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Research Interests: Psychology and Societies
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This article describes the theoretical foundation and methodology used in a study intended to increase knowledge concerning informal... more
This article describes the theoretical foundation and methodology used in a study intended to increase knowledge concerning informal caregivers' resources to health (in salutogenesis; General Resistance Resources, GRRs). A detailed description of how the approach derived from salutogenic theory was used and how it permeated the entire study, from design to findings, is provided. How participation in the study was experienced is discussed and methodological improvements and implications suggested. Using an explorative, mixed method design, data was collected through salutogenically guided interviews with 32 Swedish caregivers to older adults. A constant comparative method of analysis was used to identify caregiver-GRRs, content analysis was further used to describe how participation was experienced. The methodology unraveled GRRs caregivers used to obtain positive experiences of caregiving, but also hindrances for such usage contributing to negative experiences. Mixed data made it possible to venture beyond actual findings to derive a synthesis describing the experienced, communal context of the population reliant on these GRRs; Caregivinghood. Participating in the salutogenic data-collection was found to be a reflective, mainly positive, empowering and enlightening experience. The methodology was advantageous, even if time-consuming, as it in one study unravelled caregiver-GRRs and hindrances for their usage on individual, communal and contextual levels. It is suggested that the ability to describe Caregivinghood may be essential when developing health-promoting strategies for caregivers at individual, municipal and national levels. The methodology makes such a description possible and suggested methodological improvements may enhance its usability and adaptability to other populations.
Research Interests: Nursing, Health Promotion, Mixed Methods, Content Analysis, Aging, and 15 moreQuality of life, Humans, Human Resources for Health, Female, Male, Data Collection, Caregivers, Comparative method, Aged, Middle Aged, Older Adult, Mixed Method, Health Resources, Psychology and Cognitive Sciences, and Medical and Health Sciences
Abstract Aim: The aim of the study was to evaluate team composition and staff roles in a hybrid operating room during endovascular aortic repairs. Design: Quantitative descriptive design. Methods: Nine endovascular aortic repairs... more
Abstract
Aim: The aim of the study was to evaluate team composition and staff roles in a hybrid operating room during endovascular aortic repairs.
Design: Quantitative descriptive design.
Methods: Nine endovascular aortic repairs procedures were video‐recorded between December 2014 and September 2015. The data analysis involved examining the work process, number of people in the room and categories of staff and their involvement in the procedure.
Results: The procedures were divided into four phases. The hybrid operating room was most crowded in phase 3 when the skin wound was open. Some staff categories were in the room for the entire procedure even if they were not actively involved.
The largest number of people simultaneously in the room was 14.
KEYWORDS
endovascular aortic repairs, hybrid operating room, nursing staff, staff presence, staff roles, team composition, video observations
Aim: The aim of the study was to evaluate team composition and staff roles in a hybrid operating room during endovascular aortic repairs.
Design: Quantitative descriptive design.
Methods: Nine endovascular aortic repairs procedures were video‐recorded between December 2014 and September 2015. The data analysis involved examining the work process, number of people in the room and categories of staff and their involvement in the procedure.
Results: The procedures were divided into four phases. The hybrid operating room was most crowded in phase 3 when the skin wound was open. Some staff categories were in the room for the entire procedure even if they were not actively involved.
The largest number of people simultaneously in the room was 14.
KEYWORDS
endovascular aortic repairs, hybrid operating room, nursing staff, staff presence, staff roles, team composition, video observations
Research Interests:
Introduction: A hybrid operating room (OR) is a surgical OR with integrated imaging equipment and the possibility to serve both open surgery and image-guided interventions. Aim: This study aimed to investigate the work processes and types... more
Introduction: A hybrid operating room (OR) is a surgical OR with integrated imaging equipment and the possibility to serve both open surgery and image-guided interventions. Aim: This study aimed to investigate the work processes and types of collaboration in a hybrid OR during endovascular aortic repair (EVAR). Methods: Data consisted of video recordings from nine procedures, with a total recording time of 48 hrs 39 mins. The procedures were divided into four episodes (Acts). A qualitative cross-case analysis was conducted, resulting in a typical case. The type of collaboration during specific tasks was discussed and determined based on Thylefors´teamThylefors´team typology. Results: An extensive amount of safety activities occurred in the preparation phase (Acts 1 and 2), involving a number of staff categories. After the skin incision (Act 3), the main activities were performed by fewer staff categories, while some persons had a standby position and there were persons who were not at all involved in the procedure. Discussion: The different specialist staff in the hybrid OR worked through different types of collaboration: multi-, inter-and transprofessional. The level of needed collaboration depended on the activity performed, but it was largely multiprofessional and took place largely in separate groups of specialties: anesthesiology, surgery and radiology. Waiting time and overlapping tasks indicate that the procedures could be more efficient and safe for the patient. Conclusion: This study highlights that the three expertise specialties were required for safe treatment in the hybrid OR, but the extent of interprofessional activities was limited. Our results provide a basis for the development of more effective procedures with closer and more efficient interprofessional collaboration and reduction of overlapping roles. Considerable waiting times, traffic flow and presence of people who were not involved in the patient care are areas of further investigation.
