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Persson, M., Hildingsson, I., Hultcrantz, M., Kärrman Fredriksson, M., Peira, N., Silverstein, R. A., . . . Berterö, C. (2023). Care and support when a baby is stillborn: A systematic review and an interpretive meta-synthesis of qualitative studies in high-income countries.. PLOS ONE, 18(8), Article ID e0289617.
Open this publication in new window or tab >>Care and support when a baby is stillborn: A systematic review and an interpretive meta-synthesis of qualitative studies in high-income countries.
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2023 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 8, article id e0289617Article, review/survey (Refereed) Published
Abstract [en]

INTRODUCTION: Approximately 2 million babies are stillborn annually worldwide, most in low- and middle-income countries. Present review studies of the parental and healthcare providers' experiences of stillbirth often include a variety of settings, which may skew the findings as the available resources can vary considerably. In high-income countries, the prevalence of stillbirth is low, and support programs are often initiated immediately when a baby with no signs of life is detected. There is limited knowledge about what matters to parents, siblings, and healthcare providers when a baby is stillborn in high-income countries.

OBJECTIVES: This systematic review and interpretive meta-synthesis aim to identify important aspects of care and support for parents, siblings, and healthcare professionals in high-income countries from the diagnosis of stillbirth throughout the birth and postpartum period.

METHODS: A systematic review and qualitative meta-synthesis were conducted to gain a deeper and broader understanding of the available knowledge about treatment and support when stillbirth occurred. Relevant papers were identified by systematically searching international electronic databases and citation tracking. The quality of the included studies was assessed, and the data was interpreted and synthesised using Gadamer's hermeneutics. The review protocol, including qualitative and quantitative study approaches, was registered on PROSPERO (CRD42022306655).

RESULTS: Sixteen studies were identified and included in the qualitative meta-synthesis. Experiences of care and support were interpreted and identified as four fusions. First, Personification is of central importance and stresses the need to acknowledge the baby as a unique person. The parents became parents even though their baby was born dead: The staff should also be recognised as the individuals they are with their personal histories. Second, the personification is reinforced by a respectful attitude where the parents are confirmed in their grief; the baby is treated the same way a live baby would be. Healthcare professionals need enough time to process their experiences before caring for other families giving birth. Third, Existential issues about life and death become intensely tangible for everyone involved, and they often feel lonely and vulnerable. Healthcare professionals also reflect on the thin line between life and death and often question their performance, especially when lacking collegial and organisational support. Finally, the fusion Stigmatisation focused on how parents, siblings, and healthcare professionals experienced stigma expressed as a sense of loneliness, vulnerability, and being deviant and marginalised when a baby died before or during birth. GRADE CERQual ratings for the four fusions ranged from moderate to high confidence.

CONCLUSIONS: The profound experiences synthesised in the fusions of this meta-synthesis showed the complex impacts the birth of a baby with no signs of life had on everyone involved. These fusions can be addressed and supported by applying person-centred care to all individuals involved. Hence, grief may be facilitated for parents and siblings, and healthcare professionals may be provided with good conditions in their professional practice. Furthermore, continuing education and support to healthcare professionals may facilitate them to provide compassionate care and support to affected parents and siblings. The fusions should also be considered when implementing national recommendations, guidelines, and clinical practice.

Place, publisher, year, edition, pages
PLOS ONE, 2023
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-197229 (URN)10.1371/journal.pone.0289617 (DOI)001054317000015 ()37582089 (PubMedID)
Available from: 2023-08-28 Created: 2023-08-28 Last updated: 2024-01-22
Bergdahl, E. & Berterö, C. (2023). Creating theory: Encouragement for using creativity and deduction in qualitative nursing research.. Nursing Philosophy, 24(4), Article ID e12421.
Open this publication in new window or tab >>Creating theory: Encouragement for using creativity and deduction in qualitative nursing research.
2023 (English)In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 24, no 4, article id e12421Article in journal (Refereed) Published
Abstract [en]

