Change search
Refine search result
12 1 - 50 of 66
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1. Andersson, Elisabeth
    et al.
    Valdenäs, Stina
    Nilsson, Roland
    Willman, Ania
    Aktuellt kunskapsläge vid kateterspolning: systematisk litteraturgranskning2011In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 31, no 4, p. 27-31Article in journal (Refereed)
    Abstract [en]

    Aim: Reviewing the scientific literature with regards to urinary catheter washouts in order to prevent occlusion. Background: Patients with long-term indwelling urinary catheters often suffers from catheter blockage. Encrustations and the forming of biofilm on the catheter surface are among the most common causes of occlusion. It is unknown whether urinary catheter washout is the treatment of choice to prevent occlusion. Methods: A systematic review of the scientific literature regarding urinary catheter washouts. The study was conducted by two independent reviewers. The search used MeSH and freetext terms, in The Cochrane Database of Systematic Reviews, Academic Search Elite, CINAHL, MedLine and SweMed+, and an additional mapping of clinical guidelines in order to update praxis. Findings: The study shows that there is insufficient scientific evidence as to whether urinary catheter washouts prevent catheter blockage. Conclusion: There is insufficient evidence that urinary catheter washouts are beneficial. Individual care planning and evaluation of long-term indwelling catheter care is important in minimizing the risk of harmful side effects.

  • 2.
    Andersson, Ewa
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Borglin, Gunilla
    Blekinge Institute of Technology, School of Health Science.
    Sjöström-Strand, Annica
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Standing alone when life takes an unexpected turn: Being a midlife next of kin of a relative who has suffered a myocardial infarction2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 864-871Article in journal (Refereed)
    Abstract [en]

    Background: Suffering a myocardial infarction (MI) is a life-threatening event that impacts not only on the individual concerned but also on the next of kin. However, there seems to be a paucity of naturalistic inquiries that focus specifically on midlife next of kin and their experience of being close to a relative who has suffered an MI. This study aims to elucidate the experience of being a midlife next of kin of a relative who has suffered a myocardial infarction. Method: Nine women and four men in midlife participated in the focused interviews, which were conducted and analysed during 2010/2011 using Lindseths and Norbergs' description of the phenomenological hermeneutical method. Findings: Four themes - Solely responsible, Lurking unease, Left out of the picture and Life on hold - formed the basis of the core theme Standing alone when life takes an unexpected turn. The core theme was interpreted as a central phenomenon encompassing the experience of being solely responsible for the well-being of their relative and the family, thus putting their own life on hold. The core theme also reflected the next of kin's experience of being left out of the picture when it came to the relative's care before and after the MI. Conclusion: The next of kin's negative feelings of standing alone were further intensified by their experience of being left out of the picture by the healthcare professionals concerning their relative's care. As a cardiac nurse, it would seem essential to have knowledge about the experiences of next of kin in connection with a relative's MI event. Such knowledge can facilitate the planning and organisation of nursing care and at the same time address the next of kin's role in the recovery and rehabilitation process.

  • 3.
    Andersson, Ewa
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Borglin, Gunilla
    Blekinge Institute of Technology, School of Health Science.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    The experience of younger adults following myocardial infarction2013In: Qualitative Health Research, ISSN 1049-7323 , Vol. 23, no 6, p. 762-772Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate the meaning of the experience of younger people (< 55 years) during their first year following a myocardial infarction. We analyzed 17 interviews using a phenomenological-hermeneutic method. The core theme and central phenomenon was the everyday fight to redress the balance in life, which encompassed an existential, physical, and emotional battle to regain a foothold in daily life. The aftermath of a life-threatening event involved a process of transition while at the same time creating a new meaning in life. Lack of energy and its impact on the complex interplay of midlife combined with unreasonable demands from employers and health care professionals seemed to color the experience of the informants. The knowledge gained in this study can constitute a valuable contribution to overall quality assurance in nursing care and the development of nursing interventions for the cardiac rehabilitation of younger patients.

  • 4.
    Andersson, Ewa
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Sjöstrand-Strand, Annica
    Willman, Ania
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Borglin, Gunilla
    Registered nurses views of caring in coronary care: a deductive and inductive content analysis2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 23-24, p. 3481-3493Article in journal (Refereed)
    Abstract [en]

    Aims and objectives

    To extend nurses’ descriptions of how they understood caring, as reflected in the findings of an earlier study (i.e. the hierarchical outcome space) and to gain additional understandings and perspectives of nurses’ views of caring in relation to a coronary care patient case.

    Background

    Scientific literature from the 1970s–1990s contains descriptions of caring in nursing. In contrast, the contemporary literature on this topic – particularly in the context of coronary care – is very sparse, and the few studies that do contain descriptions rarely do so from the perspective of nurses.

    Design

    Qualitative descriptive study.

    Methods

    Twenty-one nurses were interviewed using the stimulated recall interview technique. The data were analysed using deductive and inductive qualitative content analysis.

    Results

    The results of the iterative and integrated content analysis showed that the data mainly reproduced the content of the hierarchical outcome space describing how nurses could understand caring; however, in the outcome space, the relationship broke up (i.e. flipped). The nurses’ views of caring could now also be understood as: person-centredness ‘lurking’ in the shadows; limited ‘potential’ for safeguarding patients’ best interests; counselling as virtually the ‘only’ nursing intervention; and caring preceded by the ‘almighty’ context. Their views offered alternative and, at times, contrasting perspectives of caring, thereby adding to our understanding of it.

    Conclusion

    Caring was described as operating somewhere between the nurses caring values and the contextual conditions in which caring occurred. This challenged their ability to sustain caring in accordance with their values and the patients’ preferences.

    Relevance to clinical practice

    To ensure that the essentials of caring are met at all times, nurses need to plan and deliver caring in a systematic way. The use of systematic structures in caring, as the nursing process, can help nurses to work in a person-centred way, while sustaining their professional values.

  • 5.
    Andersson, Ewa
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Willman, Ania
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Sjöstrom-Strand, Annica
    Lunds universitet, SWE.
    Borglin, Gunilla
    Malmö högskola, SWE.
    Registered nurses’ descriptions of caring: a phenomenographic interview study2015In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, no 1, article id Article number 16Article in journal (Refereed)
    Abstract [en]

    Background: Nursing has come a long way since the days of Florence Nightingale and even though no consensus exists it would seem reasonable to assume that caring still remains the inner core, the essence of nursing. In the light of the societal, contextual and political changes that have taken place during the 21st century, it is important to explore whether these might have influenced the essence of nursing. The aim of this study was to describe registered nurses’ conceptions of caring. Methods: A qualitative design with a phenomenographic approach was used. The interviews with twenty-one nurses took place between March and May 2013 and the transcripts were analysed inspired by Marton and Booth’s description of phenomenography. Results: The analysis mirrored four qualitatively different ways of understanding caring from the nurses’ perspective: caring as person-centredness, caring as safeguarding the patient’s best interests, caring as nursing interventions and caring as contextually intertwined. Conclusion: The most comprehensive feature of the nurses’ collective understanding of caring was their recognition and acknowledgment of the person behind the patient, i.e. person-centredness. However, caring was described as being part of an intricate interplay in the care context, which has impacted on all the described conceptions of caring. Greater emphasis on the care context, i.e. the environment in which caring takes place, are warranted as this could mitigate the possibility that essential care is left unaddressed, thus contributing to better quality of care and safer patient care.

