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  • 1. Asp, Margareta
    et al.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Developing Concepts in Caring Science Based on a Lifeworld Perspective2005In: International Journal of Qualitative Methods, ISSN 1609-4069, Vol. 4, no 2, 57-67 p.Article in journal (Refereed)
    Abstract [en]

    Concept development is a significant form of inquiry to expand and develop the knowledge base in caring science. The authors’ aim in this article is to illuminate the possibility of working with concept development, based on a life world perspective, especially Merleau-Ponty’s philosophy of language, wherein phenomenological, semiological, and pragmatic dimensions are included. The theoretical discussion shows that it is possible to create methodological principles for concept development based on epistemological foundations that are consistent with ontological assumptions in caring science

  • 2. Asp, Margareta
    et al.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    The woven fabric – a metaphor of nursing care: the major subject in nursing education2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 2, 115-121 p.Article in journal (Refereed)
    Abstract [en]

    Society’s future needs regarding health care present challenges to traditional nursing education. Today, the ambition is to create a nursing role that is appropriate to people’s health care needs rather than the needs of the health care system. In nursing education, the major subject – nursing care – is central. Accordingly, there is a need for a consistent and clear articulation of this subject as well as the nursing profession. The aim of the present study was to interpret and describe the major subject, its content and structure in the nursing programme at Mälardalen University. With a hermeneutic approach an interpretation and application emerged as a metaphor of nursing care – the woven fabric. In this structure concepts function as bridges linking theory and practice, whereby it is possible to integrate different aspects of knowledge in order to think, feel and act nursing care.

  • 3. Breitholtz, Agneta
    et al.
    Snellman, Ingrid
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Carers' ambivalence in conflict situations with older persons2013In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 20, no 2, 226-237 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate the meaning of professional carers’ experiences in caring situations when a conflict of interest arises with the older person receiving care. The findings reveal the complexity of the carers’ ambivalence when facing a conflict of interest, weighing up between the older persons’ right to self-determination and external demands. The carers are alone in their ambivalence, and the conclusion is that they need help and support to be more present in the encounter. The implication for this study is to focus on care as a person-centered practice and to focus on people as interdependent on support carers to maintain older people’s right to self-determination in the relationship.

  • 4. Breitholtz, Agneta
    et al.
    Snellman, Ingrid
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Living with Uncertainty: Older Persons’ Lived Experience of Making Independent Decisions over Time2013In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2013Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to illuminate the meaning of older persons’ independent decision making concerning their daily care. Autonomy when in care is highly valued in the western world. However, research shows that autonomy can give rise to problematic issues. The complexity of independence and dependence for older people when living at home with help has also been highlighted. In Sweden, older people are increasingly expected to live at home with help from municipal home care services, and study into this aspect of care is limited. This study is a part of an ongoing project and has a qualitative life world perspective. Audiotaped narrative interviews were conducted and analysed using a phenomenological hermeneutic method. Findings revealed a main theme: “living with uncertainty as to how to relate one’s own independence and dependence with regard to oneself, and others.” This involves a constant process of relating to one’s independence controlled by others or oneself, and adjusting one’s independence and dependence with regard to oneself and others. The conclusion is that professional carers need to acknowledge the changing vulnerability of dependent older persons over time. The implication is a relational approach to autonomy beyond the traditional individualistic approach.

  • 5.
    Breitholtz, Agneta
    et al.
    Karolinska Institutet.
    Snellman, Ingrid
    Mälardalens högskola.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Older people’s dependence on caregivers’ help in their own homes and their lived experiences of their opportunity to make independent decisions2013In: International Journal of Older People Nursing, ISSN 1748-3735, Vol. 8, no 2, 139-148 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate the meaning of older people’s dependence on caregivers’ help, and of their opportunity to make independent decisions.

    Background. Throughout the world, the older population is growing, and in Sweden, the system of care for older people is currently undergoing change. Older people in the need of care are expected to live at home for as long as possible.

    Design.A qualitative and life world approach was used.

    Methods. Audio-taped interviews were conducted with twelve older persons living at home, dependent on daily municipal home help service. A phenomenological hermeneutic method was utilised to disclose the meanings of lived experiences.

    Finding. The findings revealed three themes : being facilitated to make one’s own decisions, being hindered from making one’s own decisions, struggling for vs. resigning oneself to losing the opportunity to make one’s own decisions.

    The comprehensive understanding revealed that as older people become more dependent on caregivers’ help, their opportunity to self-determine is challenged and this is stressful for them.

    Conclusion. The older persons assess their opportunity to self-determine differently, depending on who they are as a person. The caregivers need an awareness of this, and further research is needed to gain knowledge and understanding of how caregivers can improve the way they support and enhance older people’s opportunity to decide for themselves.

    Implications for practice. The findings revealed older persons need to exercise more self-determination and caregivers’ need for knowledge to enable this. Further, it indicates a move towards a person-centred approach to focus on persons as individuals and see them as interdependent. The findings contribute to improvements in similar contexts worldwide.

  • 6.
    Bullington, Jennifer
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    The fuzzy concept of 'holistic care': a critical examination2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, 493-494 p.Article in journal (Refereed)
  • 7. Christine, Gustafsson
    et al.
    Asp, Margareta
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Municipal night nurses' experience of the meaning of caring2009In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 16, no 5, 599-612 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate municipal night registered nurses’ (RNs) experiences of the meaning of caring in nursing. The research context involved all night duty RNs working in municipal care of older people in a medium-sized municipality located in central Sweden. The meaning of caring in nursing was experienced as: caring for by advocacy, superior responsibility in caring, and consultative nursing service. The municipal night RNs’ experience of caring is interpreted as meanings in paradoxes: ‘being close at distance’, the condition of ‘being responsible with insignificant control’, and ‘being interdependently independent’. The RNs’ experience of the meaning of caring involves focusing on the care recipient by advocating their perspectives. The meaning of caring in this context is an endeavour to grasp an overall caring responsibility by responding to vocational and personal demands regarding the issue of being a RN, in guaranteeing ethical, qualitative and competent care for older people.

