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Shi S, Wei J, Lyu G, Zhong X, Yang M, Zhu L. Application of Comfort Therapy under eCASH Concept in Acute and Chronic Wound Treatment. Dermatol Ther (Heidelb) 2023; 13:299-314. [PMID: 36472790 PMCID: PMC9823170 DOI: 10.1007/s13555-022-00852-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Given the new ideas on wound care offered by the eCASH (early Comfort using Analgesia, minimal Sedatives, and maximal Humane care) and the substantial differences in clinical treatment between acute and chronic wounds, we aimed to investigate the effect of comfort therapy under the eCASH concept on analgesic sedation and accelerated wound healing in patients with acute or chronic wounds. METHODS This randomized clinical study was conducted in two parts: acute wounds and chronic wounds. Patients with acute wounds were allocated into the acute wound control group (AWCG) and the acute wound experimental group (AWEG). Patients with chronic wounds were allocated into the chronic wound control group (CWCG) and two experimental groups, in which they received intermittent negative pressure therapy (IPTEG) and continuous negative pressure therapy (CPTEG). On the basis of the standard treatment for patients in the control group, eCASH therapy was used in the experimental groups. In addition, pain intensity and procedural anxiety were evaluated using the visual analogue score (VAS) and the Hamilton Anxiety Scale (HAM-A). In addition, clinical effects were assessed on the basis of the size of the surface area, rate of healing, and concentration of pro-inflammatory factors (IL-1, IL-6, TNF-α) and growth factors (VEGF, bFGF, TGF-β1). RESULTS Compared with the control group, the VAS score and HAM-A score in the experimental groups were significantly decreased after intervention (P < 0.05). After intervention, the levels of IL-1β, IL-6, and TNF-α in AWEG, IPTEG, and CPTEG were significantly lower than those in AWCG. In addition, the levels of VEGF, bFGF, and TGF-β1 in IPTEG and CPTEG were significantly higher than those in CWCG (P < 0.05). CONCLUSION These results indicated that comfort therapy under the eCASH concept has a significant effect on ameliorating the pain and anxiety of patients, reducing the inflammatory reaction during the period of wound healing in the treatment of acute and chronic wounds. CLINICAL TRIAL REGISTRY The trial has been registered in the Chinese Clinical Trial Registry (ChiCTR2200057981).
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Affiliation(s)
- Shuting Shi
- Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Binhu District, Wuxi, 214122, Jiangsu, China
| | - Jiayu Wei
- Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Binhu District, Wuxi, 214122, Jiangsu, China
| | - Guozhong Lyu
- Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Binhu District, Wuxi, 214122, Jiangsu, China.,Department of Burn and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Xiaohui Zhong
- Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Binhu District, Wuxi, 214122, Jiangsu, China
| | - Minlie Yang
- Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Binhu District, Wuxi, 214122, Jiangsu, China. .,Department of Burn and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China.
| | - Lihong Zhu
- Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Binhu District, Wuxi, 214122, Jiangsu, China. .,Department of Burn and Plastic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China.
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Engwall M, Jutengren G, Bergbom I, Lindahl B, Fridh I. Patients' Self-Reported Recovery After an Environmental Intervention Aimed to Support Patient's Circadian Rhythm in Intensive Care. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 14:194-210. [PMID: 33754878 PMCID: PMC8597201 DOI: 10.1177/19375867211001541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 01/15/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients in intensive care units (ICUs) are among the most vulnerable, and they require support to start their recovery. The design of the patient area in the ICU can play a prominent role in both the quality of care and patients' recovery. The lighting environment has the opportunity to restore and strengthen the natural human circadian rhythm and health. AIM To evaluate patients' self-reported recovery after being cared for in an ICU room rebuilt according to evidence-based design principles that promote recovery. METHOD An intervention was set up in a two-bed patient room including a cycled lighting system. Self-reported recovery was reported at 6 and 12 months after discharge. Data were analyzed using a 2(mechanically ventilated, nonmechanically ventilated) × 2(intervention room, ordinary room) analysis of covariance (ANCOVA) and 2(male, women) × 2(intervention room, ordinary room) ANCOVA. RESULTS Data from the different rooms showed no significant main effects for recovery after 6 months, p = .21; however, after 12 months, it become significant, p. < .05. This indicated that patient recovery was positively influenced for patients cared for in the intervention room (M = 8.88, SD = 4.07) compared to the ordinary room (M = 10.90, SD = 4.26). There were no interaction effects for gender or if the patients had been mechanically ventilated either at 6 or 12 months' postdischarge. CONCLUSIONS A cycled lighting system may improve patient self-reported recovery after ICU care; however, more research on the topic is needed.
