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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and staff's therapeutic practices, including providing options for novel treatment needs in contrast to older and more outdated buildings that are perceived as hindering appropriate treatment conditions.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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HamdanAlshehri H, Wolf A, Öhlén J, Sawatzky R, Olausson S. Attitudes towards death and dying among intensive care professionals: A cross-sectional design evaluating culture-related differential item functioning of the frommelt attitudes toward care of the dying instrument. Heliyon 2023; 9:e18864. [PMID: 37600399 PMCID: PMC10432714 DOI: 10.1016/j.heliyon.2023.e18864] [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: 12/14/2022] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/22/2023] Open
Abstract
Objective The objective is to examine whether one of the most used instruments for measuring attitudes towards caring for dying patients, the Frommelt Attitude Toward Care of the Dying (FATCOD-B) instrument, has the same meaning across different societal contexts, as exemplified by Swedish and Saudi Arabian intensive care professionals. Methods A cross-sectional design used the 30-item FATCOD-B questionnaire. It was distributed to intensive care professionals from Sweden and Saudi Arabia, generating a total sample of 227 participants. Ordinal logistic regression models were used to examine the differential item functioning (DIF) for each item. Results Up to 12 of the 30 items were found to have significant DIF values related to: (a) Swedish and Saudi Arabian intensive care professionals, (b) Swedish and Saudi Arabian registered nurses (RNs), (c) RNs' levels of experience and (d) RNs and other intensive care professionals in Saudi Arabia. Conclusions The results indicate that FATCOD should be used cautiously when comparing attitudes towards death and dying across different societal and healthcare contexts.
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Affiliation(s)
- Hanan HamdanAlshehri
- Princess Nourah bint Abdulrahman University, Medical and Surgical Department College of Nursing, Riyadh, Saudi Arabia
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Vastra Gotland, Sweden
| | - Axel Wolf
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Vastra Gotland, Sweden
- Sahlgrenska University Hospital/Ostra, Department of Anaesthesiology and Intensive Care Medicine, Gothenburg, Sweden
- Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Vastra Gotland, Sweden
- University of Gothenburg Centre for Person-Centred Care, University of Gothenburg, Sweden
- Palliative Centre, Region Vastra Gotaland Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Vastra Gotland, Sweden
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Collet MO, Laerkner E, Jensen J, Egerod I, Christensen J, Jørgensen NK, Kjaergaard RS, Olausson S, Wøien H, Lange T, Nielsen AH, Kjaer MBN, Bruun CRL, Perner A. Functional and cognitive rehabilitation interventions during intensive care admission: A protocol for a systematic integrative review. Acta Anaesthesiol Scand 2023; 67:670-674. [PMID: 36764675 DOI: 10.1111/aas.14214] [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: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Long-term cognitive impairment occurs in up to 60% of intensive care unit (ICU) survivors. Early use of functional and cognitive rehabilitation interventions, while patients are still in ICU, may reduce cognitive decline. We aim to describe the functional and cognitive interventions used during the ICU stay, the healthcare professionals providing interventions, and the potential impact on functional and cognitive rehabilitation. METHOD In this integrative systematic review, we will include empirical qualitative, quantitative, mixed- and multiple-methods studies assessing the use of functional and cognitive rehabilitation provided in ICU. We will identify studies in relevant electronic databases from 2012 to 2022, which will be screened for eligibility by at least two reviewers. Literature reported as narrative reviews and editorials will be excluded. We will assess the impact of interventions evaluating a cognitive and functional function, quality of life, and all-cause mortality at 6-12 months after ICU discharge. The Revised Cochrane risk-of-bias Tool will be used for assessing risk of bias in clinical trials. For observational studies, we will use the National Institutes of Health Quality Assessment tool for Observational Cohort and Cross-Sectional Studies. Furthermore, we will use the critical appraisal skills programme for qualitative studies and the mixed methods appraisal tool for mixed methods studies. We will construct four matrices, including results describing which ICU patients and healthcare professionals were engaged in rehabilitation, which interventions were included in early rehabilitation in ICU, the potential impact on patient outcomes of rehabilitation interventions provided in ICU and a narrative synthesis of themes. A summary of the main results will be reported using modified GRADE methodology. IMPACT This integrative review will inform the feasibility randomised clinical trial testing the development of a complex intervention targeting functional and cognitive rehabilitation for patients in ICU.