  • 8.
    Dahlberg, Karin
    et al.
    Växjö universitet.
    Segesten, Kerstin
    Högskolan i Borås.
    Nyström, Maria
    Ersta Sköndal University College, Department of Health Care Sciences.
    Suserud, Björn-Ove
    Högskolan i Borås.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Att förstå vårdvetenskap2003Book (Other academic)
  • 9.
    Ekstedt, Mirjam
    et al.
    Karolinska institutet.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Lived experiences of the time preceding burnout2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 49, no 1, 59-67 p.Article in journal (Refereed)
    Abstract [en]

    This paper reports a study to illuminate the complex interaction between person and their life world during the burnout development period. BACKGROUND: Burnout is a construct describing the psychological state resulting from ineffective strategies for coping with enduring stress in both client and non-client work. Role conflict and role ambiguity, or long-term stress and frustration caused by strain in daily life, promote or exacerbate burnout, indicating that the person's entire life world is involved. There is still a lack of description of lived experiences of the time preceding manifest burnout. METHOD: Data were collected from interviews with eight people suffering from burnout and analysed using a phenomenological method. FINDINGS: The essential meaning of the phenomenon of burnout is understood as being trapped with stimulating challenges as a self-nourishing drive on one side and with responsibilities and demands on the other. This essence can be illuminated by its eight constituents: inner incentive, feeling responsible, threatened self-image, cutting off, bodily manifestations, psychological manifestations, fatigue and reaching the bottom line. CONCLUSIONS: The lived experiences of the time preceding manifest burnout are an ambiguous struggle. Cutting off is understood as a mean to shelter the threatened self-image in a state of vulnerability and weakened strength. Accordingly, a better understanding of how to reach behind the defence of 'cutting off' and thus help to open up for consolation and self-acceptance is an essential skill for nurses, health care professionals and others encountering the burnout sufferers. Furthermore this study illuminates early signs of burnout and an important issue is how to strengthen the individuals' ability to shelter their need for recovery and restitution.

  • 10. Engström, Gabriella
    et al.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Attitudes towards older people among Swedish health care students and health care professionals working in elder care2011In: Nursing Reports, ISSN 2039-4403, Vol. 1, no 1Article in journal (Refereed)
  • 11. Eriksson, Susanne
    et al.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Supervisor experiences of supervising nursing staff in the care of older people2008In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 16, no 7, 876-882 p.Article in journal (Refereed)
    Abstract [en]

    Aim To describe supervisors’ experiences of supervising nursing staff who care for older people in order to develop an understanding of the opportunities and limitations involved in supervision. Background Little is known of what group supervision of nursing staff means for the supervisor, particularly in regards to care of the old. Methods A reflective life-world research approach, based upon phenomenological epistemonology was used. Two supervisors with 2 years experience of supervising nursing staff caring for older people were interviewed. Conclusions Results point to the need for support for supervisors in order to enable them to develop their supervisory abilities and skills. Implications for nursing management Support is of crucial importance for both the ability to supervise and the quality of supervision.

  • 12. Erlandsson, Kerstin
    et al.
    Christensson, Kyllike
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Fatherhood as Taking the Child to Oneself: a Phenomenological Observation Study after Caesarean Birth2006In: Indo-Pacific journal of phenomenology, ISSN 1445-7377, Vol. 6, no 2, 1-9 p.Article in journal (Refereed)
    Abstract [en]

    This paper describes the meaning of a father’s presence with a full-term healthy child delivered by caesarean section, as observed during the routine post-operative separation of mother and child. Videotaped observations recorded at a maternity clinic located in the metropolitan area of Stockholm, Sweden formed the basis for the study, in which fifteen fathers with their infants participated within two hours of elective caesarean delivery in the 37th - 40th week of pregnancy.

    A phenomenological analysis based on Giorgi’s method was conducted on the data. The description of the new father’s experiences that emerged pointed to a process of being and becoming in taking the child to himself. Fatherhood developed gradually as a result of recurrent experiences of the child’s expressions. There was an ebb and flow between taking on the role of being a father and physical withdrawal from the role.

    The findings of this study not only confirm previous accounts of new fathers’ experiences, but go further in revealing an ebb and flow variation in the fathers’ involvement. What this indicates is that the process of transition to fatherhood requires not only presence but time. The period required for this process thus must not be disturbed, but supported, trusting in the father’s ability to assume his role as a father. It is suggested that, in addition to their relevance in guiding the attitudes and expectations of those professionally involved in postnatal care and community health, these findings could be useful in antenatal courses for parents, and especially in instances when caesarean birth is planned, to highlight the meaning of the role of fathers as caregivers

  • 13. Erlandsson, Kerstin
    et al.
    Christensson, Kyllike
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Fathers' Lived Experiences of Getting to Know Their Baby While Acting as Primary Caregivers Immediately Following Birth2008In: Journal of perinatal education, ISSN 1058-1243, Vol. 17, no 2, 28-36 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the meaning of the father's lived experiences when taking care of his infant as the primary caregiver during the first hours after birth, when the infant was apart from the mother due to the mother's postoperative care. Fifteen fathers were interviewed between 8 days and 6 weeks after the birth. The results describe a movement toward father-child togetherness characterized by an immediate and gradual change within the father as he undertakes increasing responsibility while getting to know his child. The results can be discussed in antenatal classes in order to integrate the father's important role in the care of his infant, especially in a situation where the mother-infant dyad has been interrupted.

