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  • 1801.
    Sundin, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jansson, Lilian
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Understanding between care providers and patients with stroke and aphasia: a phenomenological hermeneutic inquiry.2002In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 9, no 2, p. 93-103Article in journal (Refereed)
    Abstract [en]

    Understanding between care providers and patients with stroke and aphasia: a phenomenological hermeneutic inquiry The present study illuminates the understanding in communication between formal care providers and patients with stroke and aphasia. Five care providers and three such patients participated in the study. Video recordings were made during conversations about pictures (n = 15), and the care providers were also interviewed (n = 15) after the video-recorded conversations. A phenomenological hermeneutic method of interpretation of the interview text was used. The findings showed that a range of conditions for 'understanding and being understood' in the communication on the part of the care providers exists. These different conditions are: lacking both knowledge and understanding; having knowledge but not necessarily accompanied by understanding; and being in understanding. Within the condition 'being in understanding', the care providers create a feeling of at-homeness in a relaxed atmosphere and thus have the opportunity to be in 'understanding and being understood' together with the patient. The condition 'being in understanding' appears in connection with the care providers' creating of a 'calm liturgy of caring' by mediating humility and calm vitality affects to the patients, and further, when needed, being present on the level of mystery, i.e. caring communion.

  • 1802.
    Sundin, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jansson, Lilian
    Umeå University, Faculty of Medicine, Department of Nursing.
    The meaning of skilled care providers' relationships with stroke and aphasia patients.2001In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 11, no 3, p. 308-321Article in journal (Refereed)
    Abstract [en]

    Little is known about the reciprocal influence of communication difficulties on the care relationship. To illuminate care providers' lived experiences of relationships with stroke and aphasia patients, narrative interviews were conducted with providers particularly successful at communicating with patients. A phenomenological hermeneutic analysis of the narratives revealed three themes: Calling forth responsibility through fragility, restoring the patient's dignity, and being in a state of understanding. The analysis disclosed caring with regard to the patient's desire, which has its starting point in intersubjective relationship and interplay, in which nonverbal communication is essential--that is, open participation while meeting the patient as a presence. Thus, care providers prepare for deep fellowship, or communion, by being available. They described an equality with patients, interpreted as fraternity and reciprocity, that is a necessary element in presence as communion. The works of Marcel, Hegel, Stern, and Ricoeur provided the theoretical framework for the interpretation.

  • 1803.
    Sundin, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Pusa, Susanna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jonsson, Carin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Östlund, Ulrika
    Envisioning the future as expressed within family health conversations by families of persons suffering from stroke2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 707-714Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The whole family is affected when a person suffers from stroke, but few studies have focused on families' expectations following the stroke.

    OBJECTIVE: The aim of this study was to illuminate what persons with stroke and their family members talk about in Family Health Conversations (FamHCs) with focus on the future and how nurses leading these conversations apprehended the families' future shown in closing letters based on these conversations.

    METHOD: In this study, seven families with a member ≤65 years who had suffered a stroke participated in FamHC in their homes after the person with stroke had been discharged from the rehabilitation clinic. The FamHC comprised a series of three conversations conducted every other week and a closing letter sent by the nurses to the family to conclude the series. In this study, the third conversations were recorded and they and the closing letters were transcribed and analysed using qualitative content analysis.

    RESULT: The family members including the persons with stroke were found to be able to tell their stories and express their feelings, worries, losses, hopes and wishes for the future within the context of the Family Health Conversations. Support within the family was highlighted as essential to the satisfactory management of future situations.

    CONCLUSION: The persons with stroke and their belonging family members' vision of the future was reflected over in the light of theories about beliefs, possible selves, hope and suffering, and the findings highlight the need for broader use of family conversations to support persons with stroke and their families to manage the future.

  • 1804.
    Sundin, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Pusa, Susanna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundstedt, Erika
    Wincent, Nina
    Östlund, Ulrika
    Bäckström, Britt
    Lindh, Viveca
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    What Couples Choose to Focus on During Nurse-led Family Health Conversations When Suffering Stroke2015In: International journal for human caring, ISSN 1091-5710Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate which topics 2 couples, ages younger than 65 years old, where 1 partner has suffered a stroke, choose to focus on when participating in nurse-led family health conversations. Six conversations were audiotaped, transcribed, and analyzed by qualitative content analysis. Three categories emerged illustrating that the couples choose to talk about how they were affected on a personal and family level and, moreover, the importance of support within and outside the family. The altered way of living involved distressed feelings, gratitude, and hopes. This study highlights the importance of nurses viewing the family as a unit.

  • 1805.
    Sundqvist, Felicia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Åström, Hanna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Anhörigas erfarenheter av att leva med en person med bipolär sjukdom: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Title: Relatives’ experiences of living with a person with bipolar disorder. Background: Bipolar disorder is a mental illness that affects about 60 million people worldwide. In Sweden, 1-2 percent of the population are reported at some point during life to suffer from bipolar disorder. The disease causes many complicated behaviors and makes the life situation of the relative’s complex. Aim: The aim of this study is to describe the close relative’s experiences of living with a person that is diagnosed with bipolar disorder. Method: A literature study was conducted with eight scientific articles with a qualitative approach. These were analyzed and compiled to be the result of the literature study. The article search was made in these databases; CINAHL, PubMed, Scopus and PsycINFO. Result: The result was compiled in four categories; relative’s feelings and thoughts about the affected and the expressions of the disease, changes in everyday life, difficulties to get support from the society and visions of the future and associated subcategories. Conclusion: The experience of being a close relative to a person with bipolar disorder are many and varying. A lack of support, information and understanding from health care is recurrent in the literature study. Callista Roy’s adaption theory has been used in the discussion.

  • 1806.
    Sundqvist, Louice
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Magnusson, Evelina
    Patienters erfarenheter av håravfall i samband med cytostatikabehandling vid cancersjukdom: en litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract Experiences of chemotherapy-induced hair loss among patients with cancer disease.

    Background: Cancer is the second most common cause of death. Chemotherapy is a common treatment for cancer disease and prevent cancer cells from dividing, but that also affect the healthy cells that divides throughout the whole life, for example haircells. Therefore hair loss is a common side effect of chemotherapy among patients with cancer. Hair loss is experienced as a traumatic event that affects the daily life of the affected, physically, mentally and socially. Aim: The aim of this study was to describe patient's experiences of chemotherapy-induced hair loss related to cancer disease. Method: This literature review is based on eight qualitative studies. The searching of articles was performed in the databases Cinahl, PubMed, Scopus. The studies were reviewed, analyzed and compiled. Results: Patients experiences of chemotherapy-induced hair loss were described in four categories; ‘Physically distresses of hair loss’, ‘Socially distresses of hair loss’, ‘The ambiguity of hair loss’, and ‘Strategies to manage hair loss’. Conclusion: To be affected by hair loss leads to physically, mentally and socially distress, which may cause suffering for the affected patients. Providing god support and involve the patient in their treatment may hopefully help the patients gain an increased understanding, master the situation and thereby may the suffering decrease. Keywords: Cancer, chemotherapy, hair loss, patient’s experience.

  • 1807.
    Sundqvist, Nina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Arkivuo Wikström, Anni
    Umeå University, Faculty of Medicine, Department of Nursing.
    "Nu nyper det till" - Barnmorskors erfarenheter av att använda klotång vid insättning av spiral2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: The aim of this study was to investigate the midwives experience and attitude towards using tenaculum at insertion of intrauterine devices (IUD).

    Design: Qualitative semi-structured interviews analyzed with qualitative content analysis.

    Settings: Midwife units in primary health care in the northern parts of Sweden. 