Texts about theory in nursing often refer to theory construction by using inductive methods in a rigid way. In this paper, it is instead argued that theories are created, which is in line with most philosophers of science. Theory creation is regarded as a creative process that does not follow a specific method or logic. As in any creative endeavour, the inspiration for theory creation can come from many sources, including previous research and existing theory. The main idea put forward is that deductive qualitative research approaches should play a key role in theory creation. Furthermore, there is a need to differentiate between theory creation and theory justification. A model that emphasizes the creative aspects of theory creation and theory justification using qualitative approaches is presented. The model suggests that knowledge development is a deductive trial-and-error process where theory creation is followed by testing. Scientific theory creation and justification are presented as an iterative process that is deductive in that a testable hypothesis is derived from the theory. If the hypothesis is falsified, then the theory needs modification or might be altogether wrong. Several factors can block the creative process, both in theory development and in finding ways to test a theory in the justification phase. Some of these blockers are the idea of 'building blocks' and the inductive view of science often brought forward in nursing. Other blockers include striving for consensus and adherence to existing nursing philosophies and existing theories. Research and knowledge development are creative processes, and following predefined methods is not enough to ensure scientific rigour in qualitative nursing research.

Place, publisher, year, edition, pages
WILEY, 2023
Keywords
methodology, nursing research, philosophy of science, qualitative research
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-192086 (URN)10.1111/nup.12421 (DOI)000939697100001 ()36846926 (PubMedID)
Available from: 2023-03-01 Created: 2023-03-01 Last updated: 2024-03-18Bibliographically approved
Höglund, M., Wardh, I., Shahnavaz, S. & Berterö, C. (2023). Dental clinicians recognizing signs of dental anxiety: a grounded theory study. Acta Odontologica Scandinavica, 81(5), 340-348
Open this publication in new window or tab >>Dental clinicians recognizing signs of dental anxiety: a grounded theory study
2023 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, no 5, p. 340-348Article in journal (Refereed) Published
Abstract [en]

Introduction and ObjectiveThere is a knowledge gap in how dental clinicians recognise dental anxiety. The aim of this study was to identify, describe and generate concepts regarding this process.Materials and MethodsEleven semi-structured interviews were conducted with dental clinicians from the public dental service of ostergotland, Sweden. Purposive and theoretical sampling was used. Theoretical saturation was reached after eight interviews. The interviews were audio-recorded and transcribed verbatim. Classical grounded theory was used to inductively analyse data by constant comparative analysis.ResultsThe core category was identified as; the clinical eye, clinicians noticing behaviours possibly due to dental anxiety based on their knowledge, experiences, or intuition. The core category comprises the five categories: Sympathetic activation, Patient-reported anxiety, Controlling behaviours, Avoidance and Accomplishment. Initially there is usually uncertainty about whether a behaviour is due to dental anxiety or part of a patients normal behaviour. To gain additional certainty, clinicians need to recognise a stressor as something in the dental setting by observing a change in behaviour, for better or for worse, in the anticipation, presence or removal of the stressor.ConclusionsClinicians identify patients as dentally anxious if their behaviour changes with exposure to a stressor.

Place, publisher, year, edition, pages
Taylor & Francis Ltd, 2023
Keywords
Grounded theory; behavioural research; dental anxiety; diagnosis; dental staff
National Category
Dentistry
Identifiers
urn:nbn:se:liu:diva-190790 (URN)10.1080/00016357.2022.2154263 (DOI)000898032400001 ()36519282 (PubMedID)
Available from: 2023-01-02 Created: 2023-01-02 Last updated: 2024-02-08Bibliographically approved
Fornander, L., Berterö, C., Molin, I., Laukkanen, K., Nilsson, L. & Björnström-Karlsson, K. (2023). Development of trauma team cognition can be explained by "split vision": A grounded theory study. Journal of Interprofessional Care, 37(5), 706-714
Open this publication in new window or tab >>Development of trauma team cognition can be explained by "split vision": A grounded theory study
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2023 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 37, no 5, p. 706-714Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore interaction of interprofessional hospital trauma teams. A theory about how team cognition is developed through a dynamical process was established using grounded theory methodology. Video recordings of in-real-life resuscitations performed in the emergency ward of a Scandinavian mid-size urban hospital were collected and eligible for inclusion using theoretical sampling. By analyzing interactions during seven trauma resuscitations, the theory that trauma teams perform patient assessment and resuscitation by alternating between two process modes, the two main categories "team positioning" and "sensitivity to the patient," was generated. The core category "working with split vision" explicates how the teams interplay between the two modes to coordinate team focus with an emergent mental model of the specific situation. Split vision ensures that deeper aspects of the team, such as culture, knowledge, empathy, and patient needs are absorbed to continuously adapt team positioning and create precision in care for the specific patient.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS INC, 2023
Keywords
Decision-making; grounded theory; interprofessional working; team cognition; teamwork; trauma team
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-191963 (URN)10.1080/13561820.2023.2171970 (DOI)000926179300001 ()36739575 (PubMedID)
Note