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Introduction: A hybrid operating room (OR) is a surgical OR with integrated imaging equipment and the possibility to serve both open surgery and image-guided interventions. Aim: This study aimed to investigate the work processes and types... more
Introduction: A hybrid operating room (OR) is a surgical OR with integrated imaging equipment and the possibility to serve both open surgery and image-guided interventions. Aim: This study aimed to investigate the work processes and types of collaboration in a hybrid OR during endovascular aortic repair (EVAR). Methods: Data consisted of video recordings from nine procedures, with a total recording time of 48 hrs 39 mins. The procedures were divided into four episodes (Acts). A qualitative cross-case analysis was conducted, resulting in a typical case. The type of collaboration during specific tasks was discussed and determined based on Thylefors´teamThylefors´team typology. Results: An extensive amount of safety activities occurred in the preparation phase (Acts 1 and 2), involving a number of staff categories. After the skin incision (Act 3), the main activities were performed by fewer staff categories, while some persons had a standby position and there were persons who were not at all involved in the procedure. Discussion: The different specialist staff in the hybrid OR worked through different types of collaboration: multi-, inter-and transprofessional. The level of needed collaboration depended on the activity performed, but it was largely multiprofessional and took place largely in separate groups of specialties: anesthesiology, surgery and radiology. Waiting time and overlapping tasks indicate that the procedures could be more efficient and safe for the patient. Conclusion: This study highlights that the three expertise specialties were required for safe treatment in the hybrid OR, but the extent of interprofessional activities was limited. Our results provide a basis for the development of more effective procedures with closer and more efficient interprofessional collaboration and reduction of overlapping roles. Considerable waiting times, traffic flow and presence of people who were not involved in the patient care are areas of further investigation.
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Introduction: Radiographers have performed research since 1988 in Sweden. The amount of doctoral and licentiate dissertations written by registered diagnostic radiographers has increased considerably since 2000. How this new field of... more
Introduction: Radiographers have performed research since 1988 in Sweden. The amount of doctoral and licentiate dissertations written by registered diagnostic radiographers has increased considerably since 2000. How this new field of research was established and developed has facilitated understand of the boundaries that strengthen the professional evidence base. The aim of this dissertation review was to explore the nature and the current state of radiographic research, written by registered diagnostic radiographers in Sweden. Methods: Dissertations published between 1988 and 2017 were analysed both deductively and induc-tively with content analysis. Results: Radiographic research focused on structural factors, clinical radiography, radiographic technology and pedagogical approaches. The findings indicated a large interest in advancing patient information , wellbeing and care during examinations. The participants were predominantly clinical patients, followed by radiographers, adults/children and the general public. The most common study designs were descriptive with a trend towards interventional studies. Interviews and questionnaires were the most common data collection methods followed by clinical examinations and documents. Conclusion: The analyses demonstrate that the current radiographer research has its roots in clinical practice, focusing on pragmatic aspects and applied knowledge. The findings suggest that radiographer's dissertations meet the challenges of new technologies and working practise. If the knowledge is connected to the radiographic framework, radiography can be viewed as an independent discipline with its own philosophical base. When radiographers are encouraged to conduct research, evidence based knowledge increase which strengthens the profession. Radiography, as a scientific discipline is evolving in Sweden.
Abstract Aim: The aim of the study was to evaluate team composition and staff roles in a hybrid operating room during endovascular aortic repairs. Design: Quantitative descriptive design. Methods: Nine endovascular aortic repairs... more
Abstract
Aim: The aim of the study was to evaluate team composition and staff roles in a hybrid operating room during endovascular aortic repairs.
