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  • 1.
    Bastholm Rahmner, Pia
    et al.
    Karolinska Institutet, Stockholm, Sweden .
    Andersén-Karlsson, E
    South Stockholm General Hospital, Stockholm, Sweden.
    Arnhjort, T
    South Stockholm General Hospital, Stockholm, Sweden.
    Eliasson, M
    Stockholm County Council, Sweden.
    Gustafsson, L-L
    Stockholm County Council, Sweden.
    Jacobsson, L
    Ovesjö, M-L
    Stockholm County Council, Sweden.
    Rosenqvist, Urban
    University of Uppsala, Uppsala, Sweden.
    Sjöviker, S
    Karolinska Institutet, Stockholm, Sweden .
    Tomson, G
    Karolinska Institutet, Stockholm, Sweden.
    Holmström, Inger
    University of Uppsala, Uppsala, Sweden.
    Physicians perceptions of possibilities and obstacles prior to implementing a computerised drug prescribing support system2004In: International journal of health care quality assurance incorporating leadership in helath services, ISSN 1366-0756, E-ISSN 2051-3135, Vol. 17, no 4, p. 173-179Article in journal (Refereed)
    Abstract [en]

    Seeks to identify physicians' perceptions of possibilities and obstacles prior to implementing a computerised drug prescribing support system. Details a descriptive, qualitative study, with semi-structured individual interviews of 21 physicians in the Accident and Emergency Department of South Stockholm General Hospital. Identifies four descriptive categories for possibilities and obstacles. Concludes that gaining access to patient drug history enables physicians to carry out work in a professional way – a need the computerised prescription support system was not developed for and thus cannot fulfil. Alerts and producer-independent drug information are valuable in reducing workload. However, technical prerequisites form the base for a successful implementation. Time must be given to adapt to new ways of working.

  • 2.
    Bastholm Rahmner, Pia
    et al.
    Stockholm County Council.
    Tomson, Göran
    Karolinska Institutet.
    Rosenqvist, Urban
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    Gustafsson, Lars L
    Karolinska Institutet.
    Holmström, Inger
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    "Limit work to here and now": A focus group study on how emergency physicians view their work in relation to patients' drug treatment2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 3, p. 155-164Article in journal (Refereed)
    Abstract [en]

    Patients come to the emergency department (ED) with complex medication and some patients present symptoms of adverse drug effects. Drug treatment is a complex process for physicians to handle. The aim of this study was to explore how a group of ED physicians view their work in relation to patients’ drug treatment. Three semi-structured focus group discussions with 12 physicians in an ED in Sweden were conducted and analysed thematically. The core theme was ‘‘limit work to here and now’’. Three descriptive themes were identified in relation to the main theme; (1) focussing to cope with work; (2) decision making on limited patient-specific information; and (3) actively seeking learning moments. The findings show that the physicians actively seek learning moments in work. Signing their own notes in the computerized medical record is a way of getting feedback on the treatment they have initiated and it was seen as a large part of their clinical education. If we want to support the physicians with new technology for safer drug treatment, such as a computerized drug prescribing support system, the support system should be adapted to the different learning styles and needs.

  • 3.
    Holmström, Inger
    et al.
    Uppsala University, Uppsala, Sweden.
    Halford, Christina
    Uppsala University, Uppsala, Sweden.
    Rosenqvist, Urban
    Uppsala University, Uppsala, Sweden.
    Swedish health care professionals' diverse understandings of diabetes care2003In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 51, no 1, p. 53-58Article in journal (Refereed)
    Abstract [en]

    Knowledge of health care professionals’ different understandings of diabetes care is important when preparing such professionals in patient education. For patients to manage illness effectively, the actions of health care professionals are crucial. Patients’ understanding of their condition should be taken as the point of departure when creating a learning situation. The professionals’ understandings of diabetes care were mapped using a survey including 169 primary care doctors, nurses, assistant nurses and chiropodists in Stockholm, Sweden. The responses were analysed using a phenomenographic approach. Five understandings were identified: the professionals treat the patients, the professionals give information, the professionals focus relation and organisation, the professionals seek the patient’s agreement, and the professionals focus the patient’s understanding of the situation. Only 20 (12%) of the 169 professional caregivers focused the patient’s understanding. Professionals need to develop their understandings of health care and the professional–patient interaction in order to support the patients’ learning.