  • 6. Annerstedt, Magdalena
    et al.
    Willman, Ania
    Performing subcutaneous injections: a literature review.2005In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X , Vol. 2, no 3, p. 122-130Article, review/survey (Refereed)
  • 7. Bahtsevani, Christel
    et al.
    Khalaf, Azzam
    Willman, Ania
    Evaluating psychiatric nurses´awarness of evidence-based nursing publications.2005In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X , Vol. 2, no 2, p. 196-207Article in journal (Refereed)
  • 8. Bahtsevani, Christel
    et al.
    Udén, Giggi
    Willman, Ania
    Outcomes of evidence-based clinical practice guidelines: A systematic review2004In: International Journal of Technology Assessment in Health Care, ISSN 0266-4623 , Vol. 20, no 4, p. 427-433Article in journal (Refereed)
  • 9. Bahtsevani, Christel
    et al.
    Willman, Ania
    Khalaf, Azzam
    Östman, Margareta
    Developing an instrument for evaluating implementation of clinical practice guidelines: a test-retest study2008In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 14, no 5, p. 839-846Article in journal (Refereed)
    Abstract [en]

    this study focuses on the development of an instrument for the evaluation of clinical practice guidelines and is one part of a research project about the implementation and use of such guidelines among hospitals in the southern region of Sweden. The aim of the present paper was to investigate the test -retest reliability of a questionnaire. A questionnaire was designed to gather data about guidelines that have been implemented as well as information about factors, which, according to the promoting Action on Research Implementation in Health Services (PARIHS)-model, influence the success of implementation. Thirty-nine health professionals at one of the hospitals included in the survey completed the questionnaire on two occasions within a mean time of 5.5 weeks. The test-retest reliability was analysed by means of Cohen´s kappa and percentage concordance. Eight items had good agreement in terms of strength and high percentage concordance. With regard to the kappa values, 13 items show moderate and two fair agreement. The test-retest reliability scores show mainly acceptable results indicating a reasonable stability, thus suggesting the possibility of further developing the instrument. The factors described in the PARIHS-model seem relevant for use in evaluating implementation and use of guidelines. The instrument could benefit from a revision of the language in order to enhance clarity and make it less abstract.

  • 10. Bahtsevani, Christel
    et al.
    Willman, Ania
    Stoltz, Peter
    Östman, Margareta
    Experiences of the implementation of clinical practice guidelines: interviews with nurse managers and nurses in hospital care2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 3, p. 514-522Article in journal (Refereed)
    Abstract [en]

    The implementation of clinical practice guidelines (CPGs) has become an increasingly common element of clinical care, but little qualitative research has been conducted in real-life settings. The aim was to elucidate experiences and factors of importance for the implementation of CPGs in hospital care. Twenty interviews were conducted, audio-taped and transcribed verbatim. A manifest and latent content analysis was performed to interpret the text. A system of subcategories related to five categories and one overall theme were developed. the data reveal that the implementation of CPGs is continnuous processes of creating reliable and tenable routines that involve all staff members and expect to lead to better and safer patient care as well as to increased knowledge and confidence among staff. The process is initiated by internal or external demands and represents a way to keep abreast of knowledge development. Several factors facilitate the implementation and have influence on the use and compliance with CPGs. To increase support for and willingness to use the CPGs, it appears important to involve all staffs in the implementation process as well as to follow up and give feedback continuously to staff and management. It seems necessary toevaluate the process to supervise compliancewith CPGs and to balance priorities and costs. Evaluationcan also demonstrate importance of the application.

  • 11. Burke, Jacqueline
    et al.
    Smith, Lorraine
    Sveinsdottir, Herdis
    Willman, Ania
    Patient Safety in Europe: Medication Errors and Hospital-acquired Infections2008Report (Other academic)
    Abstract [en]

    The Report was commissioned by the European Federation of Nurses Associations (EFN) in November 2007 in order to support its policy statements on Patient Safety (June 2004). In that statement the EFN declares its belief that European Union health services should operate within a culture of safety that is based on working towards an open culture and the immediate reporting of mistakes; exchanging best practice and research; and lobbying for the systematic collection of information and dissemination of research findings. This Report adressess specifically the culture of highly reliable organisations using the work of James Reason (2000). Medication errors and hospital-acquired infections are examined in line with the Reprt´s parameters and a range of European studies are used as evidence. An extensive reference list is provided that allows EFN to explore work in greater detail as required.

  • 12.
    Fagerström, Cecilia
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Home Care in Denmark2012In: Home care across Europe: case studies / [ed] Genet, Nadine; Boerma, Wienke; Kroneman, Madelon; Hutchinson, Allen; Saltman, Richard B., European Obseravatory on Health Systems and Policies , 2012, p. 60-66Chapter in book (Refereed)
  • 13.
    Fagerström, Cecilia
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Home Care in Norway2012In: Home care across Europe: case studies / [ed] Genet, Nadine; Boerma, Wienke; Kroneman, Madelon; Hutchinson, Allen; Saltman, Richard B., European Obseravatory on Health Systems and Policies , 2012, p. 207-213Chapter in book (Refereed)
  • 14.
    Fagerström, Cecilia
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Home Care in Sweden2012In: Home care across Europe: case studies / [ed] Genet, Nadine; Boerma, Wienke; Kroneman, Madelon; Hutchinson, Allen; Saltman, Richard B., European Obseravatory on Health Systems and Policies , 2012, p. 272-279Chapter in book (Refereed)
  • 15. Gebru, Kerstin
    et al.
    Khalaf, Azzam
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Outcome analysis of a research-based didactic model for education to promote culturally competent nursing care in Sweden: a questionnaire study2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, p. 348-356Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To describe and analyse to what extent the goals of the education in promoting culturally competent nursing care have been achieved from a student perspective. B: As Sweden has transformed into a multicultural society over the past 50 years, there is a need to specify, at all levels of the nursing programme, transcultural concepts for the success of integration. A research-based didactic model was designed for the nursing programme at Malmö University and this was followed by investigations of its outcome. Method: The study is a prospective cohort study with an outcome analysis. A descriptive research study with a longitudinal design was performed, with the focus on Swedish nursing students´experiences of transcultural nursing knowledge and their attitudes before and after implementation of the didactic model. The students evaluate highly their competence to meet demands of multicultural health and medical service. Additionally, their ability to recognise and understand the consequences of international migration on health also received a high mean. Conclusions: The study revealed the knowledge and experience acquired by Swedish students in transcultural nursing. The assumption was that a visible development of knowledge should occurduring the three years of education. Interpreting the findings, such effectiveness can be found and hopefully the students will be able to give holistic nursing care based on a person's individual culture.