Design: Quantitative descriptive design.
Methods: Nine endovascular aortic repairs procedures were video‐recorded between December 2014 and September 2015. The data analysis involved examining the work process, number of people in the room and categories of staff and their involvement in the procedure.
Results: The procedures were divided into four phases. The hybrid operating room was most crowded in phase 3 when the skin wound was open. Some staff categories were in the room for the entire procedure even if they were not actively involved.
The largest number of people simultaneously in the room was 14.
KEYWORDS
endovascular aortic repairs, hybrid operating room, nursing staff, staff presence, staff roles, team composition, video observations
Aim: The aim of the study was to evaluate team composition and staff roles in a hybrid operating room during endovascular aortic repairs.
Design: Quantitative descriptive design.
Methods: Nine endovascular aortic repairs procedures were video‐recorded between December 2014 and September 2015. The data analysis involved examining the work process, number of people in the room and categories of staff and their involvement in the procedure.
Results: The procedures were divided into four phases. The hybrid operating room was most crowded in phase 3 when the skin wound was open. Some staff categories were in the room for the entire procedure even if they were not actively involved.
The largest number of people simultaneously in the room was 14.
KEYWORDS
endovascular aortic repairs, hybrid operating room, nursing staff, staff presence, staff roles, team composition, video observations
Research Interests:
Introduction: The expansion of the radiography profession in recent decades has widened the scope of radiographic practice. This has raised questions about which trends have had an impact on the profession over the years. The study aim... more
Introduction: The expansion of the radiography profession in recent decades has widened the scope of radiographic practice. This has raised questions about which trends have had an impact on the profession over the years. The study aim was to explore trends that have influenced the radiography profession over the last four decades. Methods: A qualitative design was used. Eleven focus group interviews inspired by the Scenario Planning Method were conducted at 11 diagnostic radiology departments in public hospitals in Sweden. The target group consisted of 48 registered radiographers. To analyse the data, qualitative content analysis was used. Results: Thematic data analysis revealed three broad categories; technological development and radiation doses, current status of the radiography profession and specialisation leading to expert knowledge. Each category derived from two or three sub-categories. Conclusion: The results demonstrate significant trends of influences on the radiography profession in Sweden over the last four decades. New methods and technology and control of radiation doses have had a favourable effect on the development of the radiography profession. Nevertheless, current status such as shortage of radiographers has had an adverse way. Specialisation leading to expert knowledge has an influence on career advancement and a specialist education regulated by the law, might be a prerequisite for the development of the radiography profession.
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Informal caregivers provide the majority of care for older adults residing in their own homes. Caregivinghood, a new evidence-based concept, describes a time of life when relatives provide care at home. These caregivers need knowledge... more
Informal caregivers provide the majority of care for older adults residing in their own homes. Caregivinghood, a new evidence-based concept, describes a time of life when relatives provide care at home. These caregivers need knowledge regarding resources to help them resolve the challenges they encounter. The theoretical framework underpinning this study is Antonovsky's salutogenic theory of health. This study had two aims: (1) to examine the salutogenic core concepts Generalized and Specific Resistance Resources and Deficits (GRRs/SRRs and GRDs/SRDs) described by Swedish informal caregivers as originating from the environmental and contextual domain of caregivinghood and (2) to discuss how this new knowledge might contribute to the development of health promotion initiatives. This qualitative and theory driven study used inductive and deductive data analysis. Data were gathered through salutogenically guided face-to-face interviews of 32 Swedish informal caregivers. In addition, the study relied on the salutogenic core concepts Specific and Generalized Resistance Resources and Deficits originating from their environment and context. Being in empowering surroundings reflects the presence of usable SRRs/GRRs, whereas Struggling in impeding surroundings reflects the presence of SRDs/GRDs. The results indicate that health-enhancing support has to be individualized (SRRs/SRDs) and generalized (GRRs/GRDs). This study's salutogenic approach and the methodology enhance the understanding of the mechanisms behind the development of Sense of Coherence. The results contribute both empirically and theoretically to strengthen health promotion research and practice when developing activities and support for caregivers in stressful situations, such as informal caregiving.
