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  • 101.
    Widar, Marita
    et al.
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Ahlström, Gerd
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Coping with long-term pain after a stroke2004In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 27, no 3, p. 215-225Article in journal (Refereed)
    Abstract [en]

    The aim of this qualitative study was to describe pain, coping strategies, and experienced outcome of coping with long-term pain conditions after a stroke. Forty-three participants were interviewed: 15 with central post-stroke pain (CPSP), 18 with nociceptive pain, and 10 with tension-type headache. Analysis of the data was by content analysis. Pain-related problems described were incomprehensibility regarding the pain, disturbed sleep, fatigue, diminished capacity, mood changes, and stress in relationships. Different coping strategies were used; the most common were making the pain comprehensible, planning of activities, taking medications, communicating, and distractions. Changing body position, making comparison, and enduring the pain were common in central or nociceptive pain, rest and relaxation in tension-type headache. Communicating their pain gave a feeling of perplexity and resignation. Satisfaction was reported in the cases of consideration shown by others. Pain after a stroke requires specialized knowledge in order to understand the patient's experiences and to enhance coping.

  • 102.
    Wikby, Kerstin
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Christensson, Lennart
    Division of Nursing Science, University College of Health Sciences, Jönköping University, Jönköping, Sweden.
    Implementation of a Nutritional Programme in Elderly People Admitted to Resident Homes2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 3, p. 421-430Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to test the hypothesis that education provided to staff regarding nutritional needs and individualizing nutritional care will improve the nutritional status and functional capacity of elderly people newly admitted to resident homes.

    Design: Pre- and posttest, quasi experimental.

    Setting: Resident homes.

    Subjects: Sixty-two residents (20 men, 42 women) in the experimental group and 53 (14 men, 39 women) in the control group were consecutively included. Mean age was 85 years.

    Methods: On admission and after 4 months, nutritional status was assessed using a combination of anthropometry (weight index, arm muscle circumference and triceps skinfold thickness) and biochemical measurements (serum albumin and transthyretin). Functional capacity and overall cognitive function were also assessed. In the experimental unit, the staff received education about nutritional needs and individualized nutritional care.

    Results: After 4 months the number of residents assessed as protein energy malnourished decreased from 20 to seven in the experimental (p = 0.004), and from 17 to 10 in the control group (p = 0.1). In the experimental group, motor activity (p = 0.006) and cognitive function (p = 0.02) increased. In the control group, motor activity decreased (p = 0.02).

    Conclusions: The results indicate that the intervention had effects, as the number of protein energy malnourished residents decreased in the experimental group and motor activity and cognitive function improved. No such improvements were seen in the control group.

  • 103.
    Wikby, Kerstin
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Christensson, Lennart
    University College of Health Sciences, Jönköping University, Jönköping, Sweden.
    Nutritional Status in Elderly People Admitted to Community Residential Homes: Comparisons between two Cohorts2006In: Journal of Nutrition, Health and Aging, ISSN 1279-7707, Vol. 10, no 3, p. 232-238Article in journal (Refereed)
    Abstract [en]

    The aim was to describe nutritional status and socio-demographic and medical data in people whowere newly admitted to community residential homes (cohort 2), and to compare the results with a previous studyperformed in the same municipality four years earlier (cohort 1). One hundred and twenty-seven people, 65 yearsof age, or older, newly admitted to residential homes in a municipality in the southern part of Sweden, wereconsecutively included. Nutritional status was assessed, using a combination of anthropometry and serum proteinmeasurements and by Mini Nutritional Assessment (MNA). The results showed that 32 % of the residents incohort 2 were assessed as protein-energy malnourished (PEM), compared with 38 % in cohort 1. Body massindex, psychological stress or acute disease, and reduced fluid intake were items in MNA which had power topredict PEM. Residents in cohort 2, diagnosed as having severe medical diseases, increased as well as residentswith neuropsychological problems. Simultaneously, the number living in residential homes decreased, ascompared to cohort 1. These differences indicate that the admission criteria have changed between cohorts 1 and 2.

  • 104.
    Wikby, Kerstin
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Christensson, Lennart
    Department of Nursing Science, University College of Health Sciences, Jönköping University, Jönköping, Sweden.
    The two-step Mini Nutritional Assessment Procedure in Community Resident Homes2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 9, p. 1211-1218Article in journal (Refereed)
    Abstract [en]

    Aims and objectivities: The aims were to test internal consistency and interrater reliability of Mini Nutritional Assessment during implementation of Mini Nutritional Assessment in community residential homes and to test sensitivity, specificity and diagnostic predictivity of Mini Nutritional Assessment-short form vs. Mini Nutritional Assessment.

