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Strandberg, Gunilla
Publications (10 of 59) Show all publications
Stenlund, A.-L. & Strandberg, G. (2023). Intensive care nurses’ experiences of Covid-19 care: a practical and ethical challenge – a qualitative descriptive design. Nordic journal of nursing research, 43(1), 1-8
Open this publication in new window or tab >>Intensive care nurses’ experiences of Covid-19 care: a practical and ethical challenge – a qualitative descriptive design
2023 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 43, no 1, p. 1-8Article in journal (Refereed) Published
Abstract [en]

The Covid-19 pandemic has generated new experiences of intensive care. It has entailed new working methods, treatment strategies, and ethical dilemmas. The aim of this study was to describe intensive care nurses' experiences of Covid-19 care and its ethical challenges. Data collection consisted of 11 individual semi-structured interviews and a qualitative content analysis was used. The COREQ checklist was followed. Three main themes emerged: to meet Covid-19 patients' needs for specifically tailored intensive care; to have a changed approach to the excluded relatives is unethical, but defensible; and to strive to protect ethical values needs to be considered as good enough. In conclusion, ICU nurses shouldered a heavy burden in taking responsibility for the safety of these patients, continuously learning about new treatment strategies. Caring for Covid-19 patients was to strive to make the best of the situation.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Covid-19, ethical dilemmas, intensive care nurse, prone position, relatives
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-205631 (URN)10.1177/20571585211062794 (DOI)2-s2.0-85206527148 (Scopus ID)
Note

First published online December 28, 2021

Available from: 2023-03-10 Created: 2023-03-10 Last updated: 2024-10-25Bibliographically approved
Ericson-Lidman, E. & Strandberg, G. (2023). Meanings of being a change agent in implementing a new organisational culture in home care services: a phenomenological hermeneutic study. Nordic journal of nursing research, 43(1), 1-8
Open this publication in new window or tab >>Meanings of being a change agent in implementing a new organisational culture in home care services: a phenomenological hermeneutic study
2023 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 43, no 1, p. 1-8Article in journal (Refereed) Published
Abstract [en]

Culture change is common in healthcare organisations worldwide today, and change agents are key persons in the process of change. It is therefore of vital importance to deepen the knowledge about change agents’ experiences. The aim of the study was to illuminate meanings of being a change agent to improve home care services. Ten change agents were interviewed individually using open-ended questions. The interviews were analysed with phenomenological hermeneutics. The design of the study followed the COREQ guidelines. Three themes were revealed in the analysis: ‘Being confirmed by the opportunity to make quality improvements’; ‘Pushing oneself to transfer the message’; and ‘Being strengthened by achievements but wishing for better conditions’. In order to prepare co-workers, change agents need training before their mission begins and during the change process.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
change agent, culture change, home care services, phenomenological hermeneutics
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-206028 (URN)10.1177/20571585231157505 (DOI)2-s2.0-85150436813 (Scopus ID)
Available from: 2023-03-27 Created: 2023-03-27 Last updated: 2023-03-27Bibliographically approved
Nazari, S., Norberg, A., Strandberg, G., Åhlin, J., Ericson-Lidman, E. & Mazaheri, M. (2023). Perceptions and stress of conscience in relation to burnout among nursing staff in older people care settings: a cross sectional study. BMC Nursing, 22(1), Article ID 379.
Open this publication in new window or tab >>Perceptions and stress of conscience in relation to burnout among nursing staff in older people care settings: a cross sectional study
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2023 (English)In: BMC Nursing, E-ISSN 1472-6955, Vol. 22, no 1, article id 379Article in journal (Refereed) Published
Abstract [en]

Background: Considering cultural influences, it is important to study the perceptions and stress of conscience in different contexts. This study aimed to investigate the association between perceptions of conscience, stress of conscience, and burnout among nursing staff working in older people care settings in Tehran.

Methods: This was a descriptive, cross-sectional study. A total of 161 participants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire, and Oldenburg Burnout Inventory, 2019. All nursing staff working at the 20 contacted nursing homes agreed to participate in the study. The descriptive and inferential analysis was conducted through SPSS, using T-tests and one-way between-groups analysis of variance, Chi-square and t-tests, Cohen's d (d), Eta-squared (η2), and Phi coefficient (φ), Partial least squares regression (PLSR), jackknife approximate t-tests of the regression coefficients, and jackknife 95% confidence intervals of the regression coefficients.