Introduction: The rapid development within Interventional Radiology presents new challenges. Hybrid operating rooms consist of interventional radiology, open surgery, computed tomography, magnetic resonance imaging and other techniques.... more
Introduction: The rapid development within Interventional Radiology presents new challenges. Hybrid
operating rooms consist of interventional radiology, open surgery, computed tomography, magnetic
resonance imaging and other techniques. This means that several disciplines and professionals need to
work in new constellations creating a multidisciplinary team around the patient. In accordance with this
development, higher professional education must provide new pedagogic strategies to successfully
address the knowledge expected in today's complex working life.
Aim: To explore the use of Applied Drama as a learning medium, focusing on the use of Forum Theatre, to
foster team work and collaboration in the field of radiography and learning.
Methods: A qualitative approach, closely related to Ethnography, was utilized.
Result: The Drama Workshop utilising Forum Theatre created a dynamic learning environment and
enabled the participants from three professions to understand each other's priorities better. The use of
drama within health care education allows the students to take different roles in order to find the best
way to co-operate.
Conclusion: Forum Theatre is a useful learning medium in order to promote teamwork and collaboration
in the radiological intervention field. By choosing a personal working experience, Forum Theatre seem to
engage the participants at a deeper level and to experience various communication strategies and how
the outcome changed depending on the approach. This can lead to improved teamwork and
collaboration
operating rooms consist of interventional radiology, open surgery, computed tomography, magnetic
resonance imaging and other techniques. This means that several disciplines and professionals need to
work in new constellations creating a multidisciplinary team around the patient. In accordance with this
development, higher professional education must provide new pedagogic strategies to successfully
address the knowledge expected in today's complex working life.
Aim: To explore the use of Applied Drama as a learning medium, focusing on the use of Forum Theatre, to
foster team work and collaboration in the field of radiography and learning.
Methods: A qualitative approach, closely related to Ethnography, was utilized.
Result: The Drama Workshop utilising Forum Theatre created a dynamic learning environment and
enabled the participants from three professions to understand each other's priorities better. The use of
drama within health care education allows the students to take different roles in order to find the best
way to co-operate.
Conclusion: Forum Theatre is a useful learning medium in order to promote teamwork and collaboration
in the radiological intervention field. By choosing a personal working experience, Forum Theatre seem to
engage the participants at a deeper level and to experience various communication strategies and how
the outcome changed depending on the approach. This can lead to improved teamwork and
collaboration
Unravelling Swedish informal caregivers’ Generalised Resistance Resources Background: Interlinked aspects, as demographic changes, accentuation on home-based community care, increase the amount of informal caregivers to older adults. To... more
Unravelling Swedish informal caregivers’ Generalised Resistance Resources
Background: Interlinked aspects, as demographic changes, accentuation on home-based community care, increase the amount of informal caregivers to older adults. To preserve and enhance their health are subsequently essential and a reoccurring topic on political agendas. How this may be achieved is vividly debated and mainly focused on elimination of risks and stresses associated with caregiving. Within health promotion, the salutogenic approach focusing on resources to health is recognised and this approach was used to acquire necessary knowledge to enhance caregivers’ health ‘the salutogenic way’. Aim: To present Generalised and Specific Resistance Resources (GRRs/SRRs) described by caregivers as stemming from themselves and their carerecipients. Methodology: To unravel caregivers’ GRRs/SRRs, a theorydriven, explorative design guided by definitions of GRRs/ SRRs was utilised. Data were collected through salutogenically guided interviews with 32 Swedish caregivers in one municipality. Inductively, data were analysed using content analysis to identify each caregiver’s SRRs and thereafter deduction to identify the population’s GRRs.
Findings: The synthesis of findings, caregivinghood, encompasses several domains of GRRs seemingly involved in caregivers’ movements towards health. In the caregiver domain, ‘Being someone significant in my own eyes’ unites the essence of having access to GRRs stemming from oneself and ‘Being “blessed” with a co-operative co-worker’ that of having access to GRRs stemming from the carerecipient. This may be the core in an orientation to life which creates positive life experiences, since it enables caregivers to find a ‘fit’ between the possible and desired when resolving challenges.
Conclusion and implications: Health-promoting initiatives should be conducted as partnerships between formal and informal sources due to the versatility of GRRs. It also seems essential to empower both parties so that they may make sense of their situation and use their available GRRs/SRRs in this ‘joint venture’ of managing. Thereby, their motivation to continue the journey through Caregivinghood may be enhanced.