    Background: There is a need in clinical practice to assess nutritional status in older people and to identify those who could benefit from early intervention.

    Methods: The two-step Mini Nutritional Assessment procedure (Mini Nutritional Assessment-short form and Mini Nutritional Assessment) was used in 127 older people admitted to eight residential homes. In three of those homes (A, B and C), registered nurses simultaneously performed the assessment procedure, after receiving education and training. The intention was to offer the registered nurses a tool for independent practice use.

    Results: Internal consistency was 0·68 (Cronbach's alpha) (n = 127). In residential home A, B and C, the registered nurses carried out Mini Nutritional Assessment in 45 residents out of 68. The agreement level between the author's and the registered nurses' assessments was 62% (kappa 0·41). In residential home A, B and C, the agreement level was 89%, 89% and 44%, respectively. Sensitivity, specificity and diagnostic predictivity of Mini Nutritional Assessment-short form vs. Mini Nutritional Assessment were 89%, 82% and 92%, respectively.

    Conclusions: The two-step Mini Nutritional Assessment procedure seems to be a useful tool to identify residents in need of nutritional interventions, despite the registered nurses not carrying out Mini Nutritional Assessment in all residents and the low agreement in residential home C. It indicates that to implement and use Mini Nutritional Assessment in nursing care demands the creating necessary staff resources, such as adequate staffing, sufficient education and continual supervision.

    Relevance to clinical practice: Because of the high sensitivity of Mini Nutritional Assessment-short form and Mini Nutritional Assessment, Mini Nutritional Assessment-short form alone might be sufficient for practice use, as its simplicity might increase its usefulness.

  • 105.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Opinions about district nurses prescribing2001In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 4, p. 326-330Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the opinions of district nurses (DNs) and general practitioners (GPs) about nurse prescribing in Sweden in order to elucidate similarities and differences, and relate different opinions to background and psychosocial working factors. In a questionnaire about psychosocial working conditions, seven statements about DNs prescribing were included. The questionnaire was sent to 554 DNs and 566 GPs with a participant rate of 83%. On all items as well as on the total score DNs rated more positively compared with GPs. Amongst the DNs a positive opinion was related to a traditional primary care organization, age < 50, good social support at work, and high workload. A positive opinion amongst GPs was associated with working in a traditional primary care organization, being male GP, and a good social support at work. In a multiple regression analysis, occupation and organization were independently associated with the total score. The result shows a strong professional solidarity amongst GPs and seems to be based on concern about the profession rather than patient care.

  • 106.
    Wilhelmsson, Susan
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Assessment of Psychosocial Work Environment in Primary Care: Development of a Questionnaire1999In: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 23, no 6, p. 447-456Article in journal (Refereed)
    Abstract [en]

    Recent studies have indicated deteriorated working conditions of health care personnel. To have an efficient health care organization requires good working conditions and the well-being of the personnel. Today there are no 'gold-standard' assessment tools measuring psychosocial working conditions. The aim of this study was to develop two valid and reliable questionnaires, one generic and one specific, measuring psychosocial working conditions for general practitioners (GPs) and district nurses (DNs) in Sweden, with a special emphasis on organizational changes. The construction of the questionnaires were made after a stepwise developing phase including literature review, interviews, and a pilot study. The pilot study included GPs n = 42 and DNs n = 39. The questionnaires were later on used in a main study (GPs n = 465, DNs n = 465). A factor analysis was carried out and showed that there were fewer items in the main study that had factor loading ≥ 0.40 in more than one factor, compared to the pilot study. The factors from the main study were easier to label and had good correspondence with other studies. After this stepwise development phase good construct validity and internal consistency were established for the questionnaire.

  • 107.
    Wissing, Ulla E.
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Wengström, Yvonne
    Department of Research and Development in Primary Health Care, Norrköping, Sweden.
    Sköld, Gunilla
    Department of Dermatology, Vrinnevi Hospital, Norrköping, Sweden.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nutritional support for elderly patients with non-healing venous ulcers: a single case studyManuscript (preprint) (Other academic)
    Abstract [en]

    Tills single-case study was undertaken in order to evaluate if an individually designed programme of nutritional support could improve healing in otherwise therapy resistant venous leg ulcers. Six patients, between 79 and 93 years of age, with venous ulcers open for one year or more were recruited from primary health care. The patients were offered liquid dietary supplements to be taken between meals in a specially designed diet plan based on individual needs and the patient's own preferences. Ulcer area, anthropometric and biochemical variables, and intake of energy and nutrients were assessed before intervention and then regularly for nine months.