  • 4.
    Holmström, Inger
    et al.
    Health Services Research, University of Uppsala, Sweden .
    Jonsson, AC
    University of Linköping, Sweden.
    Rosenqvist, Urban
    Health Services Research, Uppsala Science Park, Uppsala, Sweden .
    Understanding the job in a new way - a basis for development of competence in diabetes care2000In: Upsala Journal of Medical Sciences, Supplement, ISSN 0300-9726, Vol. 105, no 2, p. 161-169Article in journal (Refereed)
    Abstract [en]

    Patients complain that doctors and nurses do not listen, and therefore a need to develop the patient encounter is at hand. Phenomenological theory has opened new ways to develop professional competence. If the idea holds that we express our understanding about our work through our actions, a change in understanding might further develop professional competence. This idea offers a new way to develop competence in diabetes health care service. The aim of this study was to map health care professionals' understanding of the patient encounter before and after an educational intervention that focused the way the health care professional experienced the encounter, and to describe how their understanding changed. Two general practitioners and two diabetes nurses participated. They were interviewed before and after the intervention. The intervention comprised 4-5 sessions during which they together with a tutor reviewed their videotaped consultations with different persons with diabetes. The tutors' role was to make interventions that could alter the persons understanding of the diabetes consultation through questioning. The interviews were analysed using phenomenographic method. The results show that the professionals changed their ways of experiencing the encounter after the intervention. They started to question their way of working, focused the patient's learning process and became interested in how to stimulate it.

  • 5.
    Holmström, Inger
    et al.
    Health Services Research, Uppsala, Sweden .
    Larsson, Jan
    Health Services Research, Uppsala, Sweden .
    Lindberg, Eva
    Health Services Research, Uppsala, Sweden .
    Rosenqvist, Urban
    Health Services Research, Uppsala, Sweden .
    Improving the diabetes-patient encounter by reflective tutoring for staff2004In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 53, no 3, p. 325-332Article in journal (Refereed)
    Abstract [en]

    There is relative consensus about the advantages of patient-centred consultations. However, they have not been easy to realise in clinical praxis. The aim of this study was to investigate whether an intervention focused on health care professionals' understanding of the diabetes-patient encounter could facilitate a patient-centred way to encounter these patients. Two GPs and two nurses participated in the year-long intervention. The intervention focused on the staff's understanding of the encounter. Staff video recorded four to five encounters each and reflected together with a supervisor on their understanding of the encounters and how they were conducted. The encounters were analysed with the Verona-MICS/Dr coding system and patients' comments were analysed separately. The content of the consultations and how they were conducted was also assessed. There was a significant change of two patient-centred items by the staff over time. Two staff seemed to change their educational model. Modern theories of competence development seem to be useful in clinical settings.

  • 6.
    Holmström, Inger
    et al.
    Health Services Research, Uppsala Science Park, Uppsala, Sweden .
    Rosenqvist, Urban
    Health Services Research, Uppsala Science Park, Uppsala, Sweden .
    A change of the physicians' understanding of the encounter parallels competence development2001In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 42, no 3, p. 271-278Article in journal (Refereed)
    Abstract [en]

    Patients today complain that physicians do not listen. There is a need to improve the professional competence in the patient encounter. According to theory, competence is a result of how people perceive their work. Observation and reflection can improve the competence. The aim of this study was to investigate if physicians can develop a more patient-centred consultation style by an experienced-based specialist course and how such a development is related to the physicians understanding of the task. The physicians video recorded consultations and reflected on these. The video consultations were analysed with a time study and Pendleton et al.’s consultation schedule [Pendleton D, Schoefield T, Tate P, Havelock P. The consultation: an approach to learning and teaching. Oxford: Oxford University Press, 1984.]. Before–after questions were answered. The study indicates that seven out of 10 physicians participating in the course had developed a patient-centred attitude and acted according to it. The time study gave ambiguous results. This study implicates that it is possible to initiate competence development by influencing the understanding of the encounter.

