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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: 2020-03-19Bibliographically 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-centred care. In: Royal college of Nursing, Sheffield, UK: . Paper presented at Royal college of Nursing, Sheffield, UK.
Open this publication in new window or tab >>"Same same or different?" A review of reviews of person-centered and patient-centred care
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2019 (English)In: Royal college of Nursing, Sheffield, UK, 2019Conference paper, Oral presentation with published abstract (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-45437 (URN)
Conference
Royal college of Nursing, Sheffield, UK
Available from: 2019-10-07 Created: 2019-10-07 Last updated: 2020-01-28Bibliographically approved
Holmström, I., Gustafsson, S., Wesström, J. & Skoglund, K. (2019). Telephone nurses’ use of a decision support system: An observational study. Nursing and Health Sciences, 21(4), 501-507
Open this publication in new window or tab >>Telephone nurses’ use of a decision support system: An observational study
2019 (English)In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 21, no 4, p. 501-507Article in journal (Refereed) Published
Abstract [en]

Telephone nurses give advice and support and make assessments based on verbal communication only. Web-based decision support systems are often used to increase patient safety and make medically correct assessments. The aim of the present this study was to describe factors affecting the use of a decision support system and experiences with this system among telephone nurses in Swedish primary health care. Observations and semistructured interviews were conducted. Six registered nurses with at least 1 year of experience of telephone nursing participated. Field notes and interviews were analyzed by qualitative content analysis. The main findings of the present this study were factors that decrease the decision support system use or promote deviation from decision support system use, factors that are positive for decision support system use and the decision support system complicates the work. Underuse and deviations from decision support systems can be a safety risk, because decisions are based on too little information. Further research with observations of telephone nurses’ use of decision support systems is needed to develop both telephone nursing and decision support systems.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019
Keywords
content analysis, decision support system, participant observation, primary health care, telephone nursing
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-47115 (URN)10.1111/nhs.12632 (DOI)2-s2.0-85070681297 (Scopus ID)
Available from: 2020-02-20 Created: 2020-02-20 Last updated: 2020-02-20Bibliographically 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: 2020-01-28Bibliographically approved
Skoglund, K., Holmström, I., Sundler, A. J. & Marmstål Hammar, L. (2018). Previous work experience and age do not affect final semester nursing students self-efficacy in communication skills. In: Nordic Conference in Nursing Research, Oslo, Norway: . Paper presented at Nordic Conference in Nursing Research, Oslo, Norway.
Open this publication in new window or tab >>Previous work experience and age do not affect final semester nursing students self-efficacy in communication skills
2018 (English)In: Nordic Conference in Nursing Research, Oslo, Norway, 2018Conference paper, Poster (with or without abstract) (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-45443 (URN)
Conference
Nordic Conference in Nursing Research, Oslo, Norway
Available from: 2019-10-07 Created: 2019-10-07 Last updated: 2020-01-28Bibliographically approved
Håkansson Eklund, J., Holmström, I. K., Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J., . . . Summer Meranius, M. (2018). "Same same or different?" A review of reviews of person-centred and patinet-centred care. In: International Conference on Communication in Healthcare, Porto, Portugal: . Paper presented at International Conference on Communication in Healthcare, Porto, Portugal.
Open this publication in new window or tab >>"Same same or different?" A review of reviews of person-centred and patinet-centred care
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2018 (English)In: International Conference on Communication in Healthcare, Porto, Portugal, 2018Conference paper, Oral presentation with published abstract (Refereed)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45447 (URN)
Conference
International Conference on Communication in Healthcare, Porto, Portugal
Available from: 2019-10-07 Created: 2019-10-07 Last updated: 2020-01-28Bibliographically approved
Marmstål Hammar, L., Holmström, I. K., Skoglund, K., Summer Meranius, M. & Sundler, A. J. (2017). The care of and communication with older people from the perspective of student nurses. A mixed method study. Nurse Education Today, 52, 1-6
Open this publication in new window or tab >>The care of and communication with older people from the perspective of student nurses. A mixed method study
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2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 52, p. 1-6Article in journal (Refereed) Published
Abstract [en]

Background Undergraduate nurse education needs to prepare student nurses to meet the demands and to have the necessary communication skills for caring for an increasing older population. The challenges involve how best to support and empower student nurses to learn the communication skills needed to care for older people. Objective The aim of this study was to investigate student nurses' views on the care of and communication with older people. Design A descriptive study with a mixed-method approach was conducted. Methods Quantitative and qualitative data were collected from a questionnaire completed by third-year Swedish student nurses in 2015. Results The student nurses reported positive attitudes to the care of and communication with older people. The findings focus on the central aspects related to relationship building, techniques for communication and external prerequisites. Conclusions Despite positive attitudes, student nurses had a limited view of communication with older people. Educators need to increase student nurses' capacity to communicate effectively with older people. Educational interventions to improve and evaluate the communication competency of nurses and student nurses are needed.

