Beroende av vård : innebörden av fenomenet som det visar sig genom patienters, deras anhörigas och vårdares berättelser

Diss. (sammanfattning) Umeå : Umeå universitet, 2002digitalisering@um

Intensive care nurses’ experiences of Covid-19 care : A practical and ethical challenge – a qualitative descriptive design

The Covid-19 pandemic has generated new experiences of intensive care. It has entailed new working methods, treatment strategies,and ethical dilemmas. The aim of this study was to describe intensive care nurses’ experiences of Covid-19 care and itsethical challenges. Data collection consisted of 11 individual semi-structured interviews and a qualitative content analysis wasused. The COREQ checklist was followed. Three main themes emerged: to meet Covid-19 patients’ needs for specifically tailoredintensive care; to have a changed approach to the excluded relatives is unethical, but defensible; and to strive to protectethical values needs to be considered as good enough. In conclusion, ICU nurses shouldered a heavy burden in taking responsibilityfor the safety of these patients, continuously learning about new treatment strategies. Caring for Covid-19 patients was tostrive to make the best of the situation

Change agents’ experiences of implementing a new organizational culture in residential care for older people : A qualitative study

Culture change in organizations may affect employees and change agents are often a forgotten resource; their perspective is often overlooked in research. The aim of the study was to illuminate experiences of being a change agent in order to improve residential care of older people. Interviews were performed with 15 change agents who participated in a large culture transformation in residential care for older people. The study followed COREQ guidelines and content analysis was used to interpret the text. The analysis revealed that the change agents felt chosen when they accepted the challenge to become a change agent, but they also felt that transferring the message to co-workers was demanding. Conflicting demands about measuring care and aggravating circumstances to implement change were described. The results indicate that change agents benefit from preparation for the role itself as they have a great responsibility on their shoulders. In making the process more successful, all co-workers should be involved in the change process from the beginning

Meanings of being a change agent in implementing a new organisational culture in home care services : a phenomenological hermeneutic study

Culture change is common in healthcare organisations worldwide today, and change agents are key persons in the process of change. It is therefore of vital importance to deepen the knowledge about change agents’ experiences. The aim of the study was to illuminate meanings of being a change agent to improve home care services. Ten change agents were interviewed individually using open-ended questions. The interviews were analysed with phenomenological hermeneutics. The design of the study followed the COREQ guidelines. Three themes were revealed in the analysis: ‘Being confirmed by the opportunity to make quality improvements’; ‘Pushing oneself to transfer the message’; and ‘Being strengthened by achievements but wishing for better conditions’. In order to prepare co-workers, change agents need training before their mission begins and during the change process

Assessments of stress of conscience, burnout and social support amongst care providers in home care and residential care for older people

Background: Studies points to that levels of stress of conscience and burnout among staff in healthcare contexts may seriously affect their health. Aim: To compare assessments and associations of stress of conscience, perceptions of conscience, social support and burnout amongst care providers working in home care respectively residential care for older people. Methods: This cross‐sectional descriptive comparative study was performed among all care providers working in home care (n = 227) and residential care of older people (n = 354) in a municipality in northern Sweden. Data was collected using four different questionnaires. Analysis were performed using partial least square regression, descriptive statistics, statistical tests and effect size measures. Results: Care providers in residential care of older people assessed higher levels of stress of conscience compared to those working in home care. Exhaustion was an important predictor for belonging to the group of care providers working in residential care of older people. The most important predictor for belonging to the group of care providers working in home care were social support from one's immediate superior and co‐workers. Women assessed significantly higher levels of stress of conscience and exhaustion compared to men. Conclusion: Further research seems needed to investigate what the high levels of stress of conscience is caused by. A combined intervention consisting of work‐directed measures against burnout and measures aiming at reducing stress of conscience is suggested

