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  • 1.
    Aryuwat, Pimwalunn
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lövenmark [Åberg] [Engström], Annica
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Radabutr, Matanee
    Praboromarajchanok Institute, Boromarajonani College of Nursing Changwat Nonthaburi The Ministry of Public Health Nonthaburi Thailand.
    Holmgren, Jessica
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    An integrative review of resilience among nursing students in the context of nursing education2022In: Nursing Open, E-ISSN 2054-1058Article in journal (Refereed)
    Abstract [en]

    This integrative review aimed to examine empirical research on resilience among nursing students in the context of nursing education. Resilience helps nursing students handle challenges, such as changing learning styles and experiencing their first clinical practice.DesignAn integrative review.MethodsThe search terms focused on resilience and health in nursing students and nursing education. The database used in this review were CINAHL Plus, PubMed and MEDLINE. The Mixed Methods Appraisal Tool appraised the studies' quality.

    ResultsThis study explored 52 records and revealed three current research focuses related to nursing students' resilience: (1) the concept and description of resilience, (2) the characteristics affecting resilience and (3) the mediating role of resilience in maintaining holistic health. Recommendations include adding a resilience topic to the nursing curriculum, providing resilience enhancement programs, examining the relationship between resilience and holistic health and exploring the influence of resilience about global health crises.

    Public Contribution Resilience among nursing students plays a vital role in helping them to overcome adversities during their nursing education. Additionally, after graduation, nursing students can continue contributing to society as resilient Registered Nurses in the future.

  • 2.
    Aryuwat, Pimwalunn
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmgren, Jessica
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lövenmark [Åberg] [Engström], Annica
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Radabutr, Matanee
    Boromarajonani College of Nursing, Changwat Nonthaburi, Faculty of Nursing, Praboromarajchanok Institute, Nonthaburi 11000, Thailand.
    Sandborgh, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Factors Associated with Resilience among Thai Nursing Students in the Context of Clinical Education: A Cross-sectional Study2024In: Education Sciences, E-ISSN 2227-7102, Vol. 14, no 1, article id 78Article in journal (Refereed)
    Abstract [en]

    Resilience aids nursing students in dealing with adversities during their nursing education. This study examined the relationship between nursing students’ resilience and relevant variables in the context of clinical education. Methods: A cross-sectional study was conducted to collect data from 319 undergraduate nursing students in Northeast Thailand. The Connor–Davidson Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Learning Experience Scale or the Personal Responsibility Orientation to Self-Direction in Learning Scale, and the Stressors in Nursing Students scale were administered. A multiple regression analysis was performed for factors presumed to be associated with resilience. Results reported that Thai nursing students’ average resilience score was 71.79 ± 16.33. Multiple regression analysis indicated factors associated with resilience, in which social support (β = 0.354, p < 0.001, 95%CI: 0.240 to 0.469) and self-directed learning (β = 0.787, p < 0.001, 95%CI: 0.606 to 0.968) showed a positive association, while stress (β = −0.083, p = 0.025, 95%CI: −0.083 to −0.006) had a negative association. The final model accounted for 43.4% of the variance in the resilience score. In conclusion, self-directed learning, social support, and perceived stress among nursing students during clinical education are associated with their resilience.

  • 3.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Att lära sig och andra att vila2009In: Vårdpedagogiska utmaningar / [ed] Bentling Sonja och Jonsson Bosse, Stockholm: Liber, 2009, 1.a, p. 267-288Chapter in book (Other (popular science, discussion, etc.))
  • 4.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Begreppet Vila2017In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund, L & Bergbohm, I, Lund: Studentlitteratur AB, 2017, 2, p. 437-447Chapter in book (Other academic)
  • 5.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Begreppet Vila2012In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund Gustin, Lena; Bergbom, Ingegerd, Lund: Studentlitteratur AB, 2012, 1, p. 461-471Chapter in book (Other academic)
    Abstract [sv]

    Vila är ett fenomen som har betydelse för människors hälsa. Under vilan sker återhämtning om man upplever balans, harmoni och kan känna sig hel. Kapitlet handlar om vad vila innebär och hur vårdandet kan skapas för att  ge människor förutsättningar för att uppleva vila.

  • 6.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Begreppsutveckling på livsvärldsfenomenologisk grund2017In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund Gustin L & Bergbom I, Lund: Studentlitteratur AB, 2017, 2, p. 49-77Chapter in book (Other academic)
  • 7.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Developing a concept of Rest from a lifeworld perspective and by phenomenological interviewing2017Other (Refereed)
  • 8.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Editorial, SJCS September 2017 issue: NCCS in the past and for the future2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 3, p. 425-426Article in journal (Other academic)
  • 9.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Rest: A Health-Related phenomenon and concept in Caring Science2015In: Global Qualitative Nursing Research, E-ISSN 2333-3936, Vol. 2, article id 2333393615583663Article in journal (Refereed)
    Abstract [en]

    Rest is a health-related phenomenon. Researchers have explored the phenomenon of rest, but further concept development is recommended. The aim of my study was to develop and describe a concept of rest, from interviews with a total of 63 participants about their lived experiences of rest. I performed the developing process in two stages: first with descriptive phenomenology and second with a hermeneutic approach. The concept of rest is comprised of the essences of both rest and “non-rest,” and there is a current movement between these two conditions in peoples’ lives. The essence of rest is being in harmony in motivation, feeling, and action. The essence of non-rest is being in disharmony in motivation, feeling, and action. The essences reveal some meaning constituents. Health care professionals and researchers can use the concept as a frame of reference in health care praxis and in applied research.

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  • 10.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Vila och lärande om vila. En studie på livsvärldsfenomenologisk grund2002Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The aim of the dissertation was to develop a tentative teory about rest and the learning of rest, by proceeeding from people´s lived experiences of rest. The aim also has been to develop a model for learning how to rest, where the mutuality between the learning content, the people learning and the conditions for learning are considered. Three reserach questions have been used as a guide in the dissertation work: What is the meaning of rest? How do individuals learn to rest? How can conditions be created to help people learn how to rest?

    In society, there is a tendency that both the pace of life and the production process is expected to function as quickly possible as, so that the time can be used as effectively as possible. Individuals are finding it problematic to relate to and deal with these changes. An accelerated tempo, and an increased consciousness of time are signs of this. This creates ill health, which can be partly understood as an inability to rest. Therefore, it becames a pedagogic question for people to learn how to rest, which can be described as to accuire a skill or an art. A skill is situated in between theory and practice. Knowledge and action are inseparably allied with each other in skills.

    The research questions were studied with a life-world phenomenological approach, and interviews were chosen as method for collecting data. In the interviews, the reseracher was guided by concepts significant for human science research: openness, immediacy, intersubjectivity, meaning, uniqueness. In the analysis of data a descriptive phenomenological methodology was used, with searching for essence.

