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  • 1. Berg, Katarina
    et al.
    Årestedt, Kristofer
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Linnéuniversitetet.
    Kjellgren, Karin
    Postoperative recovery from the perspective of day surgery patients: A phenomenographic study2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 12, p. 1630-1638Article in journal (Refereed)
    Abstract [en]

    Background: Today, many patients undergo surgical procedures in a day surgery setting. The shift from inpatient care to care at the patients' own home following discharge places various demands on patients and their families during the recovery process. There is a need for knowledge of how the postoperative recovery process is perceived, as research indicates a lack of support for patients managing recovery at home.

    Objective: To explore day surgery patients' different perceptions of postoperative recovery.

    Design: A qualitative design with a phenomenographic approach was used.

    Methods and settings: Semi-structured interviews with 31 patients undergoing an orthopaedic, general or urologic day surgical procedure were carried out face to face at the patients' homes, 11-37 days post-discharge. Patients were recruited from two day surgery settings: one private unit and one unit associated with a local county hospital.

    Results: The patients perceived postoperative recovery as comprising internal and external prerequisites and implying changes in ordinary life with varying levels of support. The effective production at the day surgery unit was perceived as having an impact on patients' prerequisites for recovery. The results are elucidated in three descriptive categories: 'Conditions for recovery at home', 'The rollback to ordinary life' and 'Being a cog in a flow of care'.

    Conclusions: The postoperative phase seems to be a weak link in day surgery care. From the patients' perspective, postoperative recovery following day surgery implies extensive responsibility at home. Patients need knowledge and understanding concerning what constitutes the normal range in recovery and how to manage self-care following their specific surgical procedure. (C) 2013 Elsevier Ltd. All rights reserved.

  • 2. Hellsing, AL
    et al.
    Linton, S
    Andershed, Birgitta
    et, al
    Ergonomic education for nursing students1993In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 30, no 6, p. 499-510Article in journal (Refereed)
  • 3.
    Lundman, Berit
    et al.
    Umeå universitet.
    Aléx, Lena
    Umeå universitet.
    Jonsén, Elisabeth
    Umeå universitet.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Umeå universitet.
    Nygren, Björn
    Umeå universitet.
    Santamäki Fischer, Regina
    Umeå universitet.
    Strandberg, Gunilla
    Umeå universitet.
    Inner strength: A theoretical analysis of salutogenic concepts2010In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 47, no 2, p. 251-260Article in journal (Refereed)
    Abstract [en]

    Background

    Theoretical and empirical overlaps between the concepts of resilience, sense of coherence, hardiness, purpose in life, and self-transcendence have earlier been described as some kind of inner strength, but no studies have been found that focus on what attributes these concepts have in common.

    Objectives

    The objective of this study was to perform a theoretical analysis of the concepts of resilience, sense of coherence, hardiness, purpose in life, and self-transcendence, in order to identify their core dimensions in an attempt to get an overarching understanding of inner strength.

    Print method

    An analysis inspired by the procedure of meta-theory construction was performed. The main questions underlying the development of the concepts, the major paradigms and the most prominent assumptions, the critical attributes and the characteristics of the various concepts were identified.

    Results

    The analysis resulted in the identification of four core dimensions of inner strength and the understanding that inner strength relies on the interaction of these dimensions: connectedness, firmness, flexibility, and creativity. These dimensions were validated through comparison with the original descriptions of the concepts.

    Conclusion

    An overarching understanding of inner strength is that it means both to stand steady, to be firm, with both feet on the ground and to be connected to; family, friends, society, nature and spiritual dimensions and to be able to transcend. Having inner strength is to be creative and stretchable, which is to believe in own possibilities to act and to make choices and influence life's trajectory in a perceived meaningful direction. Inner strength is to shoulder responsibility for oneself and others, to endure and deal with difficulties and adversities. This knowledge about inner strength will raise the awareness of the concept and, in turn, hopefully increase our potential to support people's inner strength.

  • 4.
    Lundman, Berit
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Viglund, Kerstin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Aléx, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Jonsén, Elisabeth
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Santamäki Fischer, Regina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Strandberg, Gunilla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Nygren, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Development and psychometric properties of the Inner Strength Scale2011In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 48, no 10, p. 1266-1274Article in journal (Refereed)
    Abstract [en]

    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.

  • 5.
    Lövgren, Malin
    et al.
    Karolinska institutet, Högskolan Dalarna.
    Gustavsson, Petter
    Karolinska institutet.
    Melin, Bo
    Karolinska institutet.
    Rudman, Ann
    Karolinska institutet.
    Neck/shoulder and back pain in new graduate nurses: A growth mixture modeling analysis.2014In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 51, no 4, p. 625-639Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although it is well known that musculoskeletal disorders are common among registered nurses, little longitudinal research has been conducted to examine this problem from nursing education to working life.