Results: The nursing staff perceived their conscience mainly as an authority, asset, and warning signal. Impact of workload on family life was the most common source of stress for the nursing staff. Dealing with incompatible demands, the impact of workload on family life, witnessing insulated patients, inability to meet one’s standards in providing care, and perception of conscience as a burden were strongly associated with the burnout.

Conclusions: Perceiving conscience as a warning signal or authority may serve as a buffer against burnout among nursing staff. This study highlights the need for further exploration of perceptions of conscience in different cultural and social backgrounds.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Burnout, Nursing staff, Older people care, Perceptions of conscience, Stress of conscience
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-215722 (URN)10.1186/s12912-023-01529-w (DOI)001081831000001 ()37833719 (PubMedID)2-s2.0-85174202977 (Scopus ID)
Available from: 2023-11-07 Created: 2023-11-07 Last updated: 2024-07-04Bibliographically approved
Åhlin, J., Ericson-Lidman, E. & Strandberg, G. (2022). Assessments of stress of conscience, burnout and social support amongst care providers in home care and residential care for older people. Scandinavian Journal of Caring Sciences, 36(1), 131-141
Open this publication in new window or tab >>Assessments of stress of conscience, burnout and social support amongst care providers in home care and residential care for older people
2022 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 36, no 1, p. 131-141Article in journal (Refereed) Published
Abstract [en]

Background: Studies points to that levels of stress of conscience and burnout among staff in healthcare contexts may seriously affect their health.

Aim: To compare assessments and associations of stress of conscience, perceptions of conscience, social support and burnout amongst care providers working in home care respectively residential care for older people.

Methods: This cross‐sectional descriptive comparative study was performed among all care providers working in home care (n = 227) and residential care of older people (n = 354) in a municipality in northern Sweden. Data was collected using four different questionnaires. Analysis were performed using partial least square regression, descriptive statistics, statistical tests and effect size measures.

Results: Care providers in residential care of older people assessed higher levels of stress of conscience compared to those working in home care. Exhaustion was an important predictor for belonging to the group of care providers working in residential care of older people. The most important predictor for belonging to the group of care providers working in home care were social support from one's immediate superior and co‐workers. Women assessed significantly higher levels of stress of conscience and exhaustion compared to men.

Conclusion: Further research seems needed to investigate what the high levels of stress of conscience is caused by. A combined intervention consisting of work‐directed measures against burnout and measures aiming at reducing stress of conscience is suggested.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
burnout, home care, perception of conscience, residential care of older people, social support, stress of conscience
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-181778 (URN)10.1111/scs.12970 (DOI)000630100300001 ()33734472 (PubMedID)2-s2.0-85102709944 (Scopus ID)
Available from: 2021-03-25 Created: 2021-03-25 Last updated: 2023-03-24Bibliographically approved
Ericson-Lidman, E. & Strandberg, G. (2021). Change agents’ experiences of implementing a new organizational culture in residential care for older people: a qualitative study. Nordic journal of nursing research, 41(3), 149-157
Open this publication in new window or tab >>Change agents’ experiences of implementing a new organizational culture in residential care for older people: a qualitative study
2021 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 41, no 3, p. 149-157Article in journal (Refereed) Published
Abstract [en]

Culture change in organizations may affect employees and change agents are often a forgotten resource; their perspective is often overlooked in research. The aim of the study was to illuminate experiences of being a change agent in order to improve residential care of older people. Interviews were performed with 15 change agents who participated in a large culture transformation in residential care for older people. The study followed COREQ guidelines and content analysis was used to interpret the text. The analysis revealed that the change agents felt chosen when they accepted the challenge to become a change agent, but they also felt that transferring the message to co-workers was demanding. Conflicting demands about measuring care and aggravating circumstances to implement change were described. The results indicate that change agents benefit from preparation for the role itself as they have a great responsibility on their shoulders. In making the process more successful, all co-workers should be involved in the change process from the beginning.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
content analysis, change agents, culture change, older people, residential care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-181386 (URN)10.1177/2057158521995994 (DOI)2-s2.0-85132278135 (Scopus ID)
Available from: 2021-03-10 Created: 2021-03-10 Last updated: 2023-03-24Bibliographically approved
Ericson-Lidman, E. & Strandberg, G. (2020). Care providers' troubled conscience related to an implementation of a time management system in residential care for older people: a participatory action research study. Scandinavian Journal of Caring Sciences, 34(3), 745-753
Open this publication in new window or tab >>Care providers' troubled conscience related to an implementation of a time management system in residential care for older people: a participatory action research study
2020 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 34, no 3, p. 745-753Article in journal (Refereed) Published
Abstract [en]

Background: Care providers in residential care for older people often refer to time shortage, a problem that may generate troubled conscience.