    A general structure of the phenomenon of rest, implies a duality between rest and non-rest. The essence of rest is a harmony in feeling, action and motivation. The formation of rest develops when people´s inner reality, concerning need and longing, correspond to the shape and character of their external reality. The constituents for the essence of rest is : rest rythm in life, atmosphere of beauty and comfort, o be accepted without judgment , a relation involving mutual interests, freedom from anxiety and compulsion, a state of detachment and relaxation, enjoyable experiences and challenges. The essence of non-rest is a disharmony in motivation, fellings and actions. This experience of disharmony, drains people of energy, which becomes more obvious the longer the period on non-rest continues. The constituents for the essence of non-rest is: to be motivated but not be able to, to be able to yet not be motivated, to be motivated but not be able to feel.

    To learn how to rest involves becoming conscious of a rythm in one´s way of life, to allow for a rythm in life, and to find or create sources where energy can be drawn. The model for learning how to rest is constituted by three dimensions: learning about rest, learning through rest and learning in rest.

    Learning about rest can be related to ideas about life-world, lived body, time and space, circularity and intentionality. Knowledge about learning through rest can be related to ideas about health, and knowledge about leraning in rest can be related to ethics and aesthetics.

  • 11.
    Asp, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ekstedt, Mirjam
    KTH, Stockholm, Sweden.
    Trötthet, vila och sömn2014In: Omvårdnadens grunder: Hälsa och ohälsa / [ed] A-K Edberg & H Wijk, Lund: Studentlitteratur AB, 2014, 2:1, p. 363-417Chapter in book (Other academic)
  • 12.
    Asp, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Ekstedt, Mirjam
    KTH.
    Trötthet, vila och sömn2009In: Omvårdnadens grunder.: Hälsa och ohälsa / [ed] Edberg, A-K och Wijk Helle, Lund, 2009, 1:a, p. 417-487Chapter in book (Other academic)
  • 13.
    Asp, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ekstedt, Mirjam
    KTH Royal Institute of Technology.
    Trötthet, vila, sömn2019In: Omvårdnadens grunder: Hälsa och ohälsa / [ed] Edberg A-K & Wijk H, Lund: Studentlitteratur , 2019, 3, p. 377-420Chapter in book (Other (popular science, discussion, etc.))
  • 14.
    Asp, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Stockholm, Sweden.
    Begreppsutveckling på livsvärldsfenomenologisk grund2012In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Wiklund, Lena; Bergbom, Ingegerd, Lund, 2012, 1, p. 65-77Chapter in book (Other (popular science, discussion, etc.))
    Abstract [sv]

    I kapitlet presenteras en modell för att utveckla begrepp på livsvärldsfenomenologisk grund. Det förs en argumentation föratt denna kunskapsteoretiska grund stämmer överens med antaganden om vad som karaktäriserar en människa liksom hälsorelaterade fenomen som patienter erfar och vårdare reflekterar över.

  • 15.
    Asp, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Institutionen för vårdvetenskap, Ersta Sköndal Högskola.
    Developing concepts in caring science based on a lifeworld perspective2005In: International Journal of Qualitative Methods, E-ISSN 1609-4069, Vol. 4, no 2, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Concept development is a significant form of inquiry to expand and develop the knowledge base in caring science. The authors´aim in this article is to illuminate the possibility of working with concept development, based on a life world perspective, especially Merleau-Ponty´s philosophy of language, wherein phenomenological, semiological, and pragmatic dimensions are included. the theoretical discussion shows that it is possible to create methodological principles for concept development based on epistemological foundations that are consistent with ontological assumptions in caring science.

  • 16.
    Asp, Margareta
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Fagerberg, Ingegerd
    Mälardalen University, Department of Caring and Public Health Sciences. Karolinska Institute, Stockholm, Sweden.
    The woven fabric: - a metaphor of nursing care: the major subject in nursing education2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 16, no 2, p. 115-121Article in journal (Refereed)
    Abstract [en]

    Society's future needs regarding health care present challenges to traditional nursing education. Today, the ambition is to create a nursing role that is appropriate to people's health care needs rather than the needs of the health care system. In nursing education, the major subject - nursing care - is central. Accordingly, there is a need for a consistent and clear articulation of this subject as well as the nursing profession. The aim of the present study was to interpret and describe the major subject, its content and structure in the nursing programme at Malardalen University. With a hermeneutic approach an interpretation and application emerged as a metaphor of nursing care - the woven fabric. In this structure concepts function as bridges linking theory and practice, whereby it is possible to integrate different aspects of knowledge in order to think, feel and act nursing care.

  • 17.
    Asp, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Simonsson, B.
    Reg Vastmanland, Competence Ctr Hlth, Vasteras, Sweden..
    Larm, P.
    Uppsala Univ, Clin Res Ctr, Vasteras, Sweden..
    Molarius, A.
    Reg Vastmanland, Competence Ctr Hlth, Vasteras, Sweden..
    The association between physical activity and obesity differs by physical mobility among elderly2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27Article in journal (Other academic)
  • 18.
    Asp, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Simonsson, B.
    Competence Centre for Health, Region Västmanland.
    Peter, Larm
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Molarius, A.
    Competence Centre for Health, Region Västmanland.
    Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey2017In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 147, p. 84-91Article in journal (Refereed)
    Abstract [en]

    Objective To examine how physical activity and physical mobility are related to obesity in the elderly. Study design A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. Methods Obesity (body mass index ≥30 kg/m2) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. Results The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14–3.75) than for physical inactivity (OR 1.63, 95% CI 1.28–2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. Conclusion It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity.

  • 19.
    Beyermann, Alexandra
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Godskesen, Tove
    Palliative Research Centre, Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden; Centre for Research Ethics & Bioethics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Söderman, Mirkka
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nurses’ challenges when supporting the family of patients with ALS in specialized palliative home care: A qualitative study2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2238984Article in journal (Refereed)
    Abstract [en]

    Purpose: Being a family member to someone who has amyotrophic lateral sclerosis (ALS) is demanding and often requires sacrificing a lot. Family members can experience fatigue, anxiety, guilt and need support. The aim was to explore registered nurses’ (RNs’) experiences of providing support to the families of patients with ALS within specialized palliative home care (SPHC).

    Methods: A qualitative explorative design. Interviews were conducted with RNs (n = 11) from five SPHCs in Sweden and analysed using qualitative content analysis.

    Results: The results emerged in the following categories:”To support in an increasingly difficult everyday life”, based on the sub-categories: “Creating a trusting relationship”, “Balancing between the needs of patients and their families”, and “Sharing knowledge about dying to the families”;”To support in emotionally challenging situations”, based on the sub-categories: “Harbouring family members’ difficult feelings”, “Providing support even though the situation is unpleasant” and “Being able to give support by receiving confirmation and support from others”.