Keywords
Caring, Communication, Education, Mixed-method approach, Nursing
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-34983 (URN)10.1016/j.nedt.2017.02.002 (DOI)000400216200001 ()28214663 (PubMedID)2-s2.0-85013156178 (Scopus ID)
Available from: 2017-03-06 Created: 2017-03-06 Last updated: 2020-03-19Bibliographically approved
Skoglund, K., Hillered, L., Tsitsopoulos, P., Engquist, H., Purins, K., Lewén, A., . . . Marklund, N. (2014). The Neurological Wake-up Test Does not Alter Cerebral Energy Metabolism and Oxygenation in Patients with Severe Traumatic Brain Injury. Neurocritical Care, 2014(20), 413-426, Article ID 3.
Open this publication in new window or tab >>The Neurological Wake-up Test Does not Alter Cerebral Energy Metabolism and Oxygenation in Patients with Severe Traumatic Brain Injury
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2014 (English)In: Neurocritical Care, ISSN 1541-6933, E-ISSN 1556-0961, Neurocritical Care, ISSN 1541-6933, Vol. 2014, no 20, p. 413-426, article id 3Article in journal (Other academic) Published
Abstract [en]

Background: The neurological wake-up test (NWT) is used to monitor the level of consciousness in patients with traumatic brain injury (TBI). However, it requires interruption of sedation and may elicit a stress response. We evaluated the effects of the NWT using cerebral microdialysis (MD), brain tissue oxygenation (PbtiO2), jugular venous oxygen saturation (SjvO2), and/or arterial-venous difference (AVD) for glucose, lactate, and oxygen in patients with severe TBI.Methods: Seventeen intubated TBI patients (age16–74 years) were sedated using continuous propofol infusion. All patients received intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring in addition to MD, PbtiO2and/or SjvO2 . Up to 10 days postinjury, ICP, CPP, PbtiO2 (51 NWTs), MD (49 NWTs), and/or SjvO2 (18 NWTs) levels during propofol sedation (baseline) and NWT were ompared. MD was evaluated at a flow rate of 1.0 µL/min (28 NWTs) or the routine 0.3 µL/min rate (21 NWTs). Results: The NWT increased ICPandCPP levels (p<0.05). Compared to baseline, nterstitial levels of glucose, lactate, pyruvate, glutamate, glycerol, and the actate/pyruvate ratio were unaltered by the NWT. Pathological SjvO2(<50 % or >71 % ;n=2 NWTs) and PbtiO2(<10 mmHg; n=3 NWTs) values were rare at baseline and did not change following NWT. Finally, the NWT did not alter the AVD of glucose, lactate, or oxygen. Conclusions: The NWT-induced stress response resulted in increased ICP and CPP levels although it did not negatively alter focal neurochemistry or cerebral oygenation in TBI patients.

Place, publisher, year, edition, pages
New York: Springer Science+Business Media B.V., 2014
Keywords
Traumatic brain injury, intracerebral microdialysis, brain tissue oxygenation, jugular venous oxygenation, neurological wake up test
National Category
Clinical Medicine
Identifiers
urn:nbn:se:mdh:diva-21969 (URN)10.1007/s12028-013-9876-4 (DOI)2-s2.0-84902384968 (PubMedID)2-s2.0-84902384968 (Scopus ID)
Available from: 2012-04-24 Created: 2013-10-17 Last updated: 2017-12-06Bibliographically approved
Skoglund, K., Enblad, P. & Marklund, N. (2013). Monitoring and Sedation Differences in the Management of Severe Head Injury and Subarachnoid Hemorrhage Among Neurocritical Care Centers. Journal of Neuroscience Nursing, 45(6), 360-368
Open this publication in new window or tab >>Monitoring and Sedation Differences in the Management of Severe Head Injury and Subarachnoid Hemorrhage Among Neurocritical Care Centers
2013 (English)In: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 45, no 6, p. 360-368Article in journal (Refereed) Published
Abstract [en]