Funding Agencies|Region Ostergoetland [LIO-627951, SC-2016-00261-02, 551-53173, SC-2019-00155-07]

Available from: 2023-02-27 Created: 2023-02-27 Last updated: 2024-03-05Bibliographically approved
Grundström, H., Fredrikson, M., Alehagen, S., Berterö, C. & Kjölhede, P. (2023). Incidence of self-reported pelvic pain and risk factors for pain 1 year after benign hysterectomy: A register study from the Swedish National Quality Registry for Gynecological Surgery. Acta Obstetricia et Gynecologica Scandinavica, 102(10), 1359-1370
Open this publication in new window or tab >>Incidence of self-reported pelvic pain and risk factors for pain 1 year after benign hysterectomy: A register study from the Swedish National Quality Registry for Gynecological Surgery
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2023 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 102, no 10, p. 1359-1370Article in journal (Refereed) Published
Abstract [en]

Introduction The primary aim of this study was to determine the incidence of patient-reported pain 1 year after hysterectomy for benign gynecological conditions in relation to occurrence of preoperative pain. The secondary aim was to analyze clinical risk factors for pain 1 year after the hysterectomy in women with and without preoperatively reported pelvic/lower abdominal pain. Material and methods This was a historical cohort study using data from the Swedish National Quality Registry for Gynecological Surgery on 16 694 benign hysterectomies. Data were analyzed using multivariable logistic regression models. Results One year after surgery, 22.4% of women with preoperative pain reported pelvic pain and 7.8% reported de novo pelvic pain. For those with preoperative pain younger age (adjusted odds ratio [aOR] 1.75, 95% confidence interval [CI] 1.38-2.23 and aOR 1.21, 95% CI 1.10-1.34 for women aged <35 and 35-44 years, respectively), not being gainfully employed (aOR 1.43, 95% CI 1.26-1.63), pelvic pain as the main symptom leading to hysterectomy (aOR 1.51, 95% CI 1.19-1.90), endometriosis (aOR 1.18, 95% CI 1.06-1.31), and laparoscopic hysterectomy (aOR 1.30, 95% CI 1.07-1.58), were clinically relevant independent risk factors for pelvic/lower abdominal pain 1 year after surgery, as were postoperative complications within 8 weeks after discharge. Meanwhile, clinically relevant independent risk factors for reporting de novo pain 1 year after surgery were younger age (aOR 2.05, 95% CI 1.08-3.86 and aOR 1.29, 95% CI 1.04-1.60 for women aged <35 and 35-44 years, respectively), and postoperative complications within 8 weeks after discharge. Conclusions The incidence of pelvic pain and de novo pain 1 year after hysterectomy was relatively high. Women with and without reported preoperative pelvic/lower abdominal pain represented clinically different populations. The risk factors for pelvic pain seemed to differ in these two populations. The differences in risk factors could be taken into consideration in the preoperative counseling and in the decision-making concerning method of hysterectomy, provided that large well-designed studies confirm these risk factors.

Place, publisher, year, edition, pages
Wiley, 2023
Keywords
epidemiology; hysterectomy; incidence; lower abdominal pain; pelvic pain; risk factors
National Category
General Practice
Identifiers
urn:nbn:se:liu:diva-188576 (URN)10.1111/aogs.14455 (DOI)000852493100001 ()36073635 (PubMedID)
Note

Funding Agencies|County council of Ostergotland; Linkoping University

Available from: 2022-09-19 Created: 2022-09-19 Last updated: 2023-11-30Bibliographically approved
Drott, J., Björnsson, B., Sandström, P. & Berterö, C. (2022). Experiences of Symptoms and Impact on Daily Life and Health in Hepatocellular Carcinoma Patients: A Meta-synthesis of Qualitative Research.. Cancer Nursing, 45(6), 430-437
Open this publication in new window or tab >>Experiences of Symptoms and Impact on Daily Life and Health in Hepatocellular Carcinoma Patients: A Meta-synthesis of Qualitative Research.
2022 (English)In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 45, no 6, p. 430-437Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The incidence of hepatocellular cancer (HCC) has continually increased. To achieve optimal supportive cancer care for HCC patients, it is important to consider patients' experiences and preferences.

OBJECTIVE: This meta-synthesis aims to critically interpret how patients with HCC experience symptoms and the impact of the disease on daily life and health.