    Conclusions: RNs working in SPHC have an important role in providing support in several ways to the families of patients with ALS, through facilitating their everyday life and giving emotional support when needed, based on the needs of both patients and the families.

  • 20.
    Carnesten, Hillewi
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Region of Sörmland, Eskilstuna, Sweden; Uppsala University, Sweden.
    Caring approach for patients with chest pain–Swedish registered nurses’ lived experiences in Emergency Medical Services2021In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 16, no 1, article id 1901449Article, review/survey (Refereed)
    Abstract [en]

    Purpose: Encountering patients with chest pain iscommon for Registered Nurses (RNs) in Emergency Medical Services (EMS) who are responsible for the patient’s medical and nursing care. From a lifeworld perspective, bodily illness is related to existential suffering, requiring knowledge to asses the situation from a holistic perspective. The aim of this study is to describe the caring approach when RNs encounter patients with chest pain. Methods: A phenomenological methodology to capture RNs’ lived experiences was chosen. Seven qualitative in-depth interviews were conducted at three ambulance stations in Sweden. Results: The essence of the caring approach while encountering patients with chest pain comprises two constituents; “trust based on confidence and competence” and “the collegial striving towards the best possible care”. Trust is two-parted; trust in oneself, and striving towards gaining the patient’s trust. Competence and experience when combined, develop into confidence especially in stressful situations. The caring approach is nurtured in a well-functioning collegial team. Conclusions: This study contributes to understanding the caring approach based on the specific patient’s lifeworld in holistic EMS care. By trusting oneself, the patient, and one’s colleague, RNs in EMS shift focus from medical-orientated care to a holistic lifeworld caring approach. More research is needed on trust as a phenomenon in EMS, both from caregivers’ and patients’ perspectives. 

  • 21.
    Frank, Catharina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Dahlberg, Karin
    Växjö University.
    Patient participation in emergency care. A phenomenographic analysis of caregivers´conceptions2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 18, p. 2555-2562Article in journal (Refereed)
  • 22.
    Frank, Catharina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Dahlberg, Karin
    School of Health Sciences and Social Work, Växjö University.
    Patient participation in emergency care- A phenomenographic study based on patients' lived experience2009In: International emergency nursing, ISSN 1755-599X, Vol. 17, no 1, p. 15-22Article in journal (Refereed)
    Abstract [en]

    International guidelines promote patient participation in health care. When patients participate in their care they experience greater satisfaction. Studies have shown that patients in emergency departments express dissatisfaction with their care, and it was therefore important to study how patients understand and conceptualize their participation. The aim of this study was to describe patients’ qualitatively different conceptions of patient participation in their care in an emergency department. Based on a lifeworld perspective, nine interviews were performed with patients in an emergency department. The phenomenographic analysis shows that participation by patients means contact with the emergency department staff in three categories of conceptions: being acknowledged; struggling to become involved; and having a clear space. The different conceptions of patient participation give us a deeper understanding of how patients may experience their care, and this result may provide a foundation for developing nursing practice and the quality of health care in line with international guidelines.

     

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  • 23.
    Frank, Catharina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Fridlund, Bengt
    Hälsohögskolan, Jönköping.
    Baigi, Amir
    Halland County Council, Falkenberg, Sweden.
    Questionnarie for patient participation in emergency departments: development and psychometric testing2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 3, p. 643-651Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the study was to develop and test the psychometric properties of a patient participation questionnaire in emergency departments.

     

    Background Patient participation is an important indicator of quality of healthcare. International and national health care policy guidelines promote patient participation. While patients cared for in emergency departments generally express dissatisfaction with their care, a review of the literature fails to reveal any scientifically tested research instruments for assessing patient participation from the perspective of patients.

     

    Methods A methodological study was conducted involving a convenience sample of 356 patients recently cared for in emergency departments in Sweden. Data was collected in 2008 and the analyses performed were tested for construct and criterion validity and also homogeneity and stability reliability.

     

    Results A 17- item questionnaire was developed. Two separate factor analyses revealed a distinct four- factor solution which was labelled: fight for participation, requirement for participation, mutual participation and participating in getting basic needs satisfied. Criterion validity presented showed 9 out of 20 correlations above 0.30 and of those 3 moderate correlations of 0.62, 0.63 and 0.70. Cronbach’s alpha coefficient ranged from 0.63 - 0.84 and test- retest varied between 0.59 and 0.93.

     

    Conclusion The results signify evidence of acceptable validity and reliability and the questionnaire makes it possible to evaluate patient participation in ED caring situations. In addition it produces data which is useable by a diverse range of healthcare professionals.

     

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  • 24.
    Frank, Catharina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Fridlund, Bengt
    Hälsohögskolan Jönköping.
    Baigi, Amir
    General Practice and Public Health, Halland County Council, Falkenberg, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Patient participation in the emergency department: an evaluation using a specific instrument to measure patient participation (PPED2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 4, p. 728-735Article in journal (Refereed)
    Abstract [en]

    Aim:  This study aimed at evaluating patient participation from the perspective of patients who received care in emergency departments, with a separate examination of the relationship between participation and age, sex, education and priority level.

    Background: International and national guidelines encourage patient participation. High patient participation is required to ensure a high quality of care. No studies evaluating patient participation at an emergency department have been published.

    Methods: An evaluating study, with the Patient Participation Emergency Department questionnaire, was conducted at emergency departments in Sweden. A consecutive sample of 356 patients participated. Data was collected in 2008: participants were 49% women and with an average age of 56 years. The statistical methods used were Student’s t-test, one-way ANOVA and Spearman correlation.

    Results: The results revealed that patients experienced good requirement such as time and information for participation. Mutual participation demonstrated a reasonable level but patient participation is low in two dimensions (Fight for participation, Participation in getting basic needs satisfied). Young and well‑educated patients fought more to participate in their care and gained less attention for basic needs than older and less well‑educated patients.

    Conclusions: Patient participation in a mutual care situation between patients and healthcare professionals requires further improvement to ensure that patients are satisfied and do not have to struggle and fight in order to participate in their care.

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  • 25.
    Gustafsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare.
    Municipal Night Nurses’ Experience of the Meaning of Caring2009In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 16, no 5, p. 599-612Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate municipal night registered nurses’ (RNs) experiences of the meaning of caring in nursing. The research context involved all night duty RNs working in municipal care of older people in a medium-sized municipality located in central Sweden. The meaning of caring in nursing was experienced as: caring for by advocacy, superior responsibility in caring, and consultative nursing service. The municipal night RNs’ experience of caring is interpreted as meanings in paradoxes: ‘being close at distance’, the condition of ‘being responsible with insignificant control’, and ‘being interdependently independent’. The RNs’ experience of the meaning of caring involves focusing on the care recipient by advocating their perspectives. The meaning of caring in this context is an endeavour to grasp an overall caring responsibility by responding tovocational and personal demands regarding the issue of being a RN, in guaranteeing ethical, qualitative and competent care for older people.