Descriptions of comfort in the social networks surrounding a dying child

Aim: The aim of this study was to describe how comforters of one dying child were comforted, described by the child's mother and nurse. Background: The death of a child is one of the greatest losses parents can sustain and a stressful experience for nurses. Those who provide comfort may also need comfort, yet little is known about how comforters are comforted. Method: The interviews with mother and nurse were analysed using content analysis. Persons and activities mentioned as comforting were outlined in a sociogram. Findings: The findings show that the mother received comfort from her child and family, the nurse, extended family and others close to the family. She found comfort in being involved in the care and sharing worries with the nurse and in self-comfort. She described that siblings found comfort in each other, in living everyday life, in music and in expressing their feelings in drawings. The nurse gained comfort from sharing hardships with colleagues and a relative and from making a difference to the child. Conclusion: The findings provide a picture of interacting comforting social networks surrounding one dying child

Descriptions of comfort in the social networks surrounding a dying child

Aim: The aim of this study was to describe how comforters of one dying child were comforted, described by the child's mother and nurse. Background: The death of a child is one of the greatest losses parents can sustain and a stressful experience for nurses. Those who provide comfort may also need comfort, yet little is known about how comforters are comforted. Method: The interviews with mother and nurse were analysed using content analysis. Persons and activities mentioned as comforting were outlined in a sociogram. Findings: The findings show that the mother received comfort from her child and family, the nurse, extended family and others close to the family. She found comfort in being involved in the care and sharing worries with the nurse and in self-comfort. She described that siblings found comfort in each other, in living everyday life, in music and in expressing their feelings in drawings. The nurse gained comfort from sharing hardships with colleagues and a relative and from making a difference to the child. Conclusion: The findings provide a picture of interacting comforting social networks surrounding one dying child

Perceptions and stress of conscience in relation to burnout among nursing staff in older people care settings : A cross sectional study

BACKGROUND: Considering cultural influences, it is important to study the perceptions and stress of conscience in different contexts. This study aimed to investigate the association between perceptions of conscience, stress of conscience, and burnout among nursing staff working in older people care settings in Tehran. METHODS: This was a descriptive, cross-sectional study. A total of 161 participants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire, and Oldenburg Burnout Inventory, 2019. All nursing staff working at the 20 contacted nursing homes agreed to participate in the study. The descriptive and inferential analysis was conducted through SPSS, using T-tests and one-way between-groups analysis of variance, Chi-square and t-tests, Cohen's d (d), Eta-squared (η2), and Phi coefficient (φ), Partial least squares regression (PLSR), jackknife approximate t-tests of the regression coefficients, and jackknife 95% confidence intervals of the regression coefficients. RESULTS: The nursing staff perceived their conscience mainly as an authority, asset, and warning signal. Impact of workload on family life was the most common source of stress for the nursing staff. Dealing with incompatible demands, the impact of workload on family life, witnessing insulated patients, inability to meet one's standards in providing care, and perception of conscience as a burden were strongly associated with the burnout. CONCLUSIONS: Perceiving conscience as a warning signal or authority may serve as a buffer against burnout among nursing staff. This study highlights the need for further exploration of perceptions of conscience in different cultural and social backgrounds

Development and psychometric properties of the Inner Strength Scale

BACKGROUND: Four dimensions of inner strength were previously identified in a meta-theoretical analysis: firmness, creativity, connectedness, and flexibility. OBJECTIVE: The aim of this study was to develop an Inner Strength Scale (ISS) based on those four dimensions and to evaluate its psychometric properties. METHOD: An initial version of ISS was distributed for validation purpose with the Rosenberg Self-Esteem Scale, the resilience scale, and the sense of Coherence Scale. A convenience sample of 391 adults, aged 19-90 years participated. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were used in the process of exploring, evaluating, and reducing the 63-item ISS to the 20-item ISS. Cronbach's alpha and test-retest were used to measure reliability. RESULTS: CFA showed satisfactory goodness-of-fit for the 20-item ISS. The analysis supported a fourfactor solution explaining 51% of the variance. Cronbach's alpha on the 20-item ISS was 0.86, and the test-retest showed stability over time (r=0.79). CONCLUSION: The ISS was found to be a valid and reliable instrument for capturing a multifaceted understanding of inner strength. Further tests of psychometric properties of the ISS will be performed in forthcoming studies