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  • 1.
    Ahlstedt, C.
    et al.
    Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.
    Eriksson Lindvall, C.
    Department of Business Studies Uppsala University, Uppsala, Sweden.
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.
    Muntlin Athlin, Å.
    Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.
    What makes registered nurses remain in work?: An ethnographic study2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 89, p. 32-38Article in journal (Refereed)
    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. 

  • 2.
    Cacciatore, J.
    et al.
    Arizona State University, USA.
    Erlandsson, Kerstin
    Mälardalen University, School of Health, Care and Social Welfare.
    Rådestad, I.
    Sophiahemmet University College, Sweden.
    Fatherhood and suffering: A qualitative exploration of Swedish men's experiences of care after the death of a baby2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 5, p. 664-670Article in journal (Refereed)
    Abstract [en]

    Background: This study was designed to evaluate fathers' experiences of stillbirth and psychosocial care. Methods: Data were collected between 27 March 2008 and 1 April 2010 via a questionnaire posted on the homepage of the Swedish National Infant Foundation. The responses to the following open-ended questions were analyzed using content analysis: " Are you grateful today for anything that health care professionals did in connection with the birth of your child?" and " Are you sad, hurt or angry today about something personnel did in connection with the birth of your baby?" Results: 113/131 (86%) fathers reported feelings of being grateful. Only 22/131 (16%) fathers reported feeling sad, hurt, or angry. Fathers expressed gratitude when health care professionals treated their newborn " with respect and without fear" , " with extraordinary reverence" , and when their fatherhood was validated by providers. They were also grateful when providers helped them to create memories of their baby. Fathers also reported feeling sad, hurt, or angry when providers were nonchalant and indifferent and when they perceived providers to be uncaring and disrespectful toward their baby. Conclusion: Bereaved fathers experience overall gratitude for person-centered psychosocial care in the aftermath of stillbirth, particularly when they feel validated as a grieving father and their child is acknowledged with reverence. Clinical implications: Health care professionals should support fathers by treating the baby who died with respect and dignity and by validating and acknowledging both his grief experiences and his fatherhood just as they would for a grieving mother.

  • 3.
    Eriksson, Henrik
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Salzmann-Erikson, M.
    Dalarna University.
    Cyber nursing-Health 'experts' approaches in the post-modern era of virtual performances: A nethnography study2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 3, p. 335-344Article in journal (Refereed)
    Abstract [en]

    Background: The imperative to gather information online and to become an 'expert' by locating effective advice for oneself and others is a fairly new support phenomenon in relation to health advice. The creation of new positions for health 'experts' within the space of the Internet has been addressed as a cybernursing activity. A focused analysis of communication in health forums might give insight into the new roles that are available for health experts in cyberspace. Aim: The aim of this study is to describe approaches to being an 'expert' in lifestyle health choice forums on the Internet and to elaborate on the communicative performances that take place in the forums. Method: An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online. 2640 pages of data from two health Internet forums were gathered and analyzed. Findings: The results reveal three distinctive types of experts that emerge in the forums: (1) those that build their expertise by creating a presence in the forum based on lengthy and frequent postings, (2) those who build a presence through reciprocal exchanges with individual posters with questions or concerns, and (3) those who build expertise around a " life long learning" perspective based on logic and reason. Discussion: The results suggest that experts not only co-exist in the forums, but more importantly they reinforce each others' positions. This effect is central; alongside one another, the posts of the three types of experts we identify constitute a whole for those seeking the forum for advice and support. Users are provided with strong opinions and advice, support and Socratic reasoning, and a problem-oriented approach. The Internet is now an integral part of everyday living, not least of which among those who seek and offer support in cyberspace. As such, cyber nursing has become an important activity to monitor, and formal health care professionals and nursing researchers must stay abreast of developments. © 2012 Elsevier Ltd.