  • 7.
    Holmström, Inger
    et al.
    Uppsala Science Park, Uppsala, Sweden.
    Rosenqvist, Urban
    Uppsala Science Park, Uppsala, Sweden.
    Interventions to support reflection and learning: a qualitative study2004In: Learning in Health and Social Care, ISSN 1473-6853, E-ISSN 1473-6861, Vol. 3, no 4, p. 203-212Article in journal (Refereed)
    Abstract [en]

    The aim of this research was to explore the role of a professional development supervisor in helping health professionals to reflect on their role in patient consultations. This article is written from the viewpoint of patient-centred care and seeks to examine how the mentor/supervisor can facilitate reflection and learning by discussing, with professionals, videotapes of their regular meetings with patients. The specific context of the article is an educational intervention in Sweden, based on modern theories of competence development for professionals in diabetes care. A purposeful sample of 18 patients with type 2 diabetes agreed to have their regular meeting with a general practitioner (GP) or diabetes nurse videotaped. The GPs or diabetes nurses of these patients then participated in an intervention, comprising sessions when they reviewed with a supervisor their consultations with the patients. These supervising sessions were videotaped and are investigated in this article. The supervisor's role was to make observations that could alter the professional's understanding of the diabetes consultation through video-cued narrative reflection. Five overarching themes were identified from the content (the what-aspect) of the intervention: medical problems; patient characteristics and reactions; patient education; the consultation as such; and the healthcare organization. The activities used in carrying out the intervention (the how-aspect) were: confirmation and feedback; interpretation; reflective questioning; suggestions and corrections; and closed-end questions or brief answers. It was hypothesized that this way of conducting reflective educational interventions would be beneficial for healthcare professionals when working with patients with various longstanding medical conditions, recognizing that a patient-centred approach which included the patient's learning and possibilities for self-management are more suitable for the chronic illness encounter.

  • 8.
    Holmström, Inger
    et al.
    Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Rosenqvist, Urban
    Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Misunderstandings about illness and treatment among patients with type 2 diabetes2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 49, no 2, p. 146-154Article in journal (Refereed)
    Abstract [en]

    Aims. This paper reports a study whose aim was to describe the misunderstandings that Swedish patients with type 2 diabetes have about their illness and treatment. Background. It is well known that patients with type 2 diabetes need extensive support and education to learn to manage and live with their illness. However, a Swedish survey has shown that only 34% of these patients had good metabolic control. Despite intensive education and support, misunderstandings about both the illness and treatment seem to be common. Furthermore, patients are currently complaining that health care services sometimes obstruct rather than support self-care and learning. Methods. We videotaped 18 authentic encounters between a patient with diabetes and a physician, or a diabetes nurse. Patients then viewed the video and reflected on what took place during the consultation. Video-recordings and transcribed reflections were analysed thematically. Results. Five themes emerged from the analysis: (a) Type 2 diabetes is not 'real diabetes'; (b) Complications - horror visions or suppression; (c) Self-monitoring of blood glucose and medication is a routine, not a learning tool; (d) Diet - the important thing is to reduce fat and (e) 'Physical exercise is good, they tell us'. Four of the 18 patients showed no misunderstandings. Misunderstandings of diabetes and its treatment were thus common and numerous, despite regular checkups and good access to care. The patients adhered to prescribed regimens but did not know why they performed many routines or how they could benefit from them. Conclusion. The results show that misunderstandings of illness and treatment were common. We suggest that diabetes educators should base their education on this variation of understanding, using a phenomenological approach to learning. Reflecting on this kind of varied experiences can be a powerful tool to help people to move from 'novice to expert' and apply basic routines to new situations.

  • 9.
    Holmström, Inger
    et al.
    Uppsala Science Park, Uppsala, Sweden.
    Sanner, Margareta
    Uppsala Science Park, Uppsala, Sweden.
    Rosenqvist, Urban
    Uppsala Science Park, Uppsala, Sweden.
    Swedish medical students' views of the changing professional role of medical doctors and the organisation of health care2004In: Advances in Health Sciences Education, ISSN 1382-4996, E-ISSN 1573-1677, Vol. 9, no 1, p. 5-14Article in journal (Refereed)
    Abstract [en]

    Medical students will influence future health care considerably. Their professional orientation while at medical school will be related to their future professional development. Therefore, it is important to study this group's view of the role of medical doctors, especially because Swedish health care is currently undergoing major changes and financial cut backs. Here, the theoretical framework was contemporary theories of competence development, which has shown that people's understanding of their work influences their actions. The aim of this study was to describe medical students' views of their future professional role in health care. In total, 57 fourth-year medical students at a Swedish university were asked to write a short essay about how they conceptualised their professional role in future health care. Fifty-three students (93%) replied. The essays were analysed qualitatively in three steps and four themes were subsequently identified: the professional role in change, organisation of health care, working conditions and the possibilities of having a balanced life. Some factors mentioned that would strongly influence the professional role were being team leader, increased specialisation, supporting the patient and computer science and technology. The students expressed ambiguous feelings about power and leadership. The results indicate that the students share a rather dark view of both the medical profession and health care, which seems to be related to stress and financial cutbacks. Mentoring, time for reflection and changes in the curricula might be needed.