    Participants: Seven midwives with at least one years experience of insertion of IUD.

    Findings: The analysis generated three categories and nine subcategories. The category Midwives avoid tenaculum when it is possible describes how midwives do not always follow the clinic guidelines regarding the tenaculum use at IUD insertion, based on their experience they estimated that the tenaculum is not needed as a routine procedure. The tenaculum is used in special circumstances when midwives evaluate that the tenaculum can facilitate the insertion of the IUD or decrease risk for perforation. The category Pain at intrauterine device insertion is possible to alleviate describes how midwives make subjective assessments of the womens pain, how midwives suggest that womens psysiological and psychological conditions affects the IUD insertion and that medical pain relief can be an option. The category A deterrent instrument describes how the midwives have the desire to spare women by diverting and withhold the tenaculum. The midwives do not question the design of the tenaculum but welcome other options.

    Conclusion: The results of this study shows that the clinics guidelines for tenaculum use is too restrictive and there is lack of evidence validating that the tenaculum has the effect which is written in guidelines. Despite this, the tenaculum is a commonly used instrument when inserting IUD. Changed guidelines can help to reduce numbers of painful procedures to women during IUD insertion, which in the long run can inprove womens sexual and reproductive health.

    Implications for practice: This study can raise the issue of critical thinking in midwives, physicians and student midwives concerning the use of the tenaculum at insertion of IUD,  Contribute to a discussion that after further research may lead to changed guidelines and that a painfree replacement for the tenaculum can be designed.   

    Keywords: Tenaculum, Intrauterine Device, Midwives, Experience, Women, Qualitative Content Analysis

  • 1808.
    Sundström, Markus
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Backman, Emelie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vårdpersonals upplevelse av att vårda patientermed diagnosen afasi efter stroke: En litteraturstudie2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Stroke is one of the leading causes for longlasting sequelae, among them

    loss in cognitive function, like aphasia. Aphasia effects the patients ability to understand

    and express themselves in speaking and writing. To be able to reach a good level of care,

    the careproviders and patients ought to have the same goals and values. This requires a

    good communication between the careproviders and patients. Which can be problematic

    for the caregivers when they don't feel secure in their way of getting close to these patients.

    Aim: The purpose of this study was to illuminate caregivers experience of caring for

    patients with the diagnosis aphasia following stroke.

    Method: This is a literature study where nine studies, with qualitative design, has been

    analyzed and compiled. Inclusion- and exclusioncritera were used to limit the result. All

    the studies have been qualitychecked.

    Result: There are varied experiences for the caregivers when it comes to care for patients

    with the diagnosis aphasia after stroke. The result is presented with three categories;

    “Caregivers experience of time and resources for god care”, “Caregivers methods and aids

    in the care” and “Relationships and feelings connected to the care of patients who suffered

    aphasia after stroke”.

    Conclusion: Based on the caregivers experiences in the result, more research is needed in

    this area, partly to be able to develop strategies that will help the caregivers and save time,

    and also to be able to map how caregivers feel in the care of these patients.

  • 1809.
    Sundström, Veronica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Cancer i familjen: Kvinnors upplevelser av att genomgå cancerbehandling i relation till närstående2017Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Background: In Sweden, one third of the population is afflicted with cancer at some point in life. Dominant forms among women are breast cancer, gynaecological cancer and colo-rectal cancer. Many afflicted women live in family settings and are responsible for children and other relatives, which poses special demands during their illness.

    Aim: To illuminate women's experience of undergoing cancer treatment in relation to the family and related parties.

    Method: Semi-structured interviews were undertaken in 2016 with ten women who had gone through cancer treatment while living in a family setting. The applied method was qualitative contents analysis.

    Results: The study resulted in the main theme” Families and related parties are in an inter-personal process with the ill person” and three themes: “To be a burden and alienation”,” The struggle to safeguard the family”, “Family affected by change” and ten sub themes. Women afflicted by cancer had practical and emotional responsibilities for their families. New insights about members were gleaned and feelings of loneliness arose when others could not offer enough support, and a sense of alienation could follow. But children and partners were also sources of consolation and many women found strength in their families. Trust and deeper communications developed.

    Conclusion: When a mother is afflicted by cancer, her whole family is involved, as families function systemically through inter-personal processes. Satisfactory nursing thus requires family involvement during the time of illness.

    Key words: Cancer, family, parent, gender, communications, nursing, nurses, system.

     

  • 1810.
    Svakko, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    W. Jonsson, Angelica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Omvårdnadspersonalens erfarenheter av tillämpningen av icke farmakologiska omvårdnadsåtgärder i samband med BPSD: -En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Dementia have a high prevalence worldwide. 90% of people diagnosed with dementia will display behavioral and psychological symptoms (BPSD). Non-pharmacological interventions may reduce BPSD symptoms.Objective: The aim of the literature study was to highlight the experience of nursing staff with the application of non-pharmacological interventions in patients with BPSDDesign: A literature study with qualitative articles. The result has been analyzed inspired by Friberg´s analysis model.Results: The implementation of non-pharmacological interventions can be impeded when time, knowledge and support are lacking. Person-centered care is necessary for the non-pharmacological interventions to be successful.Conclusion: In order to maintain qualitative care, it is of great importance that nursing staff possess knowledge of BPSD and non-pharmacological interventions. Nursing staff’s experiences with BPSD shows that knowledge of the resident’s background, understanding of behavioral patterns as well as knowledge of various care strategies will improve the nursing staff’s ability to respond to a certain behavior. Further research is needed in this field due to the importance of nursing practice to be supported by evidence. And also in order to continually improve.

  • 1811. Svedberg, Petra
    et al.
    Ivarsson, Bodil
    Nilsson, Ulrica G
    Roxberg, Åsa
    Baigi, Amir
    Brunt, David
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Fridlund, Bengt
    Persson, Sylvi
    Rask, Mikael
    Alm-Roijer, Carin
    Psychometric evaluation of a Swedish version of Krantz Health Opinion Survey2012In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, no 2, p. 181-187Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate the psychometric properties of a Swedish version of The Krantz Health Opinion Survey (KHOS). A convenience sample of 79 persons (47 men and 32 women) was recruited from The Heart and Lung Patients’ National Association at ten local meeting places in different areas in Sweden. The questionnaire was examined for face and content validity, internal consistency and test-retest reliability. The findings showed that the Swedish version of KHOS is acceptable in terms of face and content validity, internal consistency and test-retest reliability over time among 79 individuals >65 years of age and with a cardiac disease. In conclusion, wider evaluations of the psychometric use of KHOS for other populations and settings are recommended.

  • 1812. Sveinbjarnardottir, E K
    et al.
    Svavarsdottir, E K
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses attitudes towards the importance of families in psychiatric care following an educational and training intervention program.2011In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 18, no 10, p. 895-903Article in journal (Refereed)
    Abstract [en]

    Accessible summary

    • The attitude that psychiatric nurses have towards the importance of involving families in their care is fundamental to the quality of the intervention family members are offered. Research evidence supports the view that psychiatric nurses' positive attitudes towards families, in psychiatric care, encourage them to engage more frequently in therapeutic conversations with families.
    • The main focus of the family nursing education and intervention program (ETI-PROGRAM) was to educate psychiatric nurses in family systems nursing. One of the beliefs in family nursing is that illness is a family affair and therefore it is important to involve families in the care of the patients to be able to soften the suffering of the psychiatric patients and their family members.
    • The main results of this study emphasize that after the psychiatric nurses had received the education and training program (ETI-PROGRAM) on family system nursing, they viewed families as less burdensome in their psychiatric care.

