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Zidén L, Erhag HF, Wijk H. Person-centered care as a tool to reduce behavioral and psychological symptoms in older adults with dementia living in residential care facilities. Geriatr Nurs 2024; 57:51-57. [PMID: 38522128 DOI: 10.1016/j.gerinurse.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/21/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
Among older adults living in dementia residential care facilities (RCF) behavioral and psychological symptoms (BPSD) are common, affecting the quality of life (QOL) for the residents as well as being challenging for the staff. The person-centered care (PCC) approach addresses BPSD by giving trained staff mandate to focus on the relation and to adapt the encounter and the environment to increase QoL for the person with dementia. The aims with this study were to improve PCC, decrease BPSD and improve QOL among older persons with dementia living in RCFs, and to explore leaders' and healthcare staff's experiences of a PCC intervention. An educational program was implemented at two RCFs. Data was collected through questionnaires, from national quality registries and through focus group interviews. A significant increase in PCC and QOL at three months was seen. However, no significant difference in BPSD was seen. The interviews showed the importance of a trust-based relationship, and support from an active management to improve PCC, as well as changing old patterns and recognising competence among staff. Factors that affect implementation of PCC in RCF are discussed in the article.
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Affiliation(s)
- Lena Zidén
- Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Dept of Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Hanna Falk Erhag
- Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Neuroscience and Physiology, Dept of Rehabilitation, Sahlgrenska Academy, University of Gothenburg, Sweden; Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Sweden; Centre for Ageing and Health - AgeCap, University of Gothenburg, Sweden.
| | - Helle Wijk
- Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Sweden; Chalmers University, Gothenburg, Sweden.
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Angelini E, Wolf A, Wijk H, Brisby H, Baranto A. Evaluating a targeted person-centred pain management intervention programme in lumbar spine surgery - a controlled segment-specific before-and-after interventional design. BMC Health Serv Res 2024; 24:315. [PMID: 38459528 PMCID: PMC10921751 DOI: 10.1186/s12913-024-10769-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 02/22/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Postoperative pain management in lumbar spine surgery care remains a challenge. The aim of this study was to evaluate the impact of a person-centred postoperative pain management intervention programme on lumbar spine surgery patients on postoperative pain, shared decision-making, and satisfaction with postoperative pain management. METHODS The study was performed with a controlled before-and-after interventional design in an orthopaedic unit at a university hospital. Person-centred pain management for patients undergoing spine surgery was developed in co-creation by a multi-professional team and implemented throughout the care pathway. The usual care group (pre-intervention) served as a comparison to the intervention group. Pain intensity, shared decision-making in pain management, and patient satisfaction with results of pain management, served as patient-reported measures, collected using the International Pain Outcomes questionnaire and analysed using descriptive statistics. RESULTS The intervention showed no benefit for patients' pain and satisfaction, while shared decision-making in pain management was significant lower in the intervention group than in the conventional group. The per-protocol analysis showed no significant differences between groups. CONCLUSION The initial assumption of the study, that the implementation of a co-created structured person-centred care pathway would improve patient-reported outcomes, was not confirmed. The periodically low fidelity to the intervention due to organizational constraints (due to sub-optimal organizational conditions and managerial support) may have affected the results.
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Affiliation(s)
- Eva Angelini
- Dept of Orthopaedics, Institute of Clinical Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Institute of Health and Care Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Axel Wolf
- Institute of Health and Care Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Dept of Anaesthesia, Operation & Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Dept. of Quality Improvement, Sahlgrenska University Hospital, Gothenburg, Sweden
- Architecture, Chalmers University of Technology, Gothenburg, Sweden
| | - Helena Brisby
- Dept of Orthopaedics, Institute of Clinical Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Dept. of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Adad Baranto
- Dept of Orthopaedics, Institute of Clinical Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Dept. of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Alexiou E, Wijk H, Åkerström M, Jonsdottir IH, Degl' Innocenti A, Ahlstrom L. Worry perception and its association with work conditions among healthcare workers during the first wave of the COVID-19 pandemic: a web-based multimethod survey at a university hospital in Sweden. BMJ Open 2024; 14:e080248. [PMID: 38382952 PMCID: PMC10882285 DOI: 10.1136/bmjopen-2023-080248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES In this study, we explored healthcare workers' (HCWs) worry perception and its association with their work situation during the first wave of the COVID-19 pandemic. DESIGN A web-based multimethods survey including multiple choice and open-ended questions was used. SETTING The study was conducted at a university hospital in Sweden. PARTICIPANTS All HCWs who were working during the first wave of the COVID-19 pandemic in March-June 2020 were eligible. HCWs (n=6484, response rate=41%) from 69 departments fulfilled the study inclusion criteria and responded to the survey. Of them, we analysed data from the 3532 participants who replied to the open-ended questions (54% of the respondents). MAIN OUTCOMES MEASURES Worry perception and its association with work conditions among HCWs. RESULTS 29% (n=1822) and 35% (n=2235) of the responding HCWs experienced a daily or more than daily strong worry of being infected or infecting others with SARS-CoV-2. This finding could be further confirmed and explored with themes from the qualitative results: 'ambiguity of feeling safe and secure', 'being obliged to adapt to a new reality' and 'into the unknown'. The themes consisted of 6 main categories and 15 subcategories. The findings revealed that the two main drivers of worry perceived by HCWs were lack of personal protective equipment and fear of bringing the virus home to their families and friends. CONCLUSIONS Worries of getting infected are common among HCWs during crises such as the COVID-19 pandemic. Several factors are raised that plausibly could minimise the negative effects of worry among HCWs. Thus, effective preventive work plans should be created, promoted and communicated in order to minimise the effects of such crises and support HCWs. By focusing on effective communication and preparedness, including access to relevant protective equipment and providing general support to HCWs, the work environment and patient care could be sustained during a crisis such as the COVID-19 pandemic.
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Affiliation(s)
- Eirini Alexiou
- Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
- Center for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Magnus Åkerström
- Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alessio Degl' Innocenti
- Center for Ethics, Law, and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Regionhälsan, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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Hagerup A, Wijk H, Lindahl G, Olausson S. Toward a Future Orientation: A Supportive Mental Health Facility Environment. HERD 2024:19375867231221151. [PMID: 38259241 DOI: 10.1177/19375867231221151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND The provision of supportive environments is essential in clinical and environmental psychology. Mental health disorders are a major issue, and the experience of being at a mental health facility is affected by numerous factors related to the building's design. AIM The aim of this study is to explore the expectations of a mental health facility planning group regarding the potential impact of a supportive design on patients' mental health and staff's therapeutic practices when planning and designing a new mental health facility. METHODS The new mental health facility is a case study and data were collected through qualitative in-depth interviews with nine participants and analyzed using a thematic analysis. The participants came from a mental health facility planning group in a new mental health facility in Norway. RESULTS The overall expectation of the new building was related to a future orientation to support patients' mental health and therapeutic practices. Three main themes were identified: toward a future orientation, supportive building design, and work environment. CONCLUSIONS Supportive environments are expected to influence patients' mental health and staff's therapeutic practices, including providing options for novel treatment needs in contrast to older and more outdated buildings that are perceived as hindering appropriate treatment conditions.
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Affiliation(s)
- Anne Hagerup
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Inland School of Business and Social Sciences, Inland Norway University of Applied Sciences, Inland Norway
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Quality strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Center for Healthcare Architecture, Chalmers University of Technology, Gothenburg, Sweden
| | - Göran Lindahl
- Division of Construction Management/Center for Healthcare Architecture, Department of Architecture and Civil Engineering, Chalmers University of Technology, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Anesthesiology and Intensive Care/Sahlgresnka, Sahlgrenska University Hospital, Gothenburg, Sweden
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Nolbeck K, Olausson S, Lindahl G, Thodelius C, Wijk H. Be prepared and do the best you can: a focus group study with staff on the care environment at Swedish secure youth homes. Int J Qual Stud Health Well-being 2023; 18:2168234. [PMID: 36727536 PMCID: PMC9897801 DOI: 10.1080/17482631.2023.2168234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE This study examined staff members' experiences of the institutional care environment within secure youth homes. METHODS Data were collected through three focus group discussions with 17 staff members at two secure youth homes. Subsequently, a thematic analysis was conducted. RESULTS The analysis indicated two main themes: risk management and damage control in a restricted environment and compensating and reconstructing ordinariness-trying to make the best of it; each theme had three subthemes. The care environment seems to be experienced by staff as characterized by conflicting demands, thus constituting a gap between needs and what is possible to achieve-a balancing act that constitutes a constant struggle. CONCLUSIONS The staff members' constant struggle could be interpreted as conflicting moral and instrumental demands; they know what the youths need, but the environment of the secure youth homes demands the decorous behaviour of sociomaterial control practices-rather than care practices.
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Affiliation(s)
- Kajsa Nolbeck
- Institute of Social Work, University of Gothenburg, Gothenburg, Sweden,CONTACT Kajsa Nolbeck University of Gothenburg, Institute of Social Work, Sprängkullsgatan 23-25, Box 720, 405 30, Gothenburg, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Göran Lindahl
- Department of Architecture and Civil Engineering, Division of Building Design, Chalmers University of Technology, and Centre for Healthcare Architecture, Gothenburg, Sweden
| | | | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Sahlgrenska University Hospital, Gothenburg, Sweden,Department of Architecture and Civil Engineering, Division of Building Design, Chalmers University of Technology, and Centre for Healthcare Architecture, Gothenburg, Sweden
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Wennman I, Wijk H, Jood K, Carlström E, Fridlund B, Alsholm L, Herlitz J, Hansson PO. Fast track to stroke unit for patients not eligible for acute intervention, a case-control register study on 1066 patients. Sci Rep 2023; 13:20799. [PMID: 38012289 PMCID: PMC10682035 DOI: 10.1038/s41598-023-48007-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/21/2023] [Indexed: 11/29/2023] Open
Abstract
Stroke patients not eligible for acute intervention often have low priority and may spend long time at the emergency department (ED) waiting for admission. The aim of this retrospective case-control register study was to evaluate outcomes for such "low priority" stroke patients who were transported via Fast Track directly to the stroke unit, according to pre-specified criteria by emergency medical service (EMS). The outcomes of Fast Track patients, transported directly to stroke unit (cases) were compared with the outcomes of patients who fulfilled these critera for Fast Track, but instead were transported to the ED (controls). In all, 557 cases and 509 controls were identified. The latter spent a mean time of 237 min in the ED before admission. The 90-day mortality rate was 12.9% for cases and 14.7% for controls (n.s.). None of the secondary outcome events differed significantly between the groups: 28-day mortality rate; death rate during hospitalisation; proportion of pneumonias, falls or pressure ulcers; or health-related outcomes according to the EQ-5D-5L questionnaire. These findings indicates that the Fast Track to the stroke unit by an EMS is safe for selected stroke patients and could avoid non-valuable time in the ED.
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Affiliation(s)
- Ingela Wennman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 405 45, Gothenburg, Sweden.
- Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden.