Keywords: caregivinghood, Generalised Resistance Resources, health promotion, homecare, informal caregiver, nursing, positive life experiences, salutogenesis, theory-driven qualitative design.
Background: Interlinked aspects, as demographic changes, accentuation on home-based community care, increase the amount of informal caregivers to older adults. To preserve and enhance their health are subsequently essential and a reoccurring topic on political agendas. How this may be achieved is vividly debated and mainly focused on elimination of risks and stresses associated with caregiving. Within health promotion, the salutogenic approach focusing on resources to health is recognised and this approach was used to acquire necessary knowledge to enhance caregivers’ health ‘the salutogenic way’. Aim: To present Generalised and Specific Resistance Resources (GRRs/SRRs) described by caregivers as stemming from themselves and their carerecipients. Methodology: To unravel caregivers’ GRRs/SRRs, a theorydriven, explorative design guided by definitions of GRRs/ SRRs was utilised. Data were collected through salutogenically guided interviews with 32 Swedish caregivers in one municipality. Inductively, data were analysed using content analysis to identify each caregiver’s SRRs and thereafter deduction to identify the population’s GRRs.
Findings: The synthesis of findings, caregivinghood, encompasses several domains of GRRs seemingly involved in caregivers’ movements towards health. In the caregiver domain, ‘Being someone significant in my own eyes’ unites the essence of having access to GRRs stemming from oneself and ‘Being “blessed” with a co-operative co-worker’ that of having access to GRRs stemming from the carerecipient. This may be the core in an orientation to life which creates positive life experiences, since it enables caregivers to find a ‘fit’ between the possible and desired when resolving challenges.
Conclusion and implications: Health-promoting initiatives should be conducted as partnerships between formal and informal sources due to the versatility of GRRs. It also seems essential to empower both parties so that they may make sense of their situation and use their available GRRs/SRRs in this ‘joint venture’ of managing. Thereby, their motivation to continue the journey through Caregivinghood may be enhanced.
Keywords: caregivinghood, Generalised Resistance Resources, health promotion, homecare, informal caregiver, nursing, positive life experiences, salutogenesis, theory-driven qualitative design.
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In salutogenic theory, individual/contextual, immaterial/material characteristics enabling movements towards health are labelled Specific and Generalised Resistance Resources, SRRs/GRRs, and characteristics counteracting such movements... more
In salutogenic theory, individual/contextual, immaterial/material characteristics enabling movements towards health are labelled Specific and Generalised Resistance Resources, SRRs/GRRs, and characteristics counteracting such movements Specific and Generalised Resistance Deficits, SRDs/GRDs. The aim of this paper was to present SRDs and GRDs described by caregivers as stemming from themselves and their care recipient. Guided by salutogenic theory, an explorative design was used to collect data through interviews with 32 Swedish informal caregivers. During the theory-driven analysis, SRDs were unravelled using within-case approaches. To be able to unite them as GRDs across cases, a serviceable GRD definition was developed from the existing theoretical GRR definition. In findings, SRDs are visualised in citations and GRDs described in detail. Caregivers’ experiences of SRDs/ GRDs are presented as themes: ‘Experiencing personal deficiencies’, when stemming from themselves; and ‘Struggling with an uncooperative co-worker’, when stemming from their care recipients. Findings indicate that if these themes dominate a caregiver’s view of life, she/he seems to have reached the ‘breaking point’ when caregiving ends due to lack of usable SRRs/ GRRs. To prolong the time until this occurs, support, making otherwise unusable SRRs/GRRs usable, is needed. When designing this type of ‘salutogenic’ support, it seems essential to involve the target group (e.g. caregivers, care recipients), to ascertain what their SRRs/GRRs and SRDs/GRDs may consist of. Such knowledge regarding SRRs/SRDs could be used to design individualised support, and regarding GRRs/ GRDs to design generalised support at group level. This study suggests how such new knowledge regarding resistance resources and deficits could be acquired.