  • 14. Erlandsson, Kerstin
    et al.
    Dsilna, Ann
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Christensson, Kyllike
    Skin-to-Skin Care with the Father after Cesarean Birth and Its Effect on Newborn Crying and Prefeeding Behavior 2007In: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 34, no 2, 105-114 p.Article in journal (Refereed)
    Abstract [en]

    Background: Previous reports have shown that skin-to-skin care immediately after vaginal birth is the optimal form of care for full-term, healthy infants. Even in cases when the mother is awake and using spinal analgesia, early skin-to-skin contact between her and her newborn directly after cesarean birth might be limited for practical and medical safety reasons. The aim of the present study was to compare the effects of skin-to-skin contact on crying and prefeeding behavior in healthy, full-term infants born by elective cesarean birth and cared for skin-to-skin with their fathers versus conventional care in a cot during the first 2 hours after birth. Methods: Twenty-nine father-infant pairs participated in a randomized controlled trial, in which infants were randomized to be either skin-to-skin with their father or next to the father in a cot. Data were collected both by tape-recording crying time for the infants and by naturalistic observations of the infants' behavioral response, scored every 15 minutes based on the scoring criteria described in the Neonatal Behavioral Assessment Scale (NBAS). Results: The primary finding was the positive impact the fathers' skin-to-skin contact had on the infants' crying behavior. The analysis of the tape recordings of infant crying demonstrated that infants in the skin-to-skin group cried less than the infants in the cot group (p < 0.001). The crying of infants in the skin-to-skin group decreased within 15 minutes of being placed skin-to-skin with the father. Analysis of the NBAS-based observation data showed that being cared for on the father's chest skin-to-skin also had an impact on infant wakefulness. These infants became drowsy within 60 minutes after birth, whereas infants cared for in a cot reached the same stage after 110 minutes. Rooting activity was more frequent in the cot group than in the skin-to-skin group (p < 0.01), as were sucking activities (p ≤0.001) and overall duration of wakefulness (p < 0.01). Conclusions: The infants in the skin-to-skin group were comforted, that is, they stopped crying, became calmer, and reached a drowsy state earlier than the infants in the cot group. The father can facilitate the development of the infant's prefeeding behavior in this important period of the newborn infant's life and should thus be regarded as the primary caregiver for the infant during the separation of mother and baby.

  • 15. Erlandsson, Kerstin
    et al.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Mothers' lived experiences of co-care and part-care after birth, and their strong desire to be close to their baby2005In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 21, no 2, 131-138 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe how mothers of premature or sick mature babies, experienced the care and their own state of health after birth in postnatal care in a neonatal co-care ward. DESIGN: A Husserlian phenomenology method inspired by Giorgi was used. Six mothers were interviewed using a semi-structured, open-ended interview guide. SETTING: A neonatal ward using a concept of co-care for premature or sick mature babies and their mothers. FINDINGS: In essence, mothers felt that, whatever the circumstances, they wanted to be close to their babies. It was the mother's experience that the organisation, staff or other circumstances prolonged the separation from her baby. The mother experienced the separation from the baby intensely during the first days after birth (even for a short period of time); after returning home, they had still not come to terms with it. The mothers regarded the entire stay in hospital as one event; they did not differentiate between wards or ward staff in the delivery, maternity or neonatal wards. All mothers in the study had, therefore, also experienced part-care for shorter or longer periods when separated from their baby, being then later reunited in co-care. CONCLUSION: This study can be used as a basis for discussion on more individualised care through co-operation and organisation between delivery, maternity and neonatal wards, in order to reduce the amount of time mother and baby are separated.

  • 16.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Forskningsprojekt - demens, vårdhundteam, personcentreradvård2013In: Omsorg: Nordisk tidsskrift for Palliativ Medisin, ISSN 0800-7489, Vol. 30, no 1, 39-41 p.Article in journal (Refereed)
  • 17.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Förvirringstillstånd2010In: Höftfraktur hos äldre: att bevara patientens förmåga / [ed] Jón Karlsson, Eric Olsson, Ewa Waern, Stockholm: Liber förlag , 2010, 157-165 p.Chapter in book (Other academic)
  • 18.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    How can we as researchers enhance the quality of our studies?2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7Article in journal (Refereed)
  • 19.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Jämlikhet inom äldreomsorgen: från ett hälso- och sjukvårdande perspektiv2013In: Acceptabel ojämlikhet? / [ed] Gunilla Silfverberg, Stockholm: Ersta Sköndal högskola , 2013, 131-142 p.Chapter in book (Other academic)
  • 20. Fagerberg, Ingegerd
    Kan utbildningen stärka sjuksköterskestudenters intresse för arbete i äldrevård?1999In: Klinisk Sygepleje, ISSN 0902-2767, Vol. 13, no 5, 279-283 p.Article in journal (Other academic)
  • 21.
    Fagerberg, Ingegerd
    Karolinska Institutet.
    Nursing students' narrated, lived experiences of caring, education and the transition into nursing, focusing on care of the elderly1998Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this longitudinal research project was to elucidate and reach an understanding of influencing aspects on nursing students' choice of future work area as newly graduated nurses. The influencing aspects should be affiliated with the three-year education, the students' transition into nursing and the care of the elderly. The first study (I) concerned the amount of projected education in gerontology and geriatrics in 30 colleges of nursing and health, and the result showed a variety between colleges. Newly admitted nursing students in three colleges responded to a questionnaire. A majority of the students preferred to work in the emergency care, rather than elder care, after graduation. Phenomenological analyses of one interview theme, after one year (II), gave two phenomena; patients' helplessness and identification/nonidentification of the individual patient. Phenomenological hermeneutic analyses were carried out on all interviews and diaries provided from the three years (III-V). The findings (III) show that the rneaning of caring for elderly patients was a process from naive caring via deeper relationships with patients to an organizational perspective. The transition into nursing (IV) meant for the students a process from a natural interest in caring to the perspective of an RN, where co-operation with team members had a strong influence. The students' experiences of theoretical and clinical elder care were not positive, which meant that their reluctance to work there was reinforced (V). Content analyses about students' reasoning regarding two fictitious elderly patient cases (Vl) showed a development in reasoning in a more acute oriented case but not in a case with a confused elderly patient. Conclusions drawn imply that both the theoretical and the clinical education in gerontology and geriatrics need to be strengthened.