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 405 45, Gothenburg, Sweden
- Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden
| | - Katarina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, at the University of Gothenburg, Gothenburg, Sweden
- Department of Neurology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Eric Carlström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 405 45, Gothenburg, Sweden
- Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden
| | - Bengt Fridlund
- Centre for Interprofessional Collaboration Within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
| | - Linda Alsholm
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, at the University of Gothenburg, Gothenburg, Sweden
| | - Johan Herlitz
- PreHospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Per-Olof Hansson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine, Geriatrics and Emergency Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Gyberg A, Brezicka T, Wijk H, Ulin K. Struggling for access to appropriate healthcare services: A qualitative content analysis of patient complaints. J Adv Nurs 2023; 79:3748-3759. [PMID: 37128937 DOI: 10.1111/jan.15688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 03/27/2023] [Accepted: 04/16/2023] [Indexed: 05/03/2023]
Abstract
AIM This study aimed to describe circumstances concerning access for patients and relatives to take part in patient health and safety in a hospital setting. DESIGN This study used a qualitative descriptive design and was conducted at a Swedish university hospital. METHOD The 79 complaints reported by patients and relatives included in this study were registered between January 2017 and June 2019. These complaints were classified as concerning access to healthcare services. Data were analysed using qualitative content analysis. RESULTS The overarching theme, struggling for access as a human being in the healthcare system, encompassed three themes describing patients' and relatives' needs. The three themes were (1) navigating through the healthcare organization, (2) making sense of self and what is going on and (3) being acknowledged as having needs. CONCLUSION Patients and relatives continuously participate in various ways in healthcare to promote health and prevent patient harm. Our findings contribute important knowledge about the meaning of access from a broad healthcare system perspective. Access was restricted in terms of appropriateness in how patients' needs were met. This restriction of access risked the deterioration of patient health and safety. IMPACT Patients and relatives play an active part in patient health and safety, although their attempts are sometimes hindered. Restrictions in the appropriateness of access prevented patients and relatives from taking part in patient health and safety, which appeared to mean that they had to adapt and expend effort to the point that it negatively affected their health and everyday life. These findings concern all patients, relatives and healthcare professionals in hospital-associated settings. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Anna Gyberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine, Geriatrics and Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Thomas Brezicka
- Department of Quality Assurance, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Quality Assurance, Sahlgrenska University Hospital, Gothenburg, Sweden
- Center of Health Care Architecture, Chalmers University, Gothenburg, Sweden
| | - Kerstin Ulin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine, Geriatrics and Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
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Silverglow A, Wijk H, Lidén E, Johansson L. Patient safety culture in home care settings in Sweden: a cross-sectional survey among home care professionals. BMC Health Serv Res 2023; 23:998. [PMID: 37716938 PMCID: PMC10505324 DOI: 10.1186/s12913-023-10010-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND The connection between a weak patient safety culture and adverse patient events is well known, but although most long-term care is provided outside of hospitals, the focus of patient safety culture is most commonly on inpatient care. In Sweden, more than a third of people who receive care at home have been affected by adverse events, with the majority judged to be preventable. The aim of this study was to investigate the patient safety culture among care professionals working in care at home with older people. METHODS This cross-sectional study used a purposive sample of 66 municipal care workers, health care professionals, and rehabilitation staff from five municipal care units in two districts in western Sweden who provided care at home for older people and had been employed for at least six months. The participants completed the Hospital Survey on Patient Safety Culture (HSOPSC) self-report questionnaire, which assessed aspects of patient safety culture-norms, beliefs, and attitudes. Logistic regression analysis was used to test how the global ratings of Patient safety grade in the care units and Reporting of patient safety events were related to the dimensions of safety culture according to the staff's professions and years of work experience. RESULTS The most positively rated safety culture dimension was Teamwork within care units (82%), which indicates good cooperation with the closest co-workers. The least positively rated dimensions were Handoffs and transitions among care units (37%) and Management support (37%), which indicate weaknesses in the exchange of patient information across care units and limited support from top-level managers. The global rating of Patient safety grade was associated with Communication openness and Management support (p < 0.01 and p = 0.03, respectively). Staff with less work experience evaluated the Patient safety grade higher than those with more work experience. CONCLUSIONS This study suggests that improvements are needed in care transitions and in support from top-level managers and that awareness of patient safety should be improved in staff with less work experience. The results also highlight that an open communication climate within the care unit is important for patient safety.
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Affiliation(s)
- Anastasia Silverglow
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Helle Wijk
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
- The Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Gothenburg, Sweden
| | - Eva Lidén
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Johansson
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
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Goldkuhl L, Gyllensten H, Begley C, Wijk H, Nilsson C, Lindahl G, Ringqvist AK, Uvnäs-Moberg K, Berg M. Corrigendum to "Room4Birth - The effect of giving birth in a hospital birthing room designed with person-centred considerations: A Swedish randomised controlled trial" [Sex. Reprod. Healthc. 32 (2022) 100731]. Sex Reprod Healthc 2023; 37:100883. [PMID: 37399758 DOI: 10.1016/j.srhc.2023.100883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Affiliation(s)
- Lisa Goldkuhl
- Institute of Health and Care Sciences, Sahlgrenska Academy, Arvid Wallgrens backe, Box 457, 405 30, University of Gothenburg, Gothenburg, Sweden; Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Diagnosvagen 11, 41685 Gothenburg, Region Västra Götaland, Sweden.
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, Arvid Wallgrens backe, Box 457, 405 30, University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, Arvid Wallgrens backe, Box 457, 405 30, University of Gothenburg, Gothenburg, Sweden; Department of Quality Assurance and Patient Safety, Sahlgrenska University Hospital, Blå stråket 5, 413 45, Region Västra Götaland, Gothenburg, Sweden; Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Chalmersplatsen 4, 412 96 Gothenburg, Sweden; Department of Architecture and Civil Engineering, Building Design, Chalmers University of Technology, Chalmersplatsen 4, 412 96 Gothenburg, Sweden
| | - Christina Nilsson
- Munkebäck Antenatal Clinic, Munkebäckstorg 6, 416 73 Gothenburg, Region Västra Götaland, Sweden
| | - Göran Lindahl
- Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Chalmersplatsen 4, 412 96 Gothenburg, Sweden; Department of Architecture and Civil Engineering, Building Design, Chalmers University of Technology, Chalmersplatsen 4, 412 96 Gothenburg, Sweden
| | - Anna-Karin Ringqvist
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Diagnosvagen 11, 41685 Gothenburg, Region Västra Götaland, Sweden
| | - Kerstin Uvnäs-Moberg
- University of Agriculture (SLU), Almas Allé 8, 750 07, Uppsala University, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, Arvid Wallgrens backe, Box 457, 405 30, University of Gothenburg, Gothenburg, Sweden; Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Diagnosvagen 11, 41685 Gothenburg, Region Västra Götaland, Sweden; Faculty of Medicine and Community Health, Evangelical University of Africa, Bukavu, DR Congo
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Rasmussen B, Holton S, Wynter K, Phillips DJ, David JL, Rothmann MJ, Skjoeth MM, Wijk H, Frederiksen K, Ahlstrom L, Anderson JE, Harris R, Conolly A, Kent B, Maben J. Letter to editor. J Adv Nurs 2023; 79:2774-2775. [PMID: 37332127 DOI: 10.1111/jan.15632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 06/20/2023]
Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
- Faculty of Health, Institute of Health Transformation, Deakin University, Geelong, Australia
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Sara Holton
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
- Faculty of Health, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - Karen Wynter
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
- Faculty of Health, Institute of Health Transformation, Deakin University, Geelong, Australia
| | - David J Phillips
- Faculty of Health, School of Nursing and Midwifery, Geelong, Australia
| | - Jennifer L David
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
| | - Mette Juel Rothmann
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Odense University Hospital, Odense, Denmark
| | | | - Helle Wijk
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kirsten Frederiksen
- Department of Public Health - Department of Science in Nursing, Aarhus University, Aarhus, Denmark
| | - Linda Ahlstrom
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Janet E Anderson
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Ruth Harris
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Anna Conolly
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Bridie Kent
- Faculty of Health, School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
- Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
- Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
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11
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Veje M, Linden K, Sengpiel V, Carlsson Y, Jonsdottir IH, Degl'Innocenti A, Ahlstrom L, Wijk H, Akerstrom M. Working conditions for healthcare workers at a Swedish university hospital infectious disease department during the COVID-19 pandemic: barriers and facilitators to maintaining employee wellbeing. Front Psychol 2023; 14:1183084. [PMID: 37275708 PMCID: PMC10233109 DOI: 10.3389/fpsyg.2023.1183084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/04/2023] [Indexed: 06/07/2023] Open
Abstract
Background Healthcare workers (HCWs) at infectious disease departments have held the frontline during the COVID-19 pandemic. This study aimed to identify barriers and facilitators to maintaining the employees' wellbeing that may be used to increase preparedness for future pandemics within ID Departments. Methods In September 2020, a web-based survey on demographics and work environment was distributed to all HCWs at the Infectious Disease Department at Sahlgrenska University Hospital. Results were compared with a pre-COVID-19 survey from October 2019. A quantitative analysis of the overall effects of the pandemic on the working conditions of HCWs was conducted; in addition, a qualitative content analysis of open-ended responses was performed. Results In total, 222 and 149 HCWs completed the pre-COVID-19 and COVID-19 surveys (84 and 54% response rate), respectively. Overall, we found significant changes regarding increased workload, lack of emotional support in stressful work situations, and inability to recover after shifts. These factors correlated both with younger age and concern of becoming infected. The open-ended answers (n = 103, 69%) revealed five generic categories (Workload; Organizational support; Worry and ethical stress; Capability; and Cooperation and unity) with a total of 14 identified factors representing plausible individual and organizational-level barriers or facilitators to sustained employee wellbeing. Conclusion Younger HCWs as well as those expressing worries about contracting the infection were found to be particularly affected during the COVID-19 pandemic and these groups may require additional support in future outbreaks. Factors both increasing and decreasing the pandemic-induced negative health consequences for HCWs were identified; this knowledge may be utilized in the future.
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Affiliation(s)
- Malin Veje
- Department of Infectious Diseases, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Institute of Biomedicine, Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Verena Sengpiel
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Center of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Ylva Carlsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Center of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alessio Degl'Innocenti
- Center for Ethics, Law, and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Gothia Forum for Clinical Trials, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Quality Strategies, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Magnus Akerstrom
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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12
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Lindahl J, Thulesius H, Wijk H, Edvardsson D, Elmqvist C. The Perceived Support From Light and Color Before and After an Evidence-Based Design Intervention in an Emergency Department Environment: A Quasi-Experimental Study. HERD 2023; 16:109-124. [PMID: 36866406 PMCID: PMC10133835 DOI: 10.1177/19375867221150215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
AIM To evaluate patients' and family members' perceived support from light and color before, compared with after an evidence-based design (EBD) intervention at an emergency department (ED) using a validated instrument-the Light and Color Questionnaire (LCQ). BACKGROUND EDs offer acute care day and night. Thus, a supportive physical environment where light and color is crucial for how the milieu is experienced is vital. Research is limited on how care settings are perceived as supportive by users. METHODS Quasi-experimental evaluation of the refurbishing and remodeling of an ED by an expert group of nurse managers, nursing staff, nursing researchers and architects in south Sweden. LCQ includes dimensions "maximizing awareness and orientation," "maximizing safety and security," "supporting functional abilities," "providing privacy," "opportunities for personal control" (not for LCQ-Color), and "regulation and quality of stimulation." LCQ was analyzed and compared in 400 surveys from 100 patients and 100 family members before the intervention and 100 patients and 100 family members after the intervention. RESULTS The LCQ total score significantly improved after the intervention for both patients and family members. Four of the six dimensions of LCQ Light subscale scores were significantly higher for family members, and three of the six dimensions were significantly higher for patients after the intervention. The LCQ Color subscale score showed significant improvements for all five dimensions for both patients and family members after the intervention. CONCLUSION This study showed improved perceived support from light and color in the physical environment for patients and family members after an EBD intervention at an emergency department using a validated instrument-the Light and Color Questionnaire.
