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Holmström, Inger K.ORCID iD iconorcid.org/0000-0002-4302-5529
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Publications (10 of 96) Show all publications
Håkansson Eklund, J., Holmström, I. K., Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J., . . . Summer Meranius, M. (2019). "Same same or different?" A review of reviews of person-centered and patient-centered care. Patient Education and Counseling, 102(1), 3-11
Open this publication in new window or tab >>"Same same or different?" A review of reviews of person-centered and patient-centered care
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2019 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 102, no 1, p. 3-11Article, review/survey (Refereed) Published
Abstract [en]

Objective: To provide a synthesis of already synthesized literature on person-centered care and patient-centered care in order to identify similarities and differences between the two concepts. Methods: A synthesis of reviews was conducted to locate synthesized literature published between January 2000 and March 2017. A total of 21 articles deemed relevant to this overview were synthesized using a thematic analysis. Results: The analysis resulted in nine themes present in person-centered as well as in patient-centered care: (1) empathy, (2), respect (3), engagement, (4), relationship, (5) communication, (6) shared decision-making, (7) holistic focus, (8), individualized focus, and (9) coordinated care. The analysis also revealed that the goal of person-centered care is a meaningful life while the goal of patient-centered care is a functional life. Conclusions: While there are a number of similarities between the two concepts, the goals for person-centered and patient-centered care differ. The similarities are at the surface and there are important differences when the concepts are regarded in light of their different goals. Practice implications: Clarification of the concepts may assist practitioners to develop the relevant aspects of care. Person-centered care broadens and extends the perspective of patient-centered care by considering the whole life of the patient.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD, 2019
Keywords
Patient-centered, Person-centered, Literature review, Concept analysis, Care
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-41771 (URN)10.1016/j.pec.2018.08.029 (DOI)000452381100002 ()30201221 (PubMedID)
Available from: 2018-12-20 Created: 2018-12-20 Last updated: 2018-12-20Bibliographically approved
Ahlstedt, C., Eriksson Lindvall, C., Holmström, I. K. & Muntlin Athlin, Å. (2019). What makes registered nurses remain in work?: An ethnographic study. International Journal of Nursing Studies, 89, 32-38
Open this publication in new window or tab >>What makes registered nurses remain in work?: An ethnographic study
2019 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 89, p. 32-38Article in journal (Refereed) Published
Abstract [en]

Background: Registered nurses’ work-related stress, dissatisfaction and burnout are some of the problems in the healthcare and that negatively affect healthcare quality and patient care. A prerequisite for sustained high quality at work is that the registered nurses are motivated. High motivation has been proved to lead to better working results. The theory of inner work life describes the dynamic interplay between a person's perceptions, emotions and motivation and the three key factors for a good working life: nourishment, progress and catalysts. Objectives: The aim of the study was to explore registered nurses’ workday events in relation to inner work life theory, to better understand what influences registered nurses to remain in work. Design: A qualitative explorative study with an ethnographic approach. Methods: Participant observation over four months; in total 56 h with 479 events and 58 informal interviews during observation; all registered nurses employed at the unit (n = 10) were included. In addition, individual interviews were conducted after the observation period (n = 9). The dataset was analysed using thematic analysis and in the final step of the analysis the categories were reflected in relation to the three key factors in theory of inner work life. Results: Nourishment in a registered nurse context describes the work motivation created by the interpersonal support between colleagues. It was important to registered nurses that physicians and colleagues respected and trusted their knowledge in the daily work, and that they felt comfortable asking questions and supporting each other. Progress in the context of registered nurses’ work motivation was the feeling of moving forward with a mix of small wins and the perception of solving more complex challenges in daily work. It was also fundamental to the registered nurses’ development through new knowledge and learning during daily work. Catalysts, actions that directly facilitate the work, were highlighted as the possibility to work independently along with the opportunity to work together with other registered nurses. Conclusion: This study has a number of implications for future work and research on creating an attractive workplace for registered nurses. Working independently, with colleagues from the same profession, integrated with learning, visible progress, and receiving feedback from the work itself, contribute to work motivation. 

