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Hammarbäck, S., Holmberg, M., Wiklund, L. & Bremer, A. (2023). Ambulance clinicians’ responsibility when encountering patients in a suicidal process. Nursing Ethics
Open this publication in new window or tab >>Ambulance clinicians’ responsibility when encountering patients in a suicidal process
2023 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Even though the traditional focus in emergency care is on life-threatening medical crisis, ambulance clinicians frequently encounter patients with mental illness, including suicidal ideation. A suicide is preceded by a complex process where most of the suicidal ideation is invisible to others. However, as most patients seek healthcare in the year before suicide, ambulance clinicians could have an important part to play in preventing suicide, as they encounter patients in different phases of the suicidal process. Aim: The aim of this study was to describe ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process. Research design: A qualitative inductive design using a phenomenographic approach was used. Participants and research context: Twenty-seven ambulance clinicians from two regions in southern Sweden were interviewed. Ethical considerations: The study was approved by the Swedish Ethical Review Authority. Findings: Three categories of descriptions captured a movement from responding to a biological being to responding to a social being. Conventional responsibility was perceived as a primary responsibility for emergency care. In conditional responsibility, the patient’s mental illness was given only limited importance and only if certain conditions were met. Ethical responsibility was perceived to have its primary focus on the encounter with the patient and listening to the patient’s life story. Conclusions: An ethical responsibility is favourable regarding suicide prevention in ambulance care, and competence development in mental illness and conversation skills could enable ambulance clinicians to have conversations with patients about suicidal ideation.

Place, publisher, year, edition, pages
SAGE Publications Ltd, 2023
Keywords
Ambulance clinicians, emergency medical services, ethical responsibility, phenomenography, suicidal ideation
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-62334 (URN)10.1177/09697330221149102 (DOI)000963458300001 ()2-s2.0-85152260693 (Scopus ID)
Available from: 2023-04-26 Created: 2023-04-26 Last updated: 2023-05-03Bibliographically approved
Carnesten, H., Wiklund Gustin, L., Skoglund, K. & von Heideken Wågert, P. (2023). Caring through barriers—Newly graduated registered nurses' lived experiences in emergency departments during the COVID-19 pandemic. Journal of Advanced Nursing
Open this publication in new window or tab >>Caring through barriers—Newly graduated registered nurses' lived experiences in emergency departments during the COVID-19 pandemic
2023 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed) Published
Abstract [en]

Aim: To illuminate the meaning of newly graduated registered nurses' experiences of caring for patients in emergency departments during the COVID-19 pandemic. Design: A phenomenological hermeneutical study guided by Lindseth and Norberg. Methods: In-depth one-on-one interviews with 14 nurses from five hospitals were conducted from March to November 2020 and analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) were used as the reporting guideline. Results: The findings comprise one main theme Caring through barriers and three themes with sub-themes. In the first theme, having intention to care, participants revealed their dedication to care for patients during the pandemic despite extensive stress, little experience and skills. The second theme, with tied hands in human suffering, illuminates experiences of being disconnected from the patient, overwhelmed by responsibility and unable to relieve suffering. The third theme, feeling inadequate, reveals experiences of lack of support and doubts meaning less space to develop into the nurse one wants to be. Conclusion: Findings reveal a new understanding of new nurses' experiences during times of crisis. The essence of caring in the emergency department during the pandemic can be explained as mediated through spatial, temporal and emotional barriers preventing new nurses from providing holistic care. Impact: The results may be used as anticipatory guidance for new nurses and inform targeted support interventions to support new nurses entering the profession in crisis conditions. Public Contribution: This study involved new nurses in semi-structured interviews. 

Place, publisher, year, edition, pages
John Wiley and Sons Inc, 2023
Keywords
caring, caring science, compassion, COVID-19, emergency care, emergency department, moral stress, nurses, nursing, phenomenological hermeneutics
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-61921 (URN)10.1111/jan.15585 (DOI)000928479500001 ()2-s2.0-85147516068 (Scopus ID)
Available from: 2023-02-15 Created: 2023-02-15 Last updated: 2024-01-09Bibliographically approved
Kitzmüller, G., Wiklund Gustin, L. & Kalhovde, A. M. (2023). Filling the void: the role of adult siblings caring for a brother or sister with severe mental illness. Global Qualitative Nursing Research, 10, Article ID 23333936231162230.
Open this publication in new window or tab >>Filling the void: the role of adult siblings caring for a brother or sister with severe mental illness
2023 (English)In: Global Qualitative Nursing Research, E-ISSN 2333-3936, Vol. 10, article id 23333936231162230Article in journal (Refereed) Published
Abstract [en]

Little is known about the role of adult siblings’ caregiver role within the context of mental illness. Therefore, our purpose was to explore how siblings narrate their experiences of being the main caregivers of a brother or sister with severe mental illness and how they cooperate with their ill sibling and their family of origin. We used a narrative hermeneutic approach and performed a secondary analysis of two interviews of siblings derived from a study of peoples’ experiences of hearing voices. The findings illuminate the participants’ multifaceted roles and how differently siblings might deal with the multiple challenges of caring for an ill sibling. The mediating role between their ill sibling and their family of origin to reestablish the broken family bonds was a significant aspect. Nurses’ awareness of the important and multidimensional role of caregiving siblings can improve the provision of family support and promote involvement of siblings in the treatment of an ill family member.