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Affiliation(s)
- Jeanette Lindahl
- Centre of Interprofessional Collaboration within Emergency care (CICE), Department of Health Caring Sciences, Linnaeus University, Växjö, Sweden.,Department of Research and Development, Region Kronoberg, Växjö, Sweden
| | - Hans Thulesius
- Department of Research and Development, Region Kronoberg, Växjö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Sweden.,Department of Quality Assurance and Patient Safety, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Architecture and Civil Engineering, Chalmers University of Technolog, Gothenburg, Sweden
| | - David Edvardsson
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.,Department of Nursing, Umeå University, Sweden
| | - Carina Elmqvist
- Centre of Interprofessional Collaboration within Emergency care (CICE), Department of Health Caring Sciences, Linnaeus University, Växjö, Sweden.,Department of Research and Development, Region Kronoberg, Växjö, Sweden
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13
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Mårtensson U, Nilsson S, Nolbris MJ, Wijk H, Mellgren K. Pain and discomfort in children with gastrostomy tubes - In the context of hematopoietic stem cell transplantation. J Pediatr Nurs 2023; 70:79-89. [PMID: 36848740 DOI: 10.1016/j.pedn.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 01/05/2023] [Accepted: 02/11/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND In children with malignant and severe non-malignant disorders undergoing hematopoietic stem cell transplantation (HSCT), treatment related pain and discomfort are common. Food consumption may become troublesome, making the use of a gastrostomy tube (G-tube) necessary and resulting in complications, why the purpose was to explore pain and discomfort during the transplantation and post-transplantation time. METHODS This was a mixed methods study where data were collected along the child's total health-care process between 2018 and 2021. Questions with fixed answer options were used, simultaneously, semi-structured interviews were performed. In total, sixteen families participated. Descriptive statistics and content analysis were used to describe analysed data. FINDINGS Intense pain was common during the post-surgery phase, especially in conjunction with G-tube care, which is why the children needed support to manage the situation. After the post-surgery phase when the skin has healed, most of the children experienced minor to no pain or bodily discomfort, why the G-tube became a well-functioning and supportive tool in daily life. CONCLUSIONS This study describes variations in and experiences of pain and bodily discomfort in conjunction with G-tube insertion in a unique sample of children who had undergone HSCT. In conclusion, the children's comfort in daily life after the post-surgery phase seemed to be only marginally affected by G-tube insertion. Children with severe non-malignant disorders seemed to experience a higher frequency and intensity of pain and bodily discomfort due to the G-tube than children with malignant disorders. PRACTICE IMPLICATIONS The paediatric care team need competence in assessing G-tube related pain and awareness that experiences may differ depending on the child's disorder.
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Affiliation(s)
- Ulrika Mårtensson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30 Gothenburg, Sweden.
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30 Gothenburg, Sweden; Department of Pediatrics, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
| | - Margaretha Jenholt Nolbris
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30 Gothenburg, Sweden; Department of Pediatrics, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 405 30 Gothenburg, Sweden; Chalmers Technology University, Centre for Health Care Architecture, SE- 405 30 Gothenburg, Sweden.
| | - Karin Mellgren
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SE- 416 85 Gothenburg, Sweden.
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14
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Björk L, Corin L, Akerstrom M, Jonsdottir IH, Innocenti AD, Wijk H, Ahlstrom L. Under pressure - The working situation of Swedish healthcare managers during the first wave of COVID-19. Front Psychol 2023; 13:1052382. [PMID: 36710753 PMCID: PMC9874142 DOI: 10.3389/fpsyg.2022.1052382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction The aim of this study is to provide insight into the psychosocial work situation of hospital managers during the first wave of the COVID-19 pandemic. Methods Mixed-effect modelling was used on survey data on job demands, job resources, job motivation, and work-life balance among over 500 managers working in 55 departments of a large Swedish university hospital in 2019 and 2020. Responses from 6011 employees were then used to stratify the analysis for COVID-19 exposure. Inductive content analysis was applied to open-ended questions on the managers' views on organisational prerequisites during the onset of the pandemic. Results The proportion of managers reporting difficulties with role clarity, quantitative demands, decision-making authority, and emotional support, time for recovery at work, motivation deficits, or problems with work-life balance clearly increased during the first wave of the pandemic. The proportion of managers reporting negative responses was higher in departments with high COVID-19 exposure. The qualitative analysis shows that overall governance in terms of clear, fair, and well-communicated routines, resource allocation, and division of responsibilities constituted an important framework for managerial during the crisis. First-line managers also require a mandate to re-organize their roles and their teams to successfully adapt to the situation. Organisational and social support was also important resources. Discussion This is the first study investigating healthcare managers' work situation during the first wave of the COVID-19 pandemic in a Swedish context. As expected, it indicates an increasingly strained work situation during the crisis, but it also provides findings on organisational prerequisites that allow healthcare managers to cope with stressful situations. In line with previous research on organisational resilience, the study provides suggestions for how higher-level managers can act in order to provide front-line managers with the organisational prerequisites they need to adapt, learn and develop successfully during times of unpredictability, insecurity, and rapid change in order to offer the best possible support to health care workers.
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Affiliation(s)
- Lisa Björk
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden,*Correspondence: Lisa Björk, ✉
| | - Linda Corin
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H. Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alessio Degl Innocenti
- Department of Psychiatry and Neurochemistry, Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden,Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Department of Orthopedics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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15
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Goldkuhl L, Gyllensten H, Begley C, Nilsson C, Wijk H, Lindahl G, Uvnäs-Moberg K, Berg M. Impact of Birthing Room Design on Maternal Childbirth Experience: Results From the Room4Birth Randomized Trial. HERD 2023; 16:200-218. [PMID: 36239523 PMCID: PMC9755691 DOI: 10.1177/19375867221124232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To study the effect of the birthing room design on nulliparous women's childbirth experience up to 1 year after birth. BACKGROUND Although it is known that the birth environment can support or hinder birth processes, the impact of the birthing room design on maternal childbirth experience over time is insufficiently studied. METHODS The Room4Birth randomized controlled trial was conducted at a labor ward in Sweden. Nulliparous women in active stage of spontaneous labor were randomized (n = 406) to either a regular birthing room (n = 202) or a new birthing room designed with more person-centered considerations (n = 204). Childbirth experiences were measured 2 hr, 3 months, and 12 months after birth by using a Visual Analogue Scale of Overall Childbirth Experience (VAS-OCE), the Fear of Birth Scale (FOBS), and the Childbirth Experience Questionnaire (CEQ2). RESULTS Women randomized to the new room had a more positive childbirth experience reported on the VAS-OCE 3 months (p = .002) and 12 months (p = .021) after birth compared to women randomized to a regular room. Women in the new room also scored higher in the total CEQ2 score (p = .039) and within the CEQ2 subdomain own capacity after 3 months (p = .028). The remaining CEQ2 domains and the FOBS scores did not differ between the groups. CONCLUSIONS These findings show that a birthing room offering more possibilities to change features and functions in the room according to personal needs and requirements, positively affects the childbirth experience of nulliparous women 3 and 12 months after they have given birth.
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Affiliation(s)
- Lisa Goldkuhl
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden,Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden,Lisa Goldkuhl, MSc, RN, RM, Arvid Wallgrens backe, Box 457, 405 30 Gothenburg, Sweden.
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden,University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Ireland
| | - Christina Nilsson
- Munkebäck Antenatal Clinic, Region Västra Götaland, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden,Department of Quality Assurance and Patient Safety, Sahlgrenska University Hospital, Gothenburg, Sweden,Centre for Healthcare Architecture, CVA, Chalmers University of Technology, Gothenburg, Sweden,Department of Architecture and Civil Engineering, Building Design, Chalmers University of Technology, Gothenburg, Sweden
| | - Göran Lindahl
- Centre for Healthcare Architecture, CVA, Chalmers University of Technology, Gothenburg, Sweden,Department of Architecture and Civil Engineering, Building Design, Chalmers University of Technology, Gothenburg, Sweden
| | | | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden,Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, D. R. Congo
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16
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Akerstrom M, Carlsson Y, Sengpiel V, Veje M, Elfvin A, Jonsdottir IH, Degl'Innocenti A, Ahlstrom L, Wijk H, Linden K. Working conditions for hospital-based maternity and neonatal health care workers during extraordinary situations - A pre-/post COVID-19 pandemic analysis and lessons learned. Sex Reprod Healthc 2022; 33:100755. [PMID: 35853385 PMCID: PMC9273518 DOI: 10.1016/j.srhc.2022.100755] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022]
Abstract
Objective The aim of this study was to investigate how the changed work routines during the COVID-19 pandemic has been affecting the working environment for hospital-based maternity and neonatal health care workers, and to identify preventive measures to be used in future situations when health care organizations are under pressure. Methods All maternity and neonatal health care workers in a Swedish university hospital were surveyed during October 2019 and September 2020. The data was analyzed by document analysis of implemented changes in working routines, a quantitative analysis of the overall effects on the working conditions, and a qualitative analysis of open-ended responses. Results A total of 660 maternity and neonatal health care workers completed the pre-COVID-19 survey (74% response rate) and 382 the COVID-19 survey (35% response rate). Lack of personal protective equipment, worry about becoming infected, uncertainty whether implemented changes were enough, and challenges in communicating updated routines had negative effects on maternity and neonatal health care workers’ working conditions. Team spirit and feeling valued by peers had a positive effect. Conclusions Results suggest that negative effects on maternity and neonatal health care workers’ health can partly be prevented in future critical situations by creating a work climate that acknowledges the employees’ worry about being infected, securing adequate pre-conditions for managers, creating a strong psychosocial safety climate and systematically improving the working conditions for the maternity and neonatal health care workers, as well as maintaining the positive perceived effects of increased team spirit and feeling valued by peers.
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Affiliation(s)
- Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Ylva Carlsson
- Region Västra Götaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Verena Sengpiel
- Region Västra Götaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden; Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Malin Veje
- Region Västra Götaland, Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anders Elfvin
- Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Department of Paediatrics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Alessio Degl'Innocenti
- Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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17
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Hedberg B, Wijk H, Andersson Gäre B, Petersson C. Shared decision-making and person-centred care in Sweden: Exploring coproduction of health and social care services. Z Evid Fortbild Qual Gesundhwes 2022; 171:129-134. [PMID: 35610136 DOI: 10.1016/j.zefq.2022.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/08/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
In Sweden the health system is nationally regulated and locally provided by 21 regions and 290 municipalities. To meet the shifting paradigm, where the person is viewed as a co-producer of health and care, Sweden has laws, regulations and policies which support the patient as an active partner in the communication with professionals in the system. Coproduction, person-centred care and shared decision making contribute jointly to the paradigm shift. Principles of human dignity and equity must be supported nationally and enacted in the decentralized, regional provision of care. Infrastructures exist or are under development which can support and strengthen care that is co-produced and based in a person-centred philosophy and approach, where shared decision making becomes a reality in practice. A Knowledge management system together with National Quality registries have the potential to form a co-produced, person-centred learning health system, where patients, and next of kin and professionals are included as partners. The joint integration of Shared decision making, Person-centre care and Coproduction into the Swedish healthcare system now looks like a possible way to realize the emerging paradigm.