    Abstract

    This study measures the attitudes of the psychiatric nurses, after having received an education and training intervention program (ETI-PROGRAM) in family systems nursing, towards the importance of the families in their care. Nurses' knowledge of the impact that family nursing intervention can have on family members may increase positive attitudes towards families. However, little is known about the impact that education and training intervention can have on nurses' attitudes, towards families in clinical practice. Quasi-experimental design was used to assess the change in nurses' attitudes towards families in psychiatric care after the intervention, which included a one-day seminar on the Calgary family nursing conceptual frameworks and skills training with clinical vignettes of families from psychiatry. The Families Importance in Nursing Care – Nurses' Attitude questionnaire was used to evaluate nurses' attitudes. A total of 81 nurses (65%) working in psychiatric care responded to the questionnaire. Nurses with more than 15 years of work experience were significantly more supportive of families in their care compared with less experienced nurses. Out of the 81 nurses, 52 (64%) answered the questionnaire again 14 months later. Furthermore, psychiatric nurses saw families significantly less burdensome after having participated in the ETI-PROGRAM.

  • 1813. Sveistrup, Joen
    et al.
    Widmark, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Fransson, Per
    Umeå University, Faculty of Medicine, Department of Nursing.
    Iversen, Peter
    Munck Af Rosenschöld, Per
    Engelholm, Svend Aage
    Petersen, Peter Meidahl
    Prospective assessment of urinary, gastrointestinal and sexual symptoms before, during and after image-guided volumetric modulated arc therapy for prostate cancer2015In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 49, no 1, p. 58-69Article in journal (Refereed)
    Abstract [en]

    Abstract Objective. The aim of this study was to prospectively assess the development of 24 urinary, gastrointestinal and sexual symptoms in patients with prostate cancer (PCa) during and after image-guided volumetric modulated arc therapy (IG-VMAT). Material and methods. A total of 87 patients with PCa participated in this study. The patients were asked to complete a modified version of the Prostate Cancer Symptom Scale (PCSS) questionnaire before radiotherapy (RT) (baseline), at the start of RT, at the end of RT and 1 year after RT. Changes in symptoms at the start of RT, at the end of RT and 1 year after RT compared to baseline were analysed by a mixed model analysis of repeated measurements with the following covariates: age, comorbidity, smoking and androgen deprivation therapy (ADT). Results. All urinary problems except for haematuria increased significantly at the end of RT compared to baseline. One year after RT, there was no longer any difference compared to baseline for any of the urinary symptoms. All gastrointestinal symptoms except for nausea increased significantly at the end of RT. One year after RT, patients also reported slightly higher degrees of stool frequency, bowel leakage, planning of toilet visits, flatulence, mucus, gastrointestinal bleeding and impact of gastrointestinal bother on daily activities compared to baseline. All sexual symptoms increased significantly at all times compared to baseline. The use of ADT was associated with worse sexual symptoms. Conclusions. IG-VMAT is a safe treatment for PCa, with few and mild changes in urinary and gastrointestinal symptoms 1 year after RT compared to baseline. Sexual symptoms deteriorated both during and after RT. The use of ADT was associated with worse sexual symptoms.

  • 1814.
    Svenfelt, Ben
    Umeå University, Faculty of Medicine, Department of Nursing.
    Glukosbalans under generell anestesi hos personer med insulinbehandlad diabetes: En intervjustudie med anestesisjuksköterskor2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Aim: To describe anesthesia nurses´ experience of maintaining a good glucose balance for patients with insulin-treated diabetes during general anesthesia.

     

    Background:  A patient with diabetes mellitus requires insulin injections to maintain a normal glucose balance. Too low as well as too high levels of glucose in the blood is dangerous. During general anesthesia, patients cannot communicate, and thereby neither express how they are feeling.  The author of this study wanted to immerse himself in the anesthesia nurses´ experience of maintaining a good glucose balance during general anesthesia for patients with insulin-treated diabetes.

     

     

    Method:  A qualitative content analysis, with inductive approach. Interviews with seven anesthesia nurses were conducted.

     

    Result: The result was divided into two main categories: personnel and patient related factors. As subcategories of personnel related factors emerged; to take responsibility, to have knowledge and cooperation. Patient related factors were; cognitive resources, unconcern, insecurity, stress factors and comfort. In the result discussion, the personnel related factors were reflected to team collaboration, and patient related factors to person centered care.

     

    Conclusion: The personnel did not experience the risk of hypoglycemia as a major problem. Everyone agreed that the problem usually was high glucose levels. Collaboration between personnel groups benefits the patients´ glucose balance. As one of the patient related factors, it is important to have the patients motivated to take care of their diabetes, both before and after surgery.

     

     

  • 1815. Svensk, A. C.
    et al.
    Öster, Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Emilsson, S.
    Hedestig, Oliver
    Umeå University, Faculty of Medicine, Department of Nursing.
    Tavelin, Björn
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Parfa, A.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Conversational support group participation during radiotherapy period helps women with breast cancer and men with prostate cancer2015In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 51, p. S232-S232Article in journal (Other academic)
  • 1816.
    Svensk, Ann-Christine
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Öster, Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Egberg Thyme, Karin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Magnusson, Eva
    Umeå University, Faculty of Social Sciences, Department of Psychology. Umeå University, Faculty of Social Sciences, Centre for Women's Studies.
    Sjödin, Marie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Eisemann, Martin
    Department of Psychology, University of Tromsøe, Tromsøe, Norway.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Art therapy improves experienced quality of life among women undergoing treatment for breast cancer: A randomized controlled study2009In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 18, no 1, p. 69-77Article in journal (Refereed)
    Abstract [en]

    Women with breast cancer are naturally exposed to strain related to diagnosis and treatment, and this influences their experienced quality of life (QoL). The present paper reports the effect, with regard to QoL aspects, of an art therapy intervention among 41 women undergoing radiotherapy treatment for breast cancer. The women were randomized to an intervention group with individual art therapy sessions for 1 h/week (n = 20), or to a control group (n = 21). The WHOQOL-BREF and EORTC Quality of Life Questionnaire-BR23, were used for QoL assessment, and administrated on three measurement occasions, before the start of radiotherapy and 2 and 6 months later. The results indicate an overall improvement in QoL aspects among women in the intervention group. A significant increase in total health, total QoL, physical health and psychological health was observed in the art therapy group. A significant positive difference within the art therapy group was also seen, concerning future perspectives, body image and systemic therapy side effects. The present study provides strong support for the use of art therapy to improve QoL for women undergoing radiotherapy treatment for breast cancer.

  • 1817.
    Svensson, Amelie
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Olsson, Linn
    Umeå University, Faculty of Medicine, Department of Nursing.
    Avvikelser i samband med neonatala transporter utförda av ett neonatalt transportteam i norra Sverige -Förekomst, klassifikation och riskskattning av avvikelser2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 1818.
    Säfström, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Humor - en naturlig del i omvårdnaden av ett sjukt barn.2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Humor kan vara ett sätt att kommunicera men kan även fungera som en copingmekanism för att hantera och bemästra svåra situationer. I mötet mellan människor kan humor skapa goda relationer och vara en isbrytare. Inom barnsjukvården kan humor gebarnet en möjlighet till avslappning och distans till obehag. Syftet med studien var att beskriva barnsjuksköterskors syn på humor och tillämpandet av humor vid omvårdnaden av ett sjukt barn. Studien genomfördes som en empirisk studie med kvalitativa intervjuer med nio barnsjuksköterskor. Intervjuerna analyserades med kvalitativ innehållsanalys. Resultatet redovisas i fem teman: humor ger en tillåtande atmosfär, humor en naturlig del i omvårdnaden, humor kan vara sårande, humor kan vara ett arbetssätt och humor skapar en personlig kontakt till barn och familj. Humor avdramatiserade och gav en avslappnad och personlig stämning. Det var ett sätt för sjuksköterskan att inge trygghet och förtroende. Sjuksköterskorna var positiva till användandet av humor i omvårdnaden men måste vara lyhörda för när det är passande och inte. Humor användes ävenmellan personalen som ett sätt att hantera situationer som uppstod iarbetet och både barn och familj upplevdes mottaga humor positivt. Humor kan ses som ett verktyg som sjuksköterskan med fördel kan använda i arbetet. Ytterligare forskning är önskvärt för att utforska ämnet ytterligare.