  • 22.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Registered Nurses' work experiences: personal accounts integrated with professional identity 2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 46, no 3, 284-291 p.Article in journal (Refereed)
    Abstract [en]

    Background. The work context is important for the development of Registered Nurses' skills and identity as professionals, but the work context and organization can also hinder their professional development.

    Aim. This paper reports a study whose purpose was to understand the meaning of Registered Nurses' narratives of their work experience 5 years after graduation.

    Research method. Data were collected in 2001 from interviews with 16 Registered Nurses 5 years after graduation and analysed using a phenomenological hermeneutic method, influenced by the philosophy of Paul Ricoeur.

    Results. Analyses of the narratives resulted in three themes: 'The meaning of caring and protection of patients', 'The meaning of work organization in nurses' work' and 'The implied meaning of using one's individual attributes in one's professional role'. Since the number of nurses participating in the study is small, it is important to re-contextualize the results when transferring them to other contexts.

    Conclusions. There is a complex interrelationship between the health care organization, individual attributes of nurses (including self-esteem) and patient care. Provision of adequate resources and support for nurses' professional and personal development is needed to ensure high quality patient care, and these are political issues.

  • 23.
    Fagerberg, Ingegerd
    Karolinska institutet.
    Utbildning för äldrevård?1998In: Tidskriften vård, Vol. 1, 50-57 p.Article in journal (Other academic)
  • 24.
    Fagerberg, Ingegerd
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Asp, Margareta
    Begreppsutveckling på livsvärldsfenomenologisk grund2012In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Lena Wiklund Gustin och Ingegerd Bergbom, Lund: Studentlitteratur, 2012, 1:1, 65-77 p.Chapter in book (Other academic)
  • 25.
    Fagerberg, Ingegerd
    et al.
    Mälardalens högskola.
    Ekman, Sirkka-Liisa
    Caring for elderly patients: a longitudinal study of Swedish nursing students' narratives1998In: Health care in later life, ISSN 1358-7390, Vol. 3, no 4, 258-271 p.Article in journal (Refereed)
    Abstract [en]

    Studied how Swedish nursing students developed their perceptions of caring for older adults during their 3 years in nursing education. Interviews were audiotaped at the end of each academic year with 27 students from three colleges of nursing. In addition, 26 of these students wrote diaries during the clinical part of the course, in the second and third years. The interviews and diaries were analyzed using the phenomenological hermeneutic method, which is based on the idea that an interpretation of people's narrated, lived experiences is focused on the utterance meaning (Ricoeur, 1976). Four themes of caring emerged: respect for individual patients, responsibility for patients' well-being, sympathy with patients, and empathy with patients. Three themes emerged that were connected with impediments to caring: students' vulnerability, frustration and powerlessness in difficult situations, and ethically difficult situations. Findings revealed a development in the students' perceptions of caring as they proceeded through their education, moving from a naive, caring perspective, via a second-year stage of deeper relationships with patients, into a third-year organizational perspective, where they used their gained knowledge and experiences in taking responsibility for providing optimum care. Two students' narratives are used to illustrate the interpretations.

  • 26.
    Fagerberg, Ingegerd
    et al.
    Karolinska Institutet.
    Ekman, Sirkka-Liisa
    First-year Swedish nursing students' experiences with elderly patients.1997In: Western Journal of Nursing Research, ISSN 0193-9459, E-ISSN 1552-8456, Vol. 19, no 2, 177-89 p.Article in journal (Refereed)
    Abstract [en]

    Nursing students' attitudes toward elderly people have frequently been found to be negative. This study's aim was to describe the experiences of first-year nursing students with elderly people. Thirty students from 3 Swedish nursing colleges, interviewed during the last weeks of their first year, were asked to describe a memorable event that had occurred when they were caring for an elderly patient. The narratives were analyzed phenomenologically. Three perspectives emerged: the students' perceptions of the patients, the staff's roles, and their own roles. From these, two phenomena were identified: patients' helplessness and students' identification/nonidentification of the individual patient. Students described difficult situations for elderly patients; patients with difficult diseases, anxiety, pride; and conflicting views of how to treat patients.

  • 27.
    Fagerberg, Ingegerd
    et al.
    Mälardalens högskola.
    Ekman, Sirkka-Liisa
    Swedish nursing students' transition into nursing during education1998In: Western Journal of Nursing Research, ISSN 0193-9459, E-ISSN 1552-8456, Vol. 20, no 5, 605-623 p.Article in journal (Refereed)
    Abstract [en]

    The transition from student to nurse involves the influence of several different educational aspects. The aim of this study is to elucidate the transition to the role of a nurse, which Swedish nursing students underwent during their 3 years in nursing education, as described from the perspective of their experiences with elderly patients. Interviews were conducted with the students at the end of each academic year, and the students wrote diaries about their clinical education in the second and third years. The narratives were analyzed with a phenomenological-hermeneutic method, and six themes appeared vital for the transition into nursing. The study implies a continuous process during education, involving many aspects of the transition from a student with a genuine and natural interest to care for others to a registered nurse ready to take up her first position. Cooperation with other team members had a strong influence on the students.