METHODS: Searches were performed in the following bibliographic databases: PubMed, CINAHL, Web of Science, Scopus, PsycINFO, and Cochrane Library. In addition, searches were performed using Open Gray to identify relevant studies in the gray literature. The search was limited to studies published in English from 2009 to 2019. Five studies (124 participants) were identified, appraised, and ultimately interpreted and synthesized.

RESULTS: Receiving an HCC diagnosis was overwhelming and affected the patients' entire lives. Three themes were identified based on the meta-synthesis: (1) disrupted life, (2) living with uncertainty, and (3) a changed body. Patients with HCC experience disrupted lives because of the cancer's effect on health and multidimensional symptoms.

CONCLUSION: Available research on the experiences of HCC patients is limited. This meta-synthesis of available studies shows that being given a diagnosis of HCC is an overwhelming event. Our study findings show that an HCC diagnosis affected the individual's entire life.

IMPLICATIONS FOR PRACTICE: It is important to identify the patients' physical, psychological, social, and existential needs during the investigation of their condition, during any curative treatment, and at the palliative stage of the disease.

Place, publisher, year, edition, pages
Philadelphia, PA, United States: Lippincott Williams & Wilkins, 2022
Keywords
Daily life, Experiences, Health, Hepatocellular cancer, Meta-synthesis, Symptoms
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-183499 (URN)10.1097/NCC.0000000000001044 (DOI)000869781400004 ()35025775 (PubMedID)
Available from: 2022-03-10 Created: 2022-03-10 Last updated: 2022-11-07Bibliographically approved
Hellqvist, C., Berterö, C., Hagell, P., Dizdar, N. & Sund-Levander, M. (2020). Effects of self-management education for persons with Parkinson's disease and their care partners: A qualitative observational study in clinical care. Paper presented at 2020/04/26. Nursing and Health Sciences, 22(3), 741-748
Open this publication in new window or tab >>Effects of self-management education for persons with Parkinson's disease and their care partners: A qualitative observational study in clinical care
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2020 (English)In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 22, no 3, p. 741-748Article in journal (Refereed) Published
Abstract [en]

Persons with Parkinson's disease and their care partners want support from healthcare to develop the skills to handle everyday life with disease. Earlier findings indicate that participants of the self‐management program Swedish National Parkinson School experience several benefits of the program. The purpose of this qualitative observational study was to explore if participants had implemented the strategies of self‐monitoring included in the program, and use them to communicate health care status and needs in clinical encounters. Data was collected 3–15 months after participation in the program and analysed using constant comparative analysis. Three categories were evident: “Self‐observation in everyday life”, “Self‐care activities to promote health” and “Managing emotional impact of Parkinson's Disease”. Categories were linked together in a core category that highlight the use of self‐management strategies described by participants during clinical encounters. Results confirmed that persons with Parkinson's disease and care partners use the techniques of self‐observation in their everyday lives. Observations of effects in clinical care can be a valuable approach to evaluate the outcomes educational interventions and their benefits for individuals and health care.

This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
Parkinson disease, self-management, patient education, follow-up studies, clinical care, qualitative research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-165313 (URN)10.1111/nhs.12721 (DOI)000528855600001 ()32270898 (PubMedID)
Conference
2020/04/26
Note

Funding agencies:Foundation for Parkinson research Linkoping University; Henry and Ella Margaretha Stahl foundation; NEURO Sweden

Available from: 2020-04-27 Created: 2020-04-27 Last updated: 2021-04-25Bibliographically approved
Ahlberg, M., Hollman Frisman, G., Berterö, C. & Ågren, S. (2020). Family Health Conversations create awareness of family functioning.. Nursing in Critical Care (2), 102-108
Open this publication in new window or tab >>Family Health Conversations create awareness of family functioning.
2020 (English)In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, no 2, p. 102-108Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The whole family is affected if one family member is critically ill. The Family Health Conversation Intervention may give the family tools that support healthier family functioning.

AIMS AND OBJECTIVES: The aim of this study was to identify which components of family function are affected when families participate in Family Health Conversations.

DESIGN: A secondary analysis was performed of existing qualitative interviews. The Family Health Conversation is an intervention where nurses ask the family reflective questions, and reflection is made possible in three conversation sessions.

METHODS: This study included transcribed data from 13 follow-up interviews from seven families attending Family Health Conversations after three and 12 months. Data were analysed with narrative analysis, focusing on family function.

RESULTS: Three themes were identified. The families' family functioning had been supported with: improved understanding of each other-there was an understanding of being in the same situation but still having totally different experiences; more concern for each other-they talked about their different experiences and felt they had become closer to each other; and a process of working through-they had experienced working through various experiences, standing by and supporting, and then being able to move on.