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Affiliation(s)
- Berith Hedberg
- Jönköping Academy, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Helle Wijk
- Institute of Health and Care Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Boel Andersson Gäre
- Jönköping Academy, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Futurum-the Academy for Health and Care, Region Jönköping, County, Sweden
| | - Christina Petersson
- Jönköping Academy, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Futurum-the Academy for Health and Care, Region Jönköping, County, Sweden
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18
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Goldkuhl L, Gyllensten H, Begley C, Wijk H, Nilsson C, Lindahl G, Ringqvist AK, Uvnäs-Moberg K, Berg M. Room4Birth - The effect of giving birth in a hospital birthing room designed with person-centred considerations: A Swedish randomised controlled trial. Sex Reprod Healthc 2022; 32:100731. [PMID: 35500476 DOI: 10.1016/j.srhc.2022.100731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate if a birthing room designed with person-centred considerations improves labour and birth outcomes for nulliparous women when compared to regular birthing rooms. METHODS A randomised controlled trial was conducted at a Swedish labour ward between January 2019 and October 2020. Nulliparous women in spontaneous labour were randomised either to a birthing room designed with person-centred considerations (New room) or a Regular room. The primary outcome was a composite of four variables: vaginal non-instrumental birth; no oxytocin augmentation; postpartum blood loss < 1000 ml; and a positive childbirth experience. To detect a difference of 8% between the groups, 1274 study participants were needed, but the trial was terminated early due to consequences of the Covid-19 pandemic. RESULTS A total of 406 women were randomised; 204 to the New room and 202 to the Regular room. There was no significant difference in the primary outcome between the groups (42.2% versus 35.1%; odds ratio: 1.35, 95% Confidence Interval 0.90-2.01; p = 0.18). Participants in the New room used epidural analgesia to a lower extent (54.4% versus 65.3%, relative risk: 0.83, 95% Confidence Interval 0.71-0.98; p = 0.03) and reported to a higher degree that the room contributed to a sense of safety, control, and integrity (p=<0.001). CONCLUSIONS The hypothesis that the New room would improve the primary outcome could not be verified. Considering the early discontinuation of the study, results should be interpreted with caution. Nevertheless, analyses of our secondary outcomes emphasise the experiential value of the built birth environment in improving care for labouring women.
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Affiliation(s)
- Lisa Goldkuhl
- Institute of Health and Care Sciences, Sahlgrenska Academy, Arvid Wallgrens backe, Box 457, 405 30, University of Gothenburg, Gothenburg, Sweden; Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Diagnosvagen 11, 41685 Gothenburg, Region Västra Götaland, Sweden.
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, Arvid Wallgrens backe, Box 457, 405 30, University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, Arvid Wallgrens backe, Box 457, 405 30, University of Gothenburg, Gothenburg, Sweden; Department of Quality Assurance and Patient Safety, Sahlgrenska University Hospital, Blå stråket 5, 413 45, Region Västra Götaland, Gothenburg, Sweden; Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Chalmersplatsen 4, 412 96 Gothenburg, Sweden; Department of Architecture and Civil Engineering, Building Design, Chalmers University of Technology, Chalmersplatsen 4, 412 96 Gothenburg, Sweden
| | - Christina Nilsson
- Munkebäck Antenatal Clinic, Munkebäckstorg 6, 416 73 Gothenburg, Region Västra Götaland, Sweden
| | - Göran Lindahl
- Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Chalmersplatsen 4, 412 96 Gothenburg, Sweden; Department of Architecture and Civil Engineering, Building Design, Chalmers University of Technology, Chalmersplatsen 4, 412 96 Gothenburg, Sweden
| | - Anna-Karin Ringqvist
- Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Diagnosvagen 11, 41685 Gothenburg, Region Västra Götaland, Sweden
| | - Kerstin Uvnäs-Moberg
- University of Agriculture (SLU), Almas Allé 8, 750 07, Uppsala University, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, Arvid Wallgrens backe, Box 457, 405 30, University of Gothenburg, Gothenburg, Sweden; Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Diagnosvagen 11, 41685 Gothenburg, Region Västra Götaland, Sweden; Faculty of Medicine and Community Health, Evangelical University of Africa, Bukavu, Democratic Republic of the Congo, The
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19
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Tavemark S, Wijk H, Pettersson C. Tensions between infection control regulations and the home care working environment: An interview study with health care providers early during the COVID-19 pandemic. J Public Health Res 2022. [DOI: 10.1177/22799036221104154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Therefore, the objective of this study was to elucidate caregivers’ experiences of ordinary homes as a working environment in home care and home health care during the COVID-19 pandemic. At the beginning of the pandemic, hospital care was in focus and the care of older adults was criticized around the world. Design and methods: Semi-structured qualitative interviews were conducted in two municipalities in Sweden between March 2020 and May 2021. One large municipality (population 155,000) with experience of care recipients with COVID-19, and a smaller municipality (population 32,000) were included; both had a focus on preventing the spread of the infection. A total of 27 participants working in home care were interviewed; these were occupational therapists, physical therapists, nurses, and assistant nurses. The interview material was analyzed using content analysis. Results: The interviews provided a comprehensive insight into the complex work environment in municipal home care during the pandemic. The staff had to deal with constantly changing information and new guidelines. They were also given new tasks and work routines that demanded more planning and were time-consuming. The staff experienced higher workload and pressure during the pandemic and did not have enough time to recover. Conclusions: During a pandemic situation, the information must be comprehensive and gathered in one place, and the managers must ensure sufficient staffing levels, time for reflection, and support for prioritization. The managers must also ensure the mental health of staff and meet their needs for recovery, both at and outside work.
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Affiliation(s)
- Sofia Tavemark
- School of Health Sciences, Örebro University, Örebro, Sweden
- Örebro municipality Healthcare and Social Services, Örebro, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
- Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
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20
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Rasmussen B, Holton S, Wynter K, Phillips DJ, David JL, Rothmann MJ, Skjoeth MM, Wijk H, Frederiksen K, Ahlstrom L, Anderson JE, Harris R, Conolly A, Kent B, Maben J. We're on mute! Exclusion of nurses' voices in national decisions and responses to COVID-19: An international perspective. J Adv Nurs 2022; 78:e87-e90. [PMID: 35352392 PMCID: PMC9111388 DOI: 10.1111/jan.15236] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia.,Institute of Health Transformation, Faculty of Health, Deakin University, Geelong, Australia.,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Sara Holton
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia.,Institute of Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - Karen Wynter
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia.,Institute of Health Transformation, Faculty of Health, Deakin University, Geelong, Australia
| | - David J Phillips
- Faculty of Health, School of Nursing and Midwifery, Geelong, Australia
| | - Jennifer L David
- School of Nursing and Midwifery, Deakin University, Geelong, Australia.,Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Australia
| | - Mette Juel Rothmann
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Odense University Hospital, Odense, Denmark
| | - Mette Maria Skjoeth
- Odense University Hospital, Odense, Denmark.,Sundhed.dk, Copenhagen, Denmark
| | - Helle Wijk
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kirsten Frederiksen
- Department of Public Health - Department of Science in Nursing, Aarhus University, Aarhus, Denmark
| | - Linda Ahlstrom
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Janet E Anderson
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Ruth Harris
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Anna Conolly
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Bridie Kent
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, United Kingdom.,Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia.,Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
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21
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Abstract
Aim: To explore women’s experiences of physical features in a birthing room
designed to be adaptable to personal wishes and needs during labor and
birth. Background: Childbirth is a central life event influenced by numerous factors, including
the healthcare environment; however, there is insufficient knowledge on how
the physical design affects women during birth. Methods: This study was part of a randomized controlled trial in the Room4Birth
research project, including women randomized to receive care in a new
birthing room designed with physical features changeable according to
personal wishes. Data consisted of responses to two questions analyzed with
descriptive statistics (n = 202) and semi-structured
interviews analyzed for content (n = 19). Results: A total of 93.6% (n = 189) assessed the physical features in
the birthing room as meaningful to a very high or high extent. The overall
impression of the room was positive and exceeded women’s expectations. They
felt welcomed and strengthened by the room, which shifted the focus to a
more positive emotional state. The room differed from traditional hospital
birthing rooms, contained familiar features that maintained integrity, and
had space for companions. The variety of physical features was appreciated.
Of nine listed physical features, the bathtub was ranked most important,
followed by the projection of nature scenery, and dimmable lighting, but the
room as a whole appeared most important. Conclusions: When planning and designing hospital-based birthing rooms, it is crucial to
offer possibilities to adapt the room and physical features according to
personal wishes.
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Affiliation(s)
- Lisa Björnson Skogström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Gothenburg, Sweden
| | - Emma Vithal
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Gothenburg, Sweden.,Division of Building Design, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Department of Quality Assurance and Patient Safety, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Göran Lindahl
- Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Gothenburg, Sweden.,Division of Building Design, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
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22
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Nyman M, Hofvander B, Nilsson T, Wijk H. "You Should Just Keep Your Mouth Shut and Do As We Say": Forensic Psychiatric Inpatients' Experiences of Risk Assessments. Issues Ment Health Nurs 2022; 43:137-145. [PMID: 34477487 DOI: 10.1080/01612840.2021.1956658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study presents findings of forensic inpatients' experiences of their role in the risk assessment process. Eleven patients, recruited from two forensic psychiatric clinics in Sweden, participated in semi-structured interviews which were analyzed using qualitative content analysis. The analysis of their experiences resulted in the information of three categories: Taking responsibility for one's own situation, in terms of taking responsibility for aspects of one's care, taking charge of the present, emphasizing potential challenges in grasping reality, and being involved and having impact, which concerns feelings of being involved in discussions related to one's care and treatment versus feelings of being an outsider.
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Affiliation(s)
- Marielle Nyman
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Center for Ethics, Law and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Björn Hofvander
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Center for Ethics, Law and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas Nilsson
- Center for Ethics, Law and Mental Health (CELAM), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,National Board of Forensic Medicine, Department of Forensic Psychiatry, Gothenburg, Sweden.,Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Forensic Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Architecture and Civil Engineering, Chalmers University of Technology Deputy Head of Cooperation, Gothenburg, Sweden
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23
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Siira E, Olaya-Contreras P, Yndigegn S, Wijk H, Rolandsson B, Wolf A. Older adults' provision of informal care and support to their peers - A cornerstone of swedish society: Demographic characteristics and experiences of social isolation. Scand J Caring Sci 2021; 36:468-481. [PMID: 34970756 DOI: 10.1111/scs.13063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/26/2021] [Accepted: 12/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Family members provide the majority of informal care for older adults in Sweden. Nevertheless, by providing a range of assistance, peers often emerge as a central to counter social isolation among older adults. Therefore, there is a need to know more about what informal care provision by older adults to their peers means for different groups of older adults. AIM This study investigated the types of informal care and support that older adults provide to their peers in Sweden, and how these types of care and support are associated with demographic characteristics and social isolation. We also compared older adults who provide informal care and support with those who do not. METHOD For this purpose, we used a national online survey named "Involuntary loneliness among senior citizens" answered by 10,044 older adults enrolled in the Swedish Citizen Panel. We adopted a mixed-method design to analyse the survey data, including free-text options (n = 2155) and numerical data. Social isolation was assessed using a score built from the social loneliness items of the UCLA Loneliness Scale. RESULTS In our population, 21.5% of the older adults were providing informal care and support to their peers. Practical/instrumental help was frequently offered by younger participants (<75 years), men and respondents who were less socially isolated. On a general level, the factors that were positively associated with giving informal care and support to peers were older age, being male, retired, married/living in a relationship, living in an urban area/big city and exhibiting greater isolation. Focusing specifically on social support shows that older participants (>80) and those experiencing less social isolation (score < 24) were more engaged in social activities. CONCLUSION: This paper is unique in exploring the informal peer-caregiver's perceptions of isolation. Data were collected during the COVID-19 pandemic; this highlights the need to recognise informal care and support between older adults and to acknowledge their contributions as an essential component of Swedish civil society, especially during a societal crisis.