  • 28.
    Fagerberg, Ingegerd
    et al.
    Karolinska Institutet.
    Ekman, Sirkka-Liisa
    Ericsson, K
    Two studies of the new nursing education in Sweden: I. The place of gerontology and geriatrics. 2. Student characteristics and expectations.1997In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 17, no 2, 150-7 p.Article in journal (Refereed)
    Abstract [en]

    In the autumn of 1993, a new system of nursing education started in Sweden. A questionnaire was sent to the presidents of all the colleges of nursing, health and the caring sciences, and questions were asked about the part played by gerontology and geriatrics in the new curricula. The responses showed a considerable variety in the amounts of theoretical and clinical education given at the colleges. During the first or second week of their education, the students admitted to three colleges in the Mälaren area answered a questionnaire containing questions about their educational backgrounds, their working experiences in the health care system, why they chose nursing education, their ideas of the tasks that a registered nurse primarily carries out, and their preferences for work after graduation. The result shows a correlation between working experience and the reasons for studies. The students stated a preference for working in emergency care rather than in geriatric care after graduation from college.

  • 29.
    Fagerberg, Ingegerd
    et al.
    Karolinska Institutet.
    Ekman, Sirkka-Liisa
    Heyman, Inga
    Nursing students' reasoning about two fictitious elderly patient cases.1999In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 13, no 4, 247-53 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine and describe how nursing students developed their reasoning and knowledge about the state of health of, and their possible actions regarding, two fictitious elderly patient case histories during their three-year education. The descriptions were audiotaped, transcribed verbatim and analysed by content analysis. The findings show a development in the students' reasoning concerning the more acute case, but no development in reasoning regarding the case of a confused person. This could be due either to a lack of education in gerontology and geriatrics, or to the students receiving limited guidance during their education on how to reason about and reflect upon different ways of approaching emerging problems. The findings could also be understood in the light of traditions and history in nursing education.

  • 30.
    Fagerberg, Ingegerd
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Engström, Gabriella
    Care of the old - a matter of ethics, organization and relationships2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7Article in journal (Refereed)
  • 31.
    Fagerberg, Ingegerd
    et al.
    Mälardalens högskola.
    Gilje, Fredricka
    A comparison of curricular approaches of care of the aged in Swedish and US nursing programs2007In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 7, no 6, 358-364 p.Article in journal (Refereed)
    Abstract [en]

    In an era of global aging, the steady increase in older people in Sweden and the United States is having a direct effect on nursing practice, presenting unprecedented opportunities and challenges in nursing education. The aim of this study was to highlight differences and similarities in curricular approaches to care of aged in Swedish and US baccalaureate nursing programs. The Swedish response rate was 100% (N=26); the US response rate was 36% (N=202). The results, which compare curricula approaches, have implications for nursing education in Sweden and the United States. Both include stand-alone and integrated courses on care of the aged, geriatrics and gerontology. Differences are noted in the percentage of programs that include care of the age in their curricula and the clinical education settings. Results of this study add to the sparse body of knowledge of cross-cultural nursing research on curricular approaches to geriatrics and gerontology, high-light similarities and differences in nursing education in two countries and invite dialogue among nurse educators. Future research is needed to address curricular issues on the aged population and cross cultural perspectives.

  • 32.
    Fagerberg, Ingegerd
    et al.
    Mälardalens högskola.
    Jönhagen, Maria Eriksdotter
    Temporary confusion: a fearful experience2002In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 9, no 3, 339-346 p.Article in journal (Refereed)
    Abstract [en]

    Older people admitted to hospital often develop acute temporary confusion. Earlier studies have focused on problems in providing care to the confused, causes of the confusion and the key aspects of caring. The aims of this study were to describe, from a nursing perspective, how older people experienced the phenomenon of temporary confusion and to describe the older peoples’ reasoning when they described their experiences. Interviews with five older informants who had recovered from their confusional state were conducted and analysed using the phenomenological method. Two phenomena were studied, ‘being temporarily confused’ and ‘reasoning about experiences of temporary confusion’, each was found to be represented by four inter-related constituents. The phenomena can be understood as aspects of suffering and power imbalance between staff and older people.

  • 33.
    Fagerberg, Ingegerd
    et al.
    Karolinska institutet.
    Kihlgren, Mona
    Experiencing a nurse identity: the meaning of identity to Swedish registered nurses 2 years after graduation2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 34, no 1, 137-145 p.Article in journal (Refereed)
    Abstract [en]

    The professional identity and experiences of nurses have been focused upon in different studies AIM: This is a longitudinal study whose aim was to understand how nurses experience the meaning of their identity as nurses, when they are students and nurses 2 years after graduation. DESIGN: Data were collected through interviews once a year during education and two years after graduation, and were analysed using a phenomenological hermeneutic method, inspired by the philosophy of Paul Ricoeur. FINDINGS: The analyses of the narratives resulted in four perspectives: 'Having the patient in focus', 'Being a team leader', 'Preceptorship' and 'Task orientation'. The nurses did not change perspectives but the perspective showed a transition over time.

  • 34.
    Fagerberg, Ingegerd
    et al.
    Mälardalens högskola.
    Kihlgren, Mona
    Registered nurses’ experiences of caring for the elderly in different health-care areas2001In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 7, no 4, 229-236 p.Article in journal (Refereed)
    Abstract [en]

    Caring for elderly patients is an undertaking for a majority of Swedish nurses in different health-care sectors. The purpose of the study was to understand how nurses experienced the meaning of caring for elderly patients after 2 years as Registered Nurses. Interviews were conducted with 20 nurses 2 years after graduation. Data were analysed with a phenomenological–hermeneutic method and resulted in two themes: (i) providing the elderly with a sense of trust; and (ii) commitment to elderly patients. Each theme was made up of four subthemes, expressing both positive and negative aspects. Caring for the elderly means that the core of caring is in focus. Nurses need a supportive context for their care of the elderly, especially when they experience that they or their staff cannot provide the optimal quality of care for the patients.