  • 1819.
    Sävenstedt, Stefan
    Umeå University, Faculty of Medicine, Department of Nursing.
    Telecare of frail elderly: reflections and experiences among health personnel and family members2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Telecare has been an approach to care that, internationally, has experienced a generally rapid development during the last ten years. There are many examples of successful pilot projects where ICT applications have been used in the care of elderly: for improved remote consultation with health professionals, to improve the communication and support of the elderly person’s social network, and as intelligent sensors intended to improve the safety of the elderly person. Despite these successes, implementation has been slow. This research project was set up to provide additional knowledge on some of the important questions regarding quality and implementation aspects of the use of ICT application on the care of frail elderly persons. The overall aim of the research project is to illuminate reasoning and experiences of using applications of telecare for frail elderly persons.

    The research project comprised five studies that were conducted using qualitative research methods. Four of them were carried out within the framework of three telecare projects. Different qualitative research approaches such as content analysis, phenomenological hermeneutics and conversational and discourse analysis were used, in accordance with the research questions of each study. The experiences revealed in the findings of the studies indicate that it is possible to have communication of good quality via videoconferencing with frail elderly persons, even those that have mild or mid-level dementia, provided the conditions are right. Technical limitations of the videoconferencing media in transferring communication cues and the limitations on what the camera can expose place special demands on those communicating with the frail elderly and on the general setting. On the other hand, these limitations on the context of interaction in some situations also seem to be an advantage for demented elderly persons and contribute to increased attention. One example of meaningful remote communication with frail elderly persons was family members’ videophone conversations with their demented relatives when they were placed in nursing homes or homes for respite services. This communication gave new possibilities of being involved in caring for, and of maintaining a relationship with, their demented relative. An introduction of teleconsultations in the care of frail elderly persons will, according to the experiences recorded, affect the professional role and the practical spheres of involved health professionals. The perceptions and experiences of participating health personnel indicate that in order for ICT applications to become valuable assets in the care of frail elderly persons they have to be part of a care alternative that is viewed by all concerned as the best alternative, as a whole, for all affected parties. Further research is needed in order to confirm or refute the findings of this thesis and in order to further broaden our understanding of the use of ICT applications in the care of frail elderly persons. This could facilitate a development of ICT applications suitable for the care of frail elderly persons and their introduction into regular care activities, to the benefit of both the frail elderly persons and their carers.

  • 1820.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing.
    Family members’ narrated experiences of communicating via video-phone with patients with dementia staying at a nursing home2003In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 9, no 4, p. 216-220Article in journal (Refereed)
    Abstract [en]

    We studied the experience of family members who communicated via video-phones with elderly demented patients who were either staying at a home for temporary respite care or living in a nursing home. The study was based on qualitative data from seven interviews. The interviewees each had three or more months' experience with a video-phone. The open interviews were transcribed. Content analysis showed that video-phone conversations made the relatives of patients at nursing homes more involved in the caring process and that conversation via the video-phone was a different way of communicating. Video-phone conversations with demented patients were in some cases more focused and of better quality than face-to-face conversations. In most cases the video-phone conversations required the assistance of staff at the home in order to be meaningful. Video-phones have the potential to become useful tools for family members caring for elderly relatives.

  • 1821.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bucht, Gösta
    Norberg, Lennart
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurse-doctor interaction in teleconsultations between a hospital and a geriatric nursing home2002In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 8, no 1, p. 11-18Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to elucidate both the interactionbetween a doctor and five registered nurses and the problemsor tasks dealt with in teleconsultations between a universityclinic for geriatric medicine and a nursing home for the elderlyin northern Sweden. The interaction and problems or tasks werestudied through analyses of video-recorded teleconsultationsand through open interviews with the participating staff. Theresults indicated that teleconsultations between a geriatricianand the nurses at a nursing home for the elderly can be a usefultool for providing medical services. Teleconsultations alterboth the 'power-control' and 'practice spheres' for the doctorand the nurses, and must be based on mutual trust. The use ofteleconsultations gives the nurse a larger role as the presenterof medical problems, and gives the doctor the role of remoteconsultant.

  • 1822.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Häggstrom, Terttu
    Working with girls living on the streets in East Africa: professionals' experiences.2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 50, no 5, p. 489-97Article in journal (Refereed)
    Abstract [en]

    AIM: This paper reports a study elucidating the meaning of caring for girls of the street, as experienced by female staff members working with street children in Eastern Africa. BACKGROUND: The phenomenon of children living on the streets is a global and escalating problem, and girls are presumed to be especially vulnerable. In East Africa, the traditional extended family system is rapidly breaking down and traditional gender values seem to remain. This was the context for investigating female carers' experience of caring for girls. METHOD: Interviews were conducted with 37 project staff members working with children living on the streets in the framework of non-governmental organizations in Kenya, Uganda and Tanzania between 1997 and 1998. Transcribed text from female interviewees (n = 13) working with girls of the street was analysed using a phenomenological-hermeneutic approach. FINDINGS: The meaning of caring for girls of the street for female professional carers in East Africa was comprehensively understood as counselling the girls to integrate the past of their adverse life stories with their present identity. Counselling meant conveying visions for a possible re-direction of the life stories, from being a girl of the street into being an accepted family girl. Caring in this context meant being squeezed between ethical demands and gender values. Experiencing frustration and powerlessness was related to gender structures in society, having to fight the grip of street culture, and a lack of professional tools. Hope and satisfaction were related to success in changing the course of life stories of girls and to seeing possibilities for contributing to empowerment of girls and community members. CONCLUSIONS: Gender issues are critical to care provided to girls of the street. Carers felt that they lacked relevant knowledge and support. Ethical aspects and gender issues in relation to professional care for vulnerable girls ought to be addressed in nursing education and practice, not only for developing countries, but also as a matter of global interest.

  • 1823.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per Olof
    Umeå University, Faculty of Medicine, Department of Nursing.
    Zingmark, Karin
    Research Manager, Department of Research and Development, Norrbotten County Council, Luleå , Sweden.
    The duality of information and communication technology (ICT): Inexperienced health personnel’s reasoning regarding the use of ICT in the care of frail elderlyManuscript (Other academic)
  • 1824.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing.
    Zingmark, Karin
    Research Manager, Department of Research and Development, Norrbotten County Council, Luleå , Sweden.
    The duality in using information and communication technology in elder care.2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, no 1, p. 17-25Article in journal (Refereed)
  • 1825.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Zingmark, Karin
    Hydén, Lars-Christer
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Establishing joint attention in remote talks with the elderly about health: a study of nurses' conversation with elderly persons in teleconsultations2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 317-24Article in journal (Refereed)
    Abstract [en]