  • 10.
    Kjeldmand, Dorte
    et al.
    University of Uppsala, Uppsala, Sweden.
    Holmström, Inger
    University of Uppsala, Uppsala, Sweden.
    Rosenqvist, Urban
    University of Uppsala, Uppsala, Sweden.
    Balint training makes GPs thrive better in their job2004In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 55, no 2, p. 230-235Article in journal (Refereed)
    Abstract [en]

    In this study, we examined Balint group participants' sense of control and satisfaction in their work situation and their attitudes towards caring for patients with psychosomatic problems. Forty-one GPs filled in a questionnaire with a 10-point visual analogue scale. Of these, 20 had participated in Balint groups for more than one year and 21 were a reference group. The Balint physicians reported better control of their work situation (e.g. taking coffee breaks and participating in decision making), thought less often that the patient should not have come for consultation or that psychosomatic patients were a time-consuming burden, and were less inclined to refer patients or take unneeded tests to terminate the consultation with the patient. These results might indicate higher work-related satisfaction and better doctor-patient relationship.

  • 11.
    Kjeldmand, Dorte
    et al.
    Uppsala universitet, Sweden.
    Holmström, Inger
    Uppsala universitet, Sweden.
    Rosenqvist, Urban
    Uppsala universitet, Sweden.
    How patient-centred am I?: A new method to measure physicians' patient-centredness2006In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 62, no 1, p. 31-37Article in journal (Refereed)
    Abstract [en]

    Objective

    To describe a new method to determine physicians’ self-perceived degree of patient-centredness. A pilot study combining qualitative and quantitative methods.

    Methods

    Forty-one general practitioners (GPs) answered a questionnaire consisting of three open-ended questions about their view of the consultation and by choosing among 28 roles of the physician in the physician–patient relationship. Twenty of the GPs had participated in Balint groups while 21 had had no access to Balint group. Patient-centredness is central to Balint groups and consequently Balint group participants would be expected to be patient-centred.

    Results

    The answers to the two parts were divided into three groups each, patient-centred, non-patient-centred and intermediary, and analysed statistically. Significantly more Balint participants were patient-centred than the reference group.

    Conclusion

    The instrument describes physicians’ self-perceptions of their patient-centredness and can distinguish a group of patient-centred physicians from a group of non-patient-centred physicians.

    Practice implications

    The instrument can be useful to evaluate educational programmes and detect decline in patient-centredness as early sign of burnout.

  • 12.
    Larsson, Jan
    et al.
    Uppsala Academic Hospital, Uppsala, Sweden.
    Holmström, Inger
    University of Uppsala, Sweden.
    Lindberg, Eva
    University of Uppsala, Sweden.
    Rosenqvist, Urban
    University of Uppsala, Sweden.
    Trainee anaesthetists understand their work in different ways: implications for specialist education2004In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 92, no 3, p. 381-387Article in journal (Refereed)
    Abstract [en]

    Background. Traditionally, programmes for specialist educationin anaesthesia and intensive care have been based on lists ofattributes such as skills and knowledge. However, modern researchin the science of teaching has shown that competence developmentis linked to changes in the way professionals understand theirwork. The aim of this study was to define the different waysin which trainee anaesthetists understand their work.

    Methods. Nineteen Swedish trainee anaesthetists were interviewed.The interviews sought the answers to three open-ended questions.(i) When do you feel you have been successful in your work?(ii) What is difficult or what hinders you in your work? (iii)What is the core of your anaesthesia work? Transcripts of theinterviews were analysed by a phenomenographic approach, a researchmethod aiming to determine the various ways a group of peopleunderstand a phenomenon.

    Results. Six ways of understanding their work were defined:giving anaesthesia according to a standard plan; taking responsibilityfor the patient’s vital functions; minimizing the patient’ssuffering and making them feel safe; giving service to specialistdoctors to facilitate their care of patients; organizing andleading the operating theatre and team; and developing one’sown competence, using the experience gained from every new patientfor learning.

    Conclusions. Trainee anaesthetists understand their work indifferent ways. The trainee’s understanding affects bothhis/her way of performing work tasks and how he/she developsnew competences. A major task for teachers of anaesthesia isto create learning situations whereby trainees can focus onnew aspects of their professional work and thus develop newways of understanding it.