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Affiliation(s)
- Marie Engwall
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Göran Jutengren
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Ingegerd Bergbom
- Institute of Health and Caring Sciences, Sahlgrenska Academy, Gothenburg University, Sweden
| | - Berit Lindahl
- Department of Health Sciences, Faculty of Medicine, University of Lund, Sweden
| | - Isabell Fridh
- Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Sweden
- Department of Anesthesiology, Surgery, and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
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3
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Egerod I, Poulsen I, Langhorn L, Aadal L. Inclusion, delivery, assessment, and outcomes in longitudinal research on sleep disturbance and agitation in TBI-rehabilitation: lessons learned and future considerations. Brain Inj 2021; 35:1616-1623. [PMID: 34550819 DOI: 10.1080/02699052.2021.1978546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This article presents some issues for consideration before scaling from a pilot study to a larger investigation in longitudinal observational studies of traumatic brain injury (TBI) rehabilitation. MATERIALS AND METHODS We present a case to discuss protocol improvements in longitudinal TBI-rehabilitation studies. The case was a pilot study conducted at two university hospitals in Denmark investigating 1-year outcomes related to sleep disturbance and agitation during neurointensive care. We included patients with moderate and severe TBI determined by the Glasgow Coma Scale, sleep disturbance was assessed using actigraphy, and agitation was assessed using the Agitated Behavior Scale. RESULTS Patients (n = 29) were more severely ill and had poorer six-month outcomes in Eastern vs. Western Denmark. Recovery was similar at one-year follow-up. Protocol improvements were needed in relation to inclusion criteria, intervention delivery, patient assessment, and follow-up outcomes. CONCLUSION In TBI-rehabilitation studies, we suggest adding the severity of disease score to the initial GCS score and a delirium detection score to the ABS score. Actigraphy should not be used during deep sedation. Established procedures should be in place along all stages of the study protocol, including preparation and periodic assessment of study nurses to optimize data quality.
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Affiliation(s)
- Ingrid Egerod
- University of Copenhagen, Rigshospitalet, Department of Intensive Care, Copenhagen, Denmark
| | - Ingrid Poulsen
- Copenhagen University Hospital, Rigshospitalet, Department of Neurorehabilitation, Hvidovre, Denmark
| | - Leanne Langhorn
- Aarhus University Hospital, Department of Anesthesiology and Intensive Care, Aarhus, Denmark
| | - Lena Aadal
- Hammel Neurorehabilitation and Research Center, Hammel, Denmark
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4
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Halvorsen K, Jensen JF, Collet MO, Olausson S, Lindahl B, Saetre Hansen B, Lind R, Eriksson T. Patients' experiences of well-being when being cared for in the intensive care unit-An integrative review. J Clin Nurs 2021; 31:3-19. [PMID: 34159663 DOI: 10.1111/jocn.15910] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this integrative review was to identify facilitators and barriers to patients' well-being when being cared for in an ICU setting, from the perspective of the patients. BACKGROUND To become critically ill and hospitalised in an ICU is a stressful, chaotic event due to the life-threatening condition itself, as well as therapeutic treatments and the environment. A growing body of evidence has revealed that patients often suffer from physical, psychological and cognitive problems after an ICU stay. Several strategies, such as sedation and pain management, are used to reduce stress and increase well-being during ICU hospitalisation, but the ICU experience nevertheless affects the body and mind. DESIGN; METHODS: Since research exploring patients' sense of well-being in an ICU setting is limited, an integrative review approach was selected. Searches were performed in CINAHL, Medline, Psych Info, Eric and EMBASE. After reviewing 66 studies, 12 studies were included in the integrative review. Thematic analysis was used to analyse the studies. The PRISMA checklist for systematic reviews was used. RESULTS The results are presented under one main theme, 'Well-being as a multidimensional experience-interwoven in barriers and facilitators' and six sub-themes representing barriers to and facilitators of well-being in an ICU. Barriers identified were physical stressors, emotional stressors, environmental disturbances and insecurity relating to time and space. Facilitators were meeting physical needs and activities that included dimensions of a caring and relational environment. CONCLUSION Our main findings were that experiences of well-being were multidimensional and included physical, emotional, relational and environmental aspects, and they were more often described through barriers than facilitators of well-being. RELEVANCE FOR CLINICAL PRACTICE This integrative review has shown that it is necessary to adopt an individual focus on patient well-being in an ICU setting since physical, emotional, relational and environmental stressors might impact each patient differently.