  • 16. Gebru, Kerstin
    et al.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Education to promote culturally competent nursing care: A content analysis of student responses2010In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 30, p. 54-60Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe and analyse the outcome of a 3-year study program from a student perspective for the purpose of promoting culturally congruent nursing care. Students were asked to complete questionnaires that included cases with open-ended questions at the beginning and end of the 3-yesr program. Two nursing situations were described and the students had to imagine how they would act in such cases. Ninety-two students completed the two questionnaires and the result of a manifest content analysis of their answers is presented. Four categories were formulated from the content analysis: an inviting attitude, a non-inviting attitude, a knowledge driven attitude and a non-knowledge driven attitude. An inviting attitude meant that the students found different strategies for approaching the patient and his/her spouse or parent. A non-inviting attitude implied that the students became frustrated with the situation and had more difficulty finding solutions that would enhance the relationship. A knowledge-driven attitude meant that the students described how they found it important to base nursing actions on knowledge of the patient. A non-knowledge-driven attitude meant that the students´responses indicated that they did not consider knowledge to be the foundation of their nursing actions. The study demonstrated marked changes in the students´approaches to culturally sensitive issues at the end of the program.

  • 17. Gebru, Kerstin
    et al.
    Willman, Ania
    Sjuksköterskestudenters syn på utbildning i kulturkongruent omvårdnad. Kapitel 122010In: Omvårdnad i mångkulturella rum: frågor om kultur, etik och reflektion / [ed] Cuadra, Björngren; , Lund: Studentlitteratur , 2010, p. 339-358Chapter in book (Other academic)
    Abstract [en]

    Kapitlet bygger på resultat av ett större pedagogiskt forskningsprojekt där det empiriska materialet samlats in från år 2000 till och med 2004. Forskningsprojektet utgick från Madeleine Leiningers omvårdnadsteori, en teori som fokuserar kulturella faktorer i mötet mellan patient och sjuksköterska. Projektets syfte var att införa en undervisningsmodell i sjuksköterskeutbildningen och att utvärdera studenternas erfarenheter av modellen. En del av forskningsreultaten återges i detta kapitel.

  • 18. Gebru, Kerstin
    et al.
    Åhsberg, Elizabeth
    Willman, Ania
    Nursing and medical documentation on patients´cultural background2007In: Journal of Clinical Nursing, ISSN 0962-1067 , Vol. 16, no 11, p. 2056-2065Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. To investigate if, and to what extent, nursing and medical documentation in patients records include entries on cultural background. Background. Health care professionals in Sweden may have difficulties in providing satisfactory care, due to lack of knowledge about immigrants´background. According to Swedish law the information needed to garantee safe care must be specified in the patients´records. It is therefore, important to investigate what information nurses and physicians document on patients´cultural background. Design and methods. In this descriptive study, archival data concerning older and terminally ill patients were analysed retrospectively. The sample consisted of records from 121 patients 65 years or more at the time of the death, who were born abroad and died during the year 1999. Content analysis was used to interrogate data collected from patients records, which related to the patient´s cultural background. Entries (sentences or proportion of sentences) were identified, coded and categorized using Leininger´s Sunrise Model. Results. From the patient records, entries could be related to all factors in the upper part of the Sunrise Model. Some factors were found in all records, and all factors, except technological factors, could be traced across the patients´records. Information concerning folk/lay care could not be found. Conclusion. The results from this study indicate that nurses´and physicians´documentation in patient records included all factors in the Sunrise Model except technological. The overall impression is that the documentation is partly atomistic and insufficient as cultural assessment. Relevance to clinical practice. Even if the health care personnel want to reduce the amount of documentation produced, this study highlighted the importance of documentation on cultural factors. To save time the nursing documentation coukd be based on the Sunrise Model and structured according to the VIPS model.

  • 19. Gunningberg, Lena
    et al.
    Carlsson, Sara
    Willman, Ania
    EPUAP-protokollet: en europeisk metod för mätning av trycksårsförekomst2006In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 26, no 2, p. 48-51Article in journal (Other academic)
    Abstract [en]

    The EPUAP (European Pressure Ulcer Advisory Panel) has developed a European-wide prevalence survey methodology, which has been used in several European countries. The EPUAP-protocol has been translated to Swedish and two prevalence studies have been conducted at Uppsala University and one at MalmöUniversity Hospital. The aim of this paper is to present the modified EPUAP-protocoll as well as our experience in using the methodology. Pressure ulcershave been described as a national quality indicator and the protocol could facilitate the follow up of an important nursing area.

  • 20.
    Gustafsson, Markus
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Holst, Göran
    Blekinge Institute of Technology, School of Health Science.
    Kristensson, Jimmie
    Blekinge Institute of Technology, School of Health Science.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Bohman, Doris
    Blekinge Institute of Technology, School of Health Science.
    Case managers’ experiences of their everyday practice2013In: European Geriatric Medicine, Venice: Elsevier Masson SAS , 2013, Vol. 4, no Supplement 1Conference paper (Refereed)
    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.

  • 21.
    Gustafsson, Markus
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Kristensson, Jimmie
    Blekinge Institute of Technology, School of Health Science.
    Holst, Göran
    Blekinge Institute of Technology, School of Health Science.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Bohman, Doris
    Blekinge Institute of Technology, School of Health Science.
    Case managers for older persons with multi-morbidity and their everyday work -- a focused ethnography2013In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, no 496Article in journal (Refereed)
    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.

  • 22. Hellström, Amanda
    et al.
    Fagerström, Cecilia
    Willman, Ania
    Promoting Sleep by Nursing Interventions in Health Care Settings: A Systematic Review2011In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X , Vol. 8, no 3, p. 128-142Article, review/survey (Refereed)
    Abstract [en]

    Background: Sleep disturbances are common problems among individuals in hospitals and institutions. Although several studies have explored this phenomenon, there is still a lack of knowledge about the effectiveness of sleep-promoting nursing interventions. This systematic review aims to describe and evaluate the effectiveness of sleep-promoting nursing interventions in health care settings. Approach: A systematic review was performed. In June 2009, a literature search was carried out in the following databases: Academic Search Elite, CINAHL, the Cochrane Library and MedLine/PubMed. Fifty-two references were identified and after critical appraisal, nine studies were selected. A compilation of the results and the outcomes of the interventions were carried out. Furthermore, the evidence strength of the interventions was assessed. Findings: Little evidence for the nursing interventions, sleep hygiene, music, natural sound and vision, stimulation of acupoints, relaxation, massage and aromatherapy is found. However, large effect size of interventions were found when using massage, acupuncture and music, natural sounds or music videos. The use of sleep hygiene and relaxation, on the other hand, produced only small effects. Conclusion: The lack of high evidence strength for the nursing interventions together with the uncertainty about their effects calls for more research before implementing these interventions into clinical practice.