  • 26.
    Gustafsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institutet, Stockholm, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institutet, Stockholm, Sweden.
    Reflection in night nursing: a phenomenographic study of municipal night duty registered nurses' conceptions of reflection2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 10, p. 1460-1469Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of the study was to describe nurses' conception of reflection in their working situation. Background. To be a municipal night duty registered nurse in Sweden means to shoulder nursing care responsibility for numerous units with older people in need of care. Two night nurses share nursing care responsibility for up to 1300 people. In nursing research, reflection is an often-mentioned phenomenon discussed with advantages and benefits within the 'traditional fields' of nursing (hospital context). A question to ask is, how do night nurses having an untraditional amount of nursing care responsibility conceptualise and experience reflection in their working situation? Design. A phenomenographic methodology was used. Methods. Data were collected by interviewing all nurses (n = 7) in a medium-sized municipality bordering a metropolitan area of Sweden. Results. The nurses' conceptions of reflection are categorised as 'Field of applications' (an instrument for interpreting, a strategy for handling the working situation and an approach to learning) and 'Field of prerequisites' (presence facilitates reflection; flexibility implies reflection; courage in thought and activity increases reflection). Conclusion. The findings reveal that reflection in the nurses' working situation is more than an instrument for learning, understanding and encouragement for change and improvement. Reflection is conceptualised as an instrument for interpreting nursing care situations, which requires courage and is facilitated by presence and flexibility. Reflection is also conceptualised as an approach to handling, managing and coping with a sometimes impossible working situation that includes nursing responsibility for hundreds of older people and can sometimes entail difficulties and stress. Relevance to clinical practice. The findings showed that reflection has a broader use than had earlier been described. Deliberate use of reflection could mean improved nursing practice. This guides nursing managers to pay attention to the phenomenon as an instrument for nursing care improvement.

  • 27.
    Gustafsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare.
    Reflective Practice in Nursing Care: embedded assumptions in qualitative studies2007In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 13, no 3, p. 151-160Article in journal (Refereed)
    Abstract [en]

    Qualitative nursing researchers have long recognized that reflective practice (RP) seems to be a valuable tool in nursing care. The aim of the present meta-study was to analyse current qualitative research on RP in nursing care, in order to create and synthesize the knowledge and the understanding of registered nurses' RP. Using a meta-study synthesis approach, embedded assumptions were identified in qualitative studies that have influenced the way researchers have interpreted and made sense of RP in nursing care. Despite empirical focus in research on RP in nursing care, it was found that assumptions about RP were predominantly based on theory. The reflective movement within the practice of nursing care has mainly a constructivist epistemology, based on learning from experience. The individual nurse's RP capability is essential in providing and improving ethical and holistic nursing care

  • 28.
    Gustafsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Ersta Sköndal högskola.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Dependency in autonomous caring: – night nurses’ working conditions for caring in nursing2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 312-320Article in journal (Refereed)
    Abstract [en]

    Few research studies have focused on nurses' working conditions for caring provided at night, and these studies have mainly described nurses' work in hospital settings, not in a municipal, social-care context. In Swedish municipal care, nurses have responsibility for hundreds of older people in need of care. This working condition compromises caring encounters; instead the nurses' caring is mainly mediated through care staff (or relatives). In considering that caring based on caring encounters is fundamental to ethical nursing practice questions leads to the aim: to explore Swedish municipal night nurses' experiences of their working conditions for caring in nursing. All municipal night-duty nurses (n = 7) in a medium-sized community in Sweden participated in interviews, while six of them also wrote diaries. Thematic content analysis has been used in analysing the data. The findings revealed that the nurses experienced their working conditions for caring in nursing in the themes of Dependency in the Organisation and Other Staff, Vocational Responsibility, Deficiency in Conditions for Caring and Autonomous Caring. The findings illustrate privileged, as well as, poor working conditions for caring in nursing. The nurses' role as consultants emerge as their main function. The consultant function implies that nurses do not participate in ordinary bed-side caring, which makes it easier for them to find time for caring in situations that arise when nurses' skills, expertise and authority are called upon. Conversely the consultancy function entails short-term solution of complex caring problems, which can signify deficient caring due to prevailing working conditions. The findings also point to nurses' possible problems in fulfilling their own and vocational demands for ethics in the practice of caring in nursing related to existing working conditions.

  • 29.
    Gustafsson, Christine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institutet, Stockholm, Sweden.
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare. Ersta Sköndal University, Stockholm, Sweden; Karolinska Institutet, Stockholm, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Supportive leadership in Swedish community night nursing2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 7, p. 822-831Article in journal (Refereed)
    Abstract [en]

    Aim  The aim of the present study was to examine the support night nurses’ give to staff in community night nursing.

    Background  Studies have shown that support given to staff is one of night registered nurses’ (RNs’) experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described.

    Methods  All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations.

    Results  The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership.

    Conclusions  Out of ‘concern for the staff’ the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs’ awareness that by giving support to staff this affects the staffs’ caring for older people.

    Implications for nursing management  The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.

    The aim of the present study was to examine the support night nurses give to staff in community night nursing. Studies have shown that support given to staff is one of night registered nurses (RNs) experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described.

    All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations. The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership.Conclusions Out of concern for the staff  the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs awareness that by giving support to staff this affects the staffs caring for older people. Implications for nursing management The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.

  • 30.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    When older persons need Emergency Medical Services at home: a critical incident study on Swedish municipal care personnel2021Conference paper (Other academic)
    Abstract [en]

    Older persons in Sweden can continue to live at home, assisted by the municipal home care services. Older age raises the risk of emergency situations that require involvement of the emergency medical services (EMS). Such situations intersect two different organizations, the municipal social care services and the regional EMS. The transfer of care between the organizations might impact the older persons´ health, and quality of life or death. Research question: How do municipal care personnel describe their experiences of and actions in situations when older persons are in need of EMS? Design: The study has a qualitative inductive design. Sample: Municipal care personnel (n=19) consisting of home care personnel and security alarm responders. Data collection and analysis: Data was collected through group interviews and free text written critical incidents analyzed according to critical incident technique. Results: Experiences related to the two main areas Lifesaving competence, and Collaborative care, which encompass the four categories Emergency knowledge, Companionship in a vulnerability, Limited caring options and Conditions for EMS collaboration. Actions related to the one main area Adjusting actions to actual conditions, which encompasses the three categories Adapting care to emergency needs, Safeguarding the person, and Adapting actions to EMS leadership.

