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  • 1.
    Cronqvist, Agneta
    et al.
    Karolinska Institutet.
    Theorell, T
    Karolinska Institutet.
    Burns, T
    Uppsala universitet.
    Lützén, Kim
    Institutionen för Vårdvetenskap, Ersta Sköndal högskola.
    Dissonant imperatives in nursing: a conceptualization of stress in intensive care in Sweden.2001In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 17, no 4, p. 228-36Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore nurses' experiences of stress within the context of intensive care. The theoretical perspective for the study builds on a cognitive-phenomenological-transactional theory of stress and coping and the theory of cognitive dissonance. Respondents were 36 registered nurses recruited from 10 intensive care units (general, neonatal and thoracic units). Their experience as nurses ranged from one to 32 years. These intensive care units had similar structural characteristics, namely a high working pace, advanced technology, constrained finances, frequent reorganizations, a shortage of registered nurses and all were filled to overcapacity. Data were collected in open-ended interviews that were audio-taped and transcribed. A content analysis identified four contradictory themes: (1) controlled by the work situation--needing to be in control; (2) constrained by prioritization--wanting to do more; (3) lacking the authority to act--knowing that something should be done; and (4) professional distance--interpersonal involvement. These four themes were synthesized at a higher level of abstraction into a main theme: stress induced by dissonant imperatives, which conceptualizes nursing stress in the intensive care unit. In conclusion, dissonant imperatives might lead to stress in intensive care nursing.

  • 2.
    Häggström, Marie
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Kristiansen, Lisbeth
    Mittuniversitetet.
    How can nurses facilitate patient's transitions from intensive care?: A grounded theory of nursing2012In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 28, no 4, p. 224-233Article in journal (Refereed)
    Abstract [en]

    Objectives: Intensive care patients often experience feelings of powerlessness and vulnerability when being transferred from an intensive care unit to a general ward. The aim of this study was to develop a grounded theory of nurses care for patients in the ICU transitional care process. Methods: Group interviews, individual interviews and participant observations were conducted with nurses in two hospitals in Sweden and were analysed using grounded theory. Result: The substantive theory shows the process of nursing care activities — from the contexts of the ICU and the general ward. The main concern was to achieve a coordinated, strengthening, person-centered standard of care to facilitate patient transitions. The core category ‘‘being perceptive and adjustable’’ was a strategy to individualise, that was related to the other categories; ‘‘preparing for a change’’ and ‘‘promoting the recovery’’. However, the nurses were forced to ‘‘balance between patient needs and the caregivers’ resources’’ and consequently were compromising their care. Conclusions: To facilitate an ICU-patient’s transition, individual care planning is needed. It is also essential that the patients are adequately prepared for the change to facilitate the transitional care. Knowledge about transitional needs, empowerment and patient-education seems to be important issues for facilitating transitions.

  • 3.
    Junehag, Lena
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Svedlund, Marianne
    Mittuniversitetet.
    A qualitative study: Perceptions of the psychosocial consequences and access to support after an acute myocardial infarction2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 1, p. 22-30Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to describe individuals' perceptions of the psychosocial consequences of an acute myocardial infarction (AMI) and of their access to support one year after the event. Methods: The study included 20 participants (14 men and six women) who lived in rural areas and had experienced their first AMI. Eleven were offered contact with a mentor. The participants were interviewed one year after their AMI. Results: The findings are presented in three themes: having a different life, having to manage the situation and having access to support, with 11 subthemes. During their recovery, the participants experienced psychosocial consequences, consisting of anxiety and the fear of being afflicted again. Most mentees appreciated their mentor and some of those without mentors wished they had received organised support. Participants were often more dissatisfied than satisfied with the follow-up provided during recovery. Conclusions: After an AMI, follow-up is important during recovery, but the standardised information provided is inadequate. During recovery, people need help dealing with existential crises. After discharge, receiving peer support from lay people with similar experiences could be valuable. The knowledge gleaned from this study could be used in education at coronary care units and in health care outside the hospital setting. © 2013 Elsevier Ltd.

  • 4. Söderström, Ing-Mari K
    et al.
    Saveman, Britt-Inger
    Hagberg, Margaretha S
    Benzein, Eva G
    Ersta Sköndal University College, Department of palliative care research.
    Family adaptation in relation to a family member's stay in ICU.2009In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 25, no 5, p. 250-7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To describe and interpret the family adaptation during the ICU hospitalisation and up to 18 months after discharge. RESEARCH METHODOLOGY/DESIGN: A qualitative design was chosen. MAIN OUTCOME MEASURES: Individual and family interviews with eight families including 31 family members. A hermeneutical analysis was performed and paradigm cases were constructed. RESULTS: The result is presented in three themes: striving for endurance, striving for consolation and striving to rebuild life under new conditions. The family adaptation started at the onset of the critical incident and continued during the ICU stay and after discharge. The family members metaphorically went through peaks and valleys during the whole process of adaptation. CONCLUSION: Adaptation is an issue for the whole family and is facilitated by being able to stay close to the patient and receive supportive unambiguous information from the staff both during the ICU stay and after discharge.

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