Place, publisher, year, edition, pages
Elsevier Ltd, 2019
Keywords
Ethnographic approach, Healthcare organization, Registered nurses, Work environment, Work motivation, adult, article, catalyst, clinical article, female, health care organization, human, human experiment, interview, learning, male, motivation, occupation, perception, physician, registered nurse, thematic analysis, theoretical study, working time, workplace
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy Work Sciences
Identifiers
urn:nbn:se:mdh:diva-41230 (URN)10.1016/j.ijnurstu.2018.09.008 (DOI)30339953 (PubMedID)2-s2.0-85054821713 (Scopus ID)
Available from: 2018-10-26 Created: 2018-10-26 Last updated: 2018-10-26Bibliographically approved
Röing, M., Holmström, I. K. & Larsson, J. (2018). A Metasynthesis of Phenomenographic Articles on Understandings of Work Among Healthcare Professionals. Qualitative Health Research, 28(2), 273-291
Open this publication in new window or tab >>A Metasynthesis of Phenomenographic Articles on Understandings of Work Among Healthcare Professionals
2018 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 28, no 2, p. 273-291Article in journal (Refereed) Published
Abstract [en]

Phenomenography is a qualitative research method based on the assumption that almost any phenomenon will be understood by a group of people in a limited number of ways. Our aim in this article was to identify the different ways work can be understood by healthcare professionals. In a world where the delivery of healthcare is continually changing, a metasynthesis of phenomenographic articles on healthcare professionals’ understandings can provide knowledge about the focus and meaning of work for these individuals today. Our metaethnographic synthesis of 14 selected phenomenographic articles identified five different ways of understanding work, ranging from a limited to an all the more comprehensive view on patients and their needs. This range of understandings reveals problem areas and challenges facing healthcare professionals today. The possibility exists as well that limited understandings of work may be negative consequences of current demands for efficiency and all the more limited healthcare resources. 

Place, publisher, year, edition, pages
SAGE Publications Inc., 2018
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-37599 (URN)10.1177/1049732317719433 (DOI)000426548800008 ()28715988 (PubMedID)2-s2.0-85038233852 (Scopus ID)
Available from: 2017-12-28 Created: 2017-12-28 Last updated: 2018-10-16Bibliographically approved
Danielsson, L., Lundstrom, M.-L., Holmström, I. K. & Kerstis, B. (2018). Anaesthetizing children-From a nurse anaesthetist's perspective-A qualitative study. Nursing Open, 5(3), 393-399
Open this publication in new window or tab >>Anaesthetizing children-From a nurse anaesthetist's perspective-A qualitative study
2018 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 3, p. 393-399Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to describe nurse anaesthetists' experiences of encountering and caring for children in connection to anaesthesia. Design: Qualitative design. Methods: Sixteen written narratives based on eight nurse anaesthetists' experiences of meeting children was analysed using qualitative content analysis. Results: The overarching theme was: "anaesthetizing children is a complex caring situation, including interactions with the child and parents as well as ensuring patient safety, affected by the perioperative team and organizational prerequisites". The nurses stated that in their interaction with the family, their goal was to ensure that children and parents felt secure and calm. "Striving to work in confidence" underlined the team and organizational influences. Encountering children involves more than knowledge about technical equipment, procedures and drugs. Knowledge about children's development and fears and parents' needs are essential for an optimal caring situation. Organizations need to realize that extra time, skills and resources are needed to safely anaesthetize children.

Place, publisher, year, edition, pages
WILEY, 2018
Keywords
anaesthetics, children, nurses, nursing, parents
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-40379 (URN)10.1002/nop2.147 (DOI)000439858900020 ()30062034 (PubMedID)
Available from: 2018-08-17 Created: 2018-08-17 Last updated: 2018-08-17Bibliographically approved
Coyne, I., Holmström, I. K. & Söderbäck, M. (2018). Centeredness in Healthcare: A Concept Synthesis of Family-centered Care, Person-centered Care and Child-centered Care. Journal of Pediatric Nursing: Nursing Care of Children and Families, 42, 45-56
Open this publication in new window or tab >>Centeredness in Healthcare: A Concept Synthesis of Family-centered Care, Person-centered Care and Child-centered Care
2018 (English)In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 42, p. 45-56Article in journal (Refereed) Published
Abstract [en]

