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  • 1.
    Holmberg, Mats
    et al.
    Karolinska institutet, Uppsala universitet.
    Forslund, Kerstin
    Örebro universitet.
    Wahlberg, Anna-Carin
    Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Karolinska institutet.
    The relationship with ambulance clinicians as experienced by significant others.2016Ingår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 21, nr 4, s. 1-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Interpersonal relationships between clinicians and patients are important aspects of the ambulance care, requiring a balance between objectified acute medical treatment and a holistic care. Being a significant other (SO) in the ambulance care setting is described as being caught between hope and dread. Little research has focused on SOs' experiences of the relationship with the ambulanceclinicians.

    AIM: To elucidate meanings of the relationship with the clinicians in the ambulance care setting as experienced by the patients' SOs.

    DESIGN: Qualitative lifeworld design.

    METHODS: Data was collected using open-ended interviews with nine SOs. The verbatim transcribed interviews were analysed with a phenomenological hermeneutic method.

    FINDINGS: The structural analysis resulted in one main theme: 'Being lonely together'. The main theme comprises three themes: 'Being in a shared struggle', 'To hand over the affected person in trust' and 'Being the second person in focus' and six subthemes. The main theme is for the SOs to share the struggles of the affected person with the ambulance clinicians and to be comforted while handing over the responsibility for the affected person. Hence the SO is excluded and lonely and on his/her own, while not the primary focus of the ambulance clinicians.

    CONCLUSIONS: The relationship with the ambulance clinicians from the perspective of the SOs can be understood as complex, involving both being lonely and together at the same time. The findings support a holistic approach towards the ambulance care involving SOs.

    RELEVANCE FOR CLINICAL PRACTICE: This study outlines the importance of an emergency ambulance care involving SOs as affected persons and supports a balance between emergency medical treatment to the patient and a holistic care, involving the SOs' suffering.

  • 2.
    Holmberg, Mats
    et al.
    Karolinska institutet, Uppsala universitet.
    Wahlberg, Anna-Carin
    Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Karolinska institutet.
    Forslund, Kerstin
    Örebro universitet.
    Ambulance clinicians' experiences of relationships with patients and significant others.2016Ingår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 21, nr 4, s. 16-23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Ambulance clinicians (ACs) have to provide advanced care and treatment to patients in a challenging and emotionally demanding environment, therefore they establish interpersonal relationships embracing both patients and significant others. Relationships in emergency care were earlier found to be short-lived and lacking a holistic understanding of the patient. In their relationship with the ambulanceclinicians, it is for patients to surrender and become dependent, which may be interpreted as both a negative and a positive experience.

    AIM: The aim of this study was to elucidate ambulance clinicians' experiences of relationships with patients and significant others.

    METHODS: Data were collected from four focus group conversations, with a total of 18 participating ambulance clinicians. An inductive qualitative content analysis method was chosen.

    FINDINGS: The analysis resulted in one main category: 'To be personal in a professional role' and three generic categories: 'To be there for the affected person', 'To be personally involved' and 'To have a professional mission'. There were subsequently nine sub-categories. The main category was described as intertwining the experience of being both personal and professional. The ambulance clinicians adapt to a situation while having the affected person in focus. They involve themselves as persons but at the same time use the power of their professional role.

    CONCLUSION:The relationship with patients and significant others from the ambulance clinicians' perspective can be understood as embracing both personal and professional aspects.

    RELEVANCE TO CLINICAL PRACTICE: This study provides an understanding of the ambulance clinicians' professional role as embracing a personal perspective, which is important when developing an emergency ambulance service focusing on care that involves more than just emergency medical treatment.

  • 3.
    Karlsson, Christina
    et al.
    Örebro universitet.
    Tisell, Anna
    Örebro universitet.
    Engström, Åsa
    Andershed, Birgitta
    Ersta Sköndal högskola, Enheten för forskning i palliativ vård.
    Family members’ satisfaction of critical care in a intensive care unit2011Ingår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 16, nr 1, s. 11-18Artikel i tidskrift (Refereegranskat)
  • 4.
    Storli, Sissel
    et al.
    Norge.
    Lindseth, Anders
    Norge.
    Asplund, Kenneth
    Mittuniversitetet, University of Tromsø,Norge.
    A journey in quest of meaning: a hermeneutic-phenomenological study on living with memories from intensive care2008Ingår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 13, nr 2, s. 86-96Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In a short-term perspective, a high incidence of psychological problems linked to memories from intensive care has been found in survivors of critical illness. Little is known about what kinds of memories patients might carry with them and what it is like to live with memories from intensive care as years go by. AIM: The aim of this study was to explore the meaning of living with memories from intensive care. METHODS: A hermeneutic-phenomenological approach. In-depth interviews with ten former intensive care patients 10 years after their admission. FINDINGS: Memories of bodily sensations and memories containing strong emotions were surprisingly well kept. Memories residing in the body at a prereflective level and that could be awakened without being triggered by will or conscious thought comprised an important segment of the memory spectrum. Complaints such as panic attacks and anxiety were strongly linked to these kinds of memories and experienced as flashbacks of frightening experiences that entailed strong emotions. Some informants still strove to understand experiences and reactions. Living with these memories and flashbacks was interpreted as a journey in quest of meaning. Having someone and something to live for implied strength on the journey. The presence of close relatives at the bedside provided strength to go on and someone with whom to share experiences afterwards. CONCLUSION: A period of critical illness and intensive care stay for treatment may leave durable traces in the patient's life. Finding meaning of existential and ontological nature seems to be of decisive significance for how people fare in their lives after having lived through intensive care treatment. The identified journey in quest of meaning points to the need for follow-up programmes, and we must acknowledge close relatives as important resources for the patient both at the bedside and in the subsequent process of discovering meaning in lived experience.

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