    OBJECTIVES: The aim was to investigate the prevalence and incidence of neck/shoulder and back pain in nursing students in their final semester, and one and two years after graduation. Furthermore, to identify common trajectories of neck/shoulder and back pain, and explore sociodemographic and lifestyle-related factors, contextual factors and health outcome that might be characteristic of individuals in the various trajectories.

    DESIGN: Longitudinal study following nursing students from their final year of studies, with follow-ups one and two years after graduation.

    SETTINGS AND PARTICIPANTS: Nursing students who graduated from the 26 universities providing undergraduate nursing education in Sweden 2002 were invited to participate (N=1700). Of those asked, 1153 gave their informed consent.

    METHODS: The participants answered postal surveys at yearly intervals. Descriptive statistics were used to analyze prevalence and incidence of pain, and growth mixture modeling was applied to identify different homogeneous clusters of individuals following similar trajectories in pain development across time.

    RESULTS: The prevalence of neck/shoulder and back pain remained constant over time (around 50% for neck/shoulder pain and just over 40% for back pain). Six different development trajectories for each symptom were found, reflecting patterns of stable pain levels or variation in levels over time: one symptom-free group, two decreasing pain groups, two increasing pain groups, and one chronic pain group. With few exceptions, the same factors (sex, children, chronic disease, working overtime, work absence, sickness presence, physical load, depression, self-rated health, sleep quality and muscular tension) were associated with neck/shoulder and back pain trajectories. Different types of physical load characterized new nurses with neck/shoulder pain and back pain respectively.

    CONCLUSIONS: The high prevalence of pain among nursing students and among new graduate nurses, suggests that it would be effective to implement preventive strategies already during nursing education, but they should also preferably continue after graduation. Many factors associated with pain in the neck/shoulder and back seem to be modifiable, and thereby constitute targets for preventive strategies.

  • 6.
    Norberg, Astrid
    et al.
    Umeå universitet.
    Melin, Else
    Gerontologiskt Centrum, Lund.
    Asplund, Kenneth
    Umeå universitet.
    Reactions to music, touch and object presentation in the final stage of dementia: an exploratory study2003In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 40, no 5, p. 473-479Article in journal (Refereed)
    Abstract [en]

    Two patients in the final stage of dementia of Alzheimer type were stimulated with music, touch and object presentation during 12 consecutive days (16 trials per patient). Evaluations were made by direct observations, analysis of video-taped recordings and registrations of pulse and rate of respiration. Both patients reacted differently to music than to touch and object presentation.

  • 7. Nordgren, Lena
    et al.
    Asp, Margareta
    Fagerberg, Ingegerd
    Support as experienced by men living with heart failure in middle age: A phenomenological study2008In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, no 9, p. 1344-1354Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Men living with heart failure (HF) in middle-age experience restrictions limiting their work capacity and/or social activities. To adjust to the life-situation they need support. The meaning of the phenomenon of support is not well known. Thus, formal carers may find it problematic to know how to support patients. AIM: The aim of the current study was to uncover and describe the meaning of the phenomenon of support as experienced by men living with HF in middle age. DESIGN: The study used a caring science perspective and a reflective lifeworld approach based on phenomenological philosophy. PARTICIPANTS AND SETTINGS: Nine men, aged 49-64 years and diagnosed with HF, were recruited from two outpatient HF clinics in Sweden. METHODS: Interviews were used for data gathering. Data were analyzed by means of reflective lifeworld research. FINDINGS: The essence of support as experienced by men living with HF in middle age can be understood as security, and a sense of having control over body and situation. Support is realized in the men's relations to other people; there is however tension between what is supportive and what is not, meaning that even though intentions are good, intended support involves limitations, uncertainties or insecurity. The essence is illuminated by the following meaning constitutes: Support--a tenuous security; Medications--a support for life; Conditional support within the context of formal care; and, Information and knowledge. CONCLUSIONS: The meaning of support as experienced by men living with HF in middle age is multi-dimensional, qualitative and contextual. When the men are supported they gain a sense of security and control, giving them strength to handle their life-situation. A lifeworld-led approach in the context of formal care can help formal carers support men living with HF in middle age.