  • 35.
    Fagerberg, Ingegerd
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Norberg, Astrid
    Ersta Sköndal University College, Department of palliative care research. Ersta Sköndal University College, Department of Health Care Sciences.
    “Learning by doing”: Or how to reach an understanding of the research method phenomenological hermeneutics2009In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 29, no 7, 735-739 p.Article in journal (Refereed)
    Abstract [en]

    One problem addressed in teaching graduate students qualitative research methods is practising the cognitive and conative skills that students need to generate both rich data and meaningful analysis.

    The aim of the study was to illuminate development in a group of pre-doctoral and doctoral students as they learnt the phenomenological hermeneutics research method.

    In a course comprising 18 doctoral students we used the “guided path” pedagogical approach and decided to use a subject of which everyone has lived experience, “troubled conscience”, for the phenomenological hermeneutic analysis conducted with the students. As the students progressed in their learning experience of the research method, they analysed their data according to the steps in the method, and we as teachers conducted separate analyses of the same data.

    The results point in the same direction as previous studies in the field. This is discussed in terms of strength of the pedagogical approach and the students’ learning, since despite the fact that their data are limited and not very detailed they were able to come up with results that were in line with previous research.

  • 36.
    Fagerberg, Ingegerd
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Silfverberg, Gunilla
    Ersta Sköndal University College, Department of Health Care Sciences.
    Hästen och hunden i människovården2014In: Vårdmiljöns betydelse / [ed] Helle Wijk, Lund: Studentlitteratur, 2014, 255-274 p.Chapter in book (Other academic)
  • 37.
    Fagerberg, Ingegerd
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Silfverberg, Gunilla
    Ersta Sköndal University College, Department of Health Care Sciences.
    Robotdjur i demensvården - i vems intresse?2014In: Hästen, hunden och den mänskliga hälsan: vård, behandling och terapi / [ed] Gunilla Silfverberg, Henrik Lerner, Stockholm: Ersta Sköndal högskola , 2014, 151-164 p.Chapter in book (Other academic)
  • 38.
    Fagerberg, Ingegerd
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Silfverberg, Gunilla
    Ersta Sköndal University College, Department of Health Care Sciences.
    Robotdjur i demensvården: i vems intresse?2014In: Hästen, hunden och den mänskliga hälsan: Vård, behandling och terapi / [ed] Gunilla Silfverberg & Henrik Lerner, Stockholm: Ersta Sköndal högskola Förlag , 2014, 151-164 p.Chapter in book (Other academic)
  • 39.
    Fagerberg, Ingegerd
    et al.
    Karolinska institutet.
    Winblad, Bengt
    Ekman, Sirkka-Liisa
    Influencing aspects in nursing education on Swedish nursing students' choice of first work area as graduated nurses2000In: Journal of Nursing Education, ISSN 0148-4834, E-ISSN 0022-3158, Vol. 39, no 5, 211-218 p.Article in journal (Refereed)
    Abstract [en]

    It is difficult to recruit RNs to positions in various areas of elder care. The aim of this study is to understand the meaning of Swedish nursing students' reasoning during education about where in the health care system they would like to work as RNs after graduation. The students were interviewed using the same guide at the end of each of their three academic years. In the second and the third year the students kept diaries about their clinical education. A phenomenological-hermeneutic method of analysis was used, and eight themes appeared vital for the students' choice of work area after graduation. The deeper interpretations of the results imply that the students received contradictory messages during the education in elder care. Students found that nurses working in this field were often isolated with no apparent support system, which in turn reinforced their own ambivalence and reluctance towards future work in elder care.

  • 40.
    Fläckman, Birgitta
    et al.
    Högskolan i Gävle & Karolinska institutet.
    Fagerberg, Ingegerd
    Mälardalens högskola & Karolinska institutet.
    Häggström, Elisabeth
    Högskolan i Gävle & Karolinska institutet.
    Kihlgren, Annica
    Örebro universitet & Karolinska institutet.
    Kihlgren, Mona
    Örebro universitet & Karolinska universitetet.
    Despite shattered expectations a willingness to care for elders remains with education and clinical supervision2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 3, 379-389 p.Article in journal (Refereed)
    Abstract [en]

    The aim was to describe nursing home (NH) caregivers' work experiences while receiving education and clinical supervision for 2 years. Working in elder care seems to be losing its attraction especially with organizational changes, cutbacks and changes in work place conditions. Clinical supervision has been reported to increase job satisfaction and creativity. Semi-structured interviews from caregivers working at an NH in Sweden were conducted, at the start and again at 12 and 24 months. At about 12 months the caregivers were informed of planned cutbacks. Content analysis was the method used to analyse the interviews from seven caregivers who participated throughout the entire period. Findings show that the value of a caring milieu was one category generated by the subcategories: experiences related to work activities and changes, and experiences related to relationships. The value of knowledge was the other category that was influenced by the experiences related to the different backgrounds and the experiences related to increased knowledge gained from the support through education and clinical supervision. The categories contained positive as well as negative influences on care. The initial focus on practical duties associated with the opening of the NH shifted towards caregiver activities with the elders they spoke warmly about. After 2 years the caregivers' willingness to care continued despite their disappointment in the worsened working conditions. The main theme that resulted was: Despite shattered expectations a willingness to care for elders remained. Continued education and clinical supervision seems to be one factor behind the retained willingness. These findings demonstrate that support and caregiver involvement in educational programmes are important during times of change and when disappointments arise in the workplace.