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Affiliation(s)
- Marie Oxenbøll Collet
- Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Eva Laerkner
- Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark
| | - Janet Jensen
- Department of Neurology Zealand University Hospital, University of Southern Denmark, Odense, Denmark
| | - Ingrid Egerod
- Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.,Department of Health & Medical Sciences Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Jan Christensen
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Niels Kasper Jørgensen
- Danish Dementia Research Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | | | - Sepideh Olausson
- Division for Intensive and Critical, University of Gothenburg and Sahlgrenska University Hospital, Institution of Health Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden
| | - Hilde Wøien
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne Højager Nielsen
- Department of Intensive Care, Gødstrup Hospital, Gødsrup, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | | | - Anders Perner
- Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
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Cederwall CJ, Rose L, Naredi S, Olausson S, Ringdal M. Care practices for patients requiring mechanical ventilation more than seven days in Swedish intensive care units: A national survey. Intensive Crit Care Nurs 2023; 74:103309. [PMID: 35965149 DOI: 10.1016/j.iccn.2022.103309] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 07/27/2022] [Accepted: 07/31/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To identify care practices in Swedish intensive care units specific to patients requiring mechanical ventilation for >7 days. RESEARCH METHODOLOGY We conducted a national cross-sectional survey inviting all adult Swedish ICUs (n = 79). Nurse managers were invited by email to complete a questionnaire by telephone. The questionnaire included seven domains: ventilator weaning, mobilisation, communication, nutrition, symptom assessment, psychosocial support and organisational characteristics. RESULTS We received responses from 77 units (response rate, 97%). Weaning protocols were available in 42 (55%) units, 52 (68%) used individualised weaning strategies and 50 (65%) involved physicians and nurses in collaborative decision making. In 48 units (62%), early mobilisation was prioritised using bed cycling but only 26 (34%) units had mobilisation protocols. Most of the intensive care units (74, 96%) had nutrition protocols but only 2 (3%) had dedicated dieticians. Delirium screening tools were available in 49 (64%) ICUs, 3 (4%) assessed anxiety and none assessed dyspnoea. Nineteen (25%) units employed a primary nursing model and 11 (14%) indicated person-centred care policies. Regular case conferences, including family participation, were held by 39 (51%) units. CONCLUSION We found that an individualised approach to ventilator weaning, decided by physicians and nurses in collaboration, was the predominant approach, although weaning protocols were available in some intensive care units. Most units prioritised early mobilisation, though few used protocols. Nutritional protocols were widely adopted, as few units had a dedicated dietician.
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Affiliation(s)
- Carl-Johan Cederwall
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden.
| | - Louise Rose
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK; Lane Fox Respiratory Unit, St Thomas' Hospital, London, UK
| | - Silvana Naredi
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Anaesthesiology and Intensive Care, 413 45 Gothenburg, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden
| | - Mona Ringdal
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; Department of Anaesthesiology and Critical Care, Kungälvs Hospital, Kungälv, Sweden
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Green J, Bagge ASL, Olausson S, Andiné P, Wallinius M, Karlén MH. Implementing clinical guidelines for co-occurring substance use and major mental disorders in Swedish forensic psychiatry: An exploratory, qualitative interview study with mental health care staff. J Subst Abuse Treat 2023; 144:108899. [PMID: 36270196 DOI: 10.1016/j.jsat.2022.108899] [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: 03/04/2022] [Revised: 07/04/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Patients with substance use disorders (SUD) and co-occurring mental disorders (COD) within forensic psychiatric care often suffer poor treatment outcomes and high rates of criminal recidivism, substance use, and psychiatric problems. This study aimed to describe the conditions for, and mental health care staff's experiences with, implementing integrated SUD-focused clinical guidelines, including assessment and treatment for patients with COD at a high-security forensic mental health services (FMHS) facility in Sweden. METHODS Study staff conducted nineteen semi-structured interviews with health care staff experienced in administering the new SUD assessment and treatment. The study conducted a thematic analysis to describe the health care staff's experiences with these guidelines and suggestions for improvement. RESULTS Most participants reported appreciation for the implementation of clinical guidelines with an SUD focus, an area they considered to have previously been neglected, but also noted the need for more practical guidance in the administration of the assessments. Participants reported the dual roles of caregiver and warden as difficult to reconcile and a similar, hindering division was also present in the health care staff's attitudes toward SUD. Participants' reports also described an imbalance prior to the implementation, whereby SUD was rarely assessed but treatment was still initiated. One year after the implementation, an imbalance still existed, but in reverse: SUD was more frequently assessed, but treatment was difficult to initiate. CONCLUSIONS Despite indications of some ambivalence among staff regarding the necessity of the assessment and treatment guidelines, many participants considered it helpful to have a structured way to assess and treat SUD in this patient group. The imbalance between frequent assessment and infrequent treatment may have been due to difficulties transitioning patients across the "gap" between assessment and treatment. To bridge this gap, mental health services should make efforts to increase patients' insight concerning their SUD, flexibility in the administration of treatment, and the motivational skills of the health care staff working with this patient group. Participants considered important for enhancing treatment quality a shared knowledge base regarding SUD, and increased collaboration between different professions and between in- and outpatient services.