  • 13.
    Larsson, Jan
    et al.
    Uppsala Academic Hospital, Uppsala, Sweden.
    Holmström, Inger
    University of Uppsala, Uppsala, Sweden .
    Rosenquist, Urban
    University of Uppsala, Uppsala, Sweden .
    Professional artist, good Samaritan, servant and co-ordinator: four ways of understanding the anaesthetist's work2007In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 47, no 7, p. 787-793Article in journal (Refereed)
    Abstract [en]

    Evaluating clinical competence among anaesthetists has so far focused mostly on theoretical knowledge and practical skills. According to theory, however, the way anaesthetists understand their own work has also greatly influenced the development of professional competence. The aim of this study was to investigate how anaesthetists understand their work. Methods: Nineteen Swedish anaesthetists were interviewed. The interviews were open and sought answers to three questions 1) When do you feel you have been successful in your work?; 2) What is difficult or what hinders you in your work?; and 3) What is the core of your professional anaesthesia work? Phenomenographic analysis was performed. Results: Four ways of understanding the anesthesiologists' professional work were found: 1) Give anaesthesia and control the patient's vital functions; 2) Help the patient, alleviate his/her pain and anxiety; 3) Give service to the whole hospital to facilitate the work of other doctors and nurses, caring for severely ill patients; and 4) Organize and direct the operation ward to make the operations list run smoothly. Conclusions: This study shows that anaesthetists understand their work in qualitatively different ways, which can be assumed to affect their work actions and also the way their competence develops. This has implications for the education of anaesthetists; it is important to find ways of making anaesthetists in training consciously aware of the different ways their work can be understood, as this will give them better prerequisites for future competence development.

  • 14.
    Larsson, Jan
    et al.
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    Holmström, Inger
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    Rosenqvist, Urban
    Uppsala universitet, Hälso- och sjukvårdsforskning.
    Burdened by training not by anaesthesia2008In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 100, no 4, p. 560-561Article in journal (Other academic)
  • 15.
    Larsson, Jan
    et al.
    Uppsala Academic Hospital, Uppsala, Sweden .
    Holmström, Inger
    University of Uppsala, Uppsala, Sweden.
    Rosenqvist, Urban
    University of Uppsala, Uppsala, Sweden.
    Professional artist, good Samaritan, servant and co-ordinator: four ways of understanding the anaesthetist's work2003In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 47, no 7, p. 787-793Article in journal (Refereed)
    Abstract [en]

    Background: Evaluating clinical competence among anaesthetists has so far focused mostly on theoretical knowledge and practical skills. According to theory, however, the way anaesthetists understand their own work has also greatly influenced the development of professional competence. The aim of this study was to investigate how anaesthetists understand their work.

    Methods: Nineteen Swedish anaesthetists were interviewed. The interviews were open and sought answers to three questions 1) When do you feel you have been successful in your work?; 2) What is difficult or what hinders you in your work?; and 3) What is the core of your professional anaesthesia work? Phenomenographic analysis was performed.

    Results: Four ways of understanding the anesthesiologists' professional work were found: 1) Give anaesthesia and control the patient's vital functions; 2) Help the patient, alleviate his/her pain and anxiety; 3) Give service to the whole hospital to facilitate the work of other doctors and nurses, caring for severely ill patients; and 4) Organize and direct the operation ward to make the operations list run smoothly.

    Conclusions: This study shows that anaesthetists understand their work in qualitatively different ways, which can be assumed to affect their work actions and also the way their competence develops. This has implications for the education of anaesthetists; it is important to find ways of making anaesthetists in training consciously aware of the different ways their work can be understood, as this will give them better prerequisites for future competence development.

  • 16.
    Larsson, Jan
    et al.
    Uppsala universitet, Sweden.
    Rosenqvist, Urban
    Uppsala universitet, Sweden.
    Holmström, Inger
    Uppsala universitet, Sweden.
    Being a young and inexperienced trainee anaesthetist: a phenomenological study on tough working conditions2006In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 50, no 6, p. 653-658Article in journal (Refereed)
    Abstract [en]

     Background: Physicians at the beginning of their specialist education have been reported to be especially exposed to stress and difficult working conditions. Considerable worry has also been caused by reports about anaesthetists dying at a younger age than other specialists as well as by reports about higher than average suicide rates among anaesthetists. Maybe as a consequence, many young doctors are reluctant to choose anaesthesiology as their future specialty. The aim of this study was to investigate what difficulties trainee anaesthetists experience at work.