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Affiliation(s)
| | - Janet F Jensen
- Department of Anesthesiology, Holbaek Hospital, Holbaek, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Marie O Collet
- Intensive Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sepideh Olausson
- Institute of Health and Care Sciences, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Berit Lindahl
- Department of Health Sciences and the Institute for Palliative Care, Medical Falucty Lund University, Lund, Sweden.,Faculty of Caring Sciences, Work Life and Social Welfare, Borås University, Borås, Sweden
| | - Britt Saetre Hansen
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Ranveig Lind
- Department of Health and Care Sciences, The Arctic University of Norway, Harstad, Norway.,Research Nurse at Intensive Care Unit, University Hospital of North Norway, Tromsø, Norway
| | - Thomas Eriksson
- Faculty of Caring Sciences, Work Life and Social Welfare, Borås University, Borås, Sweden
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5
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Pettersson C, Nilsson M, Andersson M, Wijk H. The impact of the physical environment for caregiving in ordinary housing: Experiences of staff in home- and health-care services. APPLIED ERGONOMICS 2021; 92:103352. [PMID: 33395590 DOI: 10.1016/j.apergo.2020.103352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 12/23/2020] [Accepted: 12/25/2020] [Indexed: 06/12/2023]
Abstract
The strong driving forces for ageing in place demand sustainable solutions for the housing and care of older people and the health and safety of home- and health-care staff. The aim of the study was to elucidate staff experiences of providing home- and health-care to older people living in ordinary housing. This study was part of a larger project investigating the relation between home design and conditions for care in ordinary housing. The data were gathered through focus group interviews with staff in home- and health-care. Three main themes were found according to staff experiences of particular rooms' sizes and proportions, spatial configurations, and aspects to consider when designing new housing. This study contributes important knowledge about essential features of the physical environment for staff providing home- and health-care for older people in their own homes and to aid the development of functionally sustainable housing to minimise injuries to staff.
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Affiliation(s)
- Cecilia Pettersson
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden; School of Health Sciences, Örebro University, Örebro, Sweden.
| | | | - Morgan Andersson
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Helle Wijk
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden; Institute of Health and Care Sciences, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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Sundberg F, Kirk S, Lindahl B. Qualitative Observational Research in the Intensive Care Setting: A Personal Reflection on Navigating Ethical and Methodological Issues. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2021; 58:469580211060299. [PMID: 34894840 PMCID: PMC8671657 DOI: 10.1177/00469580211060299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this theoretical paper is to critically reflect on the ethical and methodological issues that arose during a study that observed nurses’ care-giving in an intensive care unit setting. The authors critically discuss the methodological and ethical issues as well as the practical realities that were encountered when evaluating a complex intervention using unstructured qualitative observations. We describe the process with negotiating access and entering into the clinical field. Moreover, we reflect on experiences related to methodological issues such as the observer role, how to construct field notes, and how to encounter ethical dilemmas and other problems when being an observer in a closed and protected setting like an intensive care unit. We argue that qualitative observations give an insider perspective when studying the conditions for health and well-being. Our experiences can be transferred to other contexts and guide researchers interested in doing qualitative observational studies.