CONCLUSIONS: The Family Health Conversation Intervention is provided to families, accompanied by nurses. The families in this study gained an awareness of their family function that brought the family closer because of improved understanding of each other and the situation. The families experienced openness, and the family members spoke more freely with each other, which facilitated the progress of working through the experience of critical illness and helped to maintain healthy family functioning.

RELEVANCE TO CLINICAL PRACTICE: It is important to have an overall perspective and to recognize the patient and the family as equally important within the family for awareness of family function.

Keywords
family members, family nursing, intensive care, narrativism, secondary analysis
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-157714 (URN)10.1111/nicc.12454 (DOI)000516973500006 ()31197904 (PubMedID)
Note

Funding agencies: Health Research Council in the South-East of Sweden [FORSS 466311]; Department of Anaesthesiology and Intensive Care, and Department of Medical and Health Sciences, Linkoping University, Norrkoping, Sweden

Available from: 2019-06-19 Created: 2019-06-19 Last updated: 2022-11-10
Back, C. & Berterö, C. (2019). Interpretativ fenomenologisk analys (3ed.). In: Andreas Fejes, Robert Thornberg (Ed.), Handbok i kvalitativ analys: (pp. 165-178). Stockholm: Liber, Sidorna 165-178
Open this publication in new window or tab >>Interpretativ fenomenologisk analys
2019 (Swedish)In: Handbok i kvalitativ analys / [ed] Andreas Fejes, Robert Thornberg, Stockholm: Liber, 2019, 3, Vol. Sidorna 165-178, p. 165-178Chapter in book (Other academic)
Place, publisher, year, edition, pages
Stockholm: Liber, 2019 Edition: 3
Keywords
Fenomenologi
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:liu:diva-162279 (URN)9789147129706 (ISBN)
Available from: 2019-11-26 Created: 2019-11-26 Last updated: 2019-11-26Bibliographically approved
Drott, J., Fomichov, V., Starkhammar, H., Börjeson, S., Kjellgren, K. I. & Berterö, C. (2019). Oxaliplatin-Induced Neurotoxic Side Effects and Their Impact on Daily Activities. Cancer Nursing, 42(6), E40-E48
Open this publication in new window or tab >>Oxaliplatin-Induced Neurotoxic Side Effects and Their Impact on Daily Activities
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2019 (English)In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 42, no 6, p. E40-E48Article in journal (Refereed) Published
Abstract [en]

Background: Oxaliplatin (OXA) is frequently used in the treatment of patients with colorectal cancer, and OXA-induced neurotoxic side effects are common. Reports on real-time patient-reported neurotoxic side effects and impact on the patient's daily activities are sparse in existing studies. Objective: The aim of this study was to identify and assess patient-reported OXA-induced neurotoxic side effects and their impact on the patient's daily activities, during and after chemotherapy. Methods: In a multicenter prospective longitudinal study, 46 chemo-naïve patients with colorectal cancer treated with postoperative adjuvant OXA-based chemotherapy were monitored during treatment and at 3-, 6-, 9-, and 12-month follow-ups. Patients were recruited from September 2013 to June 2016. In total, 370 Oxaliplatin-Associated Neurotoxicity Questionnaire responses were available for analysis. A mobile phone-based system was used to receive real-time assessments. Results: All patients reported neurotoxic side effects and impact on daily activities during treatment. The side effects changed in character and body location over time and had an impact on the daily activities. Conclusions: The high prevalence of OXA-induced neurotoxic side effects significantly interfered with the patients' daily activities. We found significant differences between baseline data and follow-up time points for neurotoxicity, and the patients had not returned to baseline after 1 year. Implications for Practice: The real-time assessment using mobile phone technology seems to be a valuable tool for monitoring patient-reported neurotoxicity and interventions for tailored care. Effectively identifying neurotoxicity and its impact on the patient's daily activities is important in supportive cancer care.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
Keywords
Cancer nursing; Chemotherapy; Colorectal cancer; Daily activities, mHealth; Neurotoxicity; Patient-reported outcomes; Symptom control
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-154883 (URN)10.1097/ncc.0000000000000674 (DOI)000494795400005 ()
Note

Funding agencies: Swedish Cancer SocietySwedish Cancer Society; Linkoping University

Available from: 2019-03-04 Created: 2019-03-04 Last updated: 2019-11-27
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1588-135X

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