    Methods: Nineteen trainee anaesthetists in six Swedish hospitals were interviewed. Phenomenological analysis of the interview text was performed.

    Results: All trainees had experienced considerable, sometimes extreme demands at work. Most of them often felt insufficient and inadequate and had problems with the professional role. Support from consultants was sometimes lacking. Some trainees expressed deep feelings of loneliness and helplessness in difficult clinical situations.

    Conclusions: This study shows that trainee anaesthetists have to live up to high work demands, often with very little support. Because too much stress is an obstacle to professional learning, such working conditions are a hindrance to good specialist education. The first measure to be taken should be to ensure that all trainee anaesthetists always have easy access to senior cover.

    Background: Physicians at the beginning of their specialist education have been reported to be especially exposed to stress and difficult working conditions. Considerable worry has also been caused by reports about anaesthetists dying at a younger age than other specialists as well as by reports about higher than average suicide rates among anaesthetists. Maybe as a consequence, many young doctors are reluctant to choose anaesthesiology as their future specialty. The aim of this study was to investigate what difficulties trainee anaesthetists experience at work.

    Methods: Nineteen trainee anaesthetists in six Swedish hospitals were interviewed. Phenomenological analysis of the interview text was performed.

    Results: All trainees had experienced considerable, sometimes extreme demands at work. Most of them often felt insufficient and inadequate and had problems with the professional role. Support from consultants was sometimes lacking. Some trainees expressed deep feelings of loneliness and helplessness in difficult clinical situations.

    Conclusions: This study shows that trainee anaesthetists have to live up to high work demands, often with very little support. Because too much stress is an obstacle to professional learning, such working conditions are a hindrance to good specialist education. The first measure to be taken should be to ensure that all trainee anaesthetists always have easy access to senior cover.

  • 17.
    Larsson, Jan
    et al.
    Uppsala universitet, Hälso- och sjukvårdsforskning, Sweden.
    Rosenqvist, Urban
    Uppsala universitet, Hälso- och sjukvårdsforskning, Sweden.
    Holmström, Inger
    Uppsala universitet, Hälso- och sjukvårdsforskning, Sweden.
    Enjoying work or burdened by it? How anaesthetists experience and handle difficulties at work: a qualitative study2007In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 99, no 4, p. 493-499Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to explore difficulties at work fromanaesthetists’ own perspective and to examine how anaesthetistshandle and cope with situations that are perceived as difficultand potentially stressful.

    Methods: Two sets of interviews were conducted with 19 specialist anaesthetistsin Sweden. The first set of interviews aimed at finding howthe anaesthetists experienced difficulties at work. It consistedof in-depth interviews based on one open-ended question. Weanalysed the interviews with a phenomenological method, lookingfor themes in anaesthetists’ descriptions of difficultiesat work. In the second set, the interviews were semi-structuredwith open-ended questions, based on themes found in the firstinterview set. These interviews aimed at exploring how the intervieweesdescribed their ways of handling difficulties and how they copedwith potentially stressful situations.

    Results: Analysis of the first set of interviews resulted in five themes,describing how the anaesthetists experienced difficulties atwork. All interviewees talked about difficulties related tomore than one of the themes. The second set of interviews revealedtwo main categories of ways of handling difficulties. First,problem solving consisted of descriptions of methods for handlingdifficult situations which aimed at solving problems, and second,coping strategies described ways of appraising potentially stressfulsituations that minimized stress, despite the problem not beingsolved.

    Conclusions: The anaesthetists interviewed in this study maintained thatthey enjoyed work and could see no external obstacles to doinga good job. They had arrived at a reconciliation of their workwith its inherent difficulties and problems. Getting accessto their coping strategies might help young anaesthetists tocome to terms with their work.

  • 18.
    Larsson, Jan
    et al.
    Uppsala universitet, Hälso- och sjukvårdsforskning, Sweden.
    Rosenqvist, Urban
    Uppsala universitet, Hälso- och sjukvårdsforskning, Sweden.
    Holmström, Inger
    Uppsala universitet, Hälso- och sjukvårdsforskning, Sweden.
    Stressful threats or stimulating challenges: how experienced anaesthetists cope with difficult situations at work2007In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 51, no Suppl. 118, p. 17-17Article in journal (Refereed)
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