Abstract [no]

Vi vet lite om hvordan voksne søsken ivaretar rollen som omsorgsgivere når et familiemedlem har en alvorlig psykisk lidelse. Hensikten med denne studien var derfor å undersøke søskens narrativer med tanke på hvordan de erfarer omsorgsrollen og hvordan de samarbeider med den som har en psykisk lidelse og med resten av familien. Vi foretok en hermeneutisk sekundæranalyse av narrativene i to søskenintervju fra en studie som utforsket erfaringer med det å høre stemmer. Funnene synliggjør deltakernes mangefasetterte roller og hvordan de møter utfordringene med å yte omsorg for en person med alvorlig psykisk lidelse. Et fremtredende funn var at de inntok rollen som brobygger i et forsøk på å gjenopprette brutte familiebånd. Det er betydningsfullt at sykepleiere er oppmerksomme på de sammensatte rollene søsken kan ha som omsorgsgivere. Sykepleiere kan fremme involvering av søsken og forbedre familiestøtte i behandlingsforløpet til de som har en alvorlig psykisk lidelse.

Keywords
narrative hermeneutics, severe mental illness, siblings
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-62195 (URN)10.1177/23333936231162230 (DOI)000968454900001 ()2-s2.0-85160347403 (Scopus ID)
Available from: 2023-04-11 Created: 2023-04-11 Last updated: 2023-06-07Bibliographically approved
Carnesten, H., von Heideken Wågert, P., Wiklund, L., Toivanen, S., Skoglund, K., Andreae, C. & Jaarsma, T. (2023). Struggling with frightening experiences in a transformed reality: A mixed methods study of healthcare workers’ experiences during the pandemic.. In: : . Paper presented at Nordic Conference in Nursing Research, Reykjavik, 2023.
Open this publication in new window or tab >>Struggling with frightening experiences in a transformed reality: A mixed methods study of healthcare workers’ experiences during the pandemic.
Show others...
2023 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background: The COVID-19 pandemic continues to impact health care workers’ (HCWs’) mental health. Research show that psychological distress and hard challenges abide with strong commitment to contribute. Yet, in-depth understanding of HCWs’ experiences of the changed caring reality during the pandemic is missing. Mixed methods research (MMR) accommodates several features apart from employing either quantitative or qualitative methods. This presentation focuses on examples from the 13-step mixed method by Leech and Onwuegbuzie.

Methods: 97 HCWs in one hard-hit region in Sweden answered a web-based questionnaire measuring symptoms of stress (using DSM-5 criteria for post-traumatic stress syndrome, PTSD) in relation to perceived sense of coherence (SOC-scale) and self-compassion (SCS) as well as HCWs’ experiences. First, qualitative data (experiences of the pandemic) was analyzed by qualitative content analysis, then quantitative data (associations between PTSD and SOC/SCS) were analyzed with linear regression adjusted for covariates. Thirdly, a synthesis, the meta-inference of qualitative and quantitative data, explained a new comprehensive understanding. 

Results: By analyzing the categories and subcategories from the qualitative analysis in relation to symtoms of stress and SOC/SCS, a synthesis emerged. This was undertaken by merging and comparing the findings and discussing the new comprehensive understanding. Finally, to fully outline the mixed methods approach, qualitative and quantitative data were synthesized into a new comprehensive whole, a meta inference. 

Conclusion: This study moves away from dichotomic traditions between qualitative or quantitative approaches. By broadening the methodological departure this study may provide a new comprehensive understanding and contribute to enhance quality in MMR. 

Keywords
Stress, vårdande, sjuksköterskor, COVID-19, akutsjukvård, lidande, trauma
National Category
Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-65059 (URN)
Conference
Nordic Conference in Nursing Research, Reykjavik, 2023
Projects
nurses’ lived experiences focusing on the meaning of stress and caring in hospital emergency settings during the COVID-19 pandemic.
Available from: 2023-12-20 Created: 2023-12-20 Last updated: 2023-12-21Bibliographically approved
Wiklund, L. (2022). Att samtala om psykisk ohälsa (1ed.). In: Spante, M., & Almgren Eriksson, E. (Ed.), Professionella möten på distans. Bedömning och vård om råd.: (pp. 241-262). Stockholm: Liber
Open this publication in new window or tab >>Att samtala om psykisk ohälsa
2022 (Swedish)In: Professionella möten på distans. Bedömning och vård om råd. / [ed] Spante, M., & Almgren Eriksson, E., Stockholm: Liber, 2022, 1, p. 241-262Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2022 Edition: 1
National Category
Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-58297 (URN)978-91-47-14033-6 (ISBN)
Available from: 2022-05-24 Created: 2022-05-24 Last updated: 2022-06-21Bibliographically approved
Carnesten, H., Wiklund, L., Skoglund, K. & von Heideken Wågert, P. (2022). Battling extraordinary situations and conflicting emotions: A qualitative study of being a newly graduated Registered Nurse in the emergency department during the COVID-19 pandemic. Nursing Open, 9(5), 2370-2380
Open this publication in new window or tab >>Battling extraordinary situations and conflicting emotions: A qualitative study of being a newly graduated Registered Nurse in the emergency department during the COVID-19 pandemic
2022 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 9, no 5, p. 2370-2380Article in journal (Refereed) Published
Abstract [en]