  • 41.
    Fläckman, Birgitta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Skovdahl, Kirsti
    Norway.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Kihlgren, Mona
    Örebro universitet.
    Kihlgren, Annica
    Örebro universitet.
    Consequences of working in elder care during changes and cutbacks in the organisation while education and clinical supervision was provided: A mixed methods study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 9, 813-827 p.Article in journal (Refereed)
    Abstract [en]

    Background: Reorganization and downsizing can disrupt a competent staff and conflicts can arise between what the employee is being asked to do and their knowledge and competences. Reduced job satisfaction among nursing home staff with increased workload and strain can occur. Aim and Objectives: The aim was to investigate the organizational climate and prevalence of burnout symptoms among caregivers over time in three Swedish nursing homes (NH I-III) undergoing organizational changes, while education and clinical supervision were provided. Design: The study design combines qualitative and quantitative methods in a longitudinal two-year follow-up project in NH I-III. Methods: Support through education and clinical supervision was provided for caregivers only at NH I and NH II. At NH I-III caregiver self-assessments and interviews were completed and analysed three different times. Results: NH I revealed improvement and increased innovation over time, while NH II showed a decline with no ability to implement new knowledge. NH III retained a more status quo. Conclusions: Organizational changes and cutbacks, occurring at different times, appeared to cause major stress and frustration among the three personnel groups. They felt guilty about not meeting their perceived obligations, seemed to have lost pride in their work but kept struggling. The changes seemed to over-shadow attempts to improve working conditions through education and clinical supervision initially. Implications for practice: It will be important to learn from reorganizations and the consequences they will have for the staff and quality of care. Important topics for future research are to study financial cutbacks and changes in organizational processes in care of older people to be able to develop a more person centered care for older people.

  • 42. Gustafsson, Christine
    et al.
    Asp, Margareta
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Reflection in night nursing: a phenomenographic study of municipal night duty registered nurses’ conceptions of reflection2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 10, 1460-1469 p.Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of the study was to describe nurses’ conception of reflection in their working situation. Background. To be a municipal night duty registered nurse in Sweden means to shoulder nursing care responsibility for numerous units with older people in need of care. Two night nurses share nursing care responsibility for up to 1300 people. In nursing research, reflection is an often-mentioned phenomenon discussed with advantages and benefits within the ‘traditional fields’ of nursing (hospital context). A question to ask is, how do night nurses having an untraditional amount of nursing care responsibility conceptualise and experience reflection in their working situation? Design. A phenomenographic methodology was used. Methods. Data were collected by interviewing all nurses ( n = 7) in a medium-sized municipality bordering a metropolitan area of Sweden. Results. The nurses’ conceptions of reflection are categorised as ‘Field of applications’ (an instrument for interpreting, a strategy for handling the working situation and an approach to learning) and ‘Field of prerequisites’ (presence facilitates reflection; flexibility implies reflection; courage in thought and activity increases reflection). Conclusion. The findings reveal that reflection in the nurses’ working situation is more than an instrument for learning, understanding and encouragement for change and improvement. Reflection is conceptualised as an instrument for interpreting nursing care situations, which requires courage and is facilitated by presence and flexibility. Reflection is also conceptualised as an approach to handling, managing and coping with a sometimes impossible working situation that includes nursing responsibility for hundreds of older people and can sometimes entail difficulties and stress. Relevance to clinical practice. The findings showed that reflection has a broader use than had earlier been described. Deliberate use of reflection could mean improved nursing practice. This guides nursing managers to pay attention to the phenomenon as an instrument for nursing care improvement.

  • 43. Gustafsson, Christine
    et al.
    Asp, Margareta
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Reflective practice in nursing care: embedded assumptions in qualitative studies 2007In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 13, no 3, 151-160 p.Article in journal (Refereed)
    Abstract [en]

    Qualitative nursing researchers have long recognized that reflective practice (RP) seems to be a valuable tool in nursing care. The aim of the present meta-study was to analyse current qualitative research on RP in nursing care, in order to create and synthesize the knowledge and the understanding of registered nurses' RP. Using a meta-study synthesis approach, embedded assumptions were identified in qualitative studies that have influenced the way researchers have interpreted and made sense of RP in nursing care. Despite empirical focus in research on RP in nursing care, it was found that assumptions about RP were predominantly based on theory. The reflective movement within the practice of nursing care has mainly a constructivist epistemology, based on learning from experience. The individual nurse's RP capability is essential in providing and improving ethical and holistic nursing care.

  • 44. Gustafsson, Christine
    et al.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Reflection, the way to professional development?2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 3, 271-280 p.Article in journal (Refereed)
    Abstract [en]

    Background. Many studies have focused on reflection and the advantages that can be gained from the practice of reflection among Registered Nurses (RNs) but, what are the implications of the nurses' reflections, what do they reflect about, and how do they deal with their reflections?

    Aims and objectives. The aim of this study was to describe the RNs' experiences of reflection in relation to nursing care situations, and to understand how RNs use reflection in their daily work. What are the implications of the nursing care situations that the RNs' reflect upon? What consequences did the practice of reflection have in nursing care situations in relation to the RNs professional development?

    Design and method. The study was carried out with interviews and the phenomenographic method. Interviews were carried out with four RNs. The choice of informants was made with purposive sampling with the aim of finding informants who could bring the kind of knowledge that was necessary for the study.

    Results. The qualitative differences regarding the RNs' experiences of reflection were categorized as follows: to reflect (to think back – consider, mirroring, to reflect before and reflect after, to use experiences), nursing care situations (ethical considerations, to have courage, to use one's imagination, empathy) and consequences (to meet the unique, empathy, development). Finally, the findings were implicated in the model of professional development.

    Conclusion. By using reflection as a tool, many advantages can be gained in the development of nursing care. Encouraging RNs to reflect upon nursing situations, in order to promote the nurse's professional development, will imply better nursing care for the patients. The model for professional development implies a simplified representation of the thoughts pertaining to professional nursing development.