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Affiliation(s)
- Elin Siira
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), The Sahlgrenska Academy, Gothenburg, Sweden
| | - Patricia Olaya-Contreras
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), The Sahlgrenska Academy, Gothenburg, Sweden
| | - Signe Yndigegn
- Department of Digital Design, The IT University of Copenhagen, Copenhagen, Denmark
| | - Helle Wijk
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Bertil Rolandsson
- The Department of Sociology and Work Science, Gothenburg University, Gothenburg, Sweden
| | - Axel Wolf
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,University of Gothenburg Centre for Person-Centred Care (GPCC), The Sahlgrenska Academy, Gothenburg, Sweden.,Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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24
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Angelini E, Wolf A, Wijk H, Brisby H, Baranto A. The impact of implementing a person-centred pain management intervention on resistance to change and organizational culture. BMC Health Serv Res 2021; 21:1323. [PMID: 34895215 PMCID: PMC8665601 DOI: 10.1186/s12913-021-06819-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 07/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Resistance to change and organizational culture are essential factors to consider in change management in health care settings. Implementation of structural change remains a challenge. There is a lack of studies providing information on the impact of implementation processes on the organization. The aim of this study was to describe the impact of implementing a systematic change process concerning postoperative person-centred pain management on resistance to change and organizational culture in an orthopaedic spine surgery unit. METHODS The study was set in an orthopaedic spine surgery unit at a university hospital. Person-centred bundles of care for postoperative pain management of spine surgery patients were developed in co-creation by a multi-professional expert group and implemented throughout the care pathway. The intervention was underpinned by theories on organizational culture and inspired by principles of person-centred care. Quantitative data were collected using the Resistance to Change Scale and the Organizational Culture Assessment Instrument and analysed using descriptive statistics. RESULTS The findings showed a low resistance to change decreasing during the study. The organizational culture shifted from a result-oriented to a formalized and structured culture after the implementation. The culture preferred by the staff was team-oriented and participation-focused throughout the study. The discrepancy between the current and preferred cultures remained extensive over time. CONCLUSION It is challenging to describe the influence of the development and implementation of a postoperative pain management program on organizational culture as well as in terms of resistance to change, in a complex health care setting. In the current study the unit was under organizational strain during the implementation. Albeit, the important discrepancy between the current and preferred organizational culture could imply that structural changes aren't enough when implementing person-centred pain management structures and needs to be combined with relational aspects of change.
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Affiliation(s)
- Eva Angelini
- Department of Orthopaedics, Institute of Clinical Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Sahlgrenska Universitetssjukhuset Forskningsenhet ortopedi, Länsmansgatan 28, 431 80, Mölndal, Sweden.
| | - Axel Wolf
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Quality Improvement, Sahlgrenska University Hospital, Gothenburg, Sweden.,Architecture, Chalmers University of Technology, Gothenburg, Sweden
| | - Helena Brisby
- Department of Orthopaedics, Institute of Clinical Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences, at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
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25
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Wennman I, Carlström E, Fridlund B, Wijk H. Actions taken affecting lead time in the care pathway for low-priority patients with a suspected stroke: A critical incident study. Int Emerg Nurs 2021; 60:101105. [PMID: 34864324 DOI: 10.1016/j.ienj.2021.101105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/23/2021] [Accepted: 09/29/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The time delay from alerted ambulance to arrival at the stroke unit is crucial for patients suffering a suspected stroke. This is a recognized problem why additional explorative knowledge regarding actions taken are needed. AIM To explore actions taken by nurses that affect lead times in the care pathway from the alerted ambulance to the stroke unit, for low-priority patients suffering a suspected stroke. METHOD The design of the study was explorative and descriptive and used a qualitative approach based on Critical Incident Technique (CIT). Twenty-two nurses involved in the stroke care pathway at an university hospital in western Sweden were interviewed about their actions that affected the lead time. RESULTS Actions undertaken affected lead time in the stroke care pathway for low-priority patients related to "promoting the care chain process" and "taking control of the situation". CONCLUSIONS The staff within all parts of the care pathway affected the lead time, individually as well as via interaction between departments. This calls for the need of further collaboration and consensus concerning how to facilitate a smooth care pathway.
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Affiliation(s)
- Ingela Wennman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden; Gothenburg Emergency Medicine Research Group, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Eric Carlström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden; Gothenburg Emergency Medicine Research Group, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Business, History, and Social Sciences, School of Business, University of South-Eastern Norway
| | - Bengt Fridlund
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Centre for Inter-Professional Collaboration within Emergency Care, Linnaeus University, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Quality Strategies, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
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26
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Wijk H, Neziraj M, Nilsson Å, Ung EJ. Exploring the use of music as an intervention for older people living in nursing homes. Nurs Older People 2021; 33:14-20. [PMID: 34643343 DOI: 10.7748/nop.2021.e1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Enjoying cultural events such as musical performances is a human right as well as contributing to quality of life. However, older people who live in nursing homes are often excluded from such events. Music interventions for older people with cognitive decline have been shown to have a positive effect on their mood and behaviour, particularly in terms of anxiety, agitation and irritability. AIM To investigate the effect of musical interventions in nursing homes from the perspective of older people, their relatives and caregivers. METHOD Musical performances were held at 11 nursing homes in Sweden. These performances were followed by semi-structured interviews that aimed to capture the experiences of the older people, their relatives and caregivers. The interviews were analysed by qualitative thematic analysis. FINDINGS Four relational themes were generated from the analysis: music enhances well-being for the body and soul, music evokes emotions and a 'spark of life', music adds a 'silver lining' to everyday life, and music inspires a journey of the imagination through time and space. CONCLUSION The music concerts had a positive effect on older people, their relatives and caregivers. Providing cultural encounters in nursing homes is an important caring intervention.
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Affiliation(s)
- Helle Wijk
- Caring Science and Health, Gothenburg University, Gothenburg, Sweden
| | | | - Åsa Nilsson
- Research and Development, Skaraborgs Hospital, Sweden
| | - Eva Jakobsson Ung
- Caring Science and Health, Gothenburg University, Gothenburg, Sweden
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27
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Olausson S, Wijk H, Johansson Berglund I, Pihlgren A, Danielson E. Patients' experiences of place and space after a relocation to evidence-based designed forensic psychiatric hospitals. Int J Ment Health Nurs 2021; 30:1210-1220. [PMID: 33939249 DOI: 10.1111/inm.12871] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 01/10/2023]
Abstract
Forensic hospitals provide care for incarcerated patients who have committed a crime under the influence of serious mental illness. The care and (re)habilitation of the target group require highly competent staff and treatment strategies as well as purpose-built facilities that promote successful recovery. The aim of this study was to examine patients' experiences of place and space in new, purpose-built, evidence-based designed forensic psychiatric facilities in terms of supporting everydayness. A qualitative methodology was chosen. In total, 19 patients agreed to participate. Data were collected through photovoice (a combination of photographs and interviews) at three forensic hospitals, according to an evidence-based design and the concept of person-centred care in Sweden. The data were analysed through thematic content analysis. Four themes emerged from the data, revealing the patients' experiences of the new buildings: (i) having a private place, (ii) upholding one's sense of self, (iii) feelings of comfort and harmony, and (iv) remaining connected to one's life. The findings reveal that purpose-built environments can support everyday living and well-being and can create comfort. This is considered highly therapeutic by the patients. In conclusion, the findings of this study are of imperative importance in the design of health-promoting forensic hospitals.
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Affiliation(s)
- Sepideh Olausson
- Institute of Health and Care Sciences at Gothenburg University, Centre for Ethics Law and Mental Health/CELAM, Rågården Forensic Psychiatric Hospital at Sahlgrenska University Hospital, Göteborg, Sweden.,Institute of Health and Care Sciences at Gothenburg University, Göteborg, Sweden
| | - Helle Wijk
- Department of Architecture, Institute of Health and Care Sciences at Gothenburg University, Chalmers University of Technology, Göteborg, Sweden.,Department of Quality Improvement and Patient Safety, Sahlgrenska University Hospital, Göteborg, Sweden
| | | | - Anneli Pihlgren
- Institute of Health and Care Sciences at Gothenburg University, Göteborg, Sweden
| | - Ella Danielson
- Institute of Health and Care Sciences at Gothenburg University, Göteborg, Sweden.,Department of Nursing, Institute of Health and Care Sciences at Gothenburg University, Mid Sweden University, Göteborg, Sweden
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28
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Silverglow A, Johansson L, Lidén E, Wijk H. Perceptions of providing safe care for frail older people at home: A qualitative study based on focus group interviews with home care staff. Scand J Caring Sci 2021; 36:852-862. [PMID: 34423863 DOI: 10.1111/scs.13027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Providing safe care is a core competence in healthcare. The concept usually refers to hospitals but, consistent with the increasing importance of integrated care, the provision of safe care needs to be extended to the context of home care, and more research is needed concerning home healthcare providers' perspectives in this context. AIM The aim of this study was to describe care providers' perceptions of providing safe care for frail older persons living at home. METHOD A qualitative methodology was chosen. In total, 30 care providers agreed to participate. Data were collected through five focus group interviews and analysed using a phenomenographic approach. RESULTS Three themes regarding care providers' perceptions of providing safe care emerged from the data: 'safe care is created in the encounter and interaction with the older person', 'safe care requires responsibility from the caregiver' and 'safe care is threatened by insufficient organisational resources'. The findings show that providing safe care is an endeavour that requires a holistic view among the care providers as well as effective collaboration within the team, but insufficient competence or a lack of time can make it difficult to safeguard the psychological and existential needs of older persons. CONCLUSION Providing safe care in home environments encompasses more than just risk reduction. The findings highlight the importance of establishing and integrating team-based and person-centred care into home care settings. Traditional communication structures for inpatient care also need to be adapted to the cross-disciplinary work in municipalities. Care providers should be given the opportunity to develop and maintain their competences and to prioritise relationship-oriented care.
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Affiliation(s)
- Anastasia Silverglow
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Johansson
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Eva Lidén
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden.,The Centre for Healthcare Architecture (CVA), Chalmers University of Technology, Gothenburg, Sweden
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29
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Wennman I, Carlström E, Fridlund B, Wijk H. Experienced critical incidents affecting lead-times in the stroke care chain for low-priority patients - A qualitative study with critical incident technique. Int Emerg Nurs 2021; 58:101040. [PMID: 34329825 DOI: 10.1016/j.ienj.2021.101040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 04/30/2021] [Accepted: 06/05/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The time elapsing from the alarm being raised to arrival at the stroke unit is crucial for patients suffering a conceivable stroke. More knowledge is needed about critical incidents-both favourable and unfavourable-affecting the lead time in the care chain. AIM To explore favourable and unfavourable critical incidents (CIs), affecting lead times in the care chain from the alerted ambulance to the stroke unit, as experienced by nurses, for low-priority patients suffering a conceivable acute stroke. METHOD The study had an explorative descriptive design using a qualitative approach of Flanagan's Critical Incident Technique (CIT). Twenty-two nurses involved in the stroke care chain at a hospital in western Sweden were interviewed about their experiences regarding CIs influencing the lead time for low-priority patients. RESULTS There were 363 CIs identified related to human interactions and organizational structures. The types of CIs varied depending on where in the care chain they were experienced. Both favourable and unfavourable factors had an impact on the length of the lead time from alerted ambulance to stroke unit for lowpriority patients. Furthermore, CIs occurring both early and later in the care chain affected the whole process. CONCLUSIONS There is a need for greater understanding within each interrelated department in the care chain about how CIs at one part of the care chain have an impact on another.
