Ania Willman - Academia.edu (original) (raw)
Papers by Ania Willman
Journal of Clinical Nursing
Open Journal of Nursing, 2015
Social and physical activities can improve sleep in older people. However, living in a residentia... more Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents. The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility.
Modern-day health systems are complex, making it difficult to assure continuity of care for older... more Modern-day health systems are complex, making it difficult to assure continuity of care for older persons with multi-morbidity. One way of intervening in a health system that is leading to fragmented care is by utilising Case Management (CM). CM aims to improve co-ordination of healthcare and social services. To better understand and advance the development of CM, there is a need for additional research that provides rich descriptions of CM in practice. This knowledge is important as there could be unknown mechanisms, contextual or interpersonal, that contribute to the success or failure of a CM intervention. Furthermore, the CM intervention in this study is conducted in the context of the Swedish health system, which prior to this intervention was unfamiliar with this kind of coordinative service. The aim of this study was to explore the everyday work undertaken by case managers within a CM intervention, with a focus on their experiences.
The study design was qualitative and inductive, utilising a focused ethnographic approach. Data collection consisted of participant observations with field notes as well as a group interview and individual interviews with nine case managers, conducted in 2012/2013. The interviews were recorded, transcribed verbatim and subjected to thematic analysis.
An overarching theme emerged from the data: Challenging current professional identity, with three sub-themes. The sub-themes were 1) Adjusting to familiar work in an unfamiliar role; 2) Striving to improve the health system through a new role; 3) Trust is vital to advocacy.
Findings from this study shed some light on the complexity of CM for older persons with multi-morbidity, as seen from the perspective of case managers. The findings illustrate how their everyday work as case managers represents a challenge to their current professional identity. These findings could help to understand and promote the development of CM models aimed at a population of older persons with complex health needs.
Primary Health Care Research & Development, 2015
Aim To determine the psychometric properties of the Sympathy-Acceptance-Understanding-Caring Comp... more Aim To determine the psychometric properties of the Sympathy-Acceptance-Understanding-Caring Competence (SAUC) model questionnaire for foreign-born parents evaluating nursing encounters in the Swedish Primary Child Health Care (PCHC) services. Multicultural encounters in child health care from the nursing perspective are challenging and problematic worldwide. A suitable theory-based and validated questionnaire is needed for foreign-born parents to assess the quality of their encounters with nurses. The SAUC questionnaire, modified for use by new, foreign-born parents using the Swedish PCHC services, was evaluated for its congruence with the theory of Confirming Encounter. The study was ethically approved and data were collected between March and August 2009 from 83 new, foreign-born parents seen at 50 clinics. Exploratory factor analysis was used to identify related factors, and goodness-of-fit tests were used to estimate theoretical consistency. Confirmatory Factor Analysis was used to verify the results. Findings The questionnaire had satisfactory theoretical consistency with the theory of Confirming Encounter. Three factors identified by exploratory factor analysis and confirmed by confirmatory factor analysis - person support, self-support, and self-perspective support - indicated internal consistency and validated the three factors implicit in the theory Confirming Encounter. In addition, a new factor, concordance, was identified that is compatible with the theory. To conclude, despite the fact that a modified questionnaire have its limitations results demonstrate that the SAUC-model questionnaire seems to be a reliable and valid nursing quality-control measure with which foreign-born parents can evaluate the qualities of a confirming encounter with nurses. However, we suggest the need for testing the questionnaire in a larger population.
Worldviews on Evidence-Based Nursing, 2011
Objectives: Despite a growing interest in evidence-based practice (EBP), the implementation into ... more Objectives: Despite a growing interest in evidence-based practice (EBP), the implementation into clinical practice of knowledge derived from research has proved to be a cumbersome process. Additionally, the literature seems to present a fragmented picture with research mainly focusing on a few factors of possible importance, among which leadership appears to be one of the more important. Thus, this study aimed to systematically review the literature regarding leadership and its possible influence on the process of implementing EBP.