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Affiliation(s)
- J Green
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
| | - A S Lindqvist Bagge
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - S Olausson
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - P Andiné
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden; Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - M Wallinius
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden; Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - M Hildebrand Karlén
- Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Psychology, University of Gothenburg, Gothenburg, Sweden; Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
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Alshehri HH, Wolf A, Öhlén J, Olausson S. Healthcare Professionals' Perspective on Palliative Care in Intensive Care Settings: An Interpretive Descriptive Study. Glob Qual Nurs Res 2022; 9:23333936221138077. [PMID: 36507302 PMCID: PMC9729985 DOI: 10.1177/23333936221138077] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/24/2022] [Accepted: 10/04/2022] [Indexed: 12/12/2022] Open
Abstract
There is a growing need to integrate palliative care into intensive care units and to develop appropriate knowledge translation strategies. However, multiple challenges persist in attempts to achieve this objective. In this study, we aimed to explore intensive care professionals' perspectives on providing palliative and end-of-life care within an intensive care context. We used an interpretive description approach and interviewed 36 intensive care professionals at four hospitals in Saudi Arabia. Our findings reflect a discourse about end-of-life care driven by a do-not-resuscitate classification and challenges associated with family involvement in care goals. We provide key insights of importance for the development of strategies for the integration and knowledge translation of palliative care into intensive care contexts.
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Affiliation(s)
- Hanan Hamdan Alshehri
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
- Hanan Hamdan Alshehri, University of Gothenburg Sahlgrenska Academy, Box 457 405 30 Göteborg, Goteborg 405 30, Sweden. Emails: ;
| | - Axel Wolf
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
- University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital/Östra, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
- University of Gothenburg and Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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Olausson S, Lindahl B. On photovoice-Applications and reflections to an intensive care context. Scand J Caring Sci 2022; 36:1123-1133. [PMID: 35307842 PMCID: PMC9790407 DOI: 10.1111/scs.13075] [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: 04/22/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND In this paper, we share our experiences of using 'photovoice' methodology as a way to generate data in intensive care units concerning the place and space of care. We have adapted and modified 'photovoice' in researching people's lived experiences of ICU. Researching lived experiences in an intensive care context is challenging because of the complex nature of critical care. AIM This study aims to explore and discuss photovoice methodolgy in ICU as a data collection method. MATERIALS AND METHODS Photos and interviews collected from patients, loved ones and staff collected in a previous research proejct. RESULTS Although there are challenges in using cameras and photographing the environment in the ICU, due to ethics and the voiceless patients therein, many advantages are presented to the researchers in capturing the meaning of lived experiences of various phenomena in the lifeworld in general and in the meaning of place and space. This paper offers applications and reflection over ontological, epistemological and methodological concerns and also offers a detailed approach on how to employ photovoice for successful and rich data generation. DISCUSSION developing and adapting scientific methods and methodologies contributes to knowledge development in caring science and is therefore an important subject of matter. CONCLUSIONS Photovoice also presents a powerful tool in disseminating the findings as it opens up the closed world of ICU to the public and increases people's understanding of the significance of place and space of caring practice.