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Affiliation(s)
- Fredrika Sundberg
- Research and Development Centre, Skaraborg Hospital Skövde, Skovde, Sweden
- The School of Health Sciences, University of Skövde, Skovde, Sweden
| | - Sue Kirk
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, University of Manchester, Manchester,UK
| | - Berit Lindahl
- Department of Health Sciences, Lund University, Lund, Sweden
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7
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Roxberg Å, Tryselius K, Gren M, Lindahl B, Werkander Harstäde C, Silverglow A, Nolbeck K, James F, Carlsson IM, Olausson S, Nordin S, Wijk H. Space and place for health and care. Int J Qual Stud Health Well-being 2020; 15:1750263. [PMID: 33103632 PMCID: PMC7594871 DOI: 10.1080/17482631.2020.1750263] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2020] [Indexed: 11/20/2022] Open
Abstract
Purpose: This discussion paper aims to contribute to a greater understanding of the state of the art of research engaged with conceptual matters of space and place for health and care. Method: The authors, who represent a variety of academic disciplines, discuss and demonstrate the conceptual recognition of space and place in research in health and caring sciences building upon own work and experience. Results: To explore the concepts of space and place for health and care is a research pursuit of utmost importance, and should be made through transdisciplinary research collaborations, whereby spatial theories from various disciplines could be communicated to cultivate truly novel and well-informed research. Furthermore, engaging with relational and topological perceptions of space and place poses methodological challenges to overcome in future research on health and care. Conclusions: We argue that there is a need for accelerating spatially informed research on health and care that is informed by current theories and perspectives on space and place, and transdisciplinary research collaborations are a means to achieving this.
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Affiliation(s)
- Åsa Roxberg
- Section for Nursing, University West, Halmstad, Sweden
| | - Kristina Tryselius
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Martin Gren
- Department of Cultural Sciences, Linnaeus University, Kalmar, Sweden
| | - Berit Lindahl
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | | | - Anastasia Silverglow
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kajsa Nolbeck
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Franz James
- Academy for Design and Crafts, University of Gothenburg, Gothenburg, Sweden
| | | | - Sepideh Olausson
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Centre for Ethics, Law and Mental Health, Gothenburg University Hospital, Gothenburg, Sweden
| | - Susanna Nordin
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Helle Wijk
- Centre for Ethics, Law and Mental Health, Gothenburg University Hospital, Gothenburg, Sweden
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8
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Sundberg F, Fridh I, Lindahl B, Kåreholt I. Visitor's Experiences of an Evidence-Based Designed Healthcare Environment in an Intensive Care Unit. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2020; 14:178-191. [PMID: 32734781 PMCID: PMC8079796 DOI: 10.1177/1937586720943471] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: The objective of the research was to study the visitors’ experiences of
different healthcare environment designs of intensive care unit (ICU)
patient rooms. Background: The healthcare environment may seem frightening and overwhelming in times
when life-threatening conditions affect a family member or close friend and
individuals visit the patient in an ICU. A two-bed patient room was
refurbished to enhance the well-being of patients and their families
according to the principles of evidence-based design (EBD). No prior
research has used the Person-centred Climate Questionnaire—Family version
(PCQ-F) or the semantic environment description (SMB) in the ICU
setting. Methods: A sample of 99 visitors to critically ill patients admitted to a
multidisciplinary ICU completed a questionnaire; 69 visited one of the two
control rooms, while 30 visited the intervention room. Results: For the dimension of everydayness in the PCQ-F, a significantly better
experience was expressed for the intervention room (p <
.030); the dimension regarding the ward climate general was also perceived
as higher in the intervention room (p < .004). The
factors of pleasantness (p < .019), and complexity
(p < 0.049), showed significant differences favoring
the intervention room in the SMB, with borderline significance on the modern
factor (p < .061). Conclusion: Designing and implementing an enriched healthcare environment in the ICU
setting increases person-centered care in relation to the patients’
visitors. This could lead to better outcomes for the visitors, for example,
decreasing post-traumatic stress disorder symptoms, but this needs further
investigations.