  • 23. Hellström, Amanda
    et al.
    Hagell, Peter
    Fagerström, Cecilia
    Willman, Ania
    Measurement properties of the Minimal Insomnia Symptom Scale (MISS) in an elderly population in Sweden.2010In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 10:84Article in journal (Refereed)
    Abstract [en]

    Background: Insomnia is common among elderly people and associated with poor health. The Minimal Insomnia Symptom Scale (MISS) is a three item screening instrument that has been found to be psychometrically sound and capable of identifying insomnia in the general population (20-64 years). However, its measurement properties have not been studied in an elderly population. Our aim was to test the measurement properties of the MISS among people aged 65 + in Sweden, by replicating the original study in an elderly sample. Methods: Data from a cross-sectional survey of 548 elderly individuals were analysed in terms of assumptions of summation of items, floor/ceiling effects, reliability and optimal cut-off score by means of ROC-curve analysis and compared with self-reported insomnia criteria. Results: Corrected item-total correlations ranged between 0.64-0.70, floor/ceiling effects were 6.6/0.6% and reliability was 0.81. ROC analysis identified the optimal cut-off score as ≥7 (sensitivity, 0.93; specificity, 0.84; positive/negative predictive values, 0.256/0.995). Using this cut-off score, the prevalence of insomnia in the study sample was 21.7% and most frequent among women and the oldest old. Conclusions: Data support the measurement properties of the MISS as a possible insomnia screening instrument for elderly persons. This study make evident that the MISS is useful for identifying elderly people with insomnia-like sleep problems. Further studies are needed to assess its usefulness in identifying clinically defined insomnia.

  • 24. Hellström, Amanda
    et al.
    Hagell, Peter
    Fagerström, Cecilia
    Willman, Ania
    Usefulness of the Minimal Insomnia Symptom Scale (MISS) in elderly persons2010Conference paper (Refereed)
    Abstract [en]

    Sleep is found to be a fundamental part in experiencing health. Sleep is needed for memory consolidation, metabolic balance, immune functioning and alertness at day time and experiencing quality of life. Insomnia has also been found to be associated with cardiac disorders. Elderly people are especially vulnerable for poor sleep, why prevention of sleep disturbances should be of regard when caring for older persons. MISS is a 3 item questionnaire, with a total-score of 0-12 that could be used to find insomnia in elderly persons. Aim: To test of the measurement properties of the Minimal Insomnia Symptom Scale in an elderly sample ≥65 years in Sweden. Study sample Persons participating in the Swedish National Study on Ageing and Care – Blekinge were invited. ● 548 participated (response-rate 61.4%) ● Mean age 77.8 (SD 8.63) years ● Female 57.5% Results Reliability was found to be 0.81. ROC analysis where MISS was compared with self-reported insomnia criteria (i.e. day-time sleepiness, not feeling refreshed by sleep, experiencing sleep difficulties) identified optimal cut-off score as ≥7, and sensitivity 93%, specificity 84%. Area under curve = 0.93. Conclusion Data support the measurement properties of MISS as an insomnia screening instrument among elderly persons and its brevity makes it appealing. Through insomnia-screening, older persons at risk of health problems can be found and offered treatment and thereby health and quality of life can be restored.

  • 25.
    Hellström, Amanda
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Hellström, Patrik
    Willman, Ania
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Fagerström, Cecilia
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Association between Sleep Disturbances and Leisure Activities in the Elderly: A Comparison between Men and Women.2014In: Sleep Disorders, ISSN 2090-3545, E-ISSN 2090-3553, Vol. 2014, no Article ID 595208Article in journal (Refereed)
    Abstract [en]

    It has been suggested that physical or social activity is associated with fewer sleep disturbances among elderly people. Women report more sleep disturbances than men, which could indicate a variation in activity patterns between the genders. The aim of this study was to investigate associations between sleep disturbances and leisure activities in men and women (n = 945) aged ≥60 years in a Swedish population. Sleep disturbances were measured using eight dichotomous questions and seventeen variables, covering a wide range of leisure activities. Few leisure activities were found to be associated with sleep disturbances and their importance decreased when the models were adjusted for confounders and gender interactions. After clustering the leisure activities and investigating individual activities, socio-intellectual activities were shown to be significant for sleep. However, following adjustment for confounders and gender interactions, home maintenance was the only activity significant for sleep. Being a female increased the effect of home maintenance. Besides those leisure activities, poor/fair self-rated health (OR 7.50, CI: 4.27-11.81) and being female (OR 4.86, CI: 2.75-8.61) were found to have the highest association with poor sleep. Leisure activities pursued by elderly people should focus on activities of a socio-intellectual nature, especially among women, to promote sleep.

  • 26.
    Hjelm, Markus
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Holmgren, Ann-Charlotte
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Willman, Ania
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Bohman, Doris
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Holst, Göran
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Family members of older persons with multi-morbidity and their experiences of case managers in Sweden: an interpretive phenomenological approach2015In: International Journal of Integrated Care, ISSN 1568-4156, E-ISSN 1568-4156, Vol. 15, no Jan-MarArticle in journal (Refereed)
    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.

  • 27.
    Hjelm, Markus
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Holst, Göran
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Willman, Ania
    Bohman, Doris
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Kristensson, Jimmie
    The work of case managers as experienced by older persons (75+) with multi-morbidity – a focused ethnography2015In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, article id 168Article in journal (Refereed)
    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.

  • 28. Holst, Göran
    et al.
    Willman, Ania
    Fagerström, Cecilia
    Borg, Christel
    Hellström, Ylva
    Borglin, Gunilla
    Quality of care: Prevention of pressure ulcers – Nursing students facilitating evidence-based practice2010In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 30, no 1, p. 40-42Article in journal (Refereed)
    Abstract [en]

    This development project was aimed at engaging nursing students in a project targeting the prevention and reduction of pressure ulcers on an education based hospital ward. An intervention was implemented based on systematic assessment, skin observation, together with training and educational sessions, i.e. on how to make risk assessments and how to prevent and treat a pressure ulcer, were carried out. The project demonstrated the importance of offering nursing students an environment for clinical practice which supports them in participating and developing patient care starting from Evidence-Based Practice. During the project no patients developed pressure ulcers while on the ward. The opportunity to act as facilitators of evidence-based methods was found to enhance student ability to draw conclusions and make connections between quality of care and end result.

  • 29. Islamoska, Julli
    et al.
    Nilsson, Roland
    Sjöström, Kerstin
    Willman, Ania
    Arbetsmodeller som säkrar sjuksköterskekompetensen-en systematisk litteratursammanställning2009In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 29, no 2, p. 44-47Article, review/survey (Refereed)
    Abstract [en]

    The Swedish healthcare system is organized in a way that all nurses despite formal competence and experience have the same responsibilities. A newly graduated nurse has the same work-load and responsibility in patient care as the experienced nurse. newly graduated nurses need supervision by clinical experts in the process of developing skills, but also to reduce risks that exists when their authority is above their skills and level of experience. The aim was to identify existing organizational models were the nurses´work has been formalized according to their level of competence and experince in order to improve patient safety and patient satisfaction. A search with a systematic approach in CINAHL, The Cochrane Library and MedLine was performed. A total of 397 studies were identified and 31 articles were screened in full text. Finally three articles , which are insufficient with regards to issue recommendations, presented common factors as models that focus on experienced nurses´competence and the organization of patient care. The research regarding models of organization that secure nursing competence in patient care, how it is utilized and, it´s effect on patient care is insufficient. there is a need for extensive research examining this relation at ward level.