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Affiliation(s)
- Sepideh Olausson
- Institute of Health and Caring SciencesSahlgrenska AcademyUniversity of GothenburgGothenburgSweden,Department of Anesthesiology and Intensive CareSahlgrenska University HospitalGothenburgSweden
| | - Berit Lindahl
- Faculty of MedicinePalliative Care Knowledge CenterInstitute of Health SciencesLund UniversityLundSweden
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Backlund M, Olausson S. Nurses' Experiences as Care Providers for Refugees in Emergency and Critical Care in Jordan: A Qualitative Interview Study. Glob Qual Nurs Res 2021; 8:23333936211056932. [PMID: 34790839 PMCID: PMC8591209 DOI: 10.1177/23333936211056932] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/25/2022] Open
Abstract
During the global refugee crisis of the 2010s, hundreds of thousands of Syrians fled to
Jordan. As displaced Palestinians have had refugee status for several decades in Jordan
already, this study aimed to explore nurses’ perceptions of caring for Palestinian and
Syrian refugees within the context of critical and emergency care. The qualitative design
was executed through twelve semi-structured interviews with nurses working in refugee
camps and public hospitals. Three main themes were identified describing the nurses’
empathetic understanding of the refugees’ situation, various challenging factors, as well
as different aspects of the opportunities that they perceived in critical care and
emergency care. The experiences of publicly employed nurses generally differed from those
working in the camps. In addition, the findings indicate the importance of further
research conducted locally, as it suggests several elements that have a negative impact on
the quality of advanced healthcare for refugees.
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Affiliation(s)
- Maja Backlund
- Sahlgrenska Academy, Institution for Nursing Science and Health at Gothenburg University, Gothenburg, Sweden
| | - Sepideh Olausson
- Sahlgrenska Academy, Institution for Nursing Science and Health at Gothenburg University, Gothenburg, Sweden
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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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Nordenskjöld Syrous A, Malmgren J, Odenstedt Hergès H, Olausson S, Kock‐Redfors M, Ågård A, Block L. Reasons for physician-related variability in end-of-life decision-making in intensive care. Acta Anaesthesiol Scand 2021; 65:1102-1108. [PMID: 33964009 DOI: 10.1111/aas.13842] [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] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/18/2021] [Accepted: 04/29/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is increasing evidence that the individual physician is the main factor influencing variability in end-of-life decision-making in intensive care units. End-of-life decisions are complex and should be adapted to each patient. Physician-related variability is problematic as it may result in unequal assessments that affect patient outcomes. The primary aim of this study was to investigate factors contributing to physician-related variability in end-of-life decision-making. METHOD This is a qualitative substudy of a previously conducted study. In-depth thematic analysis of semistructured interviews with 19 critical care specialists from five different Swedish intensive care units was performed. Interviews took place between 1 February 2017 and 31 May 2017. RESULTS Factors influencing physician-related variability consisted of different assessment of patient preferences, as well as intensivists' personality and values. Personality was expressed mainly through pace and determination in the decision-making process. Personal prejudices appeared in decisions, but few respondents had personally witnessed this. Avoidance of criticism and conflicts as well as individual strategies for emotional coping were other factors that influenced physician-related variability. Many respondents feared criticism for making their assessments, and the challenging nature of end-of-life decision-making lead to avoidance as well as emotional stress. CONCLUSION Variability in end-of-life decision-making is an important topic that needs further investigation. It is imperative that such variability be acknowledged and addressed in a more formal and transparent manner. The ethical issues faced by intensivists have recently been compounded by the devastating impact of the COVID-19 pandemic, demonstrating in profound terms the importance of the topic.