    This study is a contribution to the sparsely studied field of nurses' teleconsultations with frail elderly people. The aim was to describe how talk and interaction are accomplished and by what means problems are handled that emerge from the fact that the communication is conducted via videoconferencing techniques. Recordings were made of 22 sessions of teleconsultation between nurses and elderly nursing home residents aided by enrolled nurses. The data were analysed with a qualitative method inspired by conversation and discourse analysis. The findings indicate that in order to create a joint attention the participants often had to verbally confirm and reconfirm that contact had been established. The triad of participants played a special part in maintaining the joint attention through compensating for the contextual aspect of the medium's limitations and the demented elderly person's communication problems. 'Talks about the communication' and passages of social talk took place when the nurse or the staff member wanted to re-establish and maintain joint attention. The joint attention seemed connected to a special sort of eye contact and gaze and to the type of camera projection that was used. One conclusion was that to create joint attention in nurses' teleconsultations with frail elderly people, the limitations in transferring communication cues and the limitations of what the camera can reveal of the general context could, to some extent, be made up for by verbal communication within the triad of participants. Another conclusion was that these limitations in the context of interaction in some situations also seemed to be an advantage for the demented elderly and contributed to increased attention

  • 1826.
    Sävenstedt, Stefan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Zingmark, Karin
    Department of Research and Development, County Council of Norrbotten, Luleå, Sweden..
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing.
    Being present in a distant room: A study of the qualitative aspects of teleconsultations with older people in a nursing home2004In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 14, no 8, p. 1046-1057Article in journal (Refereed)
  • 1827.
    Söderberg, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gilje, F
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dignity in situations of ethical difficulty in intensive care.1997In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 13, no 3, p. 135-44Article in journal (Refereed)
    Abstract [en]

    In intensive care, situations of ethical difficulty are common. For the purpose of illuminating the meaning of being in ethically difficult situations, 20 registered nurses (RNs) employed in six intensive care units in Sweden narrated episodes of ethical difficulty. From a phenomenological hermeneutic perspective, the core theme of 'dignity' was identified in 85 stories. Stories with the concept of dignity reveal a threefold meaning; transforming disrespect into respect for the inviolable value of the human being; transforming ugly situations into beautiful ones; transforming discord of death into togetherness. Stories without the concept of dignity were oriented toward skills and physical care without reflection on actions and a 'taken-for-granted attitude' that good will prevail. Comparing and contrasting stories with and without dignity revealed the demands of dignity: attentiveness, awareness, personal responsibility, engagement, fraternity and active defence of dignity. In light of the philosophies of Weil, Marcel and Ricoeur, the demands of dignity correspond to qualities generated when struggling for respecting the dignity of human beings. This study reveals that dignity begets dignity, which opens the RNs to the ethical dimension. This, in turn, counteracts the risk of dehumanizing care in technocratic environments.

  • 1828.
    Söderberg, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gilje, Fredricka
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Transforming desolation into consolation: the meaning of being in situations of ethical difficulty in intensive care.1999In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 6, no 5, p. 357-73Article in journal (Refereed)
    Abstract [en]

    The purpose of this phenomenological-hermeneutic study was to illuminate the meaning of being in ethically difficult care situations. The participants were 20 enrolled nurses employed in six intensive care units in Sweden. The results reveal a complex human process manifested in relation to one's inner self and the other person, which transforms desolation into consolation through becoming present to the suffering other when perceiving fragility rather than tragedy. The main point of significance here is for all health professionals to create an ethical work environment and strive for praxis that fosters 'at-homeness', which renders us free to transform desolation into consolation. Consolation is of significance in ethics because it makes us available and helps us to fulfil the demands of life, while desolation makes us unavailable to others.

  • 1829.
    Söderberg, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Intensive care: situations of ethical difficulty.1993In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 18, no 12, p. 2008-14Article in journal (Refereed)
    Abstract [en]

    Twenty enrolled nurses (ENs), 20 registered nurses (RNs) and 20 physicians working in intensive care in northern Sweden narrated 255 stories about their experience of being in ethically difficult care situations. The ENs' stories mainly concerned problems relating to relationship ethics, the stories narrated by the physicians mainly concerned problems relating to action ethics, while the RNs' stories gave equal attention to both kinds of problems. The most common theme of both the RNs' and the physicians' stories was that of too much treatment. An obvious similarity between the ENs, RNs and physicians was that they saw themselves as equally lacking in influence in ethically difficult care situations. The only apparent difference between the three groups, however, was that the ENs brought up relationship problems more often than the others. Thus, the differences between the RNs and the physicians were fewer than usually reported in the literature. This might be related to the specialization of intensive care.

  • 1830.
    Söderberg, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gilje, Fredricka
    Meeting tragedy: interviews about situations of ethical difficulty in intensive care.1996In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 12, no 4, p. 207-17Article in journal (Refereed)
    Abstract [en]

    For the purpose of illuminating the meaning of being in ethically difficult situations, eight enrolled nurses, 12 registered nurses and 10 physicians (n = 30) working in intensive care units in Sweden were asked to narrate care episodes of ethical difficulty. A phenomenological-hermeneutical analysis of the 30 narratives about nine care episodes disclosed that all stories concerned meeting tragedy, which evoked a spirit of compassion that pointed to values. The 'intention of compassion' aimed at respecting these ethical values. Respecting ethical values meant being consoled, which generated confidence in life that helped the person to embrace tragedy. When values were not respected, ethical problems emerged. Communication of values facilitated realisation, while unconscious values were indirectly communicated through emotions. Such communication meant risking vulnerability and meeting oneself. Meeting self and one's vulnerability demanded abilities of being consoled, i.e. in this study giving consolation, providing realistic treatment and being faithful in one's profession. A prerequisite for expressing personal standpoints and cooperating in the struggles of respecting ethical values was holding each other in great respect. When meeting tragedy, the spirit of compassion pointed to ethical problems, to the possibilities of solving the problems, and to the fulfilment of vision through converting feelings of despair into action energy.

  • 1831.
    Söderberg, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Grankvist, Kjell
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Wallin, Olof
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Preanalytical errors in primary healthcare: a questionnaire study of information search procedures, test request management and test tube labelling2009In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 47, no 2, p. 195-201Article in journal (Refereed)
    Abstract [en]

    Background: Most errors in laboratory medicine occur in the preanalytical phase and are the result of human mistakes. This study investigated information search procedures, test request management and test tube labelling in primary healthcare compared to the same procedures amongst clinical laboratory staff.

    Methods: A questionnaire was completed by 317 venous blood sampling staff in 70 primary healthcare centres and in two clinical laboratories (response rate = 94%).

    Results: Correct procedures were not always followed. Only 60% of the primary healthcare staff reported that they always sought information in the updated, online laboratory manual. Only 12% reported that they always labelled the test tubes prior to drawing blood samples. No major differences between primary healthcare centres and clinical laboratories were found, except for test tube labelling, whereby the laboratory staff reported better practices. Re-education and access to documented routines were not clearly associated with better practices.

    Conclusions: The preanalytical procedure in the surveyed primary healthcare centres was associated with a risk of errors which could affect patient safety. To improve patient safety in laboratory testing, all healthcare providers should survey their preanalytical procedures and improve the total testing process with a systems perspective.

  • 1832.
    Söderberg, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Grankvist, Kjell
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Wallin, Olof
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Incident reporting practices in the preanalytical phase: low reported frequencies in the primary health care setting2009In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 69, no 7, p. 731-735Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Incident reporting is commonly used to improve patient safety. The preanalytical phase of laboratory testing contains several manual error-prone tasks where mistakes can affect patient outcomes. However, the practical use of incident reports in this area has not been previously investigated in the primary health care setting, where the majority of the patients come in contact with health care.

    MATERIAL AND METHODS: All staff responsible for venous blood sampling in 70 primary health care centres and in two hospital clinical laboratories (317 respondents, response rate 94%) completed a questionnaire.

