortage of resources and competence were reasons for both doing and not doing military tasks. Under some circumstances, they could imagine undertaking military tasks: when under threat, if unseen or if not needed for healthcare duties.

    Discussion/conclusion:

    These discrepant views suggest a lack of a common view on what is ethically acceptable or not, and therefore we suggest further normative discussion on how these everyday ethical problems should be interpreted in the light of humanitarian law and ethical codes of healthcare personnel and following this, further training in ethical reflection before going on military operations.

  • 6.
    Munck, Berit
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Björklund, Anita
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Jansson, Inger
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Lundberg, Kristina
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Faculty of Caring science, Work Life and Social Welfare, Pre Hospen - Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Wagman, Petra
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Adulthood transitions in health and welfare; a literature review2018Ingår i: Nursing Open, E-ISSN 2054-1058, Vol. 5, nr 3, s. 254-260Artikel, forskningsöversikt (Refereegranskat)
    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.

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