Aim: The aim of the study was to describe a PAR process to assist care providers in municipal residential care for older people to constructively deal with their troubled conscience related to an implemented time management system.

Method: This intervention study was carried out with 14 care providers and their manager in residential care for older people with the support of participatory action research (PAR). The recorded PAR sessions were transcribed and compiled with inspiration from content analysis.

Ethical considerations: The participants were given oral and written information and gave their written informed consent.

Findings: The PAR process was found to empower the participants to form their own structure of the practical professional planning, adapted to the residents needs and to their daily work. In this process, participants used their troubled conscience as a driving force and as an asset.

Conclusion: Instead of launching change without any deeper information, it is important to carefully prepare, involve and inform those who are going to execute the change. Meeting places should be arranged wherein care providers have the opportunity to share and reflect on challenging situations that can generate troubled conscience, especially when comprehensive changes in their work are going to be implemented.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
action research, qualitative approaches, care for older people.
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-164681 (URN)10.1111/scs.12779 (DOI)000492671300001 ()31657043 (PubMedID)2-s2.0-85074634994 (Scopus ID)
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2023-03-24Bibliographically approved
Ericson-Lidman, E. & Strandberg, G. (2018). Using a developed participatory action research process in practice to help care providers deal with troubled conscience in residential care of older people. Action Research, 16(2), 190-206
Open this publication in new window or tab >>Using a developed participatory action research process in practice to help care providers deal with troubled conscience in residential care of older people
2018 (English)In: Action Research, ISSN 1476-7503, E-ISSN 1741-2617, Vol. 16, no 2, p. 190-206Article in journal (Refereed) Published
Abstract [en]

Stress of conscience seriously influence the quality of care and the wellbeing of the care providers in care for older people. It is therefore of great importance to take measures to address, and relieve but preferably prevent stress related to troubled conscience. In our participatory action research studies, we have used troubled conscience as a driving force to relieve care providers’ burden and to increase quality of care. The aim with this paper is to present our experiences of using a further developed participatory action research process in practice to deal with care providers’ troubled conscience in residential care for older people. The contribution to participatory action research practice in our studies is a support to the participatory action research process through using a modified model of problem processing, an approach which we found fruitful. In the paper, we describe our experiences and discuss them in relation to relevant literature and theory. Our experiences are that in participatory action research it is crucial to build a trusting relationship and striving to create a fruitful dialogue between the researchers and the participants. In our studies, we found that participatory action research is an easy approach to adapt as a problem-solving process in clinical practice and in nursing research.

Place, publisher, year, edition, pages
London: Sage Publications, 2018
Keywords
Troubled conscience, participatory action research, care for older people
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-129337 (URN)10.1177/1476750316678916 (DOI)000435909700005 ()2-s2.0-85048890995 (Scopus ID)
Available from: 2016-12-22 Created: 2016-12-22 Last updated: 2018-09-21Bibliographically approved
Johan, Å., Strandberg, G., Astrid, N., Ternestedt, B.-M. & Ericson-Lidman, E. (2017). Care providers’ narrated experiences of working in private non-profit residential care for older people during downsizing and reorganisation, focusing on troubled conscience. Nordic journal of nursing research, 37(4), 177-185
Open this publication in new window or tab >>Care providers’ narrated experiences of working in private non-profit residential care for older people during downsizing and reorganisation, focusing on troubled conscience
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2017 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 37, no 4, p. 177-185Article in journal (Refereed) Published
Abstract [en]

Knowledge about care providers’ experiences of working in residential care of older people during times of downsizing and reorganisation is scarce, and it is not known whether/how their conscience is influenced by such changes. The aim was to describe care providers’ experiences of working in private residential care for older people during downsizing and reorganisation, focusing on troubled conscience. This study adopted a qualitative descriptive design based on interviews with seven care providers. A qualitative content analysis was used. The overall understanding was revealed as perceiving oneself as pinioned in between current circumstances to provide care and what one’s conscience conveyed. Care providers perceived: deteriorating working conditions as exhausting, downsizing and reorganisation as triggering one’s conscience when collaborating, troubled conscience when downsizing and reorganisation decrease the quality of care, and good management as crucial during downsizing and reorganisation. The results highlight that adequate communication strategies, well-functioning leadership and opportunities to know together and share what one’s conscience tells are aspects that need consideration.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
care providers, conscience, content analysis, downsizing, reorganisation, residential care of older people
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-100067 (URN)10.1177/2057158516678160 (DOI)
Projects
Stress of conscience and burnout among healthcare personnel in elderly care
Funder
Swedish Research Council, K2011-70X-21823-01-3Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-0296
Note

Previously included in thesis in manuscript form, with title "Care providers’ narrated experiences of working in private residential care for older people during downsizing and reorganisation with focus on troubled conscience". 