Background: Increasingly within healthcare, different kind of ‘centeredness’ are used to denote the focus of care which can create confusion for practitioners. Methods: A concept analysis was undertaken to identify the antecedents, attributes and relationship between family-, person-, and child-centered care. PubMed and CINAHL were searched from 2012 to 2017 and thirty-five papers were reviewed. Results: Both person- and child-centered care are focused on individuals, a symmetric relationship and the tailoring of care to individual needs while family- centered care is focused on the family as a unit of which the child is included. Person-centered care focuses on an adult person with autonomy, while the focus in child-centered care is the individual child as an own actor with rights but still close to a family. Conclusion: It appears at a conceptual level that the concepts of centeredness contain both similarities and differences. Finding ways to structure nursing and focus the care that respects a person's dignity and humanity is essential in healthcare and should be a major goal of health policy and health systems worldwide. Implications: The identification of the antecedents and attributes embedded in the concepts may help raise professionals’ awareness of the different foci and how this will influence one's practice. There is a need to recognize strengths and weaknesses of the centeredness in different settings and environments. Furthermore, it is important to know which approach to apply within different situations so that quality care is enabled for every person, child and family.

Place, publisher, year, edition, pages
W.B. Saunders, 2018
Keywords
Centeredness, Child-centered care, Concept analysis, Family-centered care, Person-centered care, adult, awareness, child, Cinahl, female, health care policy, human, human dignity, male, Medline, nursing, review, synthesis, systematic review
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-40292 (URN)10.1016/j.pedn.2018.07.001 (DOI)000444524700023 ()30219299 (PubMedID)2-s2.0-85049879186 (Scopus ID)
Available from: 2018-07-26 Created: 2018-07-26 Last updated: 2018-10-16Bibliographically approved
Höglund, A. T., Carlsson, M., Holmström, I. K., Lännerström, L. & Kaminsky, E. (2018). From denial to awareness: A conceptual model for obtaining equity in healthcare. International Journal for Equity in Health, 17(1), Article ID 9.
Open this publication in new window or tab >>From denial to awareness: A conceptual model for obtaining equity in healthcare
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2018 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 17, no 1, article id 9Article in journal (Refereed) Published
Abstract [en]

Background: Although Swedish legislation prescribes equity in healthcare, studies have reported inequalities, both in face-to-face encounters and in telephone nursing. Research has suggested that telephone nursing has the capability to increase equity in healthcare, as it is open to all and not limited by long distances. However, this requires an increased awareness of equity in healthcare among telephone nurses. The aim of this study was to explore and describe perceptions of equity in healthcare among Swedish telephone nurses who had participated in an educational intervention on equity in health, including which of the power constructs gender, ethnicity and age they commented upon most frequently. Further, the aim was to develop a conceptual model for obtaining equity in healthcare, based on the results of the empirical investigation. Method: A qualitative method was used. Free text comments from questionnaires filled out by 133 telephone nurses before and after an educational intervention on equity in health, as well as individual interviews with five participants, were analyzed qualitatively. The number of comments related to inequity based on gender, ethnicity or age in the free text comments was counted descriptively. Results: Gender was the factor commented upon the least and ethnicity the most. Four concepts were found through the qualitative analysis: Denial, Defense, Openness, and Awareness. Some informants denied inequity in healthcare in general, and in telephone nursing in particular. Others acknowledged it, but argued that they had workplace routines that protected against it. There were also examples of an openness to the fact that inequity existed and a willingness to learn and prevent it, as well as an already high awareness of inequity in healthcare. Conclusion: A conceptual model was developed in which the four concepts were divided into two qualitatively different blocks, with Denial and Defense on one side of a continuum and Openness and Awareness on the other. In order to reach equity in healthcare, action is also needed, and that concept was therefore added to the model. The result can be used as a starting point when developing educational interventions for healthcare personnel. 