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Affiliation(s)
- Fredrika Sundberg
- Faculty of Caring Science, Work Life and Social Welfare, 1802University of Borås, Sweden
| | - Isabell Fridh
- Faculty of Caring Science, Work Life and Social Welfare, 1802University of Borås, Sweden
| | - Berit Lindahl
- Faculty of Caring Science, Work Life and Social Welfare, 1802University of Borås, Sweden
| | - Ingemar Kåreholt
- Institute of Gerontology, School of Health and Welfare, 4161Jönköping University, Sweden
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9
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Sundberg F, Fridh I, Lindahl B, Kåreholt I. Associations between healthcare environment design and adverse events in intensive care unit. Nurs Crit Care 2020; 26:86-93. [DOI: 10.1111/nicc.12513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Fredrika Sundberg
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Isabell Fridh
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
- Department of Anaesthesiology and Intensive Care Sahlgrenska University Hospital Gothenburg Sweden
| | - Berit Lindahl
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Ingemar Kåreholt
- School of Health and Welfare, Institute of Gerontology Jönköping University Jönköping Sweden
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10
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Eriksson T, Lindahl B, Nåden D, Bergbom I. Hermeneutic observational studies: describing a method. Scand J Caring Sci 2020; 35:319-327. [PMID: 31950514 DOI: 10.1111/scs.12819] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 12/30/2019] [Indexed: 11/28/2022]
Abstract
There is a need to develop and use research observations in the clinical field, primarily to gain insight into and assess evidence of what comprises caring in a real-life situation and confirm what is actually taking place. In addition, assessments lead to a new and different understanding of what caring constitutes, thereby enabling the identification of what kind of care is being provided and is required. Such observations also enable the observer to perceive and verbalise caring. There are ongoing discussions, specifically in Nordic countries, on how to use caring science-based observations as a means of collecting and interpreting qualitative data through the application of a hermeneutic approach, which constitutes describing what has been seen and reporting on it by way of ethical obligation. This article contributes to the debate through the provision of additional content and by reflecting on the development and usability of hermeneutical research observations from a method and methodological perspective, thereby refining previous ideas and extending previous assumptions. The primary study objective was to report on the experience of utilising observations as a single data collection method for hermeneutic research with the aim of evaluating the interplay between intensive care unit (ICU) patients and their next of kin. A secondary objective was to highlight the impact of preknowledge and preunderstanding on the interpretation process. An intensive care context was assessed as the most appropriate, as the majority of patients are unable to engage in verbal narratives during ongoing treatment and care. The benefits of employing hermeneutic observation as well as interpretation and preunderstanding from a caring science perspective are considered.
