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  • 1.
    Gustafsson, Markus
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa. Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa. Blekinge Tekniska Högskola, Sektionen för hälsa.
    Bohman, Doris M
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Gunilla, Borglin
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Challenges of conducting experimental studies within a clinical nursing context2014Ingår i: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 27, nr 2, s. 133-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In recent years, several distinguished scholars have advocated for nursing research that may carry strong evidence for practice. Their advocacy have highlighted that nursing science has reached a point where as nurse researchers we need to develop the questions we ask and design studies that have the power to produce solid, translational, evidence-based knowledge. To do so, we need to carry out experimental tests on complex, everyday nursing interventions and activities. We also need to create public space to present accounts of our endeavours pursuing this type of design in clinical practice. This paper will discuss some of the most important insights gained from conducting a quasi-experimental study in which the aim was to investigate the effect of a theory-based intervention, targeting knowledge and attitudes among registered nurses regarding cancer pain management. The importance of careful practical and methodological planning is emphasised and the need for participation-friendly interventions is discussed.

  • 2.
    Gustafsson, Markus
    et al.
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Borglin, Gunilla
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Can a theory-based educational intervention change nurses' knowledge and attitudes concerning cancer pain management? a quasi-experimental design2013Ingår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, nr 328, s. 1-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Registered Nurses (RNs) play an important role in caring for patients suffering from cancer pain. A lack of knowledge regarding pain management and the RNs' own perception of cancer pain could act as barriers to effective pain management. Educational interventions that target RNs' knowledge and attitudes have proved promising. However, an intervention consisting of evidence-based practice is a multifaceted process and demands behavioural and cognitive changes to sustain the effects of the intervention. Therefore, our study aimed to investigate if a theory-based educational intervention could change RNs' knowledge and attitudes to cancer pain and pain management, both four and 12 weeks after the start of the intervention. METHODS: A quasi-experimental design with non-equivalent control groups was used. The primary outcome was measured using a modified version of the instrument Nurses' Knowledge and Attitudes Survey Regarding Pain (NKAS) at baseline, four weeks and 12 weeks after the start of the intervention to evaluate its persistence. The intervention's educational curriculum was based on the principles of Ajzen's Theory of Planned Behaviour and consisted of interactive learning activities conducted in workshops founded on evidence-based knowledge. The RN's own experiences from cancer pain management were used in the learning process. RESULTS: The theory-based educational intervention aimed at changing RNs knowledge and attitudes regarding cancer pain management measured by primary outcome NKAS resulted in a statistical significant (p<0.05) improvement of total mean score from baseline to four weeks at the intervention ward. CONCLUSIONS: The findings of this study, suggest that a theory-based educational intervention focused at RNs can be effective in changing RN's knowledge and attitudes regarding cancer pain management. However, the high number of dropouts between baseline and four weeks needs to be taken into account when evaluating our findings. Finally, this kind of theory-based educational intervention with interactive learning activities has been sparsely researched and needs to be evaluated further in larger projects.Trial registration: Clinical Trials. Gov: NCT01313234.

  • 3.
    Gustafsson, Markus
    et al.
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Holst, Göran
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Kristensson, Jimmie
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Willman, Ania
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Bohman, Doris
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Case managers’ experiences of their everyday practice2013Ingår i: European Geriatric Medicine, Venice: Elsevier Masson SAS , 2013, Vol. 4, nr Supplement 1Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction.– Today, there is an interest in how Case Management (CM) should be designed to best suit the complex needs of the older people with multi-morbidity. Current research on CM has mainly focused on health care costs and consumption, but the results have been inconsistent and ranging from positive outcomes to no effect. To improve CM, there is need to investigate what mechanisms are important for a successful intervention. To advance this knowledge, there is a necessity for studies investigating the experiences of those practicing CM i.e. Case Managers. There might be unknown factors or interpersonal factors that can contribute to a CM intervention's success or failure. Therefore, the aim of this study was to explore the Case Managers’ experiences of their everyday practice. Methods.– The study design was qualitative and descriptive utilizing an ethnographic approach, consisting of participant observations, a focus group interview and individual interviews with nine Case Managers conducted during 2012/2013. The interviews were recorded and transcribed verbatim and then subjected to content analysis. Results.– Three main themes described Case Managers’ experience of their everyday practice: navigating the older person, working to improve the health care system and being the older persons advocate. Conclusions.– Findings from this study sheds light on the complexity of CM for older people with multi-morbidity, from the experiences of Case Managers. These findings could help in the development of CM models designed for older people with complex health needs.

