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Skoglund, K., Bescher, M., Ekwall, S. & Marmstål Hammar, L. (2024). Intrahospital transport of critically ill patients: Nurse anaesthetists' and specialist ICU nurses' experiences. Nursing in Critical Care
Open this publication in new window or tab >>Intrahospital transport of critically ill patients: Nurse anaesthetists' and specialist ICU nurses' experiences
2024 (English)In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153Article in journal (Refereed) Published
Abstract [en]

BackgroundIntrahospital transport (IHT) is often performed by nurse anaesthetists and specialist intensive care nurses. Studies have shown that IHT increases the risk of mortality and morbidity, with up to 71% negative incidents. Using checklists when preparing for an IHT is important. Several international guidelines exist to ensure IHT safety and reduce the risk of complications. However, existing guidelines are often problematic in clinical practice. AimThis study aimed to describe the experiences of nurse anaesthetists and specialized intensive care nurses during the IHT of adult patients with critical illnesses. Study DesignThis study adopted a mixed-methods approach. MethodsData were collected through a questionnaire completed by 66 nurses with specialist education in anaesthesia or intensive care. The data were analysed with qualitative content analysis, and the quantitative data were analysed with descriptive statistics. ResultsTwo categories with two subcategories each emerged from the analysis of the responses of nurse anaesthetists and specialist intensive care nurses regarding their IHT experiences: creating good circumstances (subcategories: being risk-conscious and the importance of meticulous preparations) and the importance of routines and education (subcategories: following guidelines and having adequate training). ConclusionIHT was described as a high risk for patient safety and complications. Routines with good compliance and education can positively impact patient safety during IHT. Checklists and scenario training can better prepare nurse anaesthetists and specialist intensive care nurses to manage complications that may arise during IHT, resulting in safer patient care. Relevance for Clinical PracticeThe findings underscore the importance of written guidelines for IHT, emphasizing awareness and adherence by the entire team. Careful pre-IHT preparations, coupled with an understanding of potential risks, are vital for ensuring patient safety. Clinical training and discussions following incidents during IHT play a crucial role in raising the collective awareness of patient safety within the entire team.

Place, publisher, year, edition, pages
WILEY, 2024
Keywords
intrahospital transport, nurse anaesthetist, patient safety, qualitative content analysis, specialist intensive care nurse
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-66240 (URN)10.1111/nicc.13053 (DOI)001172867200001 ()38391114 (PubMedID)2-s2.0-85186448592 (Scopus ID)
Available from: 2024-03-13 Created: 2024-03-13 Last updated: 2024-03-20Bibliographically approved
Carnesten, H., von Heideken Wågert, P., Wiklund Gustin, L., Toivanen, S., Skoglund, K., Jaarsma, T. & Andreae, C. (2024). Struggling in the dehumanized world of COVID—An exploratory mixed‐methods study of frontline healthcare workers' experiences. Journal of Advanced Nursing, 1-15
Open this publication in new window or tab >>Struggling in the dehumanized world of COVID—An exploratory mixed‐methods study of frontline healthcare workers' experiences
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2024 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, p. 1-15Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim

To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden.DesignAn online fully mixed-methods design.MethodsA web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting.

Results

Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy.

Conclusions

Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis.

National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-65889 (URN)10.1111/jan.16083 (DOI)001155994100001 ()2-s2.0-85184195479 (Scopus ID)
Available from: 2024-02-05 Created: 2024-02-05 Last updated: 2024-04-10Bibliographically 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, 79(6), 2269-2279
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 1365-2648, Vol. 79, no 6, p. 2269-2279Article 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 ()36749551 (PubMedID)2-s2.0-85147516068 (Scopus ID)
Available from: 2023-02-15 Created: 2023-02-15 Last updated: 2024-04-10Bibliographically approved
Skoglund, K., Åhlman, E., Mallin, S. & Holmgren, J. (2023). Intensive care nurses' experiences of caring for patients during the COVID-19 pandemic based on an analysis of blog posts. Nursing in Critical Care
Open this publication in new window or tab >>Intensive care nurses' experiences of caring for patients during the COVID-19 pandemic based on an analysis of blog posts
2023 (English)In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background

In 2019, coronavirus disease 2019 (COVID-19) broke out worldwide, leading to a pandemic. Studies have shown that COVID-19 patients in intensive care units (ICUs) require more nursing care than other patients. ICU nurses who care for patients with COVID-19 have shown signs of psychological and physical strain.AimThe aim of this study was to illuminate ICU nurses' experiences of caring for patients with COVID-19 in ICUs during the first wave of the pandemic.DesignA qualitative, descriptive and inductive approach was used.

Method

A total of 70 blog posts from 13 bloggers in the United States, Great Britain, Finland and Sweden were analysed using qualitative inductive manifest content analysis.

Results

The results reveal an overall theme: ‘An overturned existence under extreme conditions’. Furthermore, three categories—‘the virus caused changes in work and private lives’, ‘unreasonable demands’, and to hold on to caring ideals thanks to the support of others’—and seven subcategories were identified.

Conclusion

Caring for patients with COVID-19 during the first wave of the pandemic was demanding because of a lack of knowledge about the disease and the severity of the illness. This led to ICU nurses experiencing extreme conditions that affected various aspects of their lives. Support from colleagues and teamwork were revealed to be particularly important for how nurses dealt with the demands of working during a pandemic, as was sufficient recovery time between work shifts.