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Affiliation(s)
- Alma Nordenskjöld Syrous
- Department of Anesthesiology and Intensive Care Institute of Clinical SciencesSahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
| | - Johan Malmgren
- Department of Anesthesiology and Intensive Care Institute of Clinical SciencesSahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Department of Anesthesiology and Intensive Care Region Västra GötalandSahlgrenska University Hospital Gothenburg Sweden
| | - Helena Odenstedt Hergès
- Department of Anesthesiology and Intensive Care Institute of Clinical SciencesSahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Department of Anesthesiology and Intensive Care Region Västra GötalandSahlgrenska University Hospital Gothenburg Sweden
| | - Sepideh Olausson
- Institute of Health and Care SciencesSahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
| | - Maria Kock‐Redfors
- Department of Anesthesiology and Intensive Care Region Västra GötalandSahlgrenska University Hospital Gothenburg Sweden
| | - Anders Ågård
- Department of Cardiology Institute of MedicineSahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
| | - Linda Block
- Department of Anesthesiology and Intensive Care Institute of Clinical SciencesSahlgrenska AcademyUniversity of Gothenburg Gothenburg Sweden
- Department of Anesthesiology and Intensive Care Region Västra GötalandSahlgrenska University Hospital Gothenburg Sweden
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12
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Hamdan Alshehri H, Wolf A, Öhlén J, Olausson S. Managerial and organisational prerequisites for the integration of palliative care in the intensive care setting: A qualitative study. J Nurs Manag 2021; 29:2715-2723. [PMID: 34355447 DOI: 10.1111/jonm.13436] [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: 05/10/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/30/2022]
Abstract
AIM To explore the association of organizational structures when integrating palliative care in intensive care units. BACKGROUND Palliative care within intensive care settings has been widely recognized as an area requiring improvement when caring for patients and their families. Despite this, intensive care units continue to struggle to integrate palliative care. METHODS A qualitative descriptive methodology was used. Data were collected through research interviews with 15 managers and 36 health care professionals working in intensive care. The data were analysed adopting constant comparative analysis. RESULTS This study provides insight into a diverse range of perspectives on organizational structure in the context of facilitation and the challenges posed. Three themes were identified: Do not resuscitate policy as a gateway to palliative care, facilitating family members to enable participation and support and barriers for palliative care in intensive care unit as a result of intensive care organization. CONCLUSIONS In fostering a sustainable organizational culture and practice development in intensive care, the findings indicate the need for specific palliative care policies and implementation strategies tailored according to context. IMPLICATIONS FOR NURSING MANAGEMENT Management has a responsibility to facilitate dialogue within any multidisciplinary team regarding palliative care and, in particular, to focus on 'do not resuscitate' policies as a gateway into this conversation.
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Affiliation(s)
- Hanan Hamdan Alshehri
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Axel Wolf
- Region Västra Götaland, Vastra Gotaland County, Sweden.,Department of Anaesthesiology and Intensive Care Medicine, University Hospital/Östra, Gothenburg, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences and University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Gothenburg, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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13
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Halvorsen K, Jensen JF, Collet MO, Olausson S, Lindahl B, Saetre Hansen B, Lind R, Eriksson T. Patients' experiences of well-being when being cared for in the intensive care unit-An integrative review. J Clin Nurs 2021; 31:3-19. [PMID: 34159663 DOI: 10.1111/jocn.15910] [Citation(s) in RCA: 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] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The aim of this integrative review was to identify facilitators and barriers to patients' well-being when being cared for in an ICU setting, from the perspective of the patients. BACKGROUND To become critically ill and hospitalised in an ICU is a stressful, chaotic event due to the life-threatening condition itself, as well as therapeutic treatments and the environment. A growing body of evidence has revealed that patients often suffer from physical, psychological and cognitive problems after an ICU stay. Several strategies, such as sedation and pain management, are used to reduce stress and increase well-being during ICU hospitalisation, but the ICU experience nevertheless affects the body and mind. DESIGN; METHODS: Since research exploring patients' sense of well-being in an ICU setting is limited, an integrative review approach was selected. Searches were performed in CINAHL, Medline, Psych Info, Eric and EMBASE. After reviewing 66 studies, 12 studies were included in the integrative review. Thematic analysis was used to analyse the studies. The PRISMA checklist for systematic reviews was used. RESULTS The results are presented under one main theme, 'Well-being as a multidimensional experience-interwoven in barriers and facilitators' and six sub-themes representing barriers to and facilitators of well-being in an ICU. Barriers identified were physical stressors, emotional stressors, environmental disturbances and insecurity relating to time and space. Facilitators were meeting physical needs and activities that included dimensions of a caring and relational environment. CONCLUSION Our main findings were that experiences of well-being were multidimensional and included physical, emotional, relational and environmental aspects, and they were more often described through barriers than facilitators of well-being. RELEVANCE FOR CLINICAL PRACTICE This integrative review has shown that it is necessary to adopt an individual focus on patient well-being in an ICU setting since physical, emotional, relational and environmental stressors might impact each patient differently.