Place, publisher, year, edition, pages
BioMed Central Ltd., 2018
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-38577 (URN)10.1186/s12939-018-0723-2 (DOI)000423229400001 ()2-s2.0-85040925575 (Scopus ID)
Available from: 2018-02-08 Created: 2018-02-08 Last updated: 2018-02-08Bibliographically approved
Skoglund, K., Holmström, I. K., Sundler, A. J. & Hammar, L. (2018). Previous work experience and age do not affect final semester nursing student self-efficacy in communication skills. Nurse Education Today, 68, 182-187
Open this publication in new window or tab >>Previous work experience and age do not affect final semester nursing student self-efficacy in communication skills
2018 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 68, p. 182-187Article in journal (Refereed) Published
Abstract [en]

Background: With the continuing increase in the older population, being able to communicate with the elderly is one of the many important skills in caring for older people. Therefore, student nurses need support during education to be prepared with the necessary communication skills to meet these demands. Objective: The aim of this study was to describe the development of communication skills during nursing education. Design: A quantitative descriptive and comparative study. Settings: The nursing programme at a university in an urban area of Sweden. Participants: Student nurses in the first and third year in a nursing programme in Sweden in 2015. Methods: Data were collected with a self-efficacy questionnaire and analysed with descriptive and comparative statistics. Results: The student nurses in the final semester had a higher self-rated ability to communicate with older people than students in the second semester of the education year. There was also a difference in self efficacy between students with or without former experience of health care work or work in care with older persons in the second semester. However, these differences were not seen in the final semester. The age of the students did not affect the self-efficacy rate in either semester. Conclusions: Student nurses in the present study scored themselves relatively highly, while student nurses in previous studies expressed a need for more communication skills training. Further studies with observations of student nurses’ actual communicative skills in clinical and simulations settings are needed, to pinpoint weak spots and targets for such an education. 

Place, publisher, year, edition, pages
Churchill Livingstone, 2018
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-40192 (URN)10.1016/j.nedt.2018.05.017 (DOI)000442056100031 ()29945098 (PubMedID)2-s2.0-85048858577 (Scopus ID)
Available from: 2018-07-05 Created: 2018-07-05 Last updated: 2018-10-16Bibliographically approved
Kristensen, D. V., Sundler, A. J., Eide, H., Hafskjold, L., Ruud, I. & Holmström, I. K. (2017). Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits. Journal of Clinical Nursing, 26(23-24), 4613-4621
Open this publication in new window or tab >>Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits
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2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 23-24, p. 4613-4621Article in journal (Refereed) Published
Abstract [en]

Aims and objectivesTo describe the characteristics of communication practice in home care visits between older people (over 65years old) and nurse assistants and to discuss the findings from a person-centered perspective. BackgroundThe older population is increasing worldwide, along with the need for healthcare services in the person's home. To achieve a high-quality care, person-centered communication is crucial. DesignA descriptive design with a qualitative inductive approach was used. MethodFifteen audio recordings of naturally occurring conversations between 12 nurse assistants and 13 older people in Norway were analysed by qualitative content analysis. ResultsFour categories were revealed through analysis: (i) supporting older people's connection to everyday life; (ii) supporting older people's involvement in their own care; (iii) attention to older people's bodily and existential needs; and (iv) the impact of continuity and predictability on older people's well-being. ConclusionsThe communication between the older people and the nurse assistants during home care visits was mainly task-oriented, but also related to the person. The older people were involved in the tasks to be carried out and humour was part of the communication. Greater attention was paid to bodily than existential needs. The communication was connected with the older people's everyday life in several ways. Time frames and interruptions concern the older people; hearing and speech impairments were a challenge to communication. To enhance person-centred communication, further studies are needed, especially intervention studies for healthcare professionals and students. Relevance to clinical practiceBeing responsive to older people's subjective experiences is important in meeting their needs in home care. Communication that addresses the need for trust and predictability is important for older people. Responding to existential needs require more attention. The home care setting has an impact on communication.