Available from: 2015-02-20 Created: 2015-02-20 Last updated: 2022-03-15Bibliographically approved
Viglund, K., Jonsén, E., Lundman, B., Nygren, B. & Strandberg, G. (2017). Sources and expressions of inner strength among old people who have experienced a crisis in life associated with a disease. Nordic journal of nursing research, 37(1), 20-26
Open this publication in new window or tab >>Sources and expressions of inner strength among old people who have experienced a crisis in life associated with a disease
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2017 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 37, no 1, p. 20-26Article in journal (Refereed) Published
Abstract [en]

Inner strength is reported as an important resource associated with aging, health, and disease management. The aim was toexplore inner strength in people (n ¼ 12) aged 65 years and older, who had experienced a crisis in life associated with a disease. The participants had self-rated their inner strength as high. We found that sources of inner strength were mutual love and support, and the fact that tough times have been managed before. Expressions of inner strength comprised focusing on possibilities instead of brooding, facing and take an active part in care and treatment, and being able to confront reality and pick yourself up again. Inner strength is a complex phenomenon. Increased knowledge of inner strength can serve as an aid inefforts to identify the need to promote inner strength.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
disease management, experiences, inner strength, old people, qualitative content analysis
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-124961 (URN)10.1177/2057158516659839 (DOI)
Available from: 2016-08-31 Created: 2016-08-31 Last updated: 2018-06-07Bibliographically approved
Åhlin, J., Ericson-Lidman, E., Norberg, A. & Strandberg, G. (2015). A comparison of assessments and relationships of stress of conscience, perceptions of conscience, burnout and social support between healthcare personnel working at two different organizations for care of older people. Scandinavian Journal of Caring Sciences, 29(2), 277-287
Open this publication in new window or tab >>A comparison of assessments and relationships of stress of conscience, perceptions of conscience, burnout and social support between healthcare personnel working at two different organizations for care of older people
2015 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 2, p. 277-287Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this cross-sectional, descriptive study was to compare assessments and relationships of stress of conscience, perceptions of conscience, burnout and social support between healthcare personnel (HCP) working in two different organisations for care of older people.

METHODS: This cross-sectional, descriptive comparative study was performed among Registered Nurses and nurse assistants working in two different organisations (n(1)  = 98, n(2)  = 488) for residential care of older people. The organisations were chosen to be as different as possible, and data were collected using four different questionnaires. Hierarchical cluster analysis with multiscale bootstrap resampling was used to compare the associations between all items in the questionnaires. Descriptive statistics, 95% confidence intervals, chi-squared tests, Cohen's d, Cramer's V and the φ coefficient were all used to judge differences between the organisations.

RESULTS: The associations between stress of conscience, perceiving one's conscience as a burden, and burnout were similar in both organisations. Perceiving one's conscience as far too strict and having a troubled conscience from being unable to live up to one's standards were associated with stress of conscience and burnout in one organisation. Women had higher levels of stress of conscience and reported lower social support from co-workers compared with men.

CONCLUSIONS: This study shows that associations between perceptions of conscience, stress of conscience and burnout are common experiences that are similar among HCP despite great differences in the characteristics of organisations. It can be burdensome for HCP to be unable to realise their ambitions to provide good care, and sex/gender can be an important factor to consider in the development of measures against the negative effects of stress of conscience. More studies are needed about how HCP's ambition to provide good care and sex/gender are related to perceptions of conscience, stress of conscience and burnout.

Keywords
burnout, perceptions of conscience, residential care of older people, social support, stress of conscience
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-98475 (URN)10.1111/scs.12161 (DOI)000354260700009 ()25154457 (PubMedID)2-s2.0-85027957186 (Scopus ID)
Available from: 2015-01-22 Created: 2015-01-22 Last updated: 2023-03-24Bibliographically approved
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