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Affiliation(s)
| | - Janet F Jensen
- Department of Anesthesiology, Holbaek Hospital, Holbaek, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Marie O Collet
- Intensive Department, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sepideh Olausson
- Institute of Health and Care Sciences, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Berit Lindahl
- Department of Health Sciences and the Institute for Palliative Care, Medical Falucty Lund University, Lund, Sweden.,Faculty of Caring Sciences, Work Life and Social Welfare, Borås University, Borås, Sweden
| | - Britt Saetre Hansen
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Ranveig Lind
- Department of Health and Care Sciences, The Arctic University of Norway, Harstad, Norway.,Research Nurse at Intensive Care Unit, University Hospital of North Norway, Tromsø, Norway
| | - Thomas Eriksson
- Faculty of Caring Sciences, Work Life and Social Welfare, Borås University, Borås, Sweden
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14
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Cederwall CJ, Naredi S, Olausson S, Rose L, Ringdal M. Prevalence and Intensive Care Bed Use in Subjects on Prolonged Mechanical Ventilation in Swedish ICUs. Respir Care 2021; 66:300-306. [PMID: 32843507 PMCID: PMC9994213 DOI: 10.4187/respcare.08117] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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] [Indexed: 11/05/2022]
Abstract
BACKGROUND The number of patients requiring prolonged mechanical ventilation (PMV) is predicted to escalate due to an aging population. International studies on prevalence and resource utilization of this patient group exist, but data are lacking from Scandinavian ICUs, where there is a relatively low number of ICU beds in relation to population. The primary aim was to identify prevalence of admissions requiring mechanical ventilation ≥ 7-21 d and PMV > 21 d, and their use of ICU bed days in Sweden. Secondary aims were to describe patient characteristics and outcomes. METHODS We obtained data from the Swedish Intensive Care Registry on admissions age ≥ 18 y mechanically ventilated ≥ 7 d and used open source registry data to calculate the prevalence and use of bed days of admissions ventilated ≥ 7-21 d and PMV > 21 d. RESULTS Of the 39,510 ICU admissions to Swedish ICUs in 2017, those mechanically ventilated ≥ 7-21 d accounted for 1,643 (4%) admissions, and those with PMV > 21 d accounted for 307 (0.8%) admissions. Of the 109,457 ICU bed days, 22% were consumed by admissions ventilated ≥ 7-21 d and 10% by those with PMV > 21 d. The ICU mortality of both groups was 21%. Admissions with mechanical ventilation ≥ 7 d had a median age of 65 y and were predominantly male (64%). CONCLUSIONS Admissions to Swedish ICUs who required mechanical ventilation ≥ 7-21 d and PMV > 21 d form a relatively small proportion of all ICU admissions, but consume a significant proportion of ICU beds days. Prevalence of admissions, ICU bed days, and ICU mortality were lower than reports from other countries, but the admissions were predominantly elderly and male, in accordance with other reports.
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Affiliation(s)
- Carl-Johan Cederwall
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Central Intensive Care Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Silvana Naredi
- Department of Anaesthesiology and Intensive Care, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Anaesthesiology and Intensive Care, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sepideh Olausson
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Louise Rose
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
- Lane Fox Respiratory Unit, St Thomas' Hospital, London, United Kingdom
| | - Mona Ringdal
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Anaesthesiology and Critical Care, Kungälvs Hospital, Kungälv, Sweden
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15
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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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16
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Hamdan Alshehri H, Olausson S, Öhlén J, Wolf A. Factors influencing the integration of a palliative approach in intensive care units: a systematic mixed-methods review. BMC Palliat Care 2020; 19:113. [PMID: 32698809 PMCID: PMC7375204 DOI: 10.1186/s12904-020-00616-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 09/26/2019] [Accepted: 07/07/2020] [Indexed: 12/15/2022] Open
Abstract
Background While a palliative approach is generally perceived to be an integral part of the intensive care unit (ICU), the provision of palliative care in this setting is challenging. This review aims to identify factors (barriers and facilitators) influencing a palliative approach in intensive care settings, as perceived by health care professionals. Method A systematic mixed-methods review was conducted. Multiple electronic databases were used, and the following search terms were utilized: implementation, palliative care, and intensive care unit. In total, 1843 articles were screened, of which 24 met the research inclusion/exclusion criteria. A thematic synthesis method was used for both qualitative and quantitative studies. Results Four key prerequisite factors were identified: (a) organizational structure in facilitating policies, unappropriated resources, multi-disciplinary team involvement, and knowledge and skills; (b) work environment, including physical and psychosocial factors; (c) interpersonal factors/barriers, including family and patients’ involvement in communication and participation; and (d) decision-making, e.g., decision and transition, goal conflict, multidisciplinary team communication, and prognostication. Conclusion Factors hindering the integration of a palliative approach in an intensive care context constitute a complex interplay among organizational structure, the care environment and clinicians’ perceptions and attitudes. While patient and family involvement was identified as an important facilitator of palliative care, it was also recognized as a barrier for clinicians due to challenges in shared goal setting and communication.