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Affiliation(s)
- Ingela Wennman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Sahlgrenska Universitetssjukhuset, Gothenburg, Sweden; Gothenburg Emergency Medicine Research Group, Sahlgrenska University Hospital, Sweden.
| | - Eric Carlström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Sahlgrenska Universitetssjukhuset, Gothenburg, Sweden; Gothenburg Emergency Medicine Research Group, Sahlgrenska University Hospital, Sweden; Department of Business, History, and Social Sciences, School of Business, University of South-Eastern Norway
| | - Bengt Fridlund
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Centre for Inter-Professional Collaboration within Emergency Care, Linnaeus University, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden; Sahlgrenska Universitetssjukhuset, Gothenburg, Sweden; Chalmers University of Technology, Gothenburg, Sweden
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Goldkuhl L, Dellenborg L, Berg M, Wijk H, Nilsson C. The influence and meaning of the birth environment for nulliparous women at a hospital-based labour ward in Sweden: An ethnographic study. Women Birth 2021; 35:e337-e347. [PMID: 34321183 DOI: 10.1016/j.wombi.2021.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/18/2021] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Labour and birth are sensitive physiological processes substantially influenced by environmental and psychosocial factors. AIM To explore the influence and meaning of the birth environment for nulliparous women giving birth in either one of two differently designed birthing rooms at a hospital-based labour ward. METHODS Five months of ethnographic fieldwork was conducted at a labour ward in Sweden, consisting of participant observations of 16 nulliparous women giving birth in either a 'Regular' birthing room (n = 8) or a specially designed, 'New room' (n = 8). Data included field notes, informal interviews, reflective notes, and individual interviews with eight women after birth. The data was analysed through an ethnographic iterative hermeneutic analysis process. FINDINGS The analysis identified the birth environment as consisting of the physical space, the human interaction within it, and the institutional context. The analytic concept; Birth Manual was conceived as an instrument for managing labour in accordance with institutional authority. Significant to the interpretation of the influence and meaning of the birth environment were two abstract rooms: an Institutional room, where birth was approached as a critical event, designating birthing women as passive; and a Personal room, where birth was approached as a physiological event in which women's agency was facilitated. CONCLUSION Institutional authority permeated the atmosphere within the birth environment, irrespective of the design of the room. A power imbalance between institutional demands and birthing women's needs was identified, emphasising the vital role the birth philosophy plays in creating safe birth environments that increase women's sense of agency.
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Affiliation(s)
- Lisa Goldkuhl
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Lisen Dellenborg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Quality Assurance and Patient Safety, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden; Department of Architecture and Civil Engineering, Building Design, Chalmers University of Technology, Gothenburg, Sweden
| | - Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Jonsdottir IH, Degl'Innocenti A, Ahlstrom L, Finizia C, Wijk H, Åkerström M. A pre/post analysis of the impact of the COVID-19 pandemic on the psychosocial work environment and recovery among healthcare workers in a large university hospital in Sweden. J Public Health Res 2021; 10. [PMID: 34278769 PMCID: PMC8715269 DOI: 10.4081/jphr.2021.2329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The impact of the COVID-19 pandemic on workload, mental health, and well-being of healthcare workers, and particularly those on the front-line, has received considerable attention. DESIGN AND METHODS We surveyed hospital employees about their working environment during the pandemic and identified departments which were negatively affected in comparison to the pre-pandemic situation, as well as factors contributing to this. Setting and participants We surveyed all hospital employees at Sahlgrenska University Hospital, Sweden in September 2020 and compared results across departments and to the results of a large employee survey from October 2019. RESULTS The overall impact of the pandemic on perceived working conditions and possibility for recovery differed among departments. During the pandemic, healthcare workers working with COVID-19 patients reported poorer working environments than other employees. Factors significantly related to perception of work environment and recovery during the pandemic included worries of being infected, departmental transfer, and having insufficient access to personal protective equipment. Men reported better working conditions than women in all, but one item and higher age was related to better perceived working environment. CONCLUSIONS Our results indicate that the pandemic differentially affects hospital departments and underscores the multifactorial nature of this topic. Contributing factors to poor perceived working environment could be addressed at times of high workload, such as during the pandemic, including providing appropriate support to managers, ensuring possibility for recovery during working hours, and acknowledging worries about infection. Young healthcare workers and staff who are relocated due to the pandemic warrant special attention.
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Affiliation(s)
- Ingibjörg H Jonsdottir
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
| | - Alessio Degl'Innocenti
- Centre for Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg; Region Västra Götaland, Sahlgrenska University Hospital, Gothia Forum for Clinical Trials, Gothenburg.
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; Region Västra Götaland, Sahlgrenska University Hospital, Department of Orthopaedics, Gothenburg.
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg; Region Västra Götaland, Sahlgrenska University Hospital, Department of Research, Development, Education and Innovation, Sahlgrenska University Hospital, Gothenburg .
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
| | - Magnus Åkerström
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg; School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg.
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Mårtensson U, Cederlund M, Jenholt Nolbris M, Mellgren K, Wijk H, Nilsson S. Experiences before and after nasogastric and gastrostomy tube insertion with emphasis on mealtimes: a case study of an adolescent with cerebral palsy. Int J Qual Stud Health Well-being 2021; 16:1942415. [PMID: 34167445 PMCID: PMC8231357 DOI: 10.1080/17482631.2021.1942415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose: Adolescents with cerebral palsy may need a feeding tube due to feeding challenges, since nutritional intake and mealtimes may be negatively affected. The purpose of the study was to describe and better understand how one adolescent with cerebral palsy and her parents experienced mealtimes before and after a nasogastric and gastrostomy tube insertion and how the use of these feeding tubes was experienced in daily life. Methods: Individual interviews were performed with one adolescent and each of her parents. In total, six interviews were conducted on two separate occasions. The qualitative approach known as Interpretive Description was used during the analysis. Results: Four thematic patterns were identified within the data: (i) struggling with nutritional intake, (ii) the paradox of using an aid, (iii) being different, and (iv) challenges of public mealtimes. Conclusions: The results showed that four themes influenced daily mealtimes in adolescents with cerebral palsy and a gastrostomy tube. Nutritional intake and mealtimes may be difficult, which is why using a gastrostomy tube can be a relief. However, the gastrostomy tube can also pose a challenge and a paradox. Time of change and acceptance seems necessary in order to meet these challenges.
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Affiliation(s)
- Ulrika Mårtensson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden
| | - Mats Cederlund
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margaretha Jenholt Nolbris
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Gothenburg, Sweden and Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karin Mellgren
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Architecture and Civil Engineering, Chalmers Technology University/Centre for Health Care Architecture, Gothenburg, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg; University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden
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Blomdahl C, Guregård S, Rusner M, Wijk H. Recovery From Depression—A 6-Month Follow-up of a Randomized Controlled Study of Manual-Based Phenomenological Art Therapy for Persons With Depression. Art Therapy 2021. [DOI: 10.1080/07421656.2021.1922328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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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. Appl Ergon 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Mårtensson U, Jenholt Nolbris M, Mellgren K, Wijk H, Nilsson S. The five aspect meal model as a conceptual framework for children with a gastrostomy tube in paediatric care. Scand J Caring Sci 2021; 35:1352-1361. [PMID: 33512004 DOI: 10.1111/scs.12957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/23/2020] [Accepted: 01/04/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cancer treatments may induce side effects and cause eating problems. A gastrostomy tube may be required in order to maintain and optimise the child's nutritional needs. Despite the use of a gastrostomy tube, it is important to maintain a natural and attractive mealtime for the child. The Five Aspect Meal Model is age neutral and originally designed to improve restaurant visits. Its five aspects conceptualise what is necessary to ensure a complete meal experience. To date, there is lack of knowledge to guided model development about mealtimes adapted to children and limited knowledge regarding mealtime experiences for children with a gastrostomy tube. AIM The aim was to investigate whether the Five Aspect Meal Model could be appropriate to be used for children with a gastrostomy tube in caring science and paediatric care. METHODS The design followed steps retrieved from Renjith and colleagues. Seven interviews were performed with the Five Aspect Meal Model as a base in the interview guide. The transcripts were analysed by using a qualitative directed content analysis with a deductive approach, which finally passed into a more inductive one. FINDINGS All aspects of the Five Aspect Meal Model were represented in the interviews. There were also experiences related to the gastrostomy tube and the mealtimes that did not fit into any of the five predetermined categories. As a result, the modified version was developed, an adapted prescribing practice model that includes seven aspects, whereof bodily discomfort and time for change and acceptance are specific to children with a gastrostomy tube. CONCLUSION Based on children and their parent's experiences, the Five Aspect Meal Model has been developed and adapted into a modified version, which includes seven aspects. The modified version seems to be appropriate to use within caring science and paediatric care.
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Affiliation(s)
- Ulrika Mårtensson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margaretha Jenholt Nolbris
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karin Mellgren
- Department of Paediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Health Care Architecture, Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden.,Department of Quality Strategies, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Stefan Nilsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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36
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Alexiou E, Steingrimsson S, Akerstrom M, Jonsdottir IH, Ahlstrom L, Finizia C, Wijk H, Degl'Innocenti A. A Survey of Psychiatric Healthcare Workers' Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden. Front Psychiatry 2021; 12:770955. [PMID: 34912253 PMCID: PMC8666504 DOI: 10.3389/fpsyt.2021.770955] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/27/2021] [Indexed: 01/26/2023] Open
Abstract
Objective: This study aimed to investigate the impact of the first wave of the COVID-19 pandemic on perceived working environment, including the possibility to recover, among psychiatric healthcare workers (PHCWs) in comparison with pre-pandemic measures. Method: A link to an anonymous, web-based COVID-19 related survey was sent via email to all PHCWs at a university hospital in Sweden (n = 1,618) in September 2020. The response rate was 38% (566 of 1,507 eligible participants). Working environment survey responses collected in 2019 were used as pre-pandemic comparators. Statistical analyses were performed to assess overall impact over time on work demands, support, motivation, and recovery, stratified by professional role, and considering variables such as access to personal protective equipment. Results: The percentage of individuals responding negatively to statements about working environment increased significantly for most items after the first wave. Similarly, the increase of five of the investigated factors indicated a more negative perception of recovery during the pandemic. Registered nurses reported a greater negative impact of the pandemic on perceived working conditions and ability to recover than other professional groups. PHCWs working with patients with COVID-19 (35%) who reported being worried about becoming infected (12%) or infecting others (17%), or lacking adequate personal protective equipment (22%) were more negatively impacted regarding work environment-related items than those who did not. Conclusions: PHCWs' working environment and possibility for recovery were impacted by the first wave of the COVID-19 pandemic, nurses being most affected. Although psychiatric services do not directly care for patients with severe COVID-19 infection, the results from this study suggests that mental health services should also prepare for future pandemics.
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Affiliation(s)
- Eirini Alexiou
- Department of Psychiatry, Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.,Center for Ethics, Law, and Mental Health, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Steinn Steingrimsson
- Department of Psychiatry, Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.,Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Akerstrom
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingibjörg H Jonsdottir
- Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linda Ahlstrom
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Research, Development, Education and Innovation, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Quality Strategies, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.,Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Alessio Degl'Innocenti
- Center for Ethics, Law, and Mental Health, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Gothia Forum for Clinical Trials, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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37
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Silverglow A, Lidèn E, Berglund H, Johansson L, Wijk H. What constitutes feeling safe at home? A qualitative interview study with frail older people receiving home care. Nurs Open 2021; 8:191-199. [PMID: 33318827 PMCID: PMC7729533 DOI: 10.1002/nop2.618] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/29/2020] [Accepted: 08/14/2020] [Indexed: 11/08/2022] Open
Abstract
Aim To highlight experiences of what constitutes feeling safe at home among frail older people receiving home care. Design Qualitative descriptive study. Methods The sample consists of 12 individual recorded interviews with frail older people in their homes. Interviews were transcribed verbatim and analysed using qualitative content analysis. The data collection was performed in spring 2018. Results The analysis resulted in three categories: "Having a feeling of 'at-homeness'" describes the older people's surrounding environment and their efforts to maintain independence; "being able to influence" describes the importance for older people to shape their care by being in control and having an opportunity for self-determination in the context of home care; and "being able to trust staff" relates to expecting staff's knowledge and skills and to appreciating the staff's ability to create positive relations.