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Affiliation(s)
- Thomas Eriksson
- Faculty of Caring Sciences, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Berit Lindahl
- Faculty of Caring Sciences, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Dagfinn Nåden
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Ingegerd Bergbom
- Institute of Health and Caring Sciences, Gothenburg University, Gothenburg, Sweden
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11
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Bazzi M, Lundèn M, Ahlberg K, Bergbom I, Hellström M, Lundgren SM, Fridh I. Patients’ lived experiences of waiting for and undergoing endovascular aortic repair in a hybrid operating room: A qualitative study. J Clin Nurs 2019; 29:810-820. [DOI: 10.1111/jocn.15129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 10/09/2019] [Accepted: 11/10/2019] [Indexed: 12/27/2022]
Affiliation(s)
- May Bazzi
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Maud Lundèn
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Karin Ahlberg
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Ingegerd Bergbom
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Mikael Hellström
- Department of Radiology Sahlgrenska University Hospital and Sahlgrenska Academy Gothenburg University Gothenburg Sweden
| | - Solveig M. Lundgren
- Institute of Health and Care Sciences Sahlgrenska Academy at Gothenburg University Gothenburg Sweden
| | - Isabell Fridh
- Faculty of Caring Sciences, Work Life & Social Welfare University of Borås Borås Sweden
- Department of Anesthesiology and Intensive Care Sahlgrenska University Hospital Gothenburg Sweden
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12
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Facing the unfamiliar: Nurses’ transcultural care in intensive care – A focus group study. Intensive Crit Care Nurs 2019; 55:102752. [DOI: 10.1016/j.iccn.2019.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 07/25/2019] [Accepted: 08/01/2019] [Indexed: 11/21/2022]
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13
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Room Design-A Phenomenological-Hermeneutical Study: A Factor in Creating a Caring Environment. Crit Care Nurs Q 2019; 42:265-277. [PMID: 31135477 DOI: 10.1097/cnq.0000000000000267] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Medical technology has progressed tremendously over the last few decades, but the same development cannot be seen in the design of these intensive care unit environments. Authors report results of a study of evidence-based room design, emphasizing the impact on conveying a caring attitude to patients. Ten nonparticipant observations were conducted in patient rooms with 2 different designs, followed by interviews. The data were analyzed using a phenomenological-hermeneutical approach. The results did not reveal that it was obvious that redesigned spaces resulted in a more caring attitude. The meanings of caring displayed during nursing activities were interpreted by interpreting gazes. Some of the nursing staff had an instrumental gaze, interpreted as caring with a task-orientated approach, while others communicated their caring with an attentive and attuned gaze, where the needs of the patients regulated the working shift. The study findings indicated that caring may not be perceived when nurses use a task-oriented approach. However, when nurses practice a person-centered approach, using an attentive and attuned gaze, caring is conveyed. Caring in intensive care contexts needs to be assisted by a supportive environment design that cultivates the caring approach.
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14
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Dahlborg Lyckhage E, Brink E, Lindahl B. A Theoretical Framework for Emancipatory Nursing With a Focus on Environment and Persons' Own and Shared Lifeworld. ANS Adv Nurs Sci 2019; 41:340-350. [PMID: 30383562 DOI: 10.1097/ans.0000000000000227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
By giving a brief overview of the metaconcepts in nursing, with a focus on environment, we sketch a theoretical framework for an emancipatory perspective in nursing care practice. To meet the requirements of equality in care and treatment, we have in our theoretical framework added a critical lifeworld perspective to the antioppressive practice, to meet requirements of equity in health care encounter. The proposed model of emancipatory nursing goes from overall ideological structures to ontological aspects of the everyday world. Based on the model, nurses could identify what kind of theoretical critical knowledge and thinking they require to conduct equal care and encounter the person behind the patient role.
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15
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Andersson M, Fridh I, Lindahl B. Is it possible to feel at home in a patient room in an intensive care unit? Reflections on environmental aspects in technology‐dense environments. Nurs Inq 2019; 26:e12301. [DOI: 10.1111/nin.12301] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Morgan Andersson
- Department of Architecture and Civil Engineering Chalmers University of Technology Gothenburg Sweden
| | - Isabell Fridh
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Berit Lindahl
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
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Robstad N, Siebler F, Söderhamn U, Westergren T, Fegran L. Design and psychometric testing of instruments to measure qualified intensive care nurses' attitudes toward obese intensive care patients. Res Nurs Health 2018; 41:525-534. [PMID: 30302768 DOI: 10.1002/nur.21914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 09/16/2018] [Indexed: 11/11/2022]
Abstract
The purpose of this pilot study was to design and test research instruments to measure qualified intensive care nurses' implicit and explicit attitudes and behavioral intentions toward obese intensive care patients. In previous studies researchers have demonstrated that some health professionals hold negative attitudes toward obese patients; however, little is known about qualified intensive care nurses' attitudes toward these patients. Our cross-sectional pilot study involved Implicit Association Tests, the Anti-fat Attitude questionnaire, an explicit bias scale comprising ratings of explicit beliefs and feelings, assessment of behavioral intentions based on vignettes, and demographic questions. Thirty qualified intensive care nurses from a general intensive care unit in Norway (80% female; age range 31-62 years) completed the study. Nurses reported implicit and explicit preferences for thin over thick patients and found obese patients lazier than normal-weight patients. Measures of behavioral intentions and anti-fat attitudes were reliable. Generally, the nurses intended to help obese patients immediately. Nevertheless, explicit anti-fat attitudes (rho = -0.49) as well as implicit anti-obese stereotypes (rho = -0.40) were negatively correlated with such intentions. Data supported satisfactory face validity, and convergent and discriminant validity within and between implicit and explicit attitudes and stereotypes. The set of research instruments were reliable, valid, and suitable tools to measure qualified intensive care nurses' implicit and explicit attitudes; however, the present findings need to be replicated in a larger-scale study.