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Affiliation(s)
- Hanan Hamdan Alshehri
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences and University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Gothenburg, Sweden
| | - Axel Wolf
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. .,Department of Anaesthesiology and Intensive Care Medicine, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
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17
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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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18
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Hanan Alshehri, Olausson S, Wolf A, Öhlén J. Factors influencing integrated palliative care processes in intensive care units: a mixed methods systematic review. Aust Crit Care 2020. [DOI: 10.1016/j.aucc.2020.04.003] [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: 10/23/2022] Open
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19
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Egerod I, Kaldan G, Lindahl B, Hansen BS, Jensen JF, Collet MO, Halvorsen K, Eriksson T, Olausson S, Jensen HI. Trends and recommendations for critical care nursing research in the Nordic countries: Triangulation of review and survey data. Intensive Crit Care Nurs 2019; 56:102765. [PMID: 31685257 DOI: 10.1016/j.iccn.2019.102765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 02/12/2019] [Revised: 08/04/2019] [Accepted: 08/31/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Priorities for critical care nursing research have evolved with societal trends and values. In the 1980s priorities were the nursing workforce, in 1990s technical nursing, in 2000s evidence-based nursing and in 2010s symptom management and family-centred care. OBJECTIVES To identify current trends and future recommendations for critical care nursing research in the Nordic countries. METHODS We triangulated the results of a literature review and a survey. A review of two selected critical care nursing journals (2016-2017) was conducted using content analysis to identify contemporary published research. A self-administered computerised cross-sectional survey of Nordic critical care nursing researchers (2017) reported current and future areas of research. RESULTS A review of 156 papers identified research related to the patient (13%), family (12%), nurse (31%), and therapies (44%). Current trends in the survey (n = 76, response rate 65%) included patient and family involvement, nurse performance and education, and evidence-based protocols. The datasets showed similar trends, but aftercare was only present in the survey. Future trends included symptom management, transitions, rehabilitation, and new nursing roles. CONCLUSION Critical care nursing research is trending toward increased collaboration with patient and family, delineating a shift toward user values. Recommendations include long-term outcomes and impact of nursing.
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Affiliation(s)
- Ingrid Egerod
- University of Copenhagen, Rigshospitalet, Intensive Care Unit 4131, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
| | - Gudrun Kaldan
- Copenhagen University Hospital, Rigshospitalet, 7831, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
| | - Berit Lindahl
- Faculty of Caring Sciences, Work Life & Social Welfare, University of Borås, Borås, Sweden.
| | - Britt Sætre Hansen
- Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, P.O. Box 8100, N-4068 Stavanger, Norway; Faculty of Health Sciences, Quality and Safety in Health Care Systems, University of Stavanger, N-4036 Stavanger, Norway.
| | - Janet Froulund Jensen
- Department of Anesthesiology, Holbæk Hospital, Smedelundsgade 60, 4300 Holbæk, Denmark.
| | - Marie Oxenbøll Collet
- Department of Intensive Care 4131, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
| | - Kristin Halvorsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Norway.
| | - Thomas Eriksson
- Faculty of Caring Sciences, Work Life & Social Welfare, University of Borås, SE-501 90 Borås, Sweden.
| | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
| | - Hanne Irene Jensen
- Department of Anaesthesiology and Intensive Care, Vejle and Middelfart Hospitals, Beriderbakken 4, 7100 Vejle, Denmark; Institute of Regional Health Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000 Odense, Denmark.
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20
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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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21
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Petersson E, Wångdahl L, Olausson S. ICU nurses' experiences of environmental elements and their meaning for patient care at an ICU: A qualitative content analysis. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/2057158518778997] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In an intensive care unit (ICU), the environment is highly technological and staff are constantly present. The aim of this study was to describe environmental elements of an ICU room that nurses consider central for their provision of care. Data were collected using photovoice – photographs and in-depth interviews – and analysed using a qualitative content analysis approach. The care environment highly affected ICU nurses, in particular some elements such as medical equipment, work stations and beds. These were considered as an aid, but due to confined space some care was abstained from, maintaining privacy and confidentiality were a challenge, which led to frustration and stress. To provide care in an environment with good lightning, reduced noise and adequate space increases the wellbeing of the nurses, which indicates that an investment in a better care environment would be worthwhile.