  • 31.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Holmberg, Mats
    Linneuniversitetet, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nilsson, Kent W.
    Region Västmanland, Sweden.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Characteristic Patterns of Emergency Ambulance Assignments for Older Adults Compared with Adults Requiring Emergency Care at Home in Sweden: A Total Population Study2020In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 20, article id 94Article in journal (Refereed)
    Abstract [en]

    Background: Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18–69 years requiring emergency care at home in Sweden. Methods: A descriptive retrospective study was performed using anonymized registry data from the emergency medical services in a region of Sweden during 2017–2018. One-sample χ2 test, one-way analysis of variance, and binary logistic regression models were used for investigating group differences. Variables for analysis were age, gender, clinical assessments, on-scene time, priority levels, result of response, and temporal patterns. Results: Of all included emergency ambulance assignments (n = 28,533), 59.9% involved older adults, of which 53.8% were women. The probability for older adults to receive the highest priority was decreased for both dispatch (p < 0.001, odds ratio [OR] 0.63, 95% confidence interval [CI] 0.59–0.66), and transport priorities (p < 0.001, OR 0.74, 95% CI 0.68–0.80). Older adults were more likely to receive dispatch priority levels 2 (p < 0.001, OR 1.48, 95% CI 1.40–1.56), and 3 (p < 0.001, OR 1.73, 95% CI 1.46–2.06). The older adults were similarly more likely to receive transport priority level 3 (p < 0.001, OR 1.40, 95% CI 1.28–1.52) compared with adults. Age had a small but additive effect in relation to on-scene time (p < 0.001, R2 = 0.01, F = 53.82). Distinguishing initial clinical assessments for older adults were circulatory, respiratory, trauma, infection, and nonspecific assessments. Emergency ambulance assignments for older adults were more frequently occurring on Mondays (p < 0.001, χ2 = 232.56), and in the 08:00–11:59 interval (p < 0.001, χ2 = 1224.08). Conclusion: The issues of the lower priority level preponderance, and the decreased probability for receiving the highest priority warrant further attention in future research and clinical practice. 

  • 32.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Linneaus Univ, Fac Hlth & Life Sci, Växjö, Sweden.;Uppsala Univ, Ctr Clin Res Sormland, Eskilstuna, Sweden.;Region Sormland, Dept Ambulance Serv, Eskilstuna, Sweden..
    A matter of participation?: A critical incident study of municipal care personnel in situations involving care-dependent older persons and emergency medical services2022In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 17, no 1, article id 2082062Article in journal (Refereed)
    Abstract [en]

    Purpose This study aimed at describing municipal care personnel's experiences of and actions in situations when older persons need emergency medical services (EMS) at home. Methods An inductive descriptive design adhering to critical incident technique (CIT) was used. Data were collected through interviews and free text written questionnaires, analysed in accordance with CIT procedure. Results Experiences related to the main areas of Lifesaving competence and Collaborative care. Lifesaving competence involved having sufficient knowledge to guide older persons in emergencies without organizational support. The lack of care alternatives carries dependence on inter-organizational collaboration, as well as having to accept the collaborative conditions provided by the EMS. Actions meant Adjusting to situational needs and EMS authority, which involved safeguarding the person while being directed by the EMS. Conclusions Lack of organizational support, care alternatives, and structured collaboration jeopardize care-dependent older persons' health, and ability to influence care when emergency situations occur at home. Municipal care personnel's actions as the older person's representative support human agency, allowing older persons to become active participants in care despite acute suffering. This study underlines the importance of further developing welfare policies that facilitate and regulate inter-organizational responsibilities of health and social care to favour older people.

  • 33.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Ambulance Services, Region Sörmland, Katrineholm, Sweden.
    Balancing power: Ambulance personnel's lived experience of older persons' participation in care in the presence of municipal care personnel2023In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Background: Patient participation is considered to promote well-being and is, therefore, central in care contexts. Care-dependent older persons living at home constitute a vulnerable population with increased ambulance care needs. Care transfers risk challenging participation in care, a challenge that can be accentuated in situations involving acute illness.Aim: To illuminate meanings of older persons' participation in ambulance care in the presence of municipal care personnel from the perspective of ambulance personnel.Method: A phenomenological hermeneutical method was used to analyse transcripts of narrative interviews with 11 ambulance personnel.Results: The ambulance personnel's lived experience of older persons' participation includes passive and active dimensions and involves a balancing act between an exercise of power that impedes participation and equalisation of power that empowers participation. The main theme 'Balancing dignity in relation to manipulating the body' included the themes Providing a safe haven and Complying with bodily expressions, which means shouldering responsibility for existential well-being and being guided by reactions. The main theme 'Balancing influence in relation to perceived health risks' included the themes Agreeing on a common perspective, Directing decision-making mandate, and Sharing responsibility for well-being, which means shouldering responsibility for health focusing on risks. Influence is conditional and includes performance requirements for both the older person and municipal care personnel.Conclusion: Care-dependent older persons' participation in care from the perspective of ambulance personnel means recognising passive and active dimensions involving human dignity, the ability to influence care, and optimising care efforts through collaboration. This study provides a deepened understanding of the balancing of power involved in ambulance care determining participation, where power is equalised or exercised depending on personal engagement, health risks, and available care options. The knowledge provided holds the potential to improve ambulance care to benefit older persons in critical life situations.

  • 34.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Faculty of Health and Life Sciences Linnaeus University, Växjö, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Ambulance Services, Region Sörmland, Katrineholm, Sweden.
    Entrusting life to professionals: A phenomenological hermeneutical study of older persons' participation in prehospital emergency care involving municipal home care and ambulance services2023In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Background: Participation in care is considered to promote safe and qualitative care. Care-dependent older persons ageing in place have increased emergency care needs, which initiate inter-organisational collaboration involving municipal home care and ambulance services. Previous research concludes that uncertainties exist regarding what participation in care means in clinical practice, which necessitates the need to illuminate the phenomenon for older persons in critical life situations.

    Aim: This study aimed to illuminate meanings of participation in prehospital emergency care from the perspective of care-dependent older persons experiencing acute illness at home.

    Design: This study has a qualitative design with a lifeworld approach.

    Method: A phenomenological hermeneutical method was used to analyse transcribed telephone interviews with eleven care-dependent persons aged 70–93 years.

    Results: Care-dependent older persons' participation in prehospital emergency care means ‘Entrusting life to professional caregivers’ when being in helpless solitude and existentially unsafe, which emphasises a deepened interpersonal dependence. Meanings of participation in care from the perspective of older persons involve Being reassured in togetherness, Being pliant in trust of emergency expertise, Being enabled through the agency of professional caregivers, and Encountering readiness in the emergency care chain.