Relevance to Clinical Practice

Work in ICUs was challenging and demanding, even before the pandemic. This study contributes to an understanding of the complex work environment that existed in hospitals during the first wave of the COVID-19 pandemic. The knowledge obtained from this study can be used to revise working conditions and identify health interventions for ICU nurses.

National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-62623 (URN)10.1111/nicc.12931 (DOI)000999383200001 ()2-s2.0-85161308036 (Scopus ID)
Available from: 2023-05-30 Created: 2023-05-30 Last updated: 2023-12-07Bibliographically 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.
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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
Skoglund, K., Åhlman, E., Mallin, S. & Holmgren, J. (2023). Using blogs to describe Intensive Care nurses’ experiences of caring for patients in the COVID-19 pandemic.. In: : . Paper presented at Nordic conference in nursing research, NCNR, 2-4 oktober 2023, Reykjavik, Island..
Open this publication in new window or tab >>Using blogs to describe Intensive Care nurses’ experiences of caring for patients in the COVID-19 pandemic.
2023 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Using blogs to describe Intensive Care nurses’ experiences of caring for patients in the COVID-19 pandemic.

Background: In 2019, coronavirus disease 2019 (COVID-19) broke out worldwide, causing a pandemic. Research shows that patients with COVID-19 in intensive care units (ICUs) require more nursing care than other patients in ICU. The ICU nurses who care for these patients have shown signs of psychological and physical strain and experienced a lower sense of work satisfaction and feelings of helplessness. Analysis of blog posts has been conducted, to illuminate ICU nurses’ experiences of caring for patients with COVID-19.

Method: To acquire a deeper understanding of ICU nurses’ experiences of caring for patients with COVID-19 during the first wave of the pandemic, analyzing text from ICU nurses’ blog posts was suitable.

Seventy blog posts from 13 bloggers in the United States, Great Britain, Finland, and Sweden were analyzed using a manifest qualitative content analysis.

Results: The results revealed an overall theme: “An overturned existence under extreme conditions.” Furthermore, three categories – “The virus caused changes in work and private life,” “Unreasonable demands,” and “To hold on to caring ideals thanks to the support of others”, were identified.

Conclusion: Collecting data through blogs makes it possible to obtain information from a wide geographic area at almost no cost. Based on the overwhelming situation at ICUs, during the pandemic, analyzing blogposts was suitable to catch ICU nurses experiences without taking any time or focus from the participants during their work.

Caring for patients with COVID-19 during the first wave of the pandemic was demanding, and support from colleagues and teamwork were important.

National Category
Medical and Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-65291 (URN)
Conference
Nordic conference in nursing research, NCNR, 2-4 oktober 2023, Reykjavik, Island.
Available from: 2024-01-09 Created: 2024-01-09 Last updated: 2024-01-18Bibliographically 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: 2024-04-05Bibliographically approved
Skoglund, K. (2022). Omvårdnad av personer med andningsstöd (1ed.). In: Lena-Karin Gustafsson; Mirkka Söderman (Ed.), Omvårdnad i hemmet vid komplexa vårdbehov: (pp. 143-160). Studentlitteratur AB
Open this publication in new window or tab >>Omvårdnad av personer med andningsstöd
2022 (Swedish)In: Omvårdnad i hemmet vid komplexa vårdbehov / [ed] Lena-Karin Gustafsson; Mirkka Söderman, Studentlitteratur AB, 2022, 1, p. 143-160Chapter in book (Other academic)
Place, publisher, year, edition, pages
Studentlitteratur AB, 2022 Edition: 1
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-61090 (URN)9789144144061 (ISBN)
Available from: 2022-12-01 Created: 2022-12-01 Last updated: 2022-12-02Bibliographically approved
Summer Meranius, M., Holmström, I., Håkansson, J., Breitholtz, A., Moniri, F., Skogevall, S., . . . Rasoal, D. (2020). Paradoxes of person‐centred care: A discussion paper. Nursing Open, 7(5), 1321-1329
Open this publication in new window or tab >>Paradoxes of person‐centred care: A discussion paper
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2020 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 7, no 5, p. 1321-1329Article, review/survey (Refereed) Published
Abstract [en]

AIM: Previous research has mainly focused on the advantages of PCC and less on its disadvantages. Hence, there is a need to further explore the recent research regard-ing PCC from both sides. Therefore, the aim of this paper is to elucidate the advan-tages and disadvantages of PCC.

DESIGN: Discussion paper.

METHODS: We searched relevant literature published January 2000–March 2018 in PubMed, Medline, CHINAL, Scopus and Web of Science.

RESULTS: The results showed that PCC can contribute to improved health and well-being, improved mutual interaction in relationships, improved cost-effectiveness and im-proved work environment, while the disadvantages can involve increased personal and financial costs, exclusion of certain groups, increased personal and financial costs, exclu-sion of staff's personhood and unfairness due to empathy. An analysis of the existing literature on PCC showed paradoxes, which call for further investigation.

Keywords
clinical practice, concept, evidence, healthcare, person-centred care
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-48639 (URN)10.1002/nop2.520 (DOI)000539141600001 ()32802352 (PubMedID)2-s2.0-85086160592 (Scopus ID)
Available from: 2020-06-11 Created: 2020-06-11 Last updated: 2020-11-20Bibliographically approved
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)2-s2.0-85052965545 (Scopus ID)
Available from: 2018-12-20 Created: 2018-12-20 Last updated: 2020-10-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8008-8169

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