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Affiliation(s)
| | | | - Sepideh Olausson
- Institute of Health and Care Sciences,The Sahlgrenska Academy at Gothenburg University, Sweden
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22
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Affiliation(s)
- Franz James
- HDK –Academy of Design and Crafts, Department of Design, University of Gothenburg, Gothenburg, Sweden
| | - Sepideh Olausson
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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23
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Cederwall CJ, Olausson S, Rose L, Naredi S, Ringdal M. Person-centred care during prolonged weaning from mechanical ventilation, nurses' views: an interview study. Intensive Crit Care Nurs 2018; 46:32-37. [PMID: 29567410 DOI: 10.1016/j.iccn.2017.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 05/31/2017] [Revised: 10/11/2017] [Accepted: 11/26/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. RESEARCH METHODOLOGY Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. SETTING This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. FINDINGS Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. CONCLUSION We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research.
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Affiliation(s)
- Carl-Johan Cederwall
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden; Sahlgrenska University Hospital, Central intensive care unit, CIVA, Gröna stråket 2, 413 45, Gothenburg, Sweden.
| | - Sepideh Olausson
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden
| | - Louise Rose
- Lawrence S. Bloomberg Faculty of Nursing and Interdepartmental Division of Critical Care Medicine, University of Toronto, 155 College St, Suite 276, Toronto, ON, M5T 1P8, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada; Provincial Centre of Weaning Excellence/Prolonged Ventilation Weaning Centre, Michael Garron Hospital, Toronto, Canada
| | - Silvana Naredi
- Department of Anaesthesiology and Intensive Care at Institute of Clinical Sciences, Sahlgrenska University Hospital, 41345, Gothenburg, Sweden
| | - Mona Ringdal
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30, Gothenburg, Sweden; Department of Anaesthesiology and Critical Care, Kungälvs Hospital, Sweden
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Kauppi W, Proos M, Olausson S. Ward nurses' experiences of the discharge process between intensive care unit and general ward. Nurs Crit Care 2018; 23:127-133. [DOI: 10.1111/nicc.12336] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 12/10/2017] [Accepted: 12/12/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Wivica Kauppi
- Faculty of Caring Science, Work Life and Social Welfare, School of Health Sciences; University of Borås; Borås Sweden
| | | | - Sepideh Olausson
- Institute of Health and Care Sciences, Sahlgrenska academy, Gothenburg University; Goteborg Sweden
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Olausson S, Ekebergh M, Osterberg SA. Nurses' lived experiences of intensive care unit bed spaces as a place of care: a phenomenological study. Nurs Crit Care 2014; 19:126-34. [PMID: 24646033 DOI: 10.1111/nicc.12082] [Citation(s) in RCA: 25] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 11/06/2013] [Accepted: 12/15/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The environment of an intensive care unit (ICU) is, in general, stressful and has an impact on quality of care in terms of patient outcomes and safety. Little is known about nurses' experiences, however, from a phenomenological perspective with regard to the critical care settings as a place for the provision of care for the most critically ill patients and their families. AIM The aim of this study was to explore nurses' lived experiences of ICU bed spaces as a place of care for the critically ill. DESIGN AND METHODS A combination of qualitative lifeworld interviews and photos --photovoice methodology --was used when collecting data. Fourteen nurses from three different ICUs participated. Data were analysed using a phenomenological reflective lifeworld approach. FINDINGS An outer spatial dimension and an inner existential dimension constitute ICU bed spaces. Caring here means being uncompromisingly on call and a commitment to promoting recovery and well-being. The meanings of ICU bed spaces as a place of care comprise observing and being observed, a broken promise, cherishing life, ethical predicament and creating a caring atmosphere. CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE The architectural design of the ICU has a great impact on nurses' well-being, work satisfaction and the provision of humanistic care. Nurses need to be involved in the process of planning and building new ICU settings. There is a need for further research to highlight the quality of physical environment and its impact on caring practice.
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Affiliation(s)
- Sepideh Olausson
- S Olausson, PhD candidate, RN, CCRN, MSn, Department of Health Sciences, University of Borås, Borås, Sweden; Linnaeus University, Växjö, Sweden
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Olausson S, Ekebergh M, Lindahl B. The ICU patient room: Views and meanings as experienced by the next of kin: A phenomenological hermeneutical study. Intensive Crit Care Nurs 2012; 28:176-84. [DOI: 10.1016/j.iccn.2011.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 11/30/2011] [Accepted: 12/07/2011] [Indexed: 11/15/2022]
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