    RESULTS: Of the primary health care staff, 69% reported that they had never filed an incident report regarding venous blood sampling. Barriers for not filing incident reports often/always included lack of time (44%) and a complicated reporting procedure (27%). A higher proportion of staff with re-education (43%) had filed at least one incident report as compared to those without re-education (20%, p < 0.001). No differences in incident reporting practices were found between primary health care and hospital clinical laboratory staff.

    CONCLUSIONS: The investigated incident reporting system is likely to underreport incidents in the preanalytical phase. Therefore, the ability to discover preventable system vulnerabilities needs refinement.

  • 1833.
    Söderberg, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences.
    Wallin, Olof
    Umeå University, Faculty of Medicine, Department of Medical Biosciences.
    Grankvist, Kjell
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Is the test result correct? A questionnaire study of blood collection practices in primary health care2010In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 16, no 4, p. 707-711Article in journal (Refereed)
    Abstract [en]

    Rationale, aims and objectives  Venous blood tests are important for clinical decision making. Most errors in blood testing are due to human errors before the blood samples reach the laboratory. The present study was designed to investigate venous blood sampling (VBS) practices in primary health care centres (PHCs) compared with clinical laboratory staff.

    Method  A cross-sectional survey of 70 PHCs and two clinical laboratories is conducted. All staff responsible for VBS (317 respondents, response rate 94%) completed a questionnaire on VBS practices.

    Results  Instructions for VBS were not followed in the surveyed PHCs. For example, only 54% reported that they always identified the patient by using name/Swedish identification number and only 5% reported that they always used photo-ID, the two preferred means for patient identification. Only 12% reported that they always released venous stasis as soon as possible. Fewer PHC staff than clinical laboratory staff reported correct VBS practices. For example, 54% of the PHC staff reported that they always identified the patient by name and Swedish identification number, as compared with 95% of the clinical laboratory staff (P < 0.001). Documented VBS routines and re-education in VBS were not clearly associated with reported correct VBS practices.

    Conclusions  In the surveyed PHCs, there are clinically important risks for misidentification of patients and erroneous test results, with consequences for the diagnosis and treatment of patients. Quality interventions, aimed at improving VBS practices, are needed to ensure patient safety.

  • 1834.
    Söderberg, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Wallin, Olof
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Jonsson, P. Andreas
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Grankvist, Kjell
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Comment on the letter to the editor ‘The importance of incident reporting in laboratory diagnosics’ by Lippi and Plebani2009Other (Other academic)
  • 1835.
    Söderberg, Marcus
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brännström, Emil
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kvinnors upplevelser av anorexia nervosa: En litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Trots att alla äter har samhället svårt att förstå tanken av oreglerat ätande. Ätstörningar är ett stort och växande problem runt om i världen, och med förändrade sociokulturella normer och ideal ställs orealistiska krav på många människor, i synnerhet unga kvinnor. Dessa förväntningar tvingar kvinnor att ta till extrema metoder för att gå ner i vikt, följt av en vardag som präglas av dåligt självförtroende och andra psykiska konsekvenser. Syfte: Syftet med studien var att beskriva kvinnors upplevelser av anorexia nervosa. Metod: Tio kvalitativa studier har kvalitetsgranskats, analyserats och sammanställts till litteraturstudiens resultat. Resultat: Resultatet presenteras i tre kategorier och elva underkategorier. Resultatet visar att de bakomliggande orsakerna upplevs vara en kombination mellan låg självkänsla, lågt självförtroende och yttre förväntningar och påtryckningar. Anorexia nervosa upplevs som ett funktionellt verktyg, men övergår med tiden till en kontrollerande sjukdom som måste förgöras. Konklusion: Att leva med anorexia nervosa präglas av ambivalens och förvirring. Det är svårt att släppa taget om något som har blivit ens identitet. Litteraturstudiens resultat kan ge vårdpersonal ökad kunskap om hur det är att leva med anorexia nervosa och därmed få bättre förutsättningar för att ge stöd och god omvårdnad.

  • 1836.
    Söderholm, Anna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    The experience of living with sensory hyperreactivity: accessibility, financial security, and social relationships2011In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 32, no 8, p. 686-707Article in journal (Refereed)
    Abstract [en]

    Odor intolerance is a frequently reported problem, predominantly among women. Our purpose was to illuminate how individuals living with sensory hyperreactivity (SHR; a form of odor intolerance) experience its impact on accessibility, financial security, and social relationships. Data were collected by having 12 women with SHR write descriptive texts. These texts were analyzed with qualitative content analysis. Six themes were identified: Being limited in participating in society, being forced to behave incompatibly with one’s personality, experiencing lack of understanding and respect from others, experiencing insecurity, being dependent on others, and being forced to choose between the plague and cholera.

  • 1837.
    Söderlund, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Svensson, Lisa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjuksköterskors erfarenheter av icke farmakologiska omvårdnadsåtgärder för att lindra barns smärta: En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pain is a complex phenomenon and the experience of pain is influenced by various factors such as the child's age and earlier experiences of medical procedures. Children who come in contact with healthcare are often exposed to painful procedures and one negative experience may affect the child in the future. The healthcare personnel can use non-pharmacological methods to ease children’s pain.

    Aim: To illuminate nurses' experiences of non-pharmacological nursing actions to alleviate children's pain

    Methods: A literature study based on eight qualitative studies, which were quality controlled and analysed by using context analysis. Four different databases were used in search for the studies included in this literature study.

    Results: The theme that emerged was that there is no universal solution for non-pharmacological pain relief. The theme is presented in three categories: Social interaction is significant, Non-pharmacological pain relief is challenging, The context affects the pain relief.

    Conclusion: This literature study shows the importance of a good relationship and communication customized to fit the child. Experience and knowledge about non-pharmacological nursing actions to alleviate children's pain may improve the nurses' pain-relieving care and reduce children's suffering.

  • 1838.
    Söderlund, Mattias
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mattsson, Johannes
    Umeå University, Faculty of Medicine, Department of Nursing.
    Andningsbesvär under transport: En studie om skillnader och likheter i vitalparametrar och omvårdnadsåtgärder av äldre patienter med andningsbesvär, vid ambulanstransporter med olika transportprioriteter.2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Äldre patienter med andningsbesvär är en vanlig patientkategori inom ambulanssjukvården. Är det någon skillnad på patienters vitalparametrar eller givna läkemedel vid ambulanstransporter med prio 1 och prio 2. 43 ambulans och akutjournaler studerades retrospektivt. 24 prio 1 och 19 prio 2. Patienter som transporterats med prio 1 hade signifikant sämre värden på andningfrekvens, puls och kroppstemperatur. Det erhöll även syrgas i en betydligt större mängd. Merparten av prio 1 patienterna blev triagerade som röda, det vill säga livshotande sjuka. De äldre patienter med andningsbesvär som transporteras i ambulans med prio 1 är enligt studien betydligt sjukare än de som transporteras med prio 2.   