Journal of Nursing Management, 2013
International Journal of Mental Health Nursing, 2014
National guidelines are released regularly, and professionals are expected to adopt and implement... more National guidelines are released regularly, and professionals are expected to adopt and implement them. However, studies dealing with mental health-care professionals' views about guidelines are sparse. The aim of the present study was to highlight mental health-care staff's views on the Swedish national guidelines for 'psychosocial interventions for schizophrenia or schizophrenia-type symptoms' and their implementation. The study took place in the southeast parts of Sweden, and data were collected through five group interviews consisting of 16 professionals working either in the county council or in the municipalities. The transcribed text was analysed by content analysis, revealing two categories. The first category 'a challenge to the practice of care as known' reflected that the release of guidelines could be perceived as a challenge to prevailing care and culture. The second category 'anticipating change to come from above' mirrored views on how staff expected the implementation process to flow from top to bottom. To facilitate working in accordance with guidelines, we suggest that future guidelines should be accompanied by an implementation plan, where the educational needs of frontline staff are taken into account. There is also a need for policy makers and managers to assume responsibility in supporting the implementation of evidence-based practice.
Nordic Journal of Nursing Research, 2006
Nurse Education in Practice, 2004
The development of a new nursing curriculum in one Australian university provided the opportunity... more The development of a new nursing curriculum in one Australian university provided the opportunity for academic staff to consider the best ways to integrate the requirements of evidence-based practice (EBP) into nursing education and culminated in the development and conduct of a specific benchmarking project. Data collection for the project included the use of university documents, observations and informal discussions with staff. An analysis of this information resulted in the emergence of five categories that were grouped into two major categories, namely infrastructure and processes. Within the major category of infrastructure, two minor categories, namely evidence-based nursing (EBN) Unit and EBN champions emerged. The major category of processes included three minor categories, namely integrating a research thread, immediate introduction to EBP and planning with local services. The outcome of the benchmarking project also offers a template for other health disciplines to adopt when trying to embed and value EBP in their department and curricula.
European Journal of Pain, 2006
Primary Health Care Research & Development, 2015
Aim To determine the psychometric properties of the Sympathy-Acceptance-Understanding-Caring Comp... more Aim To determine the psychometric properties of the Sympathy-Acceptance-Understanding-Caring Competence (SAUC) model questionnaire for foreign-born parents evaluating nursing encounters in the Swedish Primary Child Health Care (PCHC) services. Multicultural encounters in child health care from the nursing perspective are challenging and problematic worldwide. A suitable theory-based and validated questionnaire is needed for foreign-born parents to assess the quality of their encounters with nurses. The SAUC questionnaire, modified for use by new, foreign-born parents using the Swedish PCHC services, was evaluated for its congruence with the theory of Confirming Encounter. The study was ethically approved and data were collected between March and August 2009 from 83 new, foreign-born parents seen at 50 clinics. Exploratory factor analysis was used to identify related factors, and goodness-of-fit tests were used to estimate theoretical consistency. Confirmatory Factor Analysis was used to verify the results. Findings The questionnaire had satisfactory theoretical consistency with the theory of Confirming Encounter. Three factors identified by exploratory factor analysis and confirmed by confirmatory factor analysis - person support, self-support, and self-perspective support - indicated internal consistency and validated the three factors implicit in the theory Confirming Encounter. In addition, a new factor, concordance, was identified that is compatible with the theory. To conclude, despite the fact that a modified questionnaire have its limitations results demonstrate that the SAUC-model questionnaire seems to be a reliable and valid nursing quality-control measure with which foreign-born parents can evaluate the qualities of a confirming encounter with nurses. However, we suggest the need for testing the questionnaire in a larger population.
Journal of Clinical Nursing, 2015
To extend nurses' descriptions of how they understood car... more To extend nurses' descriptions of how they understood caring, as reflected in the findings of an earlier study (i.e. the hierarchical outcome space) and to gain additional understandings and perspectives of nurses' views of caring in relation to a coronary care patient case. Scientific literature from the 1970s-1990s contains descriptions of caring in nursing. In contrast, the contemporary literature on this topic - particularly in the context of coronary care - is very sparse, and the few studies that do contain descriptions rarely do so from the perspective of nurses. Qualitative descriptive study. Twenty-one nurses were interviewed using the stimulated recall interview technique. The data were analysed using deductive and inductive qualitative content analysis. The results of the iterative and integrated content analysis showed that the data mainly reproduced the content of the hierarchical outcome space describing how nurses could understand caring; however, in the outcome space, the relationship broke up (i.e. flipped). The nurses' views of caring could now also be understood as: person-centredness 'lurking' in the shadows; limited 'potential' for safeguarding patients' best interests; counselling as virtually the 'only' nursing intervention; and caring preceded by the 'almighty' context. Their views offered alternative and, at times, contrasting perspectives of caring, thereby adding to our understanding of it. Caring was described as operating somewhere between the nurses caring values and the contextual conditions in which caring occurred. This challenged their ability to sustain caring in accordance with their values and the patients' preferences. To ensure that the essentials of caring are met at all times, nurses need to plan and deliver caring in a systematic way. The use of systematic structures in caring, as the nursing process, can help nurses to work in a person-centred way, while sustaining their professional values.