    After nine months, two patients, one with two ulcerated legs and another with one ulcerated leg had healed ulcers. In one patient with two ulcerated legs, one leg was healed and one leg almost healed. In another patient with one ulcerated leg, the ulcer area was reduced by about 90%. The duration of open ulcers before the study in the healed legs was 2, 1.5, 4, and 8 years and in those almost healed 4, and 1.5 years. It seems reasonable to suggest that nutritional support might have played a role in improving healing in those patients with a less satisfactory situation nutritionally. Although the relationship between nutritional supplementation and wound healing is far from well defined, an appropriately used nutritional plan is recommended when problems with the nutritional situation are anticipated and the ulcers do not heal.

  • 108.
    Wissing, Ulla
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    A follow-up study of ulcer healing, nutrition, and life-situation in elderly patients with leg ulcer2001In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 5, no 1, p. 37-42Article in journal (Refereed)
    Abstract [en]

    This study was undertaken in order to follow up ulcer healing, ulcer recurrence, nutritional status and life-situation in elderly patients with leg ulcers. Of 70 patients assessed previously in 1996, 43 (61%) were still alive in 2000 and, of these, 38 (88%) participated in the follow-up. Rate of healing, recurrence and amputation were obtained from medical records and interviews with the patients. The Mini Nutritional Assessment (MNA) was used to assess their nutritional status and the Philadelphia Geriatric Center Multilevel Assessment Instrument was used for assessment of their life-situation. Nineteen patients (50%), mean age 82+/-4.6 years, had healed ulcers. Two (5%) patients, mean age 86+/-2.8, had required amputation and had no ulceration after surgery. Seventeen patients (45%), mean age 80.3+/-6 years, had open ulcers, six had their original ulcers still unhealed, and 11 had open recurrent ulcers. Decreased mean MNA scores, as well as decreased mean scores in ADL and mobility, were seen over time in patients with open ulcers but not in those who were healed. Patients with healed ulcers had significantly higher mean scores in social interaction than those with open ulcers and significantly increased mean scores in environmental quality over time. The results indicate that nutrition and the life-situation might be related to leg ulcer healing. The nutritional situation and the whole life-situation should be observed and taken into consideration when care is planned. Additional research is needed to increase the understanding of the relationship between nutrition, life-situation and ulcer healing.

  • 109.
    Wissing, Ulla
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Life situation and function in elderly people with and without leg ulcers2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 1, p. 59-65Article in journal (Refereed)
    Abstract [en]

    The majority of elderly patients with leg ulcers live at home and receive treatment for their ulcers within the primary health care system. Little is known about the patients' ability or behaviour in the life situation and how well they manage their daily life at home. The Philadelphia Geriatric Center Multilevel Assessment Instrument (PGC MAI) was used to assess and compare the life situation in 70 patients (mean age 79 +/- 6.5 years) with leg ulcers and in 74 elderly persons (mean age 80 +/- 5.7 years) without leg ulcers. The patients with leg ulcers had significantly lower mean values in the domains of physical health, activity of daily living (ADL), cognition, time use and social behaviour, personal adjustment and environmental quality than those without ulcers. Sixty-three percent of the patients reported ulcer-related pain, and all of them were dependent on health care personnel for dressing changes. This may indicate that the life situation among elderly persons with leg ulcers is not so good as compared with that of elderly persons without ulcers and that patients with leg ulcers are more vulnerable than elderly people of the same age.

  • 110.
    Wissing, Ulla
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Ek, Anna-Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Wengström, Y
    Norrköping.
    Sköld, G
    Norrköping.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Can individualised nutritional support improve healing in therapy-resistant leg ulcers?2002In: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, Vol. 11, no 1, p. 15-20Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study investigated whether an individually designed programme of nutritional support can improve healing in otherwise therapy-resistant venous leg ulcers. METHOD: Six primary health-care patients, aged between 79 and 93 years, with venous ulcers that had been open for one year or more (range: 1.5-8 years) were recruited into the study. The patients were asked to follow an individualised diet plan which included the use of liquid dietary supplements. Ulcer area, anthropometric and biochemical variables, and energy and nutrient intake were assessed before intervention and then regularly for nine months. RESULTS: At nine months ulcer healing had occurred in two patients, of whom one had had ulcers on both legs. In a third patient the ulceration on one leg had healed and that on the other leg had almost healed. In a fourth patient, the ulcer area reduced by approximately 90%. CONCLUSION: The use of nutritional support might have assisted the wound healing in these patients. Although the relationship between nutritional supplementation and wound healing is not well defined, an appropriate nutritional plan is recommended if undernourishment is suspected and leg ulcers are not healing.