    Conclusion: Care-dependent older persons' participation in prehospital emergency care is existential and involves interpersonal dependence. Togetherness brings reassurance, safety and opportunity for emotional rest while accessing the professional caregivers' power, competence and abilities which provide opportunities for existence and movement towards well-being and continued living.

    Implications for practice: Prehospital emergency care from the perspective of care-dependent older persons transcends organisational boundaries and includes the municipal mobile safety alarm service. The involved municipal and regional organisations need to provide support by implementing lifeworld-led care models and care alternatives that enable professionals to recognise the existential dimension of participation in care.

  • 35.
    Hjalmarsson, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kerstis, Birgitta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holmberg, Mats
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Entrusting life to professionals: Older persons’ lived experience of participation in prehospital emergency care involving municipal home care and ambulance services.Manuscript (preprint) (Other academic)
  • 36.
    Källestedt, M. -LS.
    et al.
    Källestedt Clinical Skills Center, Region Västmanland, Västerås, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Letterstål, Anna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    When caring becomes an art - how clinical gaze are perceived to be developed2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2156659Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This qualitative study describes nurses' experiences and perceptions of how they develop the clinical gaze. METHODS: This qualitative study used an inductive approach and content analysis to assess the experiences of newly graduated nurses, nurse managers, and nursing teachers. Nineteen interviews were conducted. To achieve credibility, the study followed the guidelines of the Consolidated Criteria for Reporting Qualitative research (COREQ). RESULTS: Two themes emerged: nurses' personal abilities and the learning culture. Learning culture was considered the foundation of the development of the clinical gaze. The clinical gaze was found to be developed in relationships with patients and when learning together with colleagues, in which the opportunities for reflection are central. To develop the clinical gaze, structures for learning activities, such as reflection, communication exercises, and simulation, are needed so that they become a natural part of daily work. This can also be achieved through supervision and skills training both at university and in a care context. CONCLUSIONS: Prerequisites for the development of the clinical gaze include physical presence with the patient combined with learning activities such as conscious reflection with others in a safe learning culture.

  • 37. Letterstål, Anna
    et al.
    Kallestedt, M L S
    Reg Vastmanland, Västerås, Sweden.
    Widarsson, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nursing Faculties' Perceptions of Integrating Theory and Practice to Develop Professional Competence2022In: Journal of Nursing Education, ISSN 0148-4834, E-ISSN 1938-2421, Vol. 61, no 5, p. 236-241Article in journal (Refereed)
    Abstract [en]

    Background: Nursing faculties??? perceptions influence nursing education. This article describes how nursing faculty perceive nursing students??? development of professional competence by integrating theory and practice, and by examining how this context influences this integration. Method: With a phenomenographic approach, interviews were conducted with nine participants and analyzed into qualitatively different categories of description. Results: The integration of theoretical and practical knowledge is perceived as a challenge or as naturally intertwined in the entire education, focusing mainly on individual prerequisites for learning. Perceptions of a common mission create coherence for students. Evident learning structures are needed, and there is a perceived discrepancy between nurses??? competence and expectations in health care. Conclusion: If the theory and practice gap could be perceived as a driving force for continuous learning, it could become an incentive for closer collaboration by creating structures for competence development that include individuals, teams, and organizations. [J Nurs Educ. 2022;61(5):236-241.]

  • 38.
    Manasatchakun, Pornpun
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Boromarajonani College of Nursing Udon Thani, Udon Thani, Thailand .
    Chotiga, Pleumjit
    Boromarajonani College of Nursing Chiang Mai, Chiang Mai, Thailand.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Roxberg, Åsa
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Health and Welfare, Halmstad University, Halmstad, Sweden; VID Specialized University, Bergen, Norway .
    Sandborgh, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Factors Associated with Healthy Aging among Older Persons in Northeastern Thailand2016In: Journal of Cross-Cultural Gerontology, ISSN 0169-3816, E-ISSN 1573-0719, Vol. 31, no 4, p. 369-384Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe factors associated with perceived health and healthy aging among older people in northeastern Thailand. Thailand’s aging population is growing and facing an increasing old-age dependency ratio. Northeastern Thailand, known as Isan, is a region in which the number of older residents is projected to grow rapidly. Older people in this region are likely to confront great threats to their health and well-being. These issues require appropriate attention and actions to promote healthy aging. However, healthy aging in this region has not been studied. A cross-sectional study was conducted on a sample of 453 older people, aged 60 years or older. Participants completed the Healthy Aging Instrument (HAI) and provided relevant demographic characteristics. Mann-Whitney U tests, Kruskal-Wallis tests and multiple regression models were used to analyze the data. Through comparative analyses, significant differences in HAI scores were observed for the following factors: marital status, residential area, disability, income level, and perceived meaningfulness in life. In the multiple regression models, residential area, disability, and marital status explained 24.30 % of the variance in HAI scores. Health promotion strategies and future targeted intervention programs should consider the importance of these factors. 

  • 39.
    Manasatchakun, Pornpun
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Boromarajonani College of Nursing Udon Thani, Udon Thani, Thailand .
    Chotiga, Pleumjit
    Boromarajonani Coll Nursing Chiang Mai, Chiang Mai, Thailand.
    Roxberg, Åsa
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Health and Welfare, Halmstad University, Halmstad, Sweden; VID Specialized University, Bergen, Norway .
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Healthy ageing in Isan-Thai culture-A phenomenographic study based on older persons' lived experiences2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 29463Article in journal (Refereed)
    Abstract [sv]

    Healthy ageing is a concept that concerns older persons' quality of life and is a key factor in promoting well-being. The older population in Thailand is growing. Isan (a region of north-eastern Thailand) has been reported as having one of the most rapidly increasing older populations in the country. In order to care for and promote the health of older people, healthcare providers should understand how healthy ageing is perceived by this target group. Although healthy ageing has been studied in different contexts as well as perspectives, no studies have previously focused on older persons' experiences of healthy ageing from a lifeworld perspective in Isan-Thai. Therefore, the aim of this study is to describe older persons' qualitatively different conceptions of healthy ageing in Isan-Thai culture. A phenomenographic approach with an epistemological base in lifeworld theory was used to disclose the various ways to conceptualize healthy ageing. Individual, qualitative interviews were conducted with 17 people aged 60 and above who live in Isan-Thai. The findings of this study revealed three categories of descriptions: "being independent in dependence,'' "being at peace,'' and "being a valuable person.'' This study also found family members, friends, healthcare providers, and religion important to healthy ageing in the Isan-Thai culture. Understanding how older people conceptualize healthy ageing is valuable for healthcare providers. They can apply these findings regarding healthy ageing in their fieldwork when caring for older people.