    Relevance to clinical practice. The relevance for clinical practice will be to understand the contents of the RNs reflections, to recognize the advantages of reflective practice and how and when to use such measures. Furthermore, to show how the model for professional development can be used in order to create a framework for evaluating these observations and consequently, for expressing tacit knowledge.

  • 45. Gustafsson, Christine
    et al.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Asp, Margareta
    Dependency in autonomous caring - night nurses' working conditions for caring in nursing2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2Article in journal (Refereed)
    Abstract [en]

    Few research studies have focused on nurses' working conditions for caring provided at night, and these studies have mainly described nurses' work in hospital settings, not in a municipal, social-care context. In Swedish municipal care, nurses have responsibility for hundreds of older people in need of care. This working condition compromises caring encounters; instead the nurses' caring is mainly mediated through care staff (or relatives). In considering that caring based on caring encounters is fundamental to ethical nursing practice questions leads to the aim: to explore Swedish municipal night nurses' experiences of their working conditions for caring in nursing. All municipal night-duty nurses (n = 7) in a medium-sized community in Sweden participated in interviews, while six of them also wrote diaries. Thematic content analysis has been used in analysing the data. The findings revealed that the nurses experienced their working conditions for caring in nursing in the themes of Dependency in the Organisation and Other Staff, Vocational Responsibility, Deficiency in Conditions for Caring and Autonomous Caring. The findings illustrate privileged, as well as, poor working conditions for caring in nursing. The nurses' role as consultants emerge as their main function. The consultant function implies that nurses do not participate in ordinary bed-side caring, which makes it easier for them to find time for caring in situations that arise when nurses' skills, expertise and authority are called upon. Conversely the consultancy function entails short-term solution of complex caring problems, which can signify deficient caring due to prevailing working conditions. The findings also point to nurses' possible problems in fulfilling their own and vocational demands for ethics in the practice of caring in nursing related to existing working conditions.

  • 46. Gustafsson, Christine
    et al.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Asp, Margareta
    Supportive leadership in Swedish community night nursing2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 7, 822-831 p.Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the present study was to examine the support night nurses' give to staff in community night nursing. Background Studies have shown that support given to staff is one of night registered nurses' (RNs') experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described. Methods All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations. Results The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership . Conclusions Out of 'concern for the staff' the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs' awareness that by giving support to staff this affects the staffs' caring for older people. Implications for nursing management The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.

  • 47. Holmberg, Mats
    et al.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    The encounter with the unknown:: Nurses lived experiencesof their responsibility for the care of the patient in the Swedish ambulance service2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2631, Vol. 5, no 2, 1-9 p.Article in journal (Refereed)
    Abstract [en]

    Registered nurses (RNs) have, according to the Swedish National Board of Health andWelfare, the overall responsibility for the medical care in the ambulance care setting. Bringing RNs into the ambulance service are judged, according to earlier studies, to lead to a degree of professionalism with a higher quality of medical care. Implicitly in earlier studies, the work in the ambulance service involves interpersonal skills. The aim of this study was to describe RNs’ experiences of being responsible for the care of the patient in the Swedish ambulance service. A reflective lifeworld approach within the perspective of caring science was used. Five RNs with at least five years experience from care in the ambulance care setting were interviewed. The findings show that the essence of the phenomenon is to prepare and create conditions for care and to accomplish care close to the patient. Three meaning constituents emerged in the descriptions: prepare and create conditions for the nursing care, to be there for the patient and significant others and create comfort for the patient and significant others. The responsibility is a complex phenomenon, with a caring perspective, emerging from the encounter with the unique human being.

  • 48.
    Holmberg, Mats
    et al.
    Karolinska institutet.
    Forslund, Kerstin
    Örebro universitet.
    Wahlberg, Anna Carin
    Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    To surrender in dependence of another: the relationship with the ambulance clinicians as experienced by patients2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, 544-551 p.Article in journal (Refereed)
    Abstract [en]

    Historically, the ambulance care has focused on acute transports and medical treatment, although ambulance care has also been reported as complex, encompassing more than just medical treatment and transports. Previous studies, on ambulance clinicians, have pointed out the importance of interpersonal caring activities complementary to the medical treatment. Those activities can be understood as taking part in the relationship between patients and ambulance clinicians, earlier described as essential and a core component of care. The aim of this study was to elucidate the meaning of the relationship with the ambulance clinicians as experienced by patients. Twenty ambulance patients were interviewed in the study. The interviews were transcribed verbatim and analysed with a phenomenological hermeneutical method to grasp meanings in the patients' experiences. The regional ethical committee approved the study. In the result emerged one main theme: To surrender in dependence of another. The main theme includes four themes: Being in the hands of another, Being in a caring temporary presence, Being important while involved and Being powerless while insignificant, and the themes comprise eleven subthemes. The main theme meant to have no other option than to surrender and to put their life into the hand of another. This surrender also meant to adapt to the clinicians' views even if not shared. This is experienced as excessive care. Summarised, the patients' experiences were both positive and negative and the findings provide a complex understanding of the relationship between the patient and the ambulance clinicians. Overall, the relationship embraces the whole person without reducing the patient to be a recipient of an objectified ambulance care.

  • 49.
    Holmberg, Mats
    et al.
    Karolinska institutet, Uppsala universitet.
    Forslund, Kerstin
    Örebro universitet.
    Wahlberg, Anna-Carin
    Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    The relationship with ambulance clinicians as experienced by significant others.2016In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 21, no 4, 1-8 p.Article in journal (Refereed)
    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.

  • 50.
    Holmberg, Mats
    et al.
    Karolinska institutet, Uppsala universitet.
    Wahlberg, Anna-Carin
    Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Forslund, Kerstin
    Örebro universitet.
    Ambulance clinicians' experiences of relationships with patients and significant others.2016In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 21, no 4, 16-23 p.Article in journal (Refereed)
    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.

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