International journal of integrated care
Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising c... more Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers. The aim of the study was to deepen the understanding of the importance of case managers to family members of older persons (75+) with multi-morbidity. The study design was based on an interpretive phenomenological approach. Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach. The findings revealed one overarching theme: "Helps to fulfil my unmet needs", based on three sub-themes: (1) "Helps me feel secure - Experiencing a trusting relationship", (2) "Confirms and strengthens me - Challenging my sense of being alone" and (3) "Being my personal guide - Increasing my competence". The findings indicate that case ma...
Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses, Jan 13, 2015
The aim of this study was to describe and elucidate patient experiences of autonomy in an intensi... more The aim of this study was to describe and elucidate patient experiences of autonomy in an intensive care context from a caring perspective. Patients in intensive care units (ICUs) are critically ill and in a dependent and vulnerable position. There is thus a risk of staff taking command not only of the patients' vital functions but also of their decision-making. A qualitative design was selected. Individual interviews were conducted with 11 adult patients with an intensive care episode of two days or more at six Swedish ICUs. The data were analysed using Inductive Content Analysis. Patient autonomy in intensive care was shown to be 'A trajectory towards partnership in care depending on state of health and mutual understanding'. It was experienced through acknowledged dependence, being recognised as a person, invited participation and becoming a co-partner in care. Patients in need of intensive care wanted to be involved in making decisions about their care as this create...
Implementation science : IS, 2015
National guidelines are being produced at an increasing rate, and politicians and managers are ex... more National guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines. The study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second indu...
Journal of telemedicine and telecare, 2007
We developed a consultation and teaching concept about leg wounds and their care, for use by pati... more We developed a consultation and teaching concept about leg wounds and their care, for use by patients and caregivers in a home health-care setting. Descriptive data were gathered through a survey distributed to three groups, comprising 21 individuals (18 nurses and 3 health administrators). These participants provided answers regarding group activities, meeting frequency, meeting notes and meeting content, as well as responses to questions regarding the Website, Web materials, film and a pamphlet. Seventeen people answered the survey (81% response rate). They made predominantly positive comments. The combined total average score was 3.6 (1=very bad to 4=very good). The concept was implemented in one municipality in a health-care region in southern Sweden using high bandwidth videophones (640 kbit/s). The results showed that elderly persons at home and nurses working in home health care were interested in using the concept and communicating via videophone. A strength of the Web-based...
International journal of nursing studies, 2007
This research into the concept of support was undertaken because of the recurrent use of the conc... more This research into the concept of support was undertaken because of the recurrent use of the concept in nursing research and especially because of the vital importance of support to family carers of older persons. To inductively develop a definition of support, specifically in the context of family care of frail aged persons. The study followed the evolutionary method of concept analysis. The study was based on data from scientific publications, encyclopaedias and dictionaries. In order to secure a representative sample, highly systematic means of sampling were used. Working with the data underpinning this study, it was possible to put forward a definition of support for family carers who care for a frail aged person at home. The two major dimensions, as described under attributes, were merged into the following definition: "Support entails the provision of general tangibles such as information, education, economic aid, goods and external services. They are prerequisites for fa...
BMC Nursing, 2015
Background: Nursing has come a long way since the days of Florence Nightingale and even though no... more Background: Nursing has come a long way since the days of Florence Nightingale and even though no consensus exists it would seem reasonable to assume that caring still remains the inner core, the essence of nursing. In the light of the societal, contextual and political changes that have taken place during the 21st century, it is important to explore whether these might have influenced the essence of nursing. The aim of this study was to describe registered nurses' conceptions of caring.