  • 30. Jacobsson, Catrine
    et al.
    Willman, Ania
    Palm, Carl-Axel
    Torpenberg, Inger
    The Swedish Society of Nursing's National Code of Core Values for Care2011Conference paper (Refereed)
    Abstract [en]

    Core values are essential to helathcare in order to promote knowledge based care within practice, and for the curricula development in for example nursing education. Professional ethics highlight core values and how these values are sustained in connection with patients and their families. Reflections and discussions about these core values as a point of departure will raise the level of awarness for ethical dilemmas. A code of core values for care can support a common approach and illuminate ethical dilemmas in nursing care and serve as a fundation for the practice of good care in all areas of the healthcare sector. In 2010 the Swedish Society of Nursing adopted a National Code of Core Values for care. All human behaviour has an ethical dimension and we are always responsible for what we do or fail to do. Good care depends upon keeping an open mind towards the patient and the families they confides, and respecting the patient's experience of health. The values described in the Code are those that occure in situations where people are dependent on, and in need of, care. The essential values that the Swedish Society of Nursing has chosen to highlight are, among others, the following; - respect of the vulnerable, - respect of dignity, - respect of integrity, - respect of self determination. The National Code of Core Values for care has been developed from knowledge in the scientific nursing field as well as from clinical experiences. To enable nurses to work with core values, the national Code of Values for care also suggests models for discussion and reflection when applied to work in health care.

  • 31. Johansson, Maria Eiman
    et al.
    Pilhammar, Ewa
    Khalaf, Azzam
    Willman, Ania
    Registered Nurses´Adherence to Clinical Guidelines Regarding Peripheral Venous Catheters: A Structured Observational Study2008In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X , Vol. 5, no 3, p. 148-159Article in journal (Refereed)
    Abstract [en]

    peripheral catheterization is a common procedure, which affects numerous patients in health care today. having peripheral venous catheters in situ might lead to complications such as thrombophlebitis and sepsis, and clinical guidelines have been developed to assist nurses in their decisionmaking. Several reasons are given for clinicians not always adhering to clinical guidelines, although such adherence might lead to fewer complications. This papaer aims to describe registered nurses´adherence to national and local guidelines on peripheral venous catheters by focusing on time in situ, site, size, and documentation at the dressing. An additional aim is to describe the thrombophlebitis frequency associated with peripheral venous catheters in situ. Structured observational study of patients with peripheral venous catheters in situ, conducted from December 2004 to June 2005. data of 343 peripheral venous catheters were analyzed. Nurses partly adhered to national and local guidelines concerning size and site. Guideline adherence concerning documentation at the dressing was low. The results showed that non-adherence pertaining to time in situ varied between 5% and 26.3%. Differences between adherence to national or local guidelines were shown for size, site, and documentation at the dressing. Mild thrombophlebitis (Grades 1 and 2) was observed in 7.0%. Nurses partly adhered to clinical guidelines. Differences in guideline adherence were observed for wards with local or national guigelines, as well as for wards with different specialities. In accordance with clinical guidelines, the nurses seemed to replace or remove peripheral venous catheters before any severe complications arose. Adherence to clinical guidelines has an impact for preventing patient complications and thus it is essential that nurses are aware of their existence. Feedback and discussions of guideline adherence or of complication rates might influence nurses´clinical decision-making.

  • 32. Johansson, Maria Eiman
    et al.
    Pilhammar, Ewa
    Willman, Ania
    Nurses' clinical reasoning concerning management of peripheral venous cannulae2009In: Journal of Clinical Nursing, ISSN 0962-1067 , Vol. 18, no 23, p. 3366-3375Article in journal (Refereed)
    Abstract [en]

    The aim was to describe nurses´clinical reasoning regarding peripheral venous cannulae management by focusing on the clinical information and circumstances considered during the decision-making process. On every shift nurses make several decisions, among others concerning the management of peripheral venous cannuae. Thrombophlebitis is a common complication associated with its use, although more severe complications can arise. There are clinical practice guidelines within the area, but they are not always adhered to. Previous studies have examined decisions related to the management of peripheral venous cannulae, but did not include observations in a naturalistic setting. A qualitative study combining observations and interviews was designed. Methods: Participant observation facilitated open interviews about the clinical reasoning behind decision-making in observed situations, as well as semi-structured interviews regarding clinical reasoning about the general management of peripheral venouscannulae. transcribed interview texts were analysed with content analysis. Three main categories describe clinical information and circumstances: the individual patient situation, the nurse´s work situation and experience of peripheral venous cannulae management. The overall theme of the interview texts was that the clinical reasoning was a balancing act between minimising patient discomfort and preventing complications from the peripheral venous cannulae. Conclusion: At all times the patients´well-being was considered, but the ways the nurses approached this differed depending on how they considered clinical information in the individual patient situation, circumstances in their own work situation and their experience of peripheral venous cannulae management. Relevance toclinical practice: Knowledge of the clinical information and circumstances considered in naturalistic settings, is valuable when implementing and adjusting clinical practice guidelines to local settings. This knowledge is also useful in nursing education as student nurses´and nurses´ability tobalance between preventing complications and avoiding discomfort is important for enhancing patient care.

  • 33. Jönsson, Ann-Marie
    et al.
    Willman, Ania
    Development of a consultation and teaching concept for leg wound treatment in home health care2007In: Journal of Telemedicine and Telecare, ISSN 1357-633X , Vol. 13, no 5, p. 236-240Article in journal (Refereed)
    Abstract [en]

    We developed a consultation and teaching concept about leg wounds and their care, for use by patients and caregivers in a home-health-care setting. Descriptive data were gathered through a survey distributed to three groups, comprising 21 individuals (18 nurses and 3 health administrators). These participants provided answers regarding group activities, meeting frequency, meeting notes and meeting content, as well as responses to questions regarding the Web site, Web materials, film and pamphlet. Seventeen people answered the survey (81% response rate). They made predominantly positive comments. The combined total average score was 3.6 (1= very bad to 4= very good). The concept was implemented in one municipality in a health-care region in southern Sweden using high bandwidth videophones (640 kbit/s). The result showed that elderly persons at home and nurses working in home health care were interested in using the concept and communicating via videophone. A strength of the Web-based information and communication material is its adaptability to suit both patients and caregivers.