  • 4.
    Gustafsson, Markus
    et al.
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Kristensson, Jimmie
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Holst, Göran
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Willman, Ania
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Bohman, Doris
    Blekinge Tekniska Högskola, Sektionen för hälsa.
    Case managers for older persons with multi-morbidity and their everyday work -- a focused ethnography2013Ingår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, nr 496Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Modern-day health systems are complex, making it difficult to assure continuity of care for older persons with multi-morbidity. One way of intervening in a health system that is leading to fragmented care is by utilising Case Management (CM). CM aims to improve co-ordination of healthcare and social services. To better understand and advance the development of CM, there is a need for additional research that provides rich descriptions of CM in practice. This knowledge is important as there could be unknown mechanisms, contextual or interpersonal, that contribute to the success or failure of a CM intervention. Furthermore, the CM intervention in this study is conducted in the context of the Swedish health system, which prior to this intervention was unfamiliar with this kind of coordinative service. The aim of this study was to explore the everyday work undertaken by case managers within a CM intervention, with a focus on their experiences. Methods The study design was qualitative and inductive, utilising a focused ethnographic approach. Data collection consisted of participant observations with field notes as well as a group interview and individual interviews with nine case managers, conducted in 2012/2013. The interviews were recorded, transcribed verbatim and subjected to thematic analysis. Results An overarching theme emerged from the data: Challenging current professional identity, with three sub-themes. The sub-themes were 1) Adjusting to familiar work in an unfamiliar role; 2) Striving to improve the health system through a new role; 3) Trust is vital to advocacy. Conclusions Findings from this study shed some light on the complexity of CM for older persons with multi-morbidity, as seen from the perspective of case managers. The findings illustrate how their everyday work as case managers represents a challenge to their current professional identity. These findings could help to understand and promote the development of CM models aimed at a population of older persons with complex health needs.

  • 5.
    Hjelm, Markus
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Barriers encountered by doctoral nursing students during their research studies and their strategies for overcoming them: A qualitative study2015Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, nr 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to explore the barriers experienced by doctoral nursing students during their research studies. An additional aim was to explore the strategies used to overcome these barriers. It can be a very challenging endeavour for doctoral nursing students to complete their research studies. During their research studies, doctoral students encounter various barriers that impede the progress of their studies. The study design was qualitative, and data were collected through individual interviews with seven doctoral nursing students at one university in Sweden between September and the end of November 2014. The data revealed seven themes illustrating barriers and strategies used by the doctoral nursing students to overcome these barriers: 1) difficulties in defining concepts, 2) intellectual struggles with qualitative analysis, 3) lack of control during the recruitment process, 4) missing a more research-oriented environment, 5) interruption to study focus when combining research and work, 6) lack of motivation, and 7) feeling powerless during supervision. In conclusion, this study illustrates the importance of facilitating good relationships between doctoral nursing students, their supervisors and faculty as a possible way of reducing barriers during research studies. These findings could be of help in the development of better learning environments for doctoral nursing students.