  • 40.
    Manasatchakun, Pornpun
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Boromarajonani College of Nursing Udon Thani, Udon Thani, Thailand .
    Roxberg, Åsa
    School of Health and Welfare, Halmstad University, Halmstad, Sweden; VID Specialized University, Bergen, Norway .
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Conceptions of healthy ageing held by relatives of older people in Isan-Thai culture: A phenomenographic study2018In: Journal of Aging Research, ISSN 2090-2204, E-ISSN 2090-2212, article id 3734645Article in journal (Refereed)
    Abstract [en]

    Healthy ageing has been studied in various contexts. However, no studies have focused on healthy ageing from the perspective of children or grandchildren, who are the main informal caregivers for older people in northeast Thailand, also referred to as the Isan region. Therefore, this study aimed to describe the conceptions of healthy ageing harboured by children and grandchildren caring for older people in northeast Thailand. A qualitative descriptive design was performed using a phenomenographic approach with an epistemological basis in the lifeworld theory to understand the varying conceptions of healthy ageing based on participants’ lived experience. We conducted in-depth interviews comprising open-ended questions to gain an understanding of the conceptions of healthy ageing held by 14 children and grandchildren of older persons in northeast Thailand. The data collected during these interviews were analysed using the phenomenographic analysis method. The results of our analysis indicated that the conceptions of healthy ageing can be categorized into the following four descriptive categories: being independent, not being afflicted by diseases or illnesses, being a giver and a receiver, and being wise. These findings highlight that healthy ageing entails autonomy, interdependence and wisdom and emphasize the importance of holistic view on the meaning of healthy ageing. Healthcare providers should understand the different meanings of healthy ageing from the perspectives of children and grandchildren of older people and integrate their perspectives when collaborating with them to promote healthy ageing. The findings of this study may facilitate further research and ensure the provision of support to the relatives of older people to promote healthy ageing in northeast Thailand. 

  • 41.
    Manasatchakun, Pornpun
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Boromarajonani College of Nursing Udon Thani, Udon Thani, Thailand .
    Tassana, Choowattanapakorn
    Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand .
    Roxberg, Åsa
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Health and Welfare, Halmstad University, Halmstad, Sweden; VID Specialized University, Bergen, Norway .
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand2018In: Journal of Holistic Nursing, ISSN 0898-0101, E-ISSN 1552-5724, no 36, p. 54-67Article in journal (Refereed)
    Abstract [en]

    Purpose: Describe community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand. Method: Data were collected through five focus group interviews with 36 community nurses in northeastern Thailand. Latent content analysis was conducted to analyze the data. Findings: Healthy aging was characterized by the interconnection of older persons, older persons’ family members and the community. Healthy aging was associated with two themes: “being strong” and “being a supporter and feeling supported”. The nurses’ experiences in promoting healthy aging were described by the themes “providing health assessment”, “sharing knowledge” and “having limited resources”. Conclusions: The findings of this study provide a deeper understanding of the meaning of healthy aging from a holistic viewpoint. Community nurses must pay attention to older persons and their surroundings when planning how to promote healthy aging. Person-centredness should be applied in practice to promote healthy aging. The current findings contribute useful information that should help policy makers develop healthy-aging strategies in Thailand.

  • 42.
    Nordgren, Lena
    et al.
    Uppsala Univ, Ctr Clin Res Sormland, Eskilstuna, Sweden.;Uppsala Univ, Dept Publ Hlth & Caring Sci, Eskilstuna, Sweden..
    Arvidsson, Alexander
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Vincze, Mattias
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Photo-elicited conversations about meetings with a therapy dog as a tool for communication in dementia care: An observational studyIn: Dementia, ISSN 1471-3012, E-ISSN 1741-2684Article in journal (Refereed)
    Abstract [en]

    Introduction: It is well-known that people with dementia living in residential care facilities spend most of their time not engaged in meaningful activities. Being involved in activities can improve their quality of life. Animal-assisted therapy is an activity that can evoke engagement and joy. Another way to create engagement and promote communication between people with dementia and caregivers is to use photos.

    Methods: In this observational study, the researchers combined animal-assisted therapy and photobooks in order to explore whether photos of people with dementia who were engaged in animal-assisted therapy could be used as a tool for communication in dementia care. Ten persons (4 men and 6 women; aged 72-92) with dementia were video recorded during photo-elicited conversations with a dog handler/assistant nurse. The recordings were conducted in two residential care facilities in Sweden during 2017-2018. Each participant was video recorded 2-4 times. The recordings were analysed using The Observed Emotion Rating Scale and The Observational Measurement of Engagement-OME Modified. In addition, the video recordings were interpreted from a hermeneutic perspective.

    Findings: The findings showed that the most frequently observed effects were pleasure and general alertness, and the participants were observed to be attentive most of the time. The most common attitude during the conversations was 'somewhat positive'. The hermeneutic interpretations were grouped into four themes: Conveys a structure for the conversation with an inherent beginning and ending; An opportunity to recognise oneself and recall a sense of belonging; Awakens emotions and creates fellowship and Entails confirmation and revitalises their identity.

    Conclusion: Photobooks can be used by caregivers as a tool for meaningful and joyful communication with people with dementia, even those with severe dementia.

  • 43.
    Nordgren, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Region Sörmland.
    Arvidsson, Alexander
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Vincze, Mattias
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Photo-elicited conversations as a tool for engagement in people with dementia: An observational study2021Conference paper (Refereed)
  • 44.
    Nordgren, Lena
    et al.
    Centrum för klinisk forskning Region Sörmland, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Photo-elicided conversation in dementia care: A case study.2019Conference paper (Refereed)
  • 45.
    Nordgren, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. FOU Region Sörmland, Sweden.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Photo-elicited conversations about therapy dogs as a tool for engagement and communication in dementia care: a case study2019In: Animals, E-ISSN 2076-2615, Vol. 9, article id 820Article in journal (Refereed)
    Abstract [en]

    Understanding the inner life of people with dementia can be challenging and there is aneed for new and dierent approaches. Previous research shows that people with dementia canexperience emotions such as harmony, closeness, and joy as well as sadness and concern wheninteracting with a therapy dog. Simultaneously, memories of past episodes are brought back to lifewhen the person interacts with the dog. This raises questions about whether photos of interactionwith a dog can evoke memories or support people with dementia in communicating emotions in acorresponding way. The aim of this study was to explore photo-elicited conversations as a tool forengagement and communication in dementia care. Repeated video observations of photo-elicitedconversations between a woman with dementia and a dog handler/assistant nurse were used tocollect data. The video recordings were analyzed with a phenomenological hermeneutical method.The role of photo-elicited conversations as a tool for engagement and communication in dementiacare is that the conversations can help the person with dementia to feel a sense of being situatedand recall feelings of liveliness and belongingness, and thus supporting the person’s sense of self.The results can be used to deepen nursing sta’s understanding of using photo-elicited conversationsin dementia care.