When investigating the general state of radiography, an allied health care education in Sweden, one possible starting point is to conduct a review of Bachelor theses from radiography education programmes. The nature and function of the... more
When investigating the general state of radiography, an allied health care education in Sweden, one possible starting point is to conduct a review of Bachelor theses from radiography education programmes. The nature and function of the thesis can have an academic or professional perspective or a combination of both. The review of the theses can give insight into both the current state and the future of radiography. The aim of this study was to explore the contemporary theoretical, topical and methodological trends in Bachelor theses in the field of radiography. An explorative design with a qualitative approach using content analysis was employed to determine the addressed theoretical framework, topics, research questions, and designs and methods used in Bachelor theses in radiography. The theoretical framework gave the impression of a discipline with a great deal of imported knowledge, showing a theoretical pluralism. The analysis of research questions yielded four topics: evidence based care, evidence behind imaging, work environment and additional minor trends. The research designs used, involve literature review of other research and interviews. The students use qualitative, quantitative and mixed methods, whereas quality content analysis holds an exceptional position for analysis. Academically oriented theses should focus on knowledge of the subject, and it can therefore be claimed that the analysis of Bachelor theses provides a window into the state of radiography and can thereby have an impact on the development of radiography as a discipline.
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ABSTRACT
Aim: The aim of this study was to describe and analyse what characterise curricula and syllabi in diagnostic radiology nursing programs in Sweden after the implementation of the Bologna process.
This study described the work content of registered nurses (RNs) employed in municipal health care. Diary notes of three working days from 34 RNs were analysed using content analysis, and a total of 3185 activities were identified. Of... more
This study described the work content of registered nurses (RNs) employed in municipal health care. Diary notes of three working days from 34 RNs were analysed using content analysis, and a total of 3185 activities were identified. Of these, 2807 were analysed further and grouped by comparing similarities and differences. The content of the RNs' nursing activities consisted of assessing health, giving treatments and conducting check-ups, handling pharmaceuticals and teaching. In the administration category, the content comprised planning and reporting, followed by documentation. The RNs' role in municipal health care is consultative, which reinforces their need for competence in advanced nursing, as well as in leadership and pedagogy. RNs mostly work without colleagues and they are responsible for many seriously ill patients. In order to be confident in providing qualified nursing, specialist nursing education in elderly care is needed.
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Medical images are primarily used to ensure an accurate diagnosis and make treatment possible. They are more rarely used for explanation or information to or education of patients. This study investigates patients'... more
Medical images are primarily used to ensure an accurate diagnosis and make treatment possible. They are more rarely used for explanation or information to or education of patients. This study investigates patients' experiences of being shown and given an explanation of their obesity disease using CT images. Twelve patients participated: >30 BMI kg/m(2) , age between 34 and 65, and mixed sexes, seven women and five men. Patients said that seeing their own images made them more aware of and more involved in their disease, enabling them to carry out more active self-care. The deeper involvement offered them a new approach to their body and helped them to make decisions on treatment to reduce their weight.
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The aim of this study was to describe patients' experiences and perceptions of receiving nursing care in their private homes. A home is a place of security, independence and an arena for one's own routines.... more
The aim of this study was to describe patients' experiences and perceptions of receiving nursing care in their private homes. A home is a place of security, independence and an arena for one's own routines. When nurses enter a patient's home, there are expectations from both sides which affect the social interaction. Maintaining patients' dignity demands that the nurse gets to know the patients and shows respect for their autonomy and integrity. A qualitative research method was chosen. Twenty-one patients with homecare nursing were interviewed in open interviews during 2008. Data were analysed according to the principles of interpretive description. The results are described in terms of three main themes: to be a person, to have trust and to have self-esteem. Patients reported experiencing certain events that could pose threats to their dignity, integrity and autonomy, as well as to their trust in nursing care. Patients have to deal with this ambiguity of accepting care while simultaneously maintaining independence and privacy. The nurses were perceived not as a guest but as professionals who would carry out a task in the interest of the patient. For patients, there is a duality in receiving homecare nursing and still exerting independence and self-determination in their homes. The patients developed strategies to balance their own privacy and dignity, despite the inconveniences the nursing treatment and procedures involved. This empowered them in their relationship with the professional caregivers.
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ABSTRACT Changes in staffing toward a higher number of R.N.'s are common in a number of countries today. This article aims at describing the experiences of a management-induced change from mixed to all-R.N. staffing. All R.N.s in... more
ABSTRACT Changes in staffing toward a higher number of R.N.'s are common in a number of countries today. This article aims at describing the experiences of a management-induced change from mixed to all-R.N. staffing. All R.N.s in a surgical ward at a Swedish university hospital were interviewed two months after such replacements were completed. The nurses described a period of chaos and conflicts but also of support for the idea and enthusiasm for the future. A more careful planning of the change process is to be recommended.