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
audio recordings, communication, Norway, older people, person-centered care, qualitative content analysis
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-37524 (URN)10.1111/jocn.13807 (DOI)000416319600074 ()28301068 (PubMedID)2-s2.0-85021229502 (Scopus ID)
Available from: 2017-12-22 Created: 2017-12-22 Last updated: 2018-10-16Bibliographically approved
Holmström, I. K., Krantz, A., Karacagil, L. & Sundler, A. J. (2017). Frequent callers in primary health care - a qualitative study with a nursing perspective. Journal of Advanced Nursing, 73(3), 622-632
Open this publication in new window or tab >>Frequent callers in primary health care - a qualitative study with a nursing perspective
2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 3, p. 622-632Article in journal (Refereed) Published
Abstract [en]

Aim. To: (a) describe how telephone nurses define a frequent caller; and (b) describe their experiences with calls from frequent callers to primary healthcare centres. Background. Telephone nursing has been noted to be a cost-effective method to enhance access to and use of health care. Some patients use these services extensively and are called 'frequent callers'. Little is known about this group of callers, the reasons behind these calls and telephone nurses' experiences and strategies to manage the calls. Design. Descriptive design with a qualitative inductive approach. Methods. Interviews were conducted with ten telephone nurses in Sweden in 2015. Qualitative content analysis was conducted. Results. A main theme was established, called 'Balancing between the experienced and assessed needs', which described the telephone nurses' experiences with calls made by frequent callers to primary healthcare centres and was further described in five categories with 15 subcategories. The categories described telephone nurses' definitions of frequent callers, telephone nurses' views of the underlying reasons for the calls, challenges related to frequent callers, experiences with an increased work load and strategies used to manage and help frequent callers. Conclusion. Frequent callers were commonly encountered by telephone nurses' in this study. Their calls were experienced as complex and demanding to manage. The findings point to needs for guidelines and routines to improve the care of frequent callers. In addition, support and training in communication skills to encounter this group of callers in an optimal and safe way may be required.

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
content analysis, experiences, frequent callers, primary health care, qualitative methods, telephone nursing
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-35353 (URN)10.1111/jan.13153 (DOI)000399292400009 ()27650484 (PubMedID)2-s2.0-84995466542 (Scopus ID)
Available from: 2017-05-19 Created: 2017-05-19 Last updated: 2017-05-19Bibliographically approved
Sundling, V., Sundler, A. J., Holmström, I. K., Kristensen, D. V. & Eide, H. (2017). Mindfulness predicts student nurses' communication self-efficacy: A cross-national comparative study. Patient Education and Counseling, 100(8), 1558-1563
Open this publication in new window or tab >>Mindfulness predicts student nurses' communication self-efficacy: A cross-national comparative study
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2017 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 100, no 8, p. 1558-1563Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to compare student nurses' communication self-efficacy, empathy, and mindfulness across two countries, and to analyse the relationship between these qualities. Methods: The study had a cross-sectional design. Data was collected from final year student nurses in Norway and Sweden. Communication self-efficacy, empathy, and mindfulness were reported by questionnaires; Clear-cut communication with patients, Jefferson Scale of Empathy, and Langer 14 items mindfulness scale. Results: The study included 156 student nurses, 94 (60%) were Swedish. The mean communication self-efficacy score was 119 (95% CI 116-122), empathy score 115 (95% CI 113-117) and mindfulness score 79 (95% CI 78-81). A Mann-Whitney test showed that Swedish students scored significantly higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. When adjusted for age, gender, and country in a multiple linear regression, mindfulness was the only independent predictor of communication self-efficacy. Conclusion: The Swedish student nurses in this study scored higher on communication self-efficacy, empathy, and mindfulness than Norwegian students did. Student nurses scoring high on mindfulness rated their communication self-efficacy higher. Practice implications: A mindful learning approach may improve communication self-efficacy and possibly the effect of communication skills training. 

National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-36157 (URN)10.1016/j.pec.2017.03.016 (DOI)000405383800017 ()28342674 (PubMedID)2-s2.0-85015997744 (Scopus ID)
Available from: 2017-07-27 Created: 2017-07-27 Last updated: 2018-01-24Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-4302-5529

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