  • 111.
    Wissing, Ulla
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lennernäs, Maria A. C.
    National Institute of Public Health, Stockholm, Sweden.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Monitoring of dietary quality in outpatients by qualitative meal classification method1998In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 11, no 2, p. 125-133Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to evaluate whether qualitative meal-classification used as a dietary evaluation tool reflects eating frequency and key nutrients in the diet, and whether it could be used to monitor the dietary quality in elderly outpatients. The qualitative meal-classification tool used was based on eight food categories combined into four types of meals: Complete, Incomplete, Less Balanced and Vegetarian Meals, and three types of snacks: High-, Mixed- and Low-Quality Snacks.

    Methods: Dietary intake was assessed during 7 consecutive days by use of an estimated food record in nine elderly women with leg ulcers. Mean 7-day dietary intakes of energy, macronutrients, beta-carotene, retinol, vitamin E, ascorbic acid, calcium, iron, zinc and dietary fibre were calculated. Each eating event was classified in accordance with the food-based classification method. The frequency of the four types of meals and three types of snacks, their energy content and nutrients, and their contribution to total intake were subsequently analysed.

    Results: Meals were associated with a higher energy, vitamin and mineral content than were snacks. Complete Meals were the major source for beta-carotene and ascorbic acid. Intakes from Low-Quality Snacks were relatively high in energy, fat and sucrose.

    Conclusion: The qualitative meal-classification tool was found to be simple to use and useful for reflecting meal order and the nutritional roles of different types of meals and snacks in the diet. This method is recommended for dietary monitoring.

  • 112.
    Wissing, Ulla
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lennernäs, Maria A-C
    Department of Medical Sciences, Nutrition Unit, Uppsala University, Sweden.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Meal patterns and meal quality in patients with leg ulcers2000In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 13, no 1, p. 3-12Article in journal (Refereed)
    Abstract [en]

    Background Wound healing is a complex process, which requires adequate energy sources, proteins, and specific minerals and vitamins. If an individual is unable to get or to eat the nutrients required, the wound healing process might be disrupted. The aim of this study was to investigate food-related factors, meal patterns and meal quality in relation to nutritional status in elderly out-patients with leg ulcers.

    Methods Nutritional status was assessed by use of the Mini Nutritional Assessment in 70 patients living in their own homes. Fifty-six of the patients recorded actual meals and snacks over four consecutive days. Meal patterns and meal quality were evaluated with the help of a qualitative classification system, the Food Based Concept for Classification of Eating Episodes.

    Results Thirty-six patients were classified as well-nourished, 32 were at risk of malnutrition and two were malnourished. More patients in the risk group for malnutrition did not buy their own food, and usually ate alone. Incomplete Meals and Low Quality Snacks were the most common eating types. The patients at risk of malnutrition had significantly fewer prepared Complete Meals than the well-nourished patients.

    Conclusion The results show a diet and meal quality which hardly meets the requirements for nutrients that are important in wound healing, especially for those patients assessed at risk of malnutrition.

  • 113.
    Wissing, Ulla
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lennernäs, Maria A. C.
    National Food Administration, Nutrition Division, Uppsala and Department of Domestic Sciences, Faculty of Social Sciences. University of Uppsala, Uppsala.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nutritional intake and physical activity in leg ulcer patients1997In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 25, no 3, p. 571-578Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe the nutritional intake, meal patterns, physical activity and need for help in nine women living in their own homes and being treated for venous leg ulcers. Food habits were identified by use of interviews and food diaries completed by the women during a period of seven days. The intake of energy and nutrients from 304 eating events during seven days was calculated and meal patterns were evaluated using a qualitative system for meal classification. Physical activity and the degree of need were identified with the help of interviews. The intakes of energy and key nutrients for wound healing, such as protein, vitamin C and zinc, were not optimal according to the Swedish nutrition recommendations, although food habits were well organized. Most of the women had hardly any physical activities and the need of help and support varied, from daily visits to visits every second week.

  • 114. Wåhlin, I
    et al.
    Ek, Anna-Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Idvall, Ewa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Patient empowerment in intensive care2006In: 19th annual congress. European Society of Intensive Care Medicine,2006, 2006Conference paper (Other academic)
  • 115.
    Wåhlin, Ingrid
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Idvall, Ewa
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Empowerment from the perspective of next of kin in intensive care2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 18, p. 2580-2587Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. The aim of the study was to describe next of kin empowerment in an intensive care situation.

    Background. Next of kin is important in reducing intensive care patients’ fear and anxiety. However, admission to an intensive care unit is often recognised as an extremely stressful event, causing next of kin to experience shock, fear, anxiety and vulnerability. More knowledge is needed about how next of kin in intensive care can be strengthen and empowered.