  • 1839.
    Söderlund, Mona
    et al.
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm.
    Cronqvist, Agneta
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Health Care Sciences, Ersta Sköndal University College, Stockholm; Palliative Research Centre, Ersta Sköndal University College & Ersta Hospital, Stockholm.
    Ternestedt, Britt-Marie
    Department of Health Care Sciences, Ersta Sköndal University College.
    Hansebo, Görel
    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm.
    Conversations between persons with dementia disease living in nursing homes and nurses: qualitative evaluation of an intervention with the validation method2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 1, p. 37-47Article in journal (Refereed)
    Abstract [en]

    Living with dementia disease (DD) can include difficulties describing experiences of everyday lives, which can lead to withdrawal, social isolation or existential homelessness. Persons with DD living in nursing homes are mainly dependent on the nurses for establishing and maintaining relationships with those around them. It can be challenging for nurses to understand what a person with DD is trying to express and to make themselves understood in turn. The validation method is intended to facilitate communication with persons with DD, but to our knowledge, there have been no qualitative studies of how this influences persons' communication. This study aimed to illuminate the actions and reactions of persons with DD living in nursing homes in one-to-one conversations with nurses during 1 year of validation method training, as observed in videotapes. Four persons with DD were involved in videotaped conversations with four nurses who were participating in a validation method training programme. Videotapes with at least 5 months between the first and last recording were analysed and compared qualitatively. The findings are presented in four categories that were identified to various degrees in conversations at the beginning and at the end of the programme: being uninterested in or unable to answer questions, talking about more than one topic of conversation at the same time, trying to talk about what is on one's mind and speaking more freely about what is on one's mind. In the videotaped conversations at the end of the programme, the persons had the opportunity to use their remaining communication abilities. This may have been related to the development of the nurses' communication skills during the training programme, and so it is possible that persons with DD could benefit from communicating with nurses trained in the validation method.

  • 1840. Söderlund, Mona
    et al.
    Cronqvist, Agneta
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ternestedt, Britt-Marie
    Hansebo, Görel
    Nurses’ movements within and between various paths when improving their communication skills: an evaluation of validation method training2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 2, p. 265-273Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To explore any changes in nurses’ skills at communicating with residents with dementia disease when using the validation method, as observed in one-to-one videotaped conversations.

    Background: Communication difficulties due to cognitive impairment among residents with dementia disease may complicate care situations. Training can improve nurses’ communication skills and increase care quality. The validation method aims to facilitate communication with residents with dementia disease through empathic and confirmatory approaches. Evaluations of the validation method have primarily focused on the residents’ perspective, and reports on nurses’ experiences are sparse. Improved communication and relationships with residents after validation method training have been described previously. Videotaped data could provide additional information about these earlier results.

    Design: A descriptive qualitative design.

    Methods: Eight nurses participated in a year of validation method training, including videotaped conversations with eleven residents. Videotapes with at least five months between the first and last recording were analysed and compared qualitatively.

    Results: The analysis revealed an overall pattern: nurses’ movements within and between various paths when improving their communication skills. This was based on three sub-patterns: from controlling communication towards developing attentiveness in communication, from ambiguous communication towards developing coherence in communication, and from being open and attentive towards having a refined attuned communication.

    Conclusions: All nurses developed their communication skills during the programme, albeit to different degrees. The findings are in congruence with the experiences described by nurses, and so it is reasonable to believe that the programme helped to improve the nurses’ skills in communicating with residents with dementia disease.

    Relevance to clinical practice: A validation method training programme could give nurses the possibility to develop their skills in communicating with residents with dementia disease.

  • 1841. Söderlund, Mona
    et al.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing. Ersta Sköndal University College.
    Hansebo, Görel
    Implementation of the validation method: nurses’ descriptions of caring relationships with residents with dementia disease2012In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 11, no 5, p. 569-587Article in journal (Refereed)
    Abstract [en]

    This study describes nurses’ experiences of relationships with residents with dementia disease (1) before and after validation method (VM) training and (2) after extensive experience using the VM. An intervention was performed in a nursing home, involving supervision plus one year of training in using the VM. Nurses were interviewed before and after the intervention. Nurses with extensive VM experience, working at another nursing home, were interviewed once. Qualitative content analysis of the transcribed interviews revealed four themes with sub-themes. Most nurses participating in the intervention described a changed approach afterwards, focusing more on residents and on their communications, which in turn seemed to lead to closer, more trusting relationships. A similar approach was described by the nurses with extensive VM experience. One conclusion is that supervised VM training facilitated nurses’ development of communication skills and abilities to establish close relationships with residents. Some nurses described the VM as demanding.

  • 1842. Söderlund, Mona
    et al.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hansebo, Görel
    Validation method training: nurses' experiences and ratings of work climate2014In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, no 1, p. 79-89Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Training nursing staff in communication skills can impact on the quality of care for residents with dementia and contributes to nurses' job satisfaction. Changing attitudes and practices takes time and energy and can affect the entire nursing staff, not just the nurses directly involved in a training programme. Therefore, it seems important to study nurses' experiences of a training programme and any influence of the programme on work climate among the entire nursing staff. AIMS AND OBJECTIVES: To explore nurses' experiences of a 1-year validation method training programme conducted in a nursing home for residents with dementia and to describe ratings of work climate before and after the programme. DESIGN: A mixed-methods approach. METHODS: Twelve nurses participated in the training and were interviewed afterwards. These individual interviews were tape-recorded and transcribed, then analysed using qualitative content analysis. The Creative Climate Questionnaire was administered before (n = 53) and after (n = 56) the programme to the entire nursing staff in the participating nursing home wards and analysed with descriptive statistics. RESULTS: Analysis of the interviews resulted in four categories: being under extra strain, sharing experiences, improving confidence in care situations and feeling uncertain about continuing the validation method. The results of the questionnaire on work climate showed higher mean values in the assessment after the programme had ended. CONCLUSION: The training strengthened the participating nurses in caring for residents with dementia, but posed an extra strain on them. These nurses also described an extra strain on the entire nursing staff that was not reflected in the results from the questionnaire. The work climate at the nursing home wards might have made it easier to conduct this extensive training programme. IMPLICATIONS FOR PRACTICE: Training in the validation method could develop nurses' communication skills and improve their handling of complex care situations.

  • 1843.
    Söderlund, Sarah
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundmark, Tommy
    Umeå University, Faculty of Medicine, Department of Nursing.
    Strålskydd för barn vid konventionell röntgen: En litteraturstudie2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Research shows that children are more sensitive to ionizing radiation than adults. X-ray imaging may not be performed unnecessarily and its necessity must exceed the risks. It is important to optimize the imaging and as far as possible minimize the radiation dose without affecting the diagnostic performance negatively. Research shows that even low doses of radiation can cause DNA damage and ultimately induce cancer. Objective: The aim of this paper was to describe methods that optimize the x-ray examination and reduce radiation doses to children in conventional radiography. Method: A literature study whose results are based on 14 scientific articles found in the databases PubMed and CINAHL and manual searches. Results: There were several methods that optimize the x-ray examination and reduce the radiation doses to children in conventional radiography. These methods concern approaches in the examination room, parameters, filtering and new technology. Conclusion: Radiographers’ with knowledge of optimization have good opportunities to lower radiation doses in x-ray examinations of children in conventional radiography.

  • 1844. Söderström, Ing-Mari K
    et al.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hagberg, Margaretha S
    Benzein, Eva G
    Family adaptation in relation to a family member's stay in ICU2009In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 25, no 5, p. 250-257Article in journal (Refereed)
    Abstract [en]

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

  • 1845.
    Sörberg, Martin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Patienters upplevelse av preoperativ information gällande luftvägshantering samt postoperativa halsbesvär: En intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Information is an important part of the nurse anesthetist’s encounterwith the patient. Information as a tool, aims for a better care and safety for the patient. During an anesthesia, the patients airway and breathing is controlled, wherein sore throat and hoarsness can occur post operative. Post operative sore throat and hoarsness are common and affect many patients. Giving preoperative information regarding airway management and probable postoperative sore throat inconvenience, can be of importance of the patients well-being.

    Objectives: To analyze patients experiences of preoperative information regarding airway management and postoperative throat inconvenience.

    Methods: Qualitative interviews study. 8 semi structured interviews, were conducted on patients who had been operated in general anesthesia.