Journal of Clinical Nursing
Open Journal of Nursing, 2015
Social and physical activities can improve sleep in older people. However, living in a residentia... more Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents. The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility.
Modern-day health systems are complex, making it difficult to assure continuity of care for older... more Modern-day health systems are complex, making it difficult to assure continuity of care for older persons with multi-morbidity. One way of intervening in a health system that is leading to fragmented care is by utilising Case Management (CM). CM aims to improve co-ordination of healthcare and social services. To better understand and advance the development of CM, there is a need for additional research that provides rich descriptions of CM in practice. This knowledge is important as there could be unknown mechanisms, contextual or interpersonal, that contribute to the success or failure of a CM intervention. Furthermore, the CM intervention in this study is conducted in the context of the Swedish health system, which prior to this intervention was unfamiliar with this kind of coordinative service. The aim of this study was to explore the everyday work undertaken by case managers within a CM intervention, with a focus on their experiences.
The study design was qualitative and inductive, utilising a focused ethnographic approach. Data collection consisted of participant observations with field notes as well as a group interview and individual interviews with nine case managers, conducted in 2012/2013. The interviews were recorded, transcribed verbatim and subjected to thematic analysis.
An overarching theme emerged from the data: Challenging current professional identity, with three sub-themes. The sub-themes were 1) Adjusting to familiar work in an unfamiliar role; 2) Striving to improve the health system through a new role; 3) Trust is vital to advocacy.
Findings from this study shed some light on the complexity of CM for older persons with multi-morbidity, as seen from the perspective of case managers. The findings illustrate how their everyday work as case managers represents a challenge to their current professional identity. These findings could help to understand and promote the development of CM models aimed at a population of older persons with complex health needs.
Primary Health Care Research & Development, 2015
Aim To determine the psychometric properties of the Sympathy-Acceptance-Understanding-Caring Comp... more Aim To determine the psychometric properties of the Sympathy-Acceptance-Understanding-Caring Competence (SAUC) model questionnaire for foreign-born parents evaluating nursing encounters in the Swedish Primary Child Health Care (PCHC) services. Multicultural encounters in child health care from the nursing perspective are challenging and problematic worldwide. A suitable theory-based and validated questionnaire is needed for foreign-born parents to assess the quality of their encounters with nurses. The SAUC questionnaire, modified for use by new, foreign-born parents using the Swedish PCHC services, was evaluated for its congruence with the theory of Confirming Encounter. The study was ethically approved and data were collected between March and August 2009 from 83 new, foreign-born parents seen at 50 clinics. Exploratory factor analysis was used to identify related factors, and goodness-of-fit tests were used to estimate theoretical consistency. Confirmatory Factor Analysis was used to verify the results. Findings The questionnaire had satisfactory theoretical consistency with the theory of Confirming Encounter. Three factors identified by exploratory factor analysis and confirmed by confirmatory factor analysis - person support, self-support, and self-perspective support - indicated internal consistency and validated the three factors implicit in the theory Confirming Encounter. In addition, a new factor, concordance, was identified that is compatible with the theory. To conclude, despite the fact that a modified questionnaire have its limitations results demonstrate that the SAUC-model questionnaire seems to be a reliable and valid nursing quality-control measure with which foreign-born parents can evaluate the qualities of a confirming encounter with nurses. However, we suggest the need for testing the questionnaire in a larger population.
Worldviews on Evidence-Based Nursing, 2011
Objectives: Despite a growing interest in evidence-based practice (EBP), the implementation into ... more Objectives: Despite a growing interest in evidence-based practice (EBP), the implementation into clinical practice of knowledge derived from research has proved to be a cumbersome process. Additionally, the literature seems to present a fragmented picture with research mainly focusing on a few factors of possible importance, among which leadership appears to be one of the more important. Thus, this study aimed to systematically review the literature regarding leadership and its possible influence on the process of implementing EBP.