    Design and methodology. The study was conducted using a phenomenological method and is based on ten interviews with intensive care patients’ next of kin.

    Findings. Perceptions of both a genuine will and a capacity to help and relieve were found to be essential for next of kin’s experiences of empowerment in an intensive care situation. All informants were strengthened and empowered by a caring atmosphere in which they received continuous, straightforward and honest information that left room for hope, and in which closeness to the patient was facilitated and medical care was experienced as the best possible. Some of the informants were also strengthened by support from other family members and/or by being involved in caring for the patient.

    Conclusions. The findings emphasise the essential entirety of what is done and how these acts are performed. A warm and positive atmosphere in which next of kin always feel welcome, are met with empathy in an unaffected way, are confirmed and receive support or advice when needed, are crucial to next of kin’s experiences of empowerment.

    Relevance to clinical practice. Knowledge of how to empower next of kin in an intensive care situation allows caring staff to support these persons in a more sensitive and appropriate way. Findings underline the importance of creating caring relations.

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  • 116.
    Wåhlin, Ingrid
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Idvall, Ewa
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Empowerment in Intensive Care: Patient experiences compared to next of kin and staff beliefs2009In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 25, no 6, p. 332-340Article in journal (Refereed)
    Abstract [en]

    Experiences of critically ill patients are an important aspect of the quality of care in intensive care units. If next of kin and staff try to empower the patient, this is probably performed in accordance with their beliefs about what patients experience as empowering. As intensive care patients often have difficulties communicating, staff and next of kin need to interpret their wishes, but there is limited knowledge about how proper a picture next of kin and staff have of the intensive care patient’s experiences. The aim of this study was to compare intensive care patients’ experiences of empowerment with next of kin and staff beliefs. Interviews with 11 intensive care patients, 12 next of kin and 12 staff were conducted and analysed using a content analysis method. The findings show that the main content is quite similar between patient experiences, next of kin beliefs and staff beliefs, but a number of important differences were identified. Some of these differences were regarding how joy of life and the will to fight were generated, the character of relationships, teamwork, humour, hope and spiritual experiences. Staff and next of kin seemed to regard the patient as more unconscious than the patient him/herself did. 2

  • 117.
    Wåhlin, Ingrid
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Idvall, Ewa
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Patient empowerment in intensive care: An interview study2006In: Intensive and Critical Care Nursing, ISSN 0964-3397, Vol. 22, no 6, p. 370-377Article in journal (Refereed)
    Abstract [en]

    Intensive care patients often experience a lack of control, as well as inner chaos. Experiences from intensive care can continue to affect patients for a long time. Empowerment is a positive and dynamic process that focuses on people's strengths, rights and abilities. It takes on different expressions for different people in different environments and must be described by the people involved. The aim of this study was to describe patient empowerment in an intensive care situation. The study was based on open-ended interviews with 11 patients in two intensive care units. The interviews were analysed according to the empirical phenomenological psychological method. The results showed that patient empowerment in intensive care consists of strengthening and stimulating the patients’ own inherent joy of life and will to fight. A positive environment that encouraged feelings of value and motivation and in which the patient felt safe, received additional care and participated as he/she wished had a positive influence.

  • 118.
    Wåhlin, Ingrid
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Idvall, Ewa
    Malmö University.
    Staff empowerment in intensive care: nurses' and physicians' lived experiences2010In: Intensive and Critical Care Nursing, ISSN 0964-3397, Vol. 26, no 5, p. 262-269Article in journal (Other academic)
    Abstract [en]

    Aim

    The purpose of the study was to describe empowerment from the perspective of intensive care staff. What makes intensive care staff experience inner strength and power?

    Background

    Intensive care staff are repeatedly exposed to traumatic situations and demanding events, which could result in stress and burnout symptoms. A higher level of psychological empowerment at the workplace is associated with increased work satisfaction and mental health, fewer burnout symptoms and a decreased number of sick leave days.

    Method

    Open-ended interviews were conducted with 12 intensive care unit (ICU) staff (four registered nurses, four enrolled nurses and four physicians) in southern Sweden. Data were analysed using a phenomenological method.

    Findings

    Intensive care staff were found to be empowered both by internal processes such as feelings of doing good, increased self-esteem/self-confidence and increased knowledge and skills, and by external processes such as nourishing meetings, well functioning teamwork and a good atmosphere.

    Conclusion

    Findings show that not only personal knowledge and skills, but also a supporting atmosphere and a good teamwork, has to be focused and encouraged by supervisors in order to increase staff's experiences of empowerment. Staff also need a chance to feel that they do something good for patients, next of kin and other staff members.

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