    Results: The interviews resulted in three different categories with respectively sub categories. Feelings before surgery; in a stressful situation the patients felt confidence and trust, and also that calm and safety were submitted. The importance of estimating amount of information; some experienced too much information, others too little and that it is important with personalized information, fitted for what each and other patient wants to know. Means of information; where, when and how the information is given, affects the patients. Continious and concised information, with opportunity to ask questions, is experienced as positive.

    Conclusions: Patients are different and reacts different on the amount of information and means of information. It is therefor important to adjust the amount of information and to give personalized information suited for each and other patient. Given thorough information about airway management is experienced by some patients as unpleasant. Given information about postoperative throat inconvenience soothes.Keywords preoperative information; airway management; postoperative throatinconvenience; feelings; amount of information; means of information.

  • 1846.
    Sörlin, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Renklint, Rebecka
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Edin, Kerstin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Challenges and benefits during long-term use of treadmill workstations to decrease sedentary behavior at workManuscript (preprint) (Other academic)
  • 1847. Sørbye, Liv W
    et al.
    Hamran, Torunn
    Henriksen, Nils
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Home care patients in four Nordic capitals: predictors of nursing home admission during one-year followup2010In: Journal of multidisciplinary healthcare, ISSN 1178-2390, Vol. 3, p. 11-18Article in journal (Refereed)
    Abstract [en]

    The aim was to predict nursing home admission (NHA) for home care patients after a 12-month follow-up study. This Nordic study is derived from the aged in home care (AdHOC) project conducted in 2001–2003 with patients at 11 sites in Europe. The participants in the cohort study were randomly selected individuals, aged 65 years or older, receiving homecare in Oslo, Stockholm, Copenhagen, and Reykjavik. The Resident Assessment Instrument for Home Care (version 2.0) was used. Epidemiological and medical characteristics of patients and service utilization were recorded for 1508 home care patients (participation rate 74%). In this sample 75% were female. The mean age was 82.1 (6.9) years for men and 84.0 (6.6) for women. The most consistent predictor of NHA was receiving skilled nursing procedures at baseline (help with medication and injections, administration or help with oxygen, intravenous, catheter and stoma care, wounds and skin care) (adjusted odds ratio = 3.7, 95% confidence interval: 1.7–7.8; P < 0.001). In this Nordic material, stronger emphasizing on higher qualified nurses in a home care setting could prevent or delay NHA.

  • 1848. Talabani, Naghada
    et al.
    Hellström Ängerud, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Research Unit Skellefteå, Department of Medicine, Umeå University, Skellefteå, Sweden.
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University. Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
    Patients' experiences of person-centred integrated heart failure care and palliative care at home: an interview study2017In: BMJ Supportive & Palliative Care, ISSN 2045-435X, E-ISSN 2045-4368Article in journal (Refereed)
    Abstract [en]

    Objectives Patients with severe heart failure (HF) suffer from a high symptom burden and high mortality. European and Swedish guidelines for HF care recommend palliative care for these patients. Different models for integrated palliative care and HF care have been described in the literature. No studies were found that qualitatively evaluated these models. The purpose of this study is to describe patients' experiences of a new model of person-centred integrated HF and palliative care at home.

    Method Interviews were conducted with 12 patients with severe HF (New York Heart Association class III–IV) and included in the research project of Palliative advanced home caRE and heart FailurE caRe (PREFER). Qualitative content analysis was used for data analysis.

    Results Two themes and a total of five categories were identified. The first theme was feeling secure and safe through receiving care at home with the categories: having access to readily available care at home, being followed up continuously and having trust in the team members' ability to help. The second theme was being acknowledged as both a person and a patient, with the following two categories: being met as a person, participating in decisions about one's care and receiving help for symptoms of both HF and comorbidities.

    Conclusions Person-centred integrated HF and palliative care provides a secure environment and holistic care for patients with severe HF. This approach is a way to improve the care management in this population.

  • 1849.
    Talseth, Anne-Grethe
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Psychiatric care of people at risk of committing suicide: narrative interviews with registered nurses, physicians, patients and their relatives2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aims of this thesis are to illuminate the meaning of being cared for and treated by nurses and physicians, as narrated by psychiatric suicidal in-patients; the meaning of taking care of and treating patient at risk of committing suicide, as narrated by nurses and physicians; and the meaning of being met and having one’s suicidal relative taken care of by health personnel, as narrated by relatives. Narrative interviews were conducted with 42 adult patients at risk of committing suicide in an in-patient psychiatric unit, 19 RNs, 19 physicians, and 15 relatives at a hospital in Norway. The tape-recorded and transcribed interviews were interpreted using a phenomenological hermeneutic method.

    Nurses’ relations to patients at risk of committing suicide were illuminated via the dimension ‘Distance- Closeness’ (I). The relation of the suicidal patient to the nurses was illuminated via the dimension ‘Confirming- Lack of confirming’ (II). The relation of physicians to patients was illuminated via the dimension ‘Power to - Power over’. (III). The relation of suicidal patients to physicians was illuminated via the dimension ‘Participating approach-Observing approach’ (TV). Results from the relatives’ experiences of being met by health personnel of suicidal patients reveal that the context of being met was characterized by ‘being helpless-powerless’, and that the meaning of the experiences of ‘being met’ was reflected in six themes: ‘Being seen as a human being’; ‘Participating in an I-Thou relationship with personnel’; ‘Trusting personnel, treatment and care’; ‘Being trusted by personnel’; ‘Being consoled’; and ‘Entering into hope’ (V).

    The interpreted meanings of the experience of being cared for as a person at risk of committing suicide were illuminated as confirmation, communion, consolation and hope. Threaded through these meanings is the relation with self and others. Thus, the essence of the results that emerged from this study indicates the presence of a relational view of the care received by people at risk of committing suicide.

  • 1850. Talseth, Anne-Grethe
    et al.
    Gilje, Fredricka L.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses' responses to suicide and suicidal patients: a critical interpretive synthesis*2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 11-12, p. 1651-1667Article, review/survey (Refereed)
    Abstract [en]

    Aims and objectives. To provide an inclusive understanding of nurses' responses to suicide and suicidal patients that can benefit nursing practice and guide research. The question was 'What is a critical interpretive synthesis of accumulated nursing research on nurses' responses to suicide and suicidal patients?' Background. Various studies address nurses' responses to suicide and suicidal patients. An understanding of accumulated research-based literature about nurses' responses to suicide and suicidal patients may guide nurses to care for suicidal patients in ways that facilitate suicide prevention and recovery. Design. The design is reflexive and iterative. Method. A Critical Interpretive Synthesis was conducted, which comprised of six phases: formulating the review question, searching the literature, sampling, determining quality, extracting data and conducting an interpretive synthesis. Qualitative content analysis and systematic review of literature was included in these phases. Results. The results report the review question, literature review strategies, purposive sample (26 full-text studies published in peer reviewed journals, 1988-July 2009, conducted mostly in Europe and North American), quality determinants, data extraction into themes and an interpretive synthesis of four key concepts, i.e. critical reflection, attitudes, complex knowledge/professional role responsibilities, desire for support services/resources. Conclusion. This understanding of accumulated research-based literature enhances contextual, conceptual and methodological perspectives. Contextually, gaps exist in international research. Conceptually, the four key concepts can serve as a useful guide for nurses to understand their own and other nurses' responses to caring for suicidal patients in various settings. Methodologically, the Critical Interpretive Synthesis approach moved a small body of knowledge that varied in quality measures beyond an aggregate understanding. Relevance to clinical practice. Understanding nurses' responses to suicide and suicidal patients may guide nurses to care for suicidal patients in ways that facilitate suicide prevention and recovery, thus addressing the urgent work of suicide prevention in the world.

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