  • 6.
    Hjelm, Markus
    et al.
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Holmgren, Ann-Charlotte
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Willman, Ania
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Bohman, Doris
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Holst, Göran
    Blekinge Tekniska Högskola, Fakulteten för hälsovetenskaper, Institutionen för hälsa.
    Family members of older persons with multi-morbidity and their experiences of case managers in Sweden: an interpretive phenomenological approach2015Ingår i: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 15, nr Jan-MarArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers. Objectives: The aim of the study was to deepen the understanding of the importance of case managers to family members of older persons (75+) with multi-morbidity. Design: The study design was based on an interpretive phenomenological approach. Method: Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach. Results: The findings revealed one overarching theme: “Helps to fulfil my unmet needs”, based on three sub-themes: (1) “Helps me feel secure – Experiencing a trusting relationship”, (2) “Confirms and strengthens me – Challenging my sense of being alone” and (3) “Being my personal guide – Increasing my competence”. Conclusion and discussion: The findings indicate that case managers were able to fulfil unmet needs of family members. The latter recognised the importance of case managers providing them with professional services tailored to their individual needs. The findings can contribute to the improvement of case management models not only for older persons but also for their family members.

  • 7.
    Hjelm, Markus
    et al.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Holst, Göran
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Willman, Ania
    Bohman, Doris
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Kristensson, Jimmie
    The work of case managers as experienced by older persons (75+) with multi-morbidity – a focused ethnography2015Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, artikel-id 168Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Complex health systems make it difficult for older persons (75+) with multi-morbidity to achieve continuity of care. Case management could be one way to address this difficulty. Currently, there is a need to extend the knowledge regarding case management as experienced by those utilising the services, namely older persons (75+) with multi-morbidity. The study aimed to explore older persons’ (75+) with multi-morbidity experiences of case managers.

    Methods

    The study design was qualitative and used a focused ethnographic approach. Data was collected through individual interviews with 13 older persons and by participant observations with accompanying field notes, all conducted in 2012–2013.

    Results

    The data revealed four themes illustrating the older persons’ experiences of case managers:

    1) Someone providing me with a trusting relationship; 2) Someone assisting me; 3) Someone who is on my side; and 4) Someone I do not need at present.

    Conclusions

    This study illustrates the importance of establishing trusting relationships between older persons and their case managers in order to truly provide assistance. The older persons valued the case managers acting as informed but unbiased facilitators. The findings could be of help in the development of case management interventions better designed for older persons with multi-morbidity.

  • 8.
    Marcinowicz, Ludmiła
    et al.
    Medical University of Bialystok, POL.
    Andersson, Ewa K.
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Bohman, Doris
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Hjelm, Markus
    Blekinge Tekniska Högskola, Fakulteten för teknikvetenskaper, Institutionen för hälsa.
    Skarbalienė, Aelita
    Klaipeda University, LTU.
    Shpakou, Andrei
    Yanka Kupala State University of Grodno, UKR.
    Kalinowska, P.
    Medical University of Bialystok, POL.
    Jamiolkowski, Jacek
    Medical University of Bialystok, POL.
    Nursing students’ perception of the professional nurse's role in four European countries2019Ingår i: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 66, nr 2, s. 250-258Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Understanding how nursing students in European countries perceive their future professional role is an important step in creating awareness of the diversity and similarities between countries. Investigating nursing students’ perceptions of their future profession could help in the design of education and the retention of nurses. Aim: To compare nursing students’ perceptions of the professional nurse's role between Belarus, Lithuania, Poland and Sweden. Method: A cross-sectional design was implemented. The study used two scales of the Professional Nursing Image Survey, which has questions about 10 skills and abilities and 14 functions and duties of a nurse. Results: A total of 392 final-year nursing students in four countries participated in the study. Statistically significant differences were found between countries in terms of all 10 skills and abilities and in the distribution of responses concerning functions and duties of a nurse. Conclusions: Nursing students in Belarus, Lithuania, Poland and Sweden perceive differently the role of a nurse in terms of some functions and responsibilities. This may influence the adaptation of nurses who enjoy freedom of movement among the countries. Implications for nursing policy: The knowledge gained in this study could be beneficial in improving nursing education, as it could illuminate the discrepancy between educational goals and students’ perceptions of their future professional role. © 2018 International Council of Nurses

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