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  • 46.
    Nordgren, Lena
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Asp, Margareta
    Mälardalen University, Department of Caring and Public Health Sciences.
    Fagerberg, Ingegerd
    Mälardalen University, Department of Caring and Public Health Sciences.
    An exploration of formal care from the perspective of middle-aged heart failure patients2007In: European Journal of Cardiovascular Nursing: Volume 6, Supplement 1, Pages S1-S58 (March 2007), 2007Conference paper (Refereed)
    Abstract [en]

    Purpose

    To explore and describe the phenomenon: Formal care from the perspective of middle-aged persons living with HF.

    Methods

    Data was collected in seven unstructured interviews with middle-aged people (four men, three women) living with moderate-severe HF. It was analysed using a phenomenological approach.

    Results

    People with HF are dependent on care and treatment. Formal care, in the form of medication or other treatments, balances the life situation and gives hope for relief and access to a rich and meaningful life again. Care, thus, means hope for a change or improvement and makes life possible to live.

    Within the context of formal care patients are able to surrender to a secure retreat. When they surrender to care they should be the ones to whom care is given, but instead they turn into objects to be examined and treated, almost as if they were not there. As carers reduce patients to objects, to someone or something which is categorised, treated or informed on basis of standard guidelines, they feel powerless and that they have no value in the carer's eyes. The patients feel betrayed and they do not trust or rely on carers or on the care that they receive and need.

    Formal care is performed within an organisation with a structure which patients perceive as unclear. It is an organisation in which individuals are not seen or the individual's needs are not provided for. The organisation is to a great extent governed by routines, financial values and bureaucracy. The hospital environment and its routines depersonalise patients, which increases their feelings of uncertainty towards carers and to the caregiving organisation. Patients experience that carers expect them to be active in their health process and to participate in decision-making, but nobody clearly explain to them what they are up against, what they have do deal with. Instead of an opportunity to gain increased access to life, which in spite of illness and limits can be a bearable and meaningful life, patients are left with confusion and existential uncertainty.

    Conclusion

    Demands on high quality medical care signify that routines and recommendations must be followed. However, there is a danger, if care is performed solely on basis of routines and recommendations, that carers disregard the uniqueness in each patient's life situation. Carers need to find approaches to formal care that acknowledges individuals and at the same time ensures good quality medical care for patients.

  • 47.
    Nordgren, Lena
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences. Växjö University.
    Asp, Margareta
    Mälardalen University, Department of Caring and Public Health Sciences.
    Fagerberg, Ingegerd
    Mälardalen University, Department of Caring and Public Health Sciences.
    An exploration of the phenomenon of formal care from the perspective of middle-aged heart failure patients2007In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, Vol. 6, no 2, p. 121-129Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite a considerable amount of research into heart failure there remains a divergence between the care available and patient's needs. The predominant biomedical perspective is more focused on the disease rather than the patient. In order to deliver formal care appropriate to the needs of middle-aged patients with moderate-severe HF it is imperative to gain the perspective of the individual patient. AIMS: The aim of the current study was to explore and understand the phenomenon: Formal care as experienced from the perspective of middle-aged patients living with HF. METHODS: The study was performed using a lifeworld perspective. Data was collected in seven unstructured interviews with middle-aged people living with moderate-severe HF. Data was analysed using a phenomenological approach. RESULTS: Formal care, as experienced by middle-aged patients living with moderate to severe HF, means hope to once again be able to have access to life. However, the meaning of formal care is ambiguous, which signifies that care means both health and suffering at the same time. The essence's meaning constituents are: dependency of care, surrender to care and unclear participation. CONCLUSION: The experience of formal care means both well-being and suffering at the same time. Patients' suffering in relation to formal care can be reduced if formal carers act from an ethical patient perspective point of view and if carers regard patients' lived experiences.

  • 48.
    Nordgren, Lena
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Asp, Margareta
    Mälardalen University, Department of Caring and Public Health Sciences.
    Fagerberg, Ingegerd
    Mälardalen University, Department of Caring and Public Health Sciences.
    Living with Moderate – Severe CHF as a Middle-Aged Person: A Phenomenological Study2006In: QHR2006: Understanding differing perspectives in health and health care, 2006Conference paper (Refereed)
  • 49.
    Nordgren, Lena
    et al.
    Växjö University.
    Asp, Margareta
    Mälardalen University, Department of Caring and Public Health Sciences.
    Fagerberg, Ingegerd
    Mälardalen University, Department of Caring and Public Health Sciences.
    Living with moderate-severe chronic heart failure as a middle-aged person2007In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 17, no 1, p. 4-13Article in journal (Refereed)
    Abstract [en]

    In this article the authors describe a study focusing on middle-aged persons living with chronic heart failure (CHF), a group with which few studies have been conducted. They used the lifeworld perspective to focus on persons' lived experiences of the phenomenon, that is, living with moderate-severe CHF as a middle-aged person. They interviewed 7 middle-aged persons (4 men, 3 women; aged 38 to 65 years) and analyzed the data obtained using a phenomenological approach. The phenomenon's essence is described as a life situation characterized by a failing body, a life constantly under threat, a rapidly changing health condition, and an altered self-image, which implies that the persons live in a changed life situation. The essence was further illuminated by three meaning constituents: an ambiguity of the body, losing track of life, and balancing life. Knowledge from this study will help caregivers understand and support patients with this debilitating condition.

  • 50.
    Nordgren, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Vaxjo University, Vaxjo, Sweden .
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare.
    Fagerberg, Ingegerd
    Mälardalen University, School of Health, Care and Social Welfare.
    Safety and understanding: Support as experienced by women living with heart failure in middle age2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 1, p. 39-51Article in journal (Refereed)
    Abstract [en]

    To reformulate and adjust to their life-situation, women living with heart failure (HF) need help and support. However, the actual meaning of the phenomenon of support is not yet well described. The aim of the study was to uncover the meaning of the phenomenon of support as experienced by women living with HF in middle age. A reflective lifeworld approach within the perspective of caring science was used. Six women (aged 33-61 years) were interviewed. The findings show that the essence of support can be understood as safety, depicted by understanding. However, there is tension between what is supportive and what is not, meaning that even though intentions are good, intended support may involve limitations, uncertainties or insecurity. The meaning of support is further illuminated in the following constituents: "knowledge and understanding", "finding balance", "ambiguity of relationships" and "support and formal care - a matter of trust and mistrust". Findings demonstrate the need for carers to find an approach that ensures both good quality medical care and, at the same time, acknowledges the uniqueness of each individual.

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