Aim: To describe newly graduated registered nurses' (NGRNs') experiences of encountering stress in emergency departments (EDs) during the COVID-19 pandemic. Design: A qualitative descriptive study. Methods: Data from 14 in-depth interviews with NGRNs working in an ED for 3-36 months after graduation was analysed by the means of qualitative content analysis as described by Graneheim and Lundman. Interviews were conducted from March to November 2020 covering the first two waves of the pandemic. Results: Data revealed three categories and nine subcategories comprised in the theme Battling extraordinary situations and conflicting emotions. Empowered by acknowledging themselves as important caregivers during the pandemic NGRNs struggle against limitations and exert themselves beyond their known limit. External stressors due to work overload in combination with understaffing force NGRNs into the role of the experienced nurse prematurely and internal stressors derives from part taking in less qualitative care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
advanced nursing, care, COVID-19, emergency department, emergency care, nurses, qualitative approaches, stress, CONSCIENCE, PERCEPTIONS, EXPERIENCES, CHALLENGES, BURNOUT
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-58623 (URN)10.1002/nop2.1250 (DOI)000800745900001 ()2-s2.0-85130750453 (Scopus ID)
Available from: 2022-06-08 Created: 2022-06-08 Last updated: 2022-10-26Bibliographically approved
Wiklund, L. & Asp, M. (2022). Från begrepp till handling (3ed.). In: Vårdvetenskapliga begrepp i teori och praktik: (pp. 21-26). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Från begrepp till handling
2022 (Swedish)In: Vårdvetenskapliga begrepp i teori och praktik, Lund: Studentlitteratur AB, 2022, 3, p. 21-26Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2022 Edition: 3
National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-58294 (URN)978-91-44-13955-5 (ISBN)
Available from: 2022-05-24 Created: 2022-05-24 Last updated: 2022-06-21Bibliographically approved
Wiklund, L. (2022). Medlidande och närliggande begrepp (3ed.). In: Wiklund Gustin, L., & Asp, M. (Ed.), Vårdvetenskapliga begrepp i teori och praktik: (pp. 179-193). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Medlidande och närliggande begrepp
2022 (Swedish)In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund Gustin, L., & Asp, M., Lund: Studentlitteratur AB, 2022, 3, p. 179-193Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2022 Edition: 3
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-58295 (URN)9789144161372 (ISBN)
Available from: 2022-05-24 Created: 2022-05-24 Last updated: 2022-06-21Bibliographically approved
Fredriksson, L. & Wiklund, L. (2022). Vårdande kommunikation (3ed.). In: Wiklund Gustin, L. & Asp, M. (Ed.), Vårdvetenskapliga begrepp i teori och praktik: (pp. 415-428). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Vårdande kommunikation
2022 (Swedish)In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund Gustin, L. & Asp, M., Lund: Studentlitteratur AB, 2022, 3, p. 415-428Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2022 Edition: 3
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-58296 (URN)9789144161372 (ISBN)
Available from: 2022-05-24 Created: 2022-05-24 Last updated: 2022-06-21Bibliographically approved
Wiklund, L. & Asp, M. (Eds.). (2022). Vårdvetenskapliga begrepp i  teori och praktik (3ed.). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Vårdvetenskapliga begrepp i  teori och praktik
2022 (Swedish)Collection (editor) (Other academic)
Abstract [sv]

En vetenskap och dess teorier byggs upp av begrepp som på olika sätt relaterar till varandra och beskriver vetenskapens sätt att se på den egna verksamheten. Tillsammans formar begreppen en syn på verkligheten som kan te sig mer eller mindre abstrakt, samtidigt som abstraktionsnivån också bidrar till att teorier kan ha såväl djup som omfång. Boken introducerar varför begreppsutveckling är viktigt inom vårdvetenskap, ett par metoder för begreppsutveckling samt hur reflektion och forskning om begrepp kan bidra till att vårdandet evidensbaseras. I huvuddelen av boken beskriver forskare från Sverige, Finland och Norge övergripande begrepp som exempelvis hälsa, miljö och personcentrerad vård, samt mer avgränsade begrepp som vila, vårdande kommunikation och tröst. Boken vänder sig till studerande i sjuksköterskeprogrammet och olika specialistsjuksköterskeprogram, men passar också andra yrkesgrupper i vårdande verksamheter och de som är intresserade av att förstå mer om vårdvetenskap i allmänhet, och om dess begrepp och språkanvändning i synnerhet

Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2022. p. 447 Edition: 3
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-58293 (URN)978-91-44-13955-5 (ISBN)9789144161372 (ISBN)
Available from: 2022-05-24 Created: 2022-05-24 Last updated: 2022-06-21Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9714-577X

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