Journal of Nursing Management, 2013
International Journal of Mental Health Nursing, 2014
National guidelines are released regularly, and professionals are expected to adopt and implement... more National guidelines are released regularly, and professionals are expected to adopt and implement them. However, studies dealing with mental health-care professionals' views about guidelines are sparse. The aim of the present study was to highlight mental health-care staff's views on the Swedish national guidelines for 'psychosocial interventions for schizophrenia or schizophrenia-type symptoms' and their implementation. The study took place in the southeast parts of Sweden, and data were collected through five group interviews consisting of 16 professionals working either in the county council or in the municipalities. The transcribed text was analysed by content analysis, revealing two categories. The first category 'a challenge to the practice of care as known' reflected that the release of guidelines could be perceived as a challenge to prevailing care and culture. The second category 'anticipating change to come from above' mirrored views on how staff expected the implementation process to flow from top to bottom. To facilitate working in accordance with guidelines, we suggest that future guidelines should be accompanied by an implementation plan, where the educational needs of frontline staff are taken into account. There is also a need for policy makers and managers to assume responsibility in supporting the implementation of evidence-based practice.
Nordic Journal of Nursing Research, 2006
Nurse Education in Practice, 2004
The development of a new nursing curriculum in one Australian university provided the opportunity... more The development of a new nursing curriculum in one Australian university provided the opportunity for academic staff to consider the best ways to integrate the requirements of evidence-based practice (EBP) into nursing education and culminated in the development and conduct of a specific benchmarking project. Data collection for the project included the use of university documents, observations and informal discussions with staff. An analysis of this information resulted in the emergence of five categories that were grouped into two major categories, namely infrastructure and processes. Within the major category of infrastructure, two minor categories, namely evidence-based nursing (EBN) Unit and EBN champions emerged. The major category of processes included three minor categories, namely integrating a research thread, immediate introduction to EBP and planning with local services. The outcome of the benchmarking project also offers a template for other health disciplines to adopt when trying to embed and value EBP in their department and curricula.
European Journal of Pain, 2006
Primary Health Care Research & Development, 2015
Aim To determine the psychometric properties of the Sympathy-Acceptance-Understanding-Caring Comp... more Aim To determine the psychometric properties of the Sympathy-Acceptance-Understanding-Caring Competence (SAUC) model questionnaire for foreign-born parents evaluating nursing encounters in the Swedish Primary Child Health Care (PCHC) services. Multicultural encounters in child health care from the nursing perspective are challenging and problematic worldwide. A suitable theory-based and validated questionnaire is needed for foreign-born parents to assess the quality of their encounters with nurses. The SAUC questionnaire, modified for use by new, foreign-born parents using the Swedish PCHC services, was evaluated for its congruence with the theory of Confirming Encounter. The study was ethically approved and data were collected between March and August 2009 from 83 new, foreign-born parents seen at 50 clinics. Exploratory factor analysis was used to identify related factors, and goodness-of-fit tests were used to estimate theoretical consistency. Confirmatory Factor Analysis was used to verify the results. Findings The questionnaire had satisfactory theoretical consistency with the theory of Confirming Encounter. Three factors identified by exploratory factor analysis and confirmed by confirmatory factor analysis - person support, self-support, and self-perspective support - indicated internal consistency and validated the three factors implicit in the theory Confirming Encounter. In addition, a new factor, concordance, was identified that is compatible with the theory. To conclude, despite the fact that a modified questionnaire have its limitations results demonstrate that the SAUC-model questionnaire seems to be a reliable and valid nursing quality-control measure with which foreign-born parents can evaluate the qualities of a confirming encounter with nurses. However, we suggest the need for testing the questionnaire in a larger population.
Journal of Clinical Nursing, 2015
To extend nurses' descriptions of how they understood car... more To extend nurses' descriptions of how they understood caring, as reflected in the findings of an earlier study (i.e. the hierarchical outcome space) and to gain additional understandings and perspectives of nurses' views of caring in relation to a coronary care patient case. Scientific literature from the 1970s-1990s contains descriptions of caring in nursing. In contrast, the contemporary literature on this topic - particularly in the context of coronary care - is very sparse, and the few studies that do contain descriptions rarely do so from the perspective of nurses. Qualitative descriptive study. Twenty-one nurses were interviewed using the stimulated recall interview technique. The data were analysed using deductive and inductive qualitative content analysis. The results of the iterative and integrated content analysis showed that the data mainly reproduced the content of the hierarchical outcome space describing how nurses could understand caring; however, in the outcome space, the relationship broke up (i.e. flipped). The nurses' views of caring could now also be understood as: person-centredness 'lurking' in the shadows; limited 'potential' for safeguarding patients' best interests; counselling as virtually the 'only' nursing intervention; and caring preceded by the 'almighty' context. Their views offered alternative and, at times, contrasting perspectives of caring, thereby adding to our understanding of it. Caring was described as operating somewhere between the nurses caring values and the contextual conditions in which caring occurred. This challenged their ability to sustain caring in accordance with their values and the patients' preferences. To ensure that the essentials of caring are met at all times, nurses need to plan and deliver caring in a systematic way. The use of systematic structures in caring, as the nursing process, can help nurses to work in a person-centred way, while sustaining their professional values.