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Affiliation(s)
- Anastasia Silverglow
- Institute of Health and Care Sciences at Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Eva Lidèn
- Institute of Health and Care Sciences at Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Heléne Berglund
- Institute of Health and Care Sciences at Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Frail Elderly Research Support Group (FRESH)Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Lena Johansson
- Institute of Health and Care Sciences at Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Department of Psychiatry and NeurochemistrySahlgrenska AcademyCentre for Ageing and Health (AgeCap)University of GothenburgGothenburgSweden
| | - Helle Wijk
- Institute of Health and Care Sciences at Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Sahlgrenska University HospitalGothenburgSweden
- The Centre for Healthcare Architecture (CVA)Chalmers University of TechnologyGothenburgSweden
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Lindahl J, Thulesius H, Rask M, Wijk H, Edvardsson D, Elmqvist C. Assessing the Supportiveness of Healthcare Environments' Light and Color: Development and Validation of the Light and Color Questionnaire (LCQ). HERD 2020; 14:130-144. [PMID: 33251862 PMCID: PMC8079795 DOI: 10.1177/1937586720975209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Aim: The aim of this study was to develop and evaluate a self-report instrument
measuring patients’, family members’, and staff’s perceived support from
light and color in the physical environment of an emergency department
(ED)—the Light and Color Questionnaire (LCQ). Background: The physical care environment is an important part of a comprehensive caring
approach in all levels of care not only for patients but also for family
members and staff. However, no existing self-report questionnaire assessing
the extent to which light and color are perceived as being supportive in the
physical care environment from the users’ perspective was found. Method: The LCQ was developed as part of a pre–post study in which an ED serving
125,000 people was refurbished and remodeled using evidence-based design.
The LCQ consists of six items for light and five items for color and
assesses awareness/orientation, safety/security, functional abilities,
privacy, personal control, and stimulation. The study was carried out in
four steps: constructions of items, assessment of face validity, data
collection, and data analysis. Result/Conclusion: Psychometric evaluation of the two versions, LCQ-Patient/Family member and
LCQ-Staff, showed satisfactory content and internal validity (>90%) and
high internal consistency (Cronbach’s coefficient α = .9) to support the use
of the questionnaire for research and development purposes. Explorative
factor analysis of a total of 600 questionnaire responses confirmed light
and color as distinctive and independent dimensions creating perceptions of
more or less supportiveness for respondents. The LCQ instrument may be
useful for architects, administrators, and researchers of healthcare
environments.
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Affiliation(s)
- Jeanette Lindahl
- Centre for Interprofessional Cooperation Within Emergency Care (CICE), Department of Health and Caring Sciences, 249958Linnaeus University, Växjö, Sweden.,Department of Research and Development, Region Kronoberg, Växjö, Sweden
| | - Hans Thulesius
- Department of Research and Development, Region Kronoberg, Växjö, Sweden.,Family Medicine, Department of Clinical Sciences, 5193Lund University, Malmö, Sweden.,Faculty of Health and Life Sciences, Department of Medicine and Optometry, 5193Linnaeus University, Växjö, Sweden
| | - Mikael Rask
- Department of Health and Caring Sciences, 5193Linnaeus University, Växjö, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, 3570University of Gothenburg, Sweden
| | - David Edvardsson
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.,Department of Nursing, 211742Umeå University, Sweden
| | - Carina Elmqvist
- Centre for Interprofessional Cooperation Within Emergency Care (CICE), Department of Health and Caring Sciences, 249958Linnaeus University, Växjö, Sweden
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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: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Ebrahimi Z, Patel H, Wijk H, Ekman I, Olaya-Contreras P. A systematic review on implementation of person-centered care interventions for older people in out-of-hospital settings. Geriatr Nurs 2020; 42:213-224. [PMID: 32863037 DOI: 10.1016/j.gerinurse.2020.08.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022]
Abstract
THE PURPOSE of this study was to explore the content and essential components of implemented person-centered care in the out-of-hospital context for older people (65+). METHOD A systematic review was conducted, searching for published research in electronic databases: PubMed, CINAHL, Scopus, PsycInfo, Web of Science and Embase between 2017 and 2019. Original studies with both qualitative and quantitative methods were included and assessed according to the quality assessment tools EPHPP and CASP. The review was limited to studies published in English, Swedish, Danish, Norwegian and Spanish. RESULTS In total, 63 original articles were included from 1772 hits. The results of the final synthesis revealed the following four interrelated themes, which are crucial for implementing person-centered care: (1) Knowing and confirming the patient as a whole person; (2) Co-creating a tailored personal health plan; (3) Inter-professional teamwork and collaboration with and for the older person and his/her relatives; and (4) Building a person-centered foundation. CONCLUSION Approaching an interpersonal and inter-professional teamwork and consultation with focus on preventive and health promoting actions is a crucial prerequisite to co-create optimal health care practice with and for older people and their relatives in their unique context.
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Affiliation(s)
- Zahra Ebrahimi
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centred Care University of Gothenburg (GPCC), Gothenburg, Sweden.
| | - Harshida Patel
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Department of Architecture Sahlgrenska University Hospital Department of Quality Assurance and Patient Safety, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Person-Centred Care University of Gothenburg (GPCC), Gothenburg, Sweden
| | - Patricia Olaya-Contreras
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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41
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Siira E, Rolandsson B, Wijk H, Wolf A. Beyond the definition of formal care: Informal care arrangements among older swedes who are not family. Health Soc Care Community 2020; 28:633-641. [PMID: 31797482 DOI: 10.1111/hsc.12897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/28/2019] [Accepted: 11/06/2019] [Indexed: 06/10/2023]
Abstract
This study explores care practices of older people outside formal care and without appealing to predefined relationships. We conducted interviews with 30 independent-living men and women aged 67-93 in three municipalities in Sweden. The interviews explored how they cared for themselves and other older people who were not family. Interviews were conducted between December 2017 and May 2018 and later transcribed and analysed using grounded theory. Our paper presents one of the first studies on informal care practices among older people that looks beyond the definition of formal care to understand how such care complements formal care services. The findings show that older people participate in several care arrangements to care for themselves as well as for others. The arrangements feature different types of mutuality and include distant relations to other older people and larger more or less formalised groups. The findings highlight the importance of looking beyond conceptualisations of care based on understandings of formal care and specific relationships as a frame for understanding informal care. To promote older people's health by cultivating and supporting older people's care for themselves and others, research and healthcare practitioners need to explore and acknowledge the significance and complexity of older people's everyday care practices.
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Affiliation(s)
- Elin Siira
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Bertil Rolandsson
- Department of Sociology and Work Sciences, Faculty of Social Sciences, Gothenburg University, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Axel Wolf
- Institute of Health and Care Sciences, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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42
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Angelini E, Baranto A, Brisby H, Wijk H. Healthcare practitioners' experiences of postoperative pain management in lumbar spine surgery care-A qualitative study. J Clin Nurs 2020; 29:1662-1672. [PMID: 32092212 DOI: 10.1111/jocn.15230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 01/30/2020] [Accepted: 02/08/2020] [Indexed: 12/28/2022]
Abstract
AIMS AND OBJECTIVE To explore and describe healthcare practitioners' experiences of postoperative pain management to patients undergoing planned lumbar spine surgery by identifying the healthcare practitioners' behaviours, attitudes and strategies. BACKGROUND Poorly managed postoperative pain continues to cause suffering and prolong hospital care and may affect individual and team practitioners' strategies and attitudes. The impact of these strategies and attitudes needs greater understanding. DESIGN Descriptive qualitative study. METHODS In-depth interviews were conducted at a university hospital in Sweden during January-March 2016 with 9 healthcare practitioners (ages: 29-61 years; gender: male 3 and female 6; professions: medical doctor 3, registered nurse 3 and physiotherapist 3; professional experience: 1.5 months to 25 years). The interviews were analysed using Braun and Clarke's thematic analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research COREQ. RESULTS The interviews revealed healthcare practitioners' attitudes and strategies. Three themes were identified: (a) Connecting with the person was recognised as the key component in postoperative pain management; (b) Professionalism: a balancing act, accentuated health care practitioners' duality in being both vulnerable and strong in delicate care situations; and (c) Collaboration: being constantly responsive, the necessity for healthcare practitioners to be constantly responsive to their environment. CONCLUSIONS The findings pinpoint the need for healthcare organisations to build structures enabling practitioners to deliver adequate pain management in acknowledging the practitioners' delicate situation when facing patients in pain. RELEVANCE TO CLINICAL PRACTICE Given the global need for postoperative pain management, our findings have international relevance. Preconceived expectations on specific pain need to be depicted and postoperative pain taken seriously to protect the patient as well as the healthcare practitioners.
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Affiliation(s)
- Eva Angelini
- Department of Orthopaedics, Institute of Clinical Sciences, Goteborg, Sweden.,Department of Quality Improvement, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Adad Baranto
- Department of Orthopaedics, Institute of Clinical Sciences, Goteborg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena Brisby
- Department of Orthopaedics, Institute of Clinical Sciences, Goteborg, Sweden.,Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helle Wijk
- Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Health and Care Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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43
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Abstract
Aim: To summarize, categorize, and describe published research on how birthing room design influences maternal and neonate physical and emotional outcomes. Background: The physical healthcare environment has significant effects on health and well-being. Research indicates that birthing environments can impact women during labor and birth. However, summaries of the effects of different environments around birth are scarce. Methods: We conducted a systematic review, searching 10 databases in 2016 and 2017 for published research from their inception dates, on how birthing room design influences maternal and neonate physical and emotional outcomes, using a protocol agreed a priori. The quality of selected studies was assessed, and data were extracted independently by pairs of authors and described in a narrative analysis. Results: In total, 3,373 records were identified and screened by title and abstract; 2,063 were excluded and the full text of 278 assessed for analysis. Another 241 were excluded, leaving 15 articles presenting qualitative and quantitative data from six different countries on four continents. The results of the analysis reveal four prominent physical themes in birthing rooms that positively influence on maternal and neonate physical and emotional outcomes: (1) means of distraction, comfort, and relaxation; (2) raising the birthing room temperature; (3) features of familiarity; and (4) diminishing a technocratic environment. Conclusions: The evidence on how birthing environments affect outcomes of labor and birth is incomplete. There is a crucial need for more research in this field.
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Affiliation(s)
- Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Quality Assurance and Patient Safety Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Architecture, Chalmers University of Technology, Gothenburg, Sweden
| | - Lina Höglund
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Obstetric Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helen Sjöblom
- Biomedical Library, University of Gothenburg, Sweden
| | - Eva Hessman
- Biomedical Library, University of Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.,Obstetric Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
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44
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Abstract
BACKGROUND It is of great importance to understand how patients and their close relatives experience the pros and cons of advanced home care so as to further develop this quickly growing choice of care. OBJECTIVE The aim of this study was to explore the experiences of receiving advanced home care among patients affected by life-threatening illness and their close relatives. DESIGN The study was an interview study conducted with patients in their homes. Some patient interviews were conducted together with a close relative participating. SETTING/PARTICIPANTS Patients registered in advanced home care in 2017 were offered the opportunity to participate in the study. The selection criteria were that the patient was within grade 3 of the Eastern Cooperative Oncology Group's Performance Status, older than 18 years, able to orient to time and place, and not newly registered. ANALYSIS The interviews were recorded and transcribed verbatim and analyzed with qualitative content analysis. RESULTS A total of 11 interviews were conducted: 8 with patients and 1 or 2 close relatives together; and 3 with the patient alone. It resulted in 3 main categories: create a safe environment, see the person, and better to manage care at home. CONCLUSION The results of this study show that patients and close relatives perceived that advanced home care was a safe and secure form of caring during advanced as well as end-of-life care.