  • 4.
    Eva, Götell
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Brown, Steven
    Ekman, Sirkka-Liisa
    The influence of caregiver singing and background music on vocally expressed emotions and moods in dementia care: a qualitative analysis2009In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, no 4, p. 422-430Article in journal (Refereed)
    Abstract [en]

     Background: Music and singing are considered to have a strong impact on human emotions. Such an effect has been demonstrated in caregiving contexts with dementia patients. Objectives: The aim of the study was to illuminate vocally expressed emotions and moods in the communication between caregivers and persons with severe dementia during morning care sessions. Design: Three types of caring sessions were compared: the "usual" way, with no music; with background music playing; and with the caregiver singing to and/or with the patient. Participants and setting: Nine persons with severe dementia living in a nursing home in Sweden and five professional caregivers participated in this study. Methods: Qualitative content analysis was used to examine videotaped recordings of morning care sessions, with a focus on vocally expressed emotions and moods during verbal communication. Results: Compared to no music, the presence of background music and caregiver singing improved the mutuality of the communication between caregiver and patient, creating a joint sense of vitality. Positive emotions were enhanced, and aggressiveness was diminished. Whereas background music increased the sense of playfulness, caregiver singing enhanced the sense of sincerity and intimacy in the interaction. Conclusion: Caregiver singing and background music can help the caregiver improve the patient's ability to express positive emotions and moods, and to elicit a sense of vitality on the part of the person with severe dementia. The results further support the value of caregiver singing as a method to improve the quality of dementia care.

  • 5.
    Funkesson, Kajsa
    et al.
    Linköpings Universitet, Sweden.
    Anbäcken, Els-Marie
    Linköpings Universitet, Sweden.
    Ek, Anna-Christina
    Linköpings Universitet, Sweden.
    Nurses' reasoning  process during care planning taking pressure ulcer prevention as an example: A think-aloud study2007In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, no 7, p. 1109-1119Article in journal (Refereed)
  • 6.
    Lornudd, C.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Tafvelin, S.
    Umeå University, Sweden.
    von Thiele Schwarz, Ulrica
    Karolinska Institutet, Stockholm, Sweden; Stockholm University, Sweden.
    Bergman, D.
    Karolinska Institutet, Stockholm, Sweden.
    The mediating role of demand and control in the relationship between leadership behaviour and employee distress: A cross-sectional study2015In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 52, no 2, p. 543-554Article in journal (Refereed)
    Abstract [en]

    Background: The relationship between leadership and employee distress is well established, however, the processes involved in this relationship remain largely unclear. For a stretched nursing workforce, understanding in what ways leadership may influence employee distress is particularly important. Objectives: To examine possible mediating effects of the work environment factors demand and control in the relationship between leadership behaviour in change, production, and employee orientation and employee distress. Design: Cross-sectional study design. Settings: The study was conducted at a large county council in Sweden providing both institutional and non-institutional care. Participants: A random sample of 1249 employees (primarily nurses, but also a wide range of other healthcare professionals and administrative staff), who had a healthcare manager that was about to enter a leadership development programme (n=171), responded to a web-based questionnaire. The response rate was 62%. Methods: The employees rated their healthcare managers' behaviour in change, production, and employee orientation, as well as their own perceptions of level of demand, control (subdivided into decision authority and skill discretion), and five distress outcomes. Multilevel analysis was performed. Results: The mediators demand, decision authority, and skill discretion were significant predictors of all five distress outcomes for all three leadership orientations. In eight of 15 regressions, the mediators fully explained the relationships between leadership orientations and outcomes. Four of five relationships with distress outcomes were fully mediated for change-oriented leadership, whereas two of five outcomes were fully mediated for production- and employee-oriented leadership. In all three leadership orientations, the relationship between the mediator skill discretion and the distress measure disengagement were particularly strong, with B-coefficients (-.44, p<. .001) twice as high as for any of the other relationships. Conclusions: It seems that the way that employees perceive healthcare managers' change-oriented behaviour, and how that aspect is related to employee distress, is primarily explained by perception of demand and control. Furthermore, regardless of leadership behaviour orientation, how employees perceive their opportunity to use specific job skills plays an important role in the interplay between perception of healthcare managers' behaviour and disengagement. 