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Affiliation(s)
- Nastasja Robstad
- Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Frank Siebler
- Faculty of Health Sciences, Department of Psychology, University of Tromsø, Langnes, Tromsø, Norway
| | - Ulrika Söderhamn
- Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Thomas Westergren
- Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Liv Fegran
- Faculty of Health and Sport Sciences, Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
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Lindahl B. On locating the metaparadigm concept environment within caring science. Scand J Caring Sci 2018; 32:997-998. [PMID: 30252158 DOI: 10.1111/scs.12620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Berit Lindahl
- Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Department of Health Sciences Ålesund, Norwegian University of Science and Technology, Trondheim, Norway
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Use of Communication Tools for Mechanically Ventilated Patients in the Intensive Care Unit. ACTA ACUST UNITED AC 2018; 36:398-405. [DOI: 10.1097/cin.0000000000000449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nursing staff's experiences of working in an evidence-based designed ICU patient room-An interview study. Intensive Crit Care Nurs 2017; 43:75-80. [PMID: 28595825 DOI: 10.1016/j.iccn.2017.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 05/15/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION It has been known for centuries that environment in healthcare has an impact, but despite this, environment has been overshadowed by technological and medical progress, especially in intensive care. Evidence-based design is a concept concerning integrating knowledge from various research disciplines and its application to healing environments. OBJECTIVE The aim was to explore the experiences of nursing staff of working in an evidence-based designed ICU patient room. METHOD Interviews were carried out with eight critical care nurses and five assistant nurses and then subjected to qualitative content analysis. FINDINGS The experience of working in an evidence-based designed intensive care unit patient room was that the room stimulates alertness and promotes wellbeing in the nursing staff, fostering their caring activities but also that the interior design of the medical and technical equipment challenges nursing actions. CONCLUSIONS The room explored in this study had been rebuilt in order to create and evaluate a healing environment. This study showed that the new environment had a great impact on the caring staffs' wellbeing and their caring behaviour. At a time when turnover in nurses is high and sick leave is increasing, these findings show the importance of interior design ofintensive care units.
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Johansson L, Lindahl B, Knutsson S, Ögren M, Persson Waye K, Ringdal M. Evaluation of a sound environment intervention in an ICU: A feasibility study. Aust Crit Care 2017; 31:59-70. [PMID: 28506741 DOI: 10.1016/j.aucc.2017.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 04/16/2017] [Accepted: 04/21/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Currently, it is well known that the sound environment in intensive care units (ICU) is substandard. Therefore, there is a need of interventions investigating possible improvements. Unfortunately, there are many challenges to consider in the design and performance of clinical intervention studies including sound measurements and clinical outcomes. OBJECTIVES (1) explore whether it is possible to implement a full-scale intervention study in the ICU concerning sound levels and their impact on the development of ICU delirium; (2) discuss methodological challenges and solutions for the forthcoming study; (3) conduct an analysis of the presence of ICU delirium in the study group; and (4) describe the sound pattern in the intervention rooms. METHODS A quasi-randomized clinical trial design was chosen. The intervention consisted of a refurbished two-bed ICU patient room (experimental) with a new suspended wall-to-wall ceiling and a low frequency absorber. An identical two-bed room (control) remained unchanged. INCLUSION CRITERIA Patients >18 years old with ICU lengths of stay (LoS) >48h. The final study group consisted of 31 patients: six from the rebuilt experimental room and 25 from the control room. Methodological problems and possible solutions were continuously identified and documented. RESULTS Undertaking a full-scale intervention study with continuous measurements of acoustic data in an ICU is possible. However, this feasibility study demonstrated some aspects to consider before start. The randomization process and the sound measurement procedure must be developed. Furthermore, proper education and training are needed for determining ICU delirium. CONCLUSION This study raises a number of points that may be helpful for future complex interventions in an ICU. For a full-scale study to be completed a continuously updated cost calculation is necessary. Furthermore, representatives from the clinic need to be involved in all stages during the project.