  • 34. Jönsson, Ann-Marie
    et al.
    Willman, Ania
    Implementation of Telenursing Within Home Healthcare2008In: Telemedicine journal and e-health, ISSN 1530-5627, E-ISSN 1556-3669, Vol. 14, no 10, p. 1057-1062Article in journal (Refereed)
    Abstract [en]

    The implementation of telenursing within home healthcare of leg wounds is an innovative development initiative that focus on patients and to some extent next-of-kin in collaboration with nurses. Eleven patients and nine nurses participated in the study. The methods for datacollection were surveys, field-notes descriptions, and care charts, as well as digital photos of leg wounds and videotaped observations. The results show that the utility of virtual concept is that continual learning takes place for both patients and nurses. The patients felt positively about being able to via videophone see the staff caring for them, and seeing a face inspired a sense of security, which had a calming effect. The learning for nurses lay in the everyday work with leg wounds and their care as experiences were taken advantage of with the assistance of the interactive technique. The nurses felt that their time at work was better utilized and that the virtual communication between patients and nurses constituted a humane complement in home healthcare.

  • 35. Jönsson, Ann-Marie
    et al.
    Willman, Ania
    Telenursing In Home Care Services Experinces of Registered Nurses2009In: Electronic Journal of Health Informatics, ISSN 1446-4381, E-ISSN 1446-4381, Vol. 4, no 1Article in journal (Refereed)
    Abstract [en]

    This paper reports on experinces of telenursing by registered nurses working in home care services with a focus on leg wounds and their treatment. In the daily work of care giving, distant treatment was provided through technology for two-party encounters between registered nurses and patients. Ten video recorded interviews were conducted with five nurses. Data were analysed with content analysis. The results show that in virtual encounters the nurses felt great satisfaction from having an image of the patient while simultaneously assessing the situation. Acording to the nurse the patients expressed a sense of security from having audio and video contact with the nurses. The nurses were interested in and utilised the digital camera for recording photos of the wounds. They used the web application to gather information for patients and their kin, and for training while delegating to colleagues, co-workers, and students. the future vision is that two-party encounters are an effective form of communication.

  • 36.
    Lindberg, Catharina
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Fagerström, Cecilia
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Sivberg, Bengt
    Willman, Ania
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Concept analysis: patient autonomy in a caring context2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 10, p. 2208-2221Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of an analysis of the concept of patient autonomy. Background. Many problems regarding patient autonomy in healthcare contexts derive from the patient's dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experience reveal a lack of consensus among nurses regarding the meaning of this ethical concept. Design. Concept Analysis. Data sources. Medline, CINAHL, The Cochrane Library and PsycINFO were searched (2005-June 2013) using the search blocks 'autonomy', 'patient' and 'nursing/caring'. A total of 41 articles were retrieved. Review Methods. The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context. Results. Five attributes were identified, thus creating the following descriptive definition: 'Patient autonomy is a gradual, time-changing process of (re-)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one’s actions’'. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom. Conclusion. Patient autonomy in a caring context does not need to be the same before, during and after a care episode. A tentative model has been constructed, thus extending the understanding of this ethical concept in a caring context.

  • 37.
    Lindberg, Catharina
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Fagerström, Cecilia
    Linnéuniversitetet, SWE.
    Willman, Ania
    Malmö Universitet, SWE.
    Patient autonomy in a high-tech care context: A theoretical framework2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 21-22, p. 4128-4140Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To synthesise and interpret previous findings with the aim of developing a theoretical framework for patient autonomy in a high-tech care context. Background: Putting the somewhat abstract concept of patient autonomy into practice can prove difficult as when it is highlighted in healthcare literature, the patient perspective is often invisible. Autonomy presumes that a person has experience, education, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could therefore be considered paradoxical, as in most cases, these persons are vulnerable, with impaired physical and/or metacognitive capacity, thus making extended knowledge of patient autonomy for these persons even more important. Design: Theory development. Methods: The basic approaches in theory development by Walker and Avant were used to create a theoretical framework through an amalgamation of the results from three qualitative studies conducted previously by the same research group. Results: A theoretical framework-the control-partnership-transition framework-was delineated disclosing different parts cocreating the prerequisites for patient autonomy in high-tech care environments. Assumptions and propositional statements that guide theory development were also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients were revealed as follows: the strategy of control, the strategy of partnership, the strategy of trust and the strategy of transition. Conclusions: An extended knowledge base, founded on theoretical reasoning about patient autonomy, could facilitate nursing care that would allow people to remain/become autonomous in the role of patient in high-tech care environments. Relevance to clinical practice: The control-partnership-transition framework would be of help in supporting and defending patient autonomy when caring for individual patients, as it provides an understanding of the strategies employed by patients to achieve autonomy in high-tech care contexts. The guiding principles for patient autonomy presented could be used in nursing guidelines. © 2018 John Wiley & Sons Ltd.

  • 38.
    Lindberg, Catharina
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Sivberg, Bengt
    Lunds universitet, SWE.
    Willman, Ania
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health. Malmö University, SWE.
    Fagerström, Cecilia
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    A trajectory towards partnership in care - Patient experiences of autonomy in intensive care: A qualitative study2015In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 31, no 5, p. 294-302Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to describe and elucidate patient experiences of autonomy in an intensive care context from a caring perspective. Background: Patients in intensive care units (ICUs) are critically ill and in a dependent and vulnerable position. There is thus a risk of staff taking command not only of the patients’ vital functions but also of their decision-making. Methods: A qualitative design was selected. Individual interviews were conducted with 11 adult patients with an intensive care episode of two days or more at six Swedish ICUs. The data were analysed using Inductive Content Analysis. Findings: Patient autonomy in intensive care was shown to be ’A trajectory towards partnership in care depending on state of health and mutual understanding’. It was experienced through acknowledged dependence, being recognised as a person, invited participation and becoming a co-partner in care. Conclusion: Patients in need of intensive care wanted to be involved in making decisions about their care as this creates a trusting and healthy care environment. Greater awareness is required about the ICU patient not only being a passive care recipient but also an active agent and where involvement in decision-making and participation in care are crucial. © 2015 Elsevier Ltd.

  • 39.
    Lindvall, Agneta
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Kristensson, Jimmie
    Lund Univ, Dept Hlth Sci, Lund, Sweden..
    Willman, Ania
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Holst, Göran
    Lund Univ, Dept Hlth Sci, Lund, Sweden..
    Informal Care Provided by Family Caregivers Experiences of Older Adults With Multimorbidity2016In: Journal of Gerontological Nursing, ISSN 0098-9134, E-ISSN 1938-243X, Vol. 42, no 8, p. 24-31Article in journal (Refereed)
    Abstract [en]

    Informal care given by family caregivers is an important part of the total care provided to older adults with multimorbidity. The current study aimed to describe how older adults with multimorbidity experienced care from family caregivers. Interviews were conducted with 24 participants (mean age = 86 years). Older adults with multimorbidity felt gratitude toward family caregivers for their willingness to help with everyday life and for representing their interests in contacts with health care providers. Family caregivers also had a significant impact on older adults' psychological well-being. However, the results also showed that older adults often felt they were a burden to their family caregivers and that their independence might be reduced. Older adults with multimorbidity should have the opportunity to be more involved in and have more influence over their health care so that they do not have to depend on representation by family caregivers.