  • 7.
    Stenwall, Ewa
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Inst., Stockholm, Sweden.
    Eriksdotter Jönhagen, Maria
    Karolinska Inst., Stockholm, Sweden.
    Sandberg, Jonas
    Mälardalen University, School of Health, Care and Social Welfare. Ersta Sköndal University College, Stockholm, Sweden .
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Inst., Stockholm, Sweden.
    The older patient's experience of encountering professional carers and close relatives during an acute confusional state: An interview study2008In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, no 11, p. 1577-1585Article in journal (Refereed)
    Abstract [en]

    Background: Acute confusional state (ACS) is a common and difficult condition among older patients with a variety of opinions about how to act when encountering patients with ACS. Few studies to our knowledge have been found exploring the encounter from the perspective of older patients and their experiences. Objectives: The aim of this study was to understand the experiences of older patientswith ACS when encountering professional carers and close relatives. Design: In order to understand older patients' experiences of encounters during their ACS a latent qualitative content analysis was used. Settings: The data collection took place at two geriatric wards in an emergency hospital in a metropolitan area. Participants: The inclusion criteria included being aged 65 years or older and having suffered from ACS, according to the DSM-IV criteria, and having regained lucidity. Participants were being cared for at one of two geriatric wards. Patients diagnosed with dementia were excluded. About 150patients were screened, 67 patients fulfilled the inclusion criteria and seven patients were included in the study, four females and three males, aged between 78 and 98 years. Methods: Data were collected by interviews. Results: Three themes were found, namely; 'Feeling lonely within the perceived reality of ACS', with three sub-themes: the unequal encounter, keeping a distance and being an outsider; 'striving towards understanding' with two sub-themes: searching for answers and it takes time to understand; and 'feelings of participation in the encounter' with two sub-themes: a mutual understanding and feeling safe and supported. Conclusions: Within the encounter the older patients with ACS are searching for answers to what is happening and why. The patients feel dependent on the persons they encounter and their willingness to understand and communicate. The patients also feel lonely, unnecessarily questioned and untrustworthy; but they can also feel safe, trusted and understood.

  • 8.
    Söderbäck, Maja
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Christensson, Kyllike
    Mälardalen University, School of Health, Care and Social Welfare.
    Family involvement in the care of a hospitalised child: a questionnaire survey of Mozambican family caregivers.2008In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, no 12, p. 1778-1788Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous research from Western and Eastern countries shows that parents of a sick child want to be involved and to participate during a child's hospitalisation. However, the stay can be stressful and parents have their own needs. Conditions and cultural constructs are different among countries. No published study on parents' or close family caregivers' involvement and participation during paediatric hospitalization has been found for an African population. OBJECTIVE: The aim of this study was to articulate Mozambican family caregivers' expressed needs, expectations and experiences of hospital care and hospital staff. SETTING AND PARTICIPANTS: The study was conducted at the Paediatric Clinic at the Central Hospital in Maputo, Mozambique. A sample of 100 family caregivers was chosen, representing one third of all family caregivers of hospitalised children over a one-month period. DESIGN AND METHOD: A cross-sectional study was conducted, using a questionnaire. RESULTS: Participating Mozambican family caregivers have, for the most part, a low level of education and reduced socio-economic conditions. This made the admission to and the time in hospital hard to cope with, and difficult for them to understand. The study showed that they were badly informed of anything to do with hospitalisation. They needed explanation and support to make the hospital situation less intimidating. Hospital staff's behaviour was to some extent characterised by attentiveness, kindness, and sympathy, but it was also shown that the family caregivers had experiences of communication difficulties and of being neglected. CONCLUSION: The result, in this Sub-Saharan African context, shows that parents or family caregivers have a desire to be involved in the care of their hospitalised child, much the same as has been shown in studies in Western and Eastern countries. But Mozambican family caregivers' expectations, needs and experiences are rooted not only in poverty, their household situation and the health system, but also in the hierarchical construct of their culture. All these factors influence their communication and relationships. Hospital staff is perceived to be superior. To empower the family caregivers to take part in the caring process in a cultural sensitive way is therefore of great importance.

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