  • 8.
    Sjöling, Mats
    et al.
    Mittuniversitetet, Umeå universitet.
    Ågren, Ylva
    Länssjukhuset i Sundsvall.
    Olofsson, Niclas
    Landstingen Västernorrland.
    Hellzén, Ove
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet, Universitetet i Tromsø. Norge.
    Waiting for surgery; living a life on hold: A continuous struggle against a faceless system2005In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 42, no 5, p. 539-547Article in journal (Refereed)
    Abstract [en]

    This interpretive-phenomenological study examined the lived experience of being on the waiting list for arthroplastic surgery of the knee or hip and its impact on daily life. The interviews reveal that respondents experience suffering from different points of view; illness-, caring- and life- suffering. Suffering leads to a struggle in order to have their caring needs met and the struggle is often fruitless - against a faceless enemy - "the system". No one is there to answer their plea or to address the frustration that then arises and, in combination with their present life situation, this may lead to a disrupted self-image. Finding or creating meaning in suffering appears to be a crucial issue in the struggling process. Respondents who are able to preserve or create meaning in life may find it easier to accept the waiting times and wait for their turn in the queue. They are able to reformulate their life-world and live a full life, in spite of severe pain and disability.

  • 9. Squires, Allison
    et al.
    Aiken, Linda H
    van den Heede, Koen
    Sermeus, Walter
    Bruyneel, Luk
    Lindqvist, Rikard
    Ersta Sköndal University College.
    Schoonoven, Lisette
    Stromseng, Ingeborg
    Busse, Reinhard
    Brozstek, Tomas
    Ensio, Anneli
    Moreno-Casbas, Mayte
    Rafferty, Anne Marie
    Schubert, Maria
    Zikos, Dimitris
    Matthews, Anne
    A systematic survey instrument translation process for multi-country, comparative health workforce studies.2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 2, p. 264-273Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As health services research (HSR) expands across the globe, researchers will adopt health services and health worker evaluation instruments developed in one country for use in another. This paper explores the cross-cultural methodological challenges involved in translating HSR in the language and context of different health systems. OBJECTIVES: To describe the pre-data collection systematic translation process used in a twelve country, eleven language nursing workforce survey. DESIGN AND SETTINGS: We illustrate the potential advantages of Content Validity Indexing (CVI) techniques to validate a nursing workforce survey developed for RN4CAST, a twelve country (Belgium, England, Finland, Germany, Greece, Ireland, Netherlands, Norway, Poland, Spain, Sweden, and Switzerland), eleven language (with modifications for regional dialects, including Dutch, English, Finnish, French, German, Greek, Italian, Norwegian, Polish, Spanish, and Swedish), comparative nursing workforce study in Europe. PARTICIPANTS: Expert review panels comprised of practicing nurses from twelve European countries who evaluated cross-cultural relevance, including translation, of a nursing workforce survey instrument developed by experts in the field. METHODS: The method described in this paper used Content Validity Indexing (CVI) techniques with chance correction and provides researchers with a systematic approach for standardizing language translation processes while simultaneously evaluating the cross-cultural applicability of a survey instrument in the new context. RESULTS: The cross-cultural evaluation process produced CVI scores for the instrument ranging from .61 to .95. The process successfully identified potentially problematic survey items and errors with translation. CONCLUSIONS: The translation approach described here may help researchers reduce threats to data validity and improve instrument reliability in multinational health services research studies involving comparisons across health systems and language translation.

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

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

  • 11. Söderström, Ing-Mari
    et al.
    Saveman, Britt-Inger
    Benzein, Eva
    Ersta Sköndal University College, Department of palliative care research.
    Interactions between family members and staff in intensive care units--an observation and interview study.2006In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 43, no 6, p. 707-16Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Research about interactions between family members and staff are sparse, although family members' needs and experiences in intensive care units are well researched areas. AIM: The aim was to describe and interpret interactions between family members and staff in intensive care units. METHODS: Interviews (n=24) with family members and repeated observations of interactions of family members and staff in intensive care units were performed and analysed together by means of content analysis. RESULTS: The initial interactions between staff and family members had a substantial effect on family members and influenced their further interactions with the staff. Two kinds of interactions were revealed; mutual understanding and mutual misunderstanding. Family members, who understood the explicit information and the implicit messages were open in communication with the staff, adjusted well to the system, were acknowledged by the staff and sometimes consoled. Family members, who had difficulties understanding information and implicit messages drew back from communication with staff, did not adjust to the system and were sometimes insulted by the staff. CONCLUSIONS: Unambiguous information from the staff is important for developing interactions of mutual understanding. The results may be a starting point for intensive care unit staff to reflect on how all family members are initially met and further informed and treated. Further research of family members' experiences of interactions with staff in a longitudinal perspective and the influence of critical illness on families are needed.

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