  • 40. Lämås, Kristina
    et al.
    Willman, Ania
    Lindholm, Lars
    Jacobsson, Catrin
    Economic evaluation of nursing practices: a review of the literature.2009In: International Nursing Review, ISSN 0020-8132 , Vol. 56, no 1, p. 13-20Article, review/survey (Refereed)
    Abstract [en]

    The aim of this paper was to investigate how studies of nursing prctices apply economic evaluations. A literature review was conducted that included studies through August 2007. the search was performed using Medline, CINAHL, Psycinfo, Ecinlit, DARE, HTA, NHS EED, Cochrane reviews and clinical trials with a search term connected to nursing and health economics. Protocols were used in the screening procedure and the result is reported in a descriptive form. the search identified 115 studies published between 1984 and August 2007. Studies were found in the following nursing practices: provision of support and treatment (n=17); assessing suffering/well-being (n=1), preventing or treating ill health (n=53); and organization of individual care (n=44). In 22% of all the studies, the authors explicitly presented the health economic method used. In 25% of all studies, the perspective of the economic analysis was explicitly stated and a large variability in cost was considered in the analysis. In 82 studies, the authors reported cost-effective interventions. Although economic evaluation of nursing practice has increased, it is still a rather small area. According to the items elucidated in this study, further methodological improvement is needed to evaluate the economics of nursing.

  • 41. Nillson, Roland
    et al.
    Björdal, Catharina
    Andersson, Mats
    Björdal, Jörn
    Nyberg, A
    Welin, B
    Willman, Ania
    Health risks and occupational exposure to volatile anesthetics: a review with a systematic approach.2005In: Journal of Clinical Nursing, ISSN 0962-1067 , Vol. 14, no 2, p. 173-186Article in journal (Refereed)
  • 42. Nilsson, Ing-Marie
    et al.
    List, Thomas
    Willman, Ania
    Adolescents with Temporomandibular Disorder Pain: The Living with TMD Pain Phenomenon2011In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 25, no 2, p. 107-116Article in journal (Refereed)
    Abstract [en]

    Aim: To acquire a deeper understanding of adolescents' experiences of living with temporomandibular disorder (TMD) pain. Methods: twenty-one adolescents with TMD pain, aged 15 to 19, were strategically selected from a group of patients referred to an orofacial pain clinic. The patients were examined and received diagnoses per the Research Diagnostic Criteria for TMD. One-on-one interviews that followed a semistructured protocol focused on the patient's experiences of living with TMD pain. The interviews were recorded and transcribed verbatim, followed by content analysis to obtain a deeper understanding of adolescents' experieces living with TMD pain. Results: Content analysis led to the overall theme "Adolescents with TMD live with recurrent pain; physical problems and daily demands form a vicious circle that causes adolescents to oscillate between hope and despondency." The latent content forming the theme is grounded in three categories that evolved from 13 subcategories. For instance, five subcategories - headache; headache on awakening; jaw and tooth pain; constant thoughts of pain; and popping, cracking, clicking, and locking - formed the category that was labeled TMD pain is recurrent. The latent interpretation, ie, the meaning, of this category was that adolescents with TMD pain constantly thought about the pain, even when it was absent. Conclussion: TMD pain is a substantial problem for affected adolescents and has consequences for all aspects of their lives. In this study, the adolescents were able to talk openly and introduce issues outside of the interview protocol. Qualitative analysis deepens our understanding of the adolescent patient with TMD pain.

  • 43. Nilsson, Ing-Marie
    et al.
    List, Thomas
    Willman, Ania
    Adolescents with TMD Pain: the Living with TMD Pain Phenomenon2010Conference paper (Refereed)
    Abstract [en]

    Temporomandibular disorder (TMD) pain is common among adolescents, with more girls than boys reporting pain. Studies have shovn that TMD pain in adolescents has an impact on daily living. Depressive symtoms scores, somatic complaints, and limitations in jaw function were higher in adolescents with TMD pain than in non-affected adolescents. Quantitative research observes patients on a group level. But all patients are unique and the third cornerstone in evidence-based medicine - patient values - is often neglected. patient values are the unique preferences, concerns and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions if they are to serve the patient. Qualitative research methods can contribute to our knowledge by deepening our understanding of the experiences of the individual teenager with TMD pain. Aims: To acquire a deeper understanding of adolescents' experiences of living with TMD pain. Method: Twenty-one adolescents with TMD pain, aged 15 to 19, were strategically selected from a group of patients referred to an orofacial pain clinic. The patients were examined and received diagnosis per the Research Diagnostic Criteria for Temporomandibular Disorders. One-on-one interviews that followed a semi-structured protocol focused on the patient's experiences of living with TMD pain. The interviews were recorded and transcribed verbatim, followed by content analysis. Result: Content analysis led to the overall theme "Adolescents with TMD pain live in continual pain; physical problems and daily demands form a vicious circle that causes adolescents to oscillate between hope and despondency". The manifest content formning the theme consisted of three categories that evolved from 13 subcategories. Conclusion: TMD pain is a substantial problem for affected adolescents and has consequences for their life, Qualitative analysis deepens our understanding of the adolescent patient with pain, thus making more individualized support and treatment possible.

  • 44. Nystedt, Astrid
    et al.
    Edvardsson, David
    Willman, Ania
    Epidural Analgesia for pain relief in labour and childbirth- a review with a systematic approach2004In: Journal of Clinical Nursing, ISSN 0962-1067 , Vol. 13, no -, p. 455-466Article in journal (Refereed)
  • 45. Olsson, Pernilla Turonen
    et al.
    Petersson, Helena
    Willman, Ania
    Gardulf, Ann
    Standardized care plans in Swedish health care: their quality and the extent to which they are used.2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 4, p. 820-825Article in journal (Refereed)
    Abstract [en]

    The objective was to investigate the quality of standardized care plans and the extent to which they are used within Swedish in-hospital somatic care. Further, to examine the quality of the knowledge summaries on which existing standardized care plans were supposed to be based. Submitted documents were reviewed with studyspecific protocols. The setting was a national survey, based on a structured selection of Swedish hospitals. A total of 25 Swedish hospitals participated, and were asked to submit all documents in use that were labelled standardized care plans. Only 4% (34 out of 782) of the reviewed documents fulfilled the criteria for being a standardized care plan. None of the 34 knowledge summaries (an accompanying document with a compilation of scientif facts and reliable experience) was evidence-based. the conclusion is that there is a lack of knowledge regarding what a standardized care plan is, and how such a document should emanate from evidence-based knowledge. Our results raise the question of how recent developments in research are used to create standardized care plans for the best possible care. In the process of developing standardized care plans it is important to acknowledge that staff who develop these plans need scientific training end experience. Standardized care plans are in the early stages of development, and at this stage it seems appropriate to initiate a discussion regarding possible cooperation at national level when developing standardized care plans for certain groups of patients suffering from specific diseases, or undergoing the same treatment.