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Affiliation(s)
- Ingela Wennman
- Department of Strategic Planning, Sahlgrenska University Hospital, Göteborg, Sweden.,Institute of Caring Sciences and Health, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden
| | - Anna Ringheim
- Department of Quality Development, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Helle Wijk
- Institute of Caring Sciences and Health, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden.,Department of Quality Development, Sahlgrenska University Hospital, Göteborg, Sweden.,Gothenburg Center of Person Centred Care (GPCC), Gothenburg University, Göteborg, Sweden.,Center for Health Care Architecture, Chalmers University, Göteborg, Sweden
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45
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Nolbeck K, Wijk H, Lindahl G, Olausson S. "If you don't behave, you're in real shit, you don't get outside the doors"-a phenomenological hermeneutic study of adolescents' lived experiences of the socio-spatial environment of involuntary institutional care. Int J Qual Stud Health Well-being 2020; 15:1726559. [PMID: 32049605 PMCID: PMC7034456 DOI: 10.1080/17482631.2020.1726559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In Sweden, according to law, adolescents with extensive psychosocial problems, substance abuse or criminal behaviour can be cared for in institutions. The two-fold aim of these institutions (to rehabilitate and incarcerate) puts special demands to their socio-spatial context. Purpose: To elucidate adolescents’ lived experiences of the socio-spatial environment at special youth homes run by the Swedish National Board of Institutional Care (SiS) in Sweden. Methods: Data collected through Photovoice and analysed employing a phenomenological hermeneutical method. Fourteen adolescents (age 15–19) were asked to photograph their environment, and this was followed up by in-depth interviews. Results: Two themes emerged from the material: the dense walls of institutional life and create and capture the caring space. The socio-spatial environment can be seen as an additional “other” that distances the adolescents and the staff from one another. Negotiating with their behaviour, the adolescents strive to present themselves as worthy of increased degrees of freedom and ultimately access to the desired outside life. Conclusions: In an institutional setting dominated by a security and criminal justice logic, words appear to have less impact than the environment. The adolescents appear to understand themselves through the socio-spatial other, causing reinforced feelings of social exclusion.
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Affiliation(s)
- Kajsa Nolbeck
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department for Quality Assurance, Sahlgrenska University Hospital, Gothenburg, Sweden.,Centre for Healthcare Architecture, Chalmers University of Technology, Gothenburg, Sweden
| | - Göran Lindahl
- Department of Architecture and Civil Engineering, Division of Building Design, Chalmers University of Technology, Gothenburg, Sweden.,Centre for Healthcare Architecture, Chalmers University of Technology, Gothenburg, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Ethics, Law and Mental Health, Rågården Forensic Psychiatry Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
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46
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Pettersson C, Malmqvist I, Gromark S, Wijk H. Enablers and Barriers in the Physical Environment of Care for Older People in Ordinary Housing: A Scoping Review. Journal of Aging and Environment 2020. [DOI: 10.1080/02763893.2019.1683671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Cecilia Pettersson
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - Inga Malmqvist
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Sten Gromark
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health & Care Sciences, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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47
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Degl' Innocenti A, Wijk H, Kullgren A, Alexiou E. The Influence of Evidence-Based Design on Staff Perceptions of a Supportive Environment for Person-Centered Care in Forensic Psychiatry. J Forensic Nurs 2020; 16:E23-E30. [PMID: 31834079 DOI: 10.1097/jfn.0000000000000261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This prospective longitudinal study aimed to examine the relocation of three forensic psychiatric hospitals in Sweden into new facilities. The research focused on the effects of the physical and psychosocial environment and other staff-related parameters on the delivery of person-centered care after relocation. In forensic psychiatry, most relocations to new environments are to support a person-centered approach and to promote patients' rehabilitation and reintegration into society. Hopefully, this is undertaken in accordance with an evidence-based design strategy allowing improvement in staff satisfaction and working conditions as well as their capacity to provide individualized care. All staff members working on the wards of the facilities in question were invited to participate in the study. Data were collected prospectively between 2010 and 2014, before and after relocation of the forensic psychiatric clinics to new buildings. Structured validated questionnaires were employed. Staff members' job satisfaction and perceptions of a person-centered physical and psychosocial environment increased after relocation and provide evidence that staff perceptions of ward atmosphere in forensic psychiatric clinics are susceptible to factors in the physical and psychosocial environment. The importance of always taking the environmental factors into consideration, to achieve greater staff well-being and capacity to accomplish goals in forensic psychiatry, is emphasized.
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Affiliation(s)
| | | | - Anette Kullgren
- Institute of Health and Care Science, Sahlgrenska Academy, University of Gothenburg
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48
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Berg M, Goldkuhl L, Nilsson C, Wijk H, Gyllensten H, Lindahl G, Uvnäs Moberg K, Begley C. Room4Birth - the effect of an adaptable birthing room on labour and birth outcomes for nulliparous women at term with spontaneous labour start: study protocol for a randomised controlled superiority trial in Sweden. Trials 2019; 20:629. [PMID: 31744523 PMCID: PMC6862754 DOI: 10.1186/s13063-019-3765-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 09/28/2019] [Indexed: 12/24/2022] Open
Abstract
Background An important prerequisite for optimal healthcare is a secure, safe and comfortable environment. There is little research on how the physical design of birthing rooms affects labour, birth, childbirth experiences and birthing costs. This protocol outlines the design of a randomised controlled superiority trial (RCT) measuring and comparing effects and experiences of two types of birthing rooms, conducted in one labour ward in Sweden. Methods/design Following ethics approval, a study design was developed and tested for feasibility in a pilot study, which led to some important improvements for conducting the study. The main RCT started January 2019 and includes nulliparous women presenting to the labour ward in active, spontaneous labour and who understand either Swedish, Arabic, Somali or English. Those who consent are randomised on a 1:1 ratio to receive care either in a regular room (control group) or in a newly built birthing room designed with a person-centred approach and physical aspects (such as light, silencer, media installation offering programmed nature scenes with sound, bathtub, birth support tools) that are changeable according to a woman’s wishes (intervention group). The primary efficacy endpoint is a composite score of four outcomes: no use of oxytocin for augmentation of labour; spontaneous vaginal births (i.e. no vaginal instrumental birth or caesarean section); normal postpartum blood loss (i.e. bleeding < 1000 ml); and a positive overall childbirth experience (7–10 on a scale of 1–10). To detect a difference in the composite score of 8% between the groups we need 1274 study participants (power of 80% with significance level 0.05). Secondary outcomes include: the four variables in the primary outcome; other physical outcomes of labour and birth; women’s self-reported experiences (the birthing room, childbirth, fear of childbirth, health-related quality of life); and measurement of costs in relation to the hospital stay for mother and neonate. Additionally, an ethnographic study with participant observations will be conducted in both types of birthing rooms. Discussion The findings aim to guide the design of birthing rooms that contribute to optimal quality of hospital-based maternity care. Trial registration ClinicalTrials.gov NCT03948815. Registered 13 May 2019—retrospectively registered.
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Affiliation(s)
- Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Box 457, SE-405 30, Gothenburg, Sweden. .,Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, SE-416 50, Gothenburg, Sweden.
| | - Lisa Goldkuhl
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Box 457, SE-405 30, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, SE-416 50, Gothenburg, Sweden
| | - Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, SE-501 90, Borås, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Box 457, SE-405 30, Gothenburg, Sweden.,Quality and Patient Safety Unit, Sahlgrenska University Hospital of Gothenburg, SE-413 45, Gothenburg, Sweden.,Centre for Healthcare Architecture , CVA, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden
| | - Hanna Gyllensten
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Box 457, SE-405 30, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden
| | - Göran Lindahl
- Centre for Healthcare Architecture , CVA, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden.,Building Design, Architecture and Civil Engineering, Chalmers University of Technology, SE 412 96, Gothenburg, Sweden
| | | | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, 24 D'Olier St, Dublin 2, Ireland
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49
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Gyberg A, Henoch I, Lepp M, Wijk H, Ulin K. Written reports of adverse events in acute care-A discourse analysis. Nurs Inq 2019; 26:e12298. [PMID: 31134720 DOI: 10.1111/nin.12298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/02/2019] [Accepted: 05/09/2019] [Indexed: 11/30/2022]
Abstract
Adverse health care events are a global public health issue despite major efforts, and they have been acknowledged as a complex concern. The aim of this study was to explore the construction of unsafe care using accounts of adverse events concerning the patient, as reported by patients, relatives, and health care professionals. Twenty-nine adverse events reported in an acute care setting in a Swedish university hospital were analyzed through discourse analysis, where the construction of what was considered to be real and true in the descriptions of unsafe care was analyzed. In the written reports about unsafe events, the patient was spoken of in three different ways: (a) the patient as a presentation of physical signs, (b) the patient as suffering and vulnerable, and (c) the patient as unpredictable. When the patient's voice was subordinate to physical signs, this was described as being something that conflicted with patient safety. The conclusion was that the patient's voice might be the only sign available in the early stages of adverse events. Therefore, it is crucial for health care professionals to give importance to the patient's voice to prevent patients from harm and not unilaterally act only upon abnormal physical signs.
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Affiliation(s)
- Anna Gyberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Geriatrics and Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingela Henoch
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Angered Hospital, Gothenburg, Sweden
| | - Margret Lepp
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Østfold University College, Halden, Norway.,School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Quality Assurance, Sahlgrenska University Hospital, Gothenburg, Sweden.,Center of Health Care Architecture, Chalmers University, Gothenburg, Sweden
| | - Kerstin Ulin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medicine, Geriatrics and Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden
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50
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Olausson S, Danielson E, Berglund Johansson I, Wijk H. The meanings of place and space in forensic psychiatric care - A qualitative study reflecting patients' point of view. Int J Ment Health Nurs 2019; 28:516-526. [PMID: 30525285 DOI: 10.1111/inm.12557] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2018] [Indexed: 12/22/2022]
Abstract
The outcome of care for patients sentenced to forensic psychiatric care is of importance not only for the patient but also for society, in preventing new crimes. In recent years, a person-centered perspective is influencing the care, recognizing the design of the physical environment as a therapeutic resource. To capture the complexity of patients' experience of the physical environment, a qualitative approach is needed. The aim of this study was to investigate the meanings of the patient room as a place and space in forensic psychiatric in-patient care from the patients' perspective. An explorative qualitative design was chosen, data were collected by photovoice; a combination of photographs, taken by the patients, followed by interviews. Eleven (N = 11) patients were interviewed. The interviews were analysed by a thematic analysis method. Four themes emerged from the data revealing the meanings of the patient room as a place and space: (i) striving towards normality; (ii) being anchored and protected; (iii) being at-home and homeness; and (iv) being in communion and meaningfulness. The findings show that the physical environment has a say in patients' basic needs and a role in maintaining normality. Substandard reveals a lack of respect and dignity towards this patient group. Involving patients in the design process of new facilities can be a way to make progress.
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Affiliation(s)
- Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,CELAM, Centre for Ethics, Law and Mental Health, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ella Danielson
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Inger Berglund Johansson
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,Department of Quality Improvement, Sahlgrenska University Hospital, Gothenburg, Sweden
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