Background: The emergence of specialized neurocritical care (NCC) centers has been associated with an improved survival of patients with severe traumatic brain injury or subarachnoid hemorrhage. However, there are no established guidelines on sedation strategy or the frequency of evaluating the level of consciousness using the neurological wake-up test (NWT) in sedated NCC patients. Objectives: The aim was to compare the (1) monitoring techniques, (2) sedation principles, and (3) the use of the NWT in patients with severe traumatic brain injury or subarachnoid hemorrhage in 16 NCC centers. Method: A systematic survey of all 16 centers providing NCC in Scandinavia was performed using a questionnaire regarding the routine primary choice of sedative and analgesic compounds, monitoring techniques, and the frequency of the NWT, sent to the director of each center during 1999, 2004, and 2009. Results: The response rate was 100%. Except for one center in 1999, all included centers routinely used monitoring of intracranial and cerebral perfusion pressure. In contrast, newer monitoring techniques such as microdialysis, jugular bulb oximetry, and brain tissue oxygenation were infrequently used throughout the survey period. Approximately half of the NCC centers used propofol infusion as the primary sedative, whereas the remaining centers used midazolam infusion, and there was a marked variation in the choice of analgesia in each evaluated year. The NWT was never used in 50% of centers and six times daily in one center from 1999 to 2009. Most differences among the NCC centers remained unchanged over the evaluated 10-year period. Discussion: Although Scandinavian countries have similar healthcare systems, there were marked differences among the participating NCC centers in the choice of monitoring tools and sedatives and the routine use of the NWT. These differences likely reflect different clinical management traditions and a lack of evidence-based guidelines in routine NCC. 

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-23500 (URN)10.1097/JNN.0b013e3182a3cf4f (DOI)000326966300007 ()24217146 (PubMedID)2-s2.0-84892390857 (Scopus ID)
Available from: 2013-12-13 Created: 2013-12-13 Last updated: 2019-06-18Bibliographically approved
Skoglund, K., Enblad, P., Hillered, L. & Marklund, N. (2012). The neurological wake-up test increases stress hormone levels in patients with severe traumatic brain injury. Critical Care Medicine, 40(1), 216-222
Open this publication in new window or tab >>The neurological wake-up test increases stress hormone levels in patients with severe traumatic brain injury
2012 (English)In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 40, no 1, p. 216-222Article in journal (Refereed) Published
Abstract [en]

Objectives: The "neurological wake-up test" is needed to evaluate the level of consciousness in patients with severe traumatic brain injury. However, the neurological wake-up test requires interruption of continuous sedation and may induce a stress response and its use in neurocritical care is controversial. We hypothesized that the neurological wake-up test induces an additional biochemical stress response in patients with severe traumatic brain injury.

Patients: Twenty-four patients who received continuous propofol sedation and mechanical ventilation after moderate to severe traumatic brain injury (Glasgow Coma Scale score <= 8; patient age 18-71 yrs old) were analyzed. Exclusion criteria were age <18 yrs old, ongoing pentobarbital infusion, or markedly increased intracranial pressure on interruption of continuous sedation.

Design: Single-center prospective study. During postinjury days 1-8, 65 neurological wake-up tests were evaluated. Adrenocorticotrophic hormone, epinephrine, and norepinephrine levels in plasma and cortisol levels in saliva were analyzed at baseline (during continuous intravenous propofol sedation) and during neurological wake-up test. Data are presented using medians and 25th and 75th percentiles.

Setting: The study was performed in a university hospital neurocritical care unit.

Interventions: None.

Measurements and Main Results: At baseline, adrenocorticotrophic hormone and cortisol levels were 10.6 (6.0-19.4) ng/L and 16.0 (10.7-31.8) nmol/L, respectively. Immediately after the neurological wake-up test, adrenocorticotrophic hormone levels increased to 20.5 (11.1-48.4) ng/L (p < .05) and cortisol levels in saliva increased to 24.0 (12.3-42.5) nmol/L (p < .05). The plasma epinephrine and norepinephrine levels increased from a baseline of 0.3 (0.3-0.6) and 1.6 (0.9-2.3) nmol/L, respectively, to 0.75 (0.3-1.4) and 2.8 (1.28-3.58) nmol/L, respectively (both p < .05).

Conclusions: The neurological wake-up test induces a biochemical stress response in patients with severe traumatic brain injury. The clinical importance of this stress response remains to be established but should be considered when deciding the frequency and use of the neurological wake-up test during neurocritical care.

Keywords
ACTH, catecholamines, cerebral perfusion pressure (CPP), cortisol, epinephrine, intracranial pressure (ICP), neurological wake-up test, norepinephrine, propofol, sedation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-21971 (URN)10.1097/CCM.0b013e31822d7dbd (DOI)000298379800031 ()2-s2.0-84055190016 (Scopus ID)
Available from: 2012-02-07 Created: 2013-10-17 Last updated: 2017-12-06Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8008-8169

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