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Affiliation(s)
- Lotta Johansson
- Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Berit Lindahl
- Faculty of Caring Science, Work Life and Social Welfare, Borås University College, Sweden
| | - Susanne Knutsson
- Department of Nursing, School of Health Sciences, Jönköping University, Sweden
| | - Mikael Ögren
- Department of Occupational & Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Kerstin Persson Waye
- Department of Occupational & Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Mona Ringdal
- Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden
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Engwall M, Fridh I, Jutengren G, Bergbom I, Sterner A, Lindahl B. The effect of cycled lighting in the intensive care unit on sleep, activity and physiological parameters: A pilot study. Intensive Crit Care Nurs 2017; 41:26-32. [PMID: 28268055 DOI: 10.1016/j.iccn.2017.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 01/09/2017] [Accepted: 01/22/2017] [Indexed: 12/26/2022]
Abstract
Patients in intensive care suffer from severe illnesses or injuries and from symptoms related to care and treatments. Environmental factors, such as lighting at night, can disturb patients' circadian rhythms. The aim was to investigate whether patients displayed circadian rhythms and whether a cycled lighting intervention would impact it. In this pilot study (N=60), a cycled lighting intervention in a two-bed patient room was conducted. An ordinary hospital room functioned as the control. Patient activity, heart rate, mean arterial pressure and body temperature were recorded. All data were collected during the patients' final 24h in the intensive care unit. There was a significant difference between day and night patient activity within but not between conditions. Heart rates differed between day and night significantly for patients in the ordinary room but not in the intervention room or between conditions. Body temperature was lowest at night for all patients with no significant difference between conditions. Patients in both conditions had a natural circadian rhythm; and the cycled lighting intervention showed no significant impact. As the sample size was small, a larger repeated measures study should be conducted to determine if other types of lighting or environmental factors can impact patients' well-being.
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Affiliation(s)
- Marie Engwall
- Faculty of Caring Sciences, Work Life & Social Welfare, University of Borås, SE-50190 Borås, Sweden; Sahlgrenska Academy, Gothenburg University and the Institute of Health & Caring Sciences, Arvid Wallgrens Backe 1, SE 41346 Gothenburg, Sweden.
| | - Isabell Fridh
- Faculty of Caring Sciences, Work Life & Social Welfare, University of Borås, SE-50190 Borås, Sweden.
| | - Göran Jutengren
- Faculty of Caring Sciences, Work Life & Social Welfare, University of Borås, SE-50190 Borås, Sweden.
| | - Ingegerd Bergbom
- Faculty of Caring Sciences, Work Life & Social Welfare, University of Borås, SE-50190 Borås, Sweden; Sahlgrenska Academy, Gothenburg University and the Institute of Health & Caring Sciences, Arvid Wallgrens Backe 1, SE 41346 Gothenburg, Sweden.
| | - Anders Sterner
- Faculty of Caring Sciences, Work Life & Social Welfare, University of Borås, SE-50190 Borås, Sweden.
| | - Berit Lindahl
- Faculty of Caring Sciences, Work Life & Social Welfare, University of Borås, SE-50190 Borås, Sweden; Sahlgrenska Academy, Gothenburg University and the Institute of Health & Caring Sciences, Arvid Wallgrens Backe 1, SE 41346 Gothenburg, Sweden.
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