International journal of integrated care
Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising c... more Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers. The aim of the study was to deepen the understanding of the importance of case managers to family members of older persons (75+) with multi-morbidity. The study design was based on an interpretive phenomenological approach. Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach. The findings revealed one overarching theme: "Helps to fulfil my unmet needs", based on three sub-themes: (1) "Helps me feel secure - Experiencing a trusting relationship", (2) "Confirms and strengthens me - Challenging my sense of being alone" and (3) "Being my personal guide - Increasing my competence". The findings indicate that case ma...
Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses, Jan 13, 2015
The aim of this study was to describe and elucidate patient experiences of autonomy in an intensi... more The aim of this study was to describe and elucidate patient experiences of autonomy in an intensive care context from a caring perspective. Patients in intensive care units (ICUs) are critically ill and in a dependent and vulnerable position. There is thus a risk of staff taking command not only of the patients' vital functions but also of their decision-making. A qualitative design was selected. Individual interviews were conducted with 11 adult patients with an intensive care episode of two days or more at six Swedish ICUs. The data were analysed using Inductive Content Analysis. Patient autonomy in intensive care was shown to be 'A trajectory towards partnership in care depending on state of health and mutual understanding'. It was experienced through acknowledged dependence, being recognised as a person, invited participation and becoming a co-partner in care. Patients in need of intensive care wanted to be involved in making decisions about their care as this create...
Implementation science : IS, 2015
National guidelines are being produced at an increasing rate, and politicians and managers are ex... more National guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines. The study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second indu...
Journal of telemedicine and telecare, 2007
We developed a consultation and teaching concept about leg wounds and their care, for use by pati... more We developed a consultation and teaching concept about leg wounds and their care, for use by patients and caregivers in a home health-care setting. Descriptive data were gathered through a survey distributed to three groups, comprising 21 individuals (18 nurses and 3 health administrators). These participants provided answers regarding group activities, meeting frequency, meeting notes and meeting content, as well as responses to questions regarding the Website, Web materials, film and a pamphlet. Seventeen people answered the survey (81% response rate). They made predominantly positive comments. The combined total average score was 3.6 (1=very bad to 4=very good). The concept was implemented in one municipality in a health-care region in southern Sweden using high bandwidth videophones (640 kbit/s). The results showed that elderly persons at home and nurses working in home health care were interested in using the concept and communicating via videophone. A strength of the Web-based...
International journal of nursing studies, 2007
This research into the concept of support was undertaken because of the recurrent use of the conc... more This research into the concept of support was undertaken because of the recurrent use of the concept in nursing research and especially because of the vital importance of support to family carers of older persons. To inductively develop a definition of support, specifically in the context of family care of frail aged persons. The study followed the evolutionary method of concept analysis. The study was based on data from scientific publications, encyclopaedias and dictionaries. In order to secure a representative sample, highly systematic means of sampling were used. Working with the data underpinning this study, it was possible to put forward a definition of support for family carers who care for a frail aged person at home. The two major dimensions, as described under attributes, were merged into the following definition: "Support entails the provision of general tangibles such as information, education, economic aid, goods and external services. They are prerequisites for fa...
BMC Nursing, 2015
Background: Nursing has come a long way since the days of Florence Nightingale and even though no... more Background: Nursing has come a long way since the days of Florence Nightingale and even though no consensus exists it would seem reasonable to assume that caring still remains the inner core, the essence of nursing. In the light of the societal, contextual and political changes that have taken place during the 21st century, it is important to explore whether these might have influenced the essence of nursing. The aim of this study was to describe registered nurses' conceptions of caring.