  • 46. Sandström, Boel
    et al.
    Borglin, Gunilla
    Nilsson, Roland
    Willman, Ania
    Promoting the implementation of evidence-based practice: A literature review focusing on the role of nursing leadership2011In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X , Vol. 8, no 4, p. 212-223Article, review/survey (Refereed)
    Abstract [en]

    Objectives: Despite a growing interest in evidence-based practice (EBP), the implementation into clinical practice of knowledge derived from research has proved to be a cumbersome process. Additionally, the literature seems to present a fragmented picture with research mainly focusing on a few factors of possible importance, among which leadership appears to be one of the more important. Thus, this study aimed to systematically review the literature regarding leadership and its possible influence on the process of implementing EBP. Approach: A literature review was conducted. Electronic database searches were conducted to identify studies on leadership, administrators, managers, implementation, evidence-based and nursing. The search identified 43 potentially relevant papers, of which 36 were excluded after an appraisal was performed by two independent reviewers. Results were extracted and synthesised into a narrative text. Findings: Seven papers were included in the literature review. The findings can be divided into three major areas: (1) characteristics of the leader, (2) characteristics of the organisation and (3) characteristics of the culture. Our findings indicate that leadership is vital for the process of implementing EBP in nursing and also highlights the possible importance of the organisation and the culture in which the leader operates. These factors together with their characteristics were interpreted to be intrinsic in the creation of a nursing milieu that is open and responsive to the implementation of EBP. Conclusions: Although there seems to be scholarly agreement that leadership is a vital part of the process of implementing EBP, more rigorous research is needed concerning the possible role of the leader. Our findings also indicate that leadership cannot be studied in isolation or without being clearly defined.

  • 47.
    Sandström, Boel
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Svensson, Bengt
    Lunds universitet, SWE.
    Borglin, Gunilla
    Blekinge Institute of Technology, School of Health Science.
    How do we know if this is the best? Mental health-care professionals' views on national guidelines for psychosocial interventions2014In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 23, no 3, p. 221-231Article in journal (Refereed)
    Abstract [en]

    National guidelines are released regularly, and professionals are expected to adopt and implement them. However, studies dealing with mental health-care professionals' views about guidelines are sparse. The aim of the present study was to highlight mental health-care staff's views on the Swedish national guidelines for 'psychosocial interventions for schizophrenia or schizophrenia-type symptoms' and their implementation. The study took place in the southeast parts of Sweden, and data were collected through five group interviews consisting of 16 professionals working either in the county council or in the municipalities. The transcribed text was analysed by content analysis, revealing two categories. The first category 'a challenge to the practice of care as known' reflected that the release of guidelines could be perceived as a challenge to prevailing care and culture. The second category 'anticipating change to come from above' mirrored views on how staff expected the implementation process to flow from top to bottom. To facilitate working in accordance with guidelines, we suggest that future guidelines should be accompanied by an implementation plan, where the educational needs of frontline staff are taken into account. There is also a need for policy makers and managers to assume responsibility in supporting the implementation of evidence-based practice.

  • 48.
    Sandström, Boel
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Willman, Ania
    Blekinge Institute of Technology, School of Health Science.
    Svensson, Bengt
    Borglin, Gunilla
    Mapping attitudes and awareness with regard to national guidelines: An e-mail survey among decision makers2014In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 22, no 7, p. 884-893Article in journal (Refereed)
    Abstract [en]

    The adoption of evidence-based guidelines within the mental health field has been slow. Changing inadequate practice is therefore a formidable challenge for mental health-care managers. Aim: To explore decision-makers' attitudes and awareness regarding the national guidelines for psychosocial interventions targeting people with schizophrenia. Method: A questionnaire distributed by e-mail to 592 Swedish decision-makers was analysed using descriptive and comparative techniques. Results: Significantly more of the top-level mental health-care managers than politicians stated that they knew about the national guidelines (i.e. their release and content) and they considered the guidelines to be a good source of support for planning and allocating resources. Conclusion: If those responsible for allocating resources (i.e. politicians) are unaware of the dissemination of national guidelines or their content, and they do not perceive the national guidelines to be a good source of support for planning and allocating resources, this is likely to have a negative influence on the remit of nurse managers as well as nursing practice. Implications for nursing management: Top-level mental health-care managers have a vital role to play in the implementation of national guidelines. However, our findings indicate that implementing national guidelines in practice could be virtually impossible without strategic government support.

  • 49.
    Sandström, Boel
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Willman, Ania
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Svensson, Bengt
    Borglin, Gunilla
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Perceptions of national guidelines and their (non) implementation in mental healthcare: a deductive and inductive content analysis2015In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 10, no 1, article id 43Article in journal (Refereed)
    Abstract [en]

    Background: National guidelines are being produced at an increasing rate, and politicians and managers are expected to promote these guidelines and their implementation in clinical work. However, research seldom deals with how decision-makers can perceive these guidelines or their challenges in a cultural context. Therefore, the aim of this study was twofold: to investigate how well Promoting Action on Research Implementation in Health Services (PARIHS) reflected the empirical reality of mental healthcare and to gain an extended understanding of the perceptions of decision-makers operating within this context, in regard to the implementation of evidence-based guidelines. Methods: The study took place in the southeast of Sweden and employed a qualitative design. The data were collected through 23 interviews with politicians and managers working either in the county council or in the municipalities. The transcribed text was analysed iteratively and in two distinct phases, first deductively and second inductively by means of qualitative content analysis. Results: Our deductive analysis showed that the text strongly reflected two out of three categorisation matrices, i.e. evidence and context representing the PARIHS framework. However, the key element of facilitation was poorly mirrored in the text. Results from the inductive analysis can be seen in light of the main category sitting on the fence; thus, the informants' perceptions reflected ambivalence and contradiction. This was illustrated by conflicting views and differences in culture and ideology, a feeling of security in tradition, a certain amount of resistance to change and a lack of role clarity and clear directions. Together, our two analyses provide a rich description of an organisational culture that is highly unlikely to facilitate the implementation of the national guidelines, together with a distrust of the source behind such guidelines, which stands in stark contrast to the high confidence in the knowledge of experienced people in authority within the organisational context. Conclusions: Our findings have highlighted that, regardless of by whom guidelines are released, they are not likely to be utilised or implemented if those who are responsible for implementing them do not trust the source. This aspect (i.e. contextual trust) is not covered by PARIHS.

  • 50. Skärsäter, Ingela
    et al.
    Willman, Ania
    The Recovery Process in Major Depression: an Analysis Employing Meleis´Transition Framework for Deeper Understanding as a Foundation for Nursing Interventions.2006In: Advances in Nursing Science, ISSN 0161-9268, E-ISSN 1550-5014, Vol. 29, no 3, p. 245-259Article in journal (Refereed)
    Abstract [en]

    The number of persons with mental illness is increasing globally; despite this fact, nursing research on research-based interventions to prevent or minimize illness and increase quality of life is sparse. The purpose of this secondary analysis of men and women recovering from major depression (N=25) was to gain a deeper understanding of the concept of transition in the recovery process associated with major depression as well as to develop and suggest nursing interventions that support the recovery process. The transition framework was useful, as it was describing the transition process as fluid, going back and forth, which was confirmed by the respondents´statements. Transition planning is a feasible way of supporting both the recovery process and health promotion, thus laying the foundation for a good quality of life.

12 1 - 50 of 66
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf