oru.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Forslund, Kerstin
Publications (10 of 15) Show all publications
Holmberg, M., Wahlberg, A. C., Fagerberg, I. & Forslund, K. (2016). Ambulance clinicians' experiences of relationships with patients and significant others. Nursing in Critical Care, 21(4), e16-e23
Open this publication in new window or tab >>Ambulance clinicians' experiences of relationships with patients and significant others
2016 (English)In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 21, no 4, p. e16-e23Article in journal (Refereed) Published
Abstract [en]

Background: Ambulance clinicians (ACs) have to provide advanced care and treatment to patients in a challenging and emotionally demanding environment, therefore they establish interpersonal relationships embracing both patients and significant others. Relationships in emergency care were earlier found to be short-lived and lacking a holistic understanding of the patient. In their relationship with the ambulance clinicians, it is for patients to surrender and become dependent, which may be interpreted as both a negative and a positive experience.

Aim: The aim of this study was to elucidate ambulance clinicians' experiences of relationships with patients and significant others.

Methods: Data were collected from four focus group conversations, with a total of 18 participating ambulance clinicians. An inductive qualitative content analysis method was chosen.

Findings: The analysis resulted in one main category: 'To be personal in a professional role' and three generic categories: 'To be there for the affected person', 'To be personally involved' and 'To have a professional mission'. There were subsequently nine sub-categories. The main category was described as intertwining the experience of being both personal and professional. The ambulance clinicians adapt to a situation while having the affected person in focus. They involve themselves as persons but at the same time use the power of their professional role.

Conclusion: The relationship with patients and significant others from the ambulance clinicians' perspective can be understood as embracing both personal and professional aspects.

Relevance to critical practice: This study provides an understanding of the ambulance clinicians' professional role as embracing a personal perspective, which is important when developing an emergency ambulance service focusing on care that involves more than just emergency medical treatment.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2016
Keywords
Ambulance care, ambulance clinicians, focus groups, nursing, professional relationship
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-51155 (URN)10.1111/nicc.12196 (DOI)000379065200003 ()26184114 (PubMedID)2-s2.0-84975144056 (Scopus ID)
Available from: 2016-07-01 Created: 2016-07-01 Last updated: 2017-11-28Bibliographically approved
Holmberg, M., Forslund, K., Wahlberg, A. C. & Fagerberg, I. (2016). The relationship with the ambulance clinicians as experienced by significant others. Nursing in Critical Care, 21(4), e1-e8
Open this publication in new window or tab >>The relationship with the ambulance clinicians as experienced by significant others
2016 (English)In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 21, no 4, p. e1-e8Article in journal (Refereed) Published
Abstract [en]

Background: Interpersonal relationships between clinicians and patients are important aspects of the ambulance care, requiring a balance between objectified acute medical treatment and a holistic care. Being a significant other (SO) in the ambulance care setting is described as being caught between hope and dread. Little research has focused on SOs' experiences of the relationship with the ambulance clinicians.

Aim: To elucidate meanings of the relationship with the clinicians in the ambulance care setting as experienced by the patients' SOs.

Design: Qualitative lifeworld design.

Methods: Data was collected using open-ended interviews with nine SOs. The verbatim transcribed interviews were analysed with a phenomenological hermeneutic method.

Findings: The structural analysis resulted in one main theme: 'Being lonely together'. The main theme comprises three themes: 'Being in a shared struggle', 'To hand over the affected person in trust' and 'Being the second person in focus' and six subthemes. The main theme is for the SOs to share the struggles of the affected person with the ambulance clinicians and to be comforted while handing over the responsibility for the affected person. Hence the SO is excluded and lonely and on his/her own, while not the primary focus of the ambulance clinicians.

Conclusions: The relationship with the ambulance clinicians from the perspective of the SOs can be understood as complex, involving both being lonely and together at the same time. The findings support a holistic approach towards the ambulance care involving SOs.

Relevance for clinical practice: This study outlines the importance of an emergency ambulance care involving SOs as affected persons and supports a balance between emergency medical treatment to the patient and a holistic care, involving the SOs' suffering.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell Publishing Inc., 2016
Keywords
Ambulance care, nursing, phenomenological hermeneutic, professional relationship, significant others
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-51156 (URN)10.1111/nicc.12144 (DOI)000379065200001 ()25571767 (PubMedID)2-s2.0-84923086509 (Scopus ID)
Available from: 2016-07-01 Created: 2016-07-01 Last updated: 2017-11-28Bibliographically approved
Holmberg, M., Forslund, K., Wahlberg, A. C. & Fagerberg, I. (2014). To surrender in dependence of another: the relationship with the ambulance clinicians as experienced by patients. Scandinavian Journal of Caring Sciences, 28(3), 544-551
Open this publication in new window or tab >>To surrender in dependence of another: the relationship with the ambulance clinicians as experienced by patients
2014 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, p. 544-551Article in journal (Refereed) Published
Abstract [en]

Historically, the ambulance care has focused on acute transports and medical treatment, although ambulance care has also been reported as complex, encompassing more than just medical treatment and transports. Previous studies, on ambulance clinicians, have pointed out the importance of interpersonal caring activities complementary to the medical treatment. Those activities can be understood as taking part in the relationship between patients and ambulance clinicians, earlier described as essential and a core component of care. The aim of this study was to elucidate the meaning of the relationship with the ambulance clinicians as experienced by patients. Twenty ambulance patients were interviewed in the study. The interviews were transcribed verbatim and analysed with a phenomenological hermeneutical method to grasp meanings in the patients' experiences. The regional ethical committee approved the study. In the result emerged one main theme: To surrender in dependence of another. The main theme includes four themes: Being in the hands of another, Being in a caring temporary presence, Being important while involved and Being powerless while insignificant, and the themes comprise eleven subthemes. The main theme meant to have no other option than to surrender and to put their life into the hand of another. This surrender also meant to adapt to the clinicians' views even if not shared. This is experienced as excessive care. Summarised, the patients' experiences were both positive and negative and the findings provide a complex understanding of the relationship between the patient and the ambulance clinicians. Overall, the relationship embraces the whole person without reducing the patient to be a recipient of an objectified ambulance care.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keywords
ambulance care; caring science; patients; phenomenological hermeneutic method; prehospital emergency care; professional patient relationship
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-36115 (URN)10.1111/scs.12079 (DOI)000340288100014 ()24067194 (PubMedID)2-s2.0-84905052088 (Scopus ID)
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2017-10-18Bibliographically approved
Forslund, K., Quell, R. & Sørlie, V. (2008). Acute chest pain emergencies: spouses' prehospital experiences. International emergency nursing, 16(4), 233-240
Open this publication in new window or tab >>Acute chest pain emergencies: spouses' prehospital experiences
2008 (English)In: International emergency nursing, ISSN 1878-013X, Vol. 16, no 4, p. 233-240Article in journal (Refereed) Published
Abstract [en]

The call to the Emergency Medical Dispatch Centre is often a person's first contact with the health-care system in cases of acute illness or injury and acute chest pain is a common reason for calling. The aim was to illuminate how spouses to persons with acute chest pain experienced the alarm situation, the emergency call and the prehospital emergency care. Interviews were conducted with nineteen spouses. A phenomenological-hermeneutic approach was used for the analyses. The themes responsibility and uneasiness emerged as well as an overall theme of aloneness. Being a spouse to a person in need of acute medical and nursing assistance was interpreted as "Being responsible and trying to preserve life" and "Being able to manage the uneasiness and having trust in an uncertain situation." When their partners' life was at risk the spouses were in an escalating spiral of worry, uncertainty, stress, fear of loss, feeling of loneliness and desperation. They had to manage emotional distress and felt compelled to act to preserve life, a challenging situation.

National Category
Social Sciences Interdisciplinary Nursing Veterinary Science
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-5945 (URN)10.1016/j.ienj.2008.07.001 (DOI)
Available from: 2009-03-06 Created: 2009-03-06 Last updated: 2018-01-13Bibliographically approved
Forslund, K. (2008). Det akuta larmsamtalet. In: Inger Holmström (Ed.), Telefonrådgivning inom hälso- och sjukvård (pp. 147-161). Lund: Studentlitteratur
Open this publication in new window or tab >>Det akuta larmsamtalet
2008 (Swedish)In: Telefonrådgivning inom hälso- och sjukvård / [ed] Inger Holmström, Lund: Studentlitteratur , 2008, p. 147-161Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur, 2008
National Category
Social Sciences Interdisciplinary Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-6001 (URN)978-91-44-04776-8 (ISBN)
Available from: 2009-03-12 Created: 2009-03-12 Last updated: 2018-01-13Bibliographically approved
Forslund, K. (2007). Challenges in prehospital emergency care: patient, spouse and personnel perspectives. (Doctoral dissertation). Örebro: Örebro universitetsbibliotek
Open this publication in new window or tab >>Challenges in prehospital emergency care: patient, spouse and personnel perspectives
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Prehospital emergency care (PEC) with the emergency call to the Emergency Medical Dispatch (EMD) centre is an essential part of the health-care system. It is important to obtain knowledge about the links in the PEC chain from the perspectives of those providing the service and those receiving it. The overall aim of this thesis was to describe the challenges surrounding PEC based on the experiences of patients, spouses and personnel. A qualitative descriptive design was used in the five papers included. The data analysis methods were phenomenological-hermeneutics (I–III), qualitative content analysis (IV–V) and descriptive statistics (V).

Interviews with thirteen patients who had called the EMD-centre due to acute chest pain (I) revealed a general satisfaction with PEC. They were aware of the number to call in an emergency but were uncertain when to call. The potentially life threatening emergency situation was marked by vulnerability and dependency and was fraught with pain, fear and a sense of aloneness.

An overall theme of aloneness emerged from the interviews with nineteen spouses who had placed an emergency call for their husband or wife that was experiencing acute chest pain (II). The challenges in being a spouse to a person in need of PEC were associated with: “Being responsible and trying to preserve life” and “Being able to manage the uneasiness and feel trust in an uncertain situation”. The spouses were in an escalating spiral of aloneness, worry, uncertainty, stress, fear of loss and desperation.

Interviews with sixteen emergency operators dealt with situations they considered difficult to deal with and their reflections on how they managed such situations (III). Uncertainty, communication difficulties and insufficient resources characterized those situations. Skills, knowledge, experience, as well as personal qualities such as sensitivity, self-insight, empathy and intuition were regarded as important when handling them.

Interviews with four nurses and fifteen emergency operators related to their experiences of working together for two years at an EMD-centre were conducted after the nurses were added to the EMD-centre to increase medical and nursing competence (IV). Initial frustration and scepticism changed to positive experiences with improved cooperation and service. The nurses voiced difficulties dealing with the more medically urgent calls and the emergency operators with the more complicated and diffuse medical cases.

A total of 336 questionnaires related to alarms involving acute chest pain and given the highest priority by the emergency operator were collected in a study aimed at describing the ambulance personnel’s perceptions of the quality of the information received from the EMD-centre (V). The ambulance personnel perceived most of the information such as patient assessment, condition, history, preparedness and in particular pain status to be of high quality.

In summary: In PEC there is many interdependent complexities that present demands and challenges to the actors involved (I–V). In general those who received emergency assistance from PEC were satisfied, but the margins between success and failure are small. Risks for errors exist throughout the PEC chain and time poses a challenge. Understanding is crucial for all involved, and the same situation can be experienced differently. Challenges inherent in PEC are the communication problems, unpredictability and uniqueness along with daring to be in the acute situation and dealing with a sense of aloneness, uncertainty and dependency. The personnel that do not have the ability to see the person they are helping are even more challenged. Important attributes for PEC personnel are caring attitudes, personal skills, experiences and professional knowledge. PEC personnel have the authority and power to act and make decisions, in which responsibility, sensitivity, and human dignity must be addressed. Lives are saved with PEC despite all the challenges and possibilities for error, such as those that exist between the different actors. It is vital that the PEC chain is as strong as possible.

Place, publisher, year, edition, pages
Örebro: Örebro universitetsbibliotek, 2007. p. 74
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 16
Keywords
challenge, prehospital, emergency, care, patient, spouse, personnel, chain, acute chest pain
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-1525 (URN)978-91-7668-554-9 (ISBN)
Public defence
2007-11-01, Wilandersalen, Universitetssjukhuset Örebro, Örebro, 13:00
Opponent
Supervisors
Available from: 2007-10-11 Created: 2007-10-11 Last updated: 2017-10-18Bibliographically approved
Forslund, K., Kihlgren, M. & Sørlie, V. (2006). Experiences of adding nurses to increase medical competence at an emergency medical dispatch centre. Accident and Emergency Nursing, 14(4), 230-236
Open this publication in new window or tab >>Experiences of adding nurses to increase medical competence at an emergency medical dispatch centre
2006 (English)In: Accident and Emergency Nursing, ISSN 0965-2302, E-ISSN 1532-9267, Vol. 14, no 4, p. 230-236Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Prehospital care begins when the call is placed to the emergency medical dispatch (EMD) centre and ends when the patient is cared for at the emergency department. The highly technical and specialized character demands advanced medical competence. Communication problems, serious and unpredictable situations can often occur during the emergency calls. A two-year intervention study involved the addition of registered nurses to an EMD-centre team to increase medical competence. AIM: To describe registered nurses' and emergency-operators' experiences of working together at an EMD-centre after adding registered nurses to increase medical competence. METHODS: Qualitative content analysis was used to analyse the text from interviews with four registered nurses and 15 emergency-operators involved in the intervention. RESULTS: Initial frustration and scepticism changed to more positive experiences that resulted in improved cooperation and service. The registered nurses had difficulties dealing with the more urgently acute calls, while the emergency-operators had difficulties with the more complicated, somewhat diffuse cases. The two professions complemented each other. CONCLUSION: Combining the registered nurses' and emergency-operators' knowledge and experience at an EMD-centre can perhaps improve the prehospital care for those requiring emergency medical care.

National Category
Social Sciences Interdisciplinary Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-5943 (URN)10.1016/j.aaen.2006.06.006 (DOI)
Available from: 2009-03-06 Created: 2009-03-06 Last updated: 2018-01-13Bibliographically approved
Kihlgren, A. & Forslund, K. (2006). Managements' perception of community nurses' decision making processes when refering older patients to an emergency department. Journal of Nursing Management, 14(6), 428-436, Article ID PMID16919120.
Open this publication in new window or tab >>Managements' perception of community nurses' decision making processes when refering older patients to an emergency department
2006 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 6, p. 428-436, article id PMID16919120Article, review/survey (Refereed) Published
Abstract [en]

In Sweden, older adults are living and being cared for under the responsibility of their respective community. Extensive reorganizations in the community led to management having different backgrounds, which may have caused uncertainty among community nurses, especially in decision-making processes. The aim was to understand how 10 nurses, 10 doctors and 10 home care assistants as leaders for the nurses conceptualized the decision-making processes of community nurses, when referring older persons to Emergency Departments, and whether perceptual differences and/or similarities exist. Narrative interviews and content analysis were performed. The managers had differing views, but all felt there was a need to feel secure in order to trust professional decisions as being correct, thus avoiding inappropriate referrals. Management could see nursesexposed position, but had varying solutions. This might lead to different messages being given regarding what is important and might explain why the nurses reported that the managers did not understand them.

Place, publisher, year, edition, pages
West Sussex, United Kingdom: Wiley-Blackwell, 2006
National Category
Medical and Health Sciences Nursing
Research subject
Caring sciences; Medicine
Identifiers
urn:nbn:se:oru:diva-45964 (URN)10.1111/j.1365-2934.2006.00642.x (DOI)16919120 (PubMedID)2-s2.0-33747062695 (Scopus ID)
Available from: 2015-09-30 Created: 2015-09-30 Last updated: 2017-12-01Bibliographically approved
Kihlgren, A., Forslund, K. & Fagerberg, I. (2006). Managements' perception of community nurses' decision-making processes when referring older adults to an emergency department. Journal of Nursing Management, 14(6), 428-436
Open this publication in new window or tab >>Managements' perception of community nurses' decision-making processes when referring older adults to an emergency department
2006 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 6, p. 428-436Article in journal (Refereed) Published
Abstract [en]

In Sweden, older adults are living and being cared for under the responsibility of their respective community. Extensive reorganizations in the community led to management having different backgrounds, which may have caused uncertainty among community nurses, especially in decision-making processes. The aim was to understand how 10 nurses, 10 doctors and 10 home care assistants as leaders for the nurses conceptualized the decision-making processes of community nurses, when referring older persons to Emergency Departments, and whether perceptual differences and/or similarities exist. Narrative interviews and content analysis were performed. The managers had differing views, but all felt there was a need to feel secure in order to trust professional decisions as being correct, thus avoiding inappropriate referrals. Management could see nurses' exposed position, but had varying solutions. This might lead to different messages being given regarding what is important and might explain why the nurses reported that the managers did not understand them.

National Category
Social Sciences Interdisciplinary Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-5942 (URN)10.1111/j.1365-2934.2006.00642.x (DOI)
Available from: 2009-03-06 Created: 2009-03-06 Last updated: 2018-01-13Bibliographically approved
Forslund, K., Kihlgren, M. & Sorlie, V. (2006). Theory and practice in nursing education: Five Aspects Meal Model (FAMM) : a tool for nursing practice and education?. In: Kirsten Beedholm, Niels Buus, Susanne Malchau, Inger Moos, Ulli Zeitler (Ed.), Theory and practice in nursing education: proceedings 2005. Paper presented at 4th International Research and Development Conference, Aarhus, 24 - 26 Aug 2005 (pp. 141--150). Århus, Danmark: The Center for Innovation in Nursing Education
Open this publication in new window or tab >>Theory and practice in nursing education: Five Aspects Meal Model (FAMM) : a tool for nursing practice and education?
2006 (English)In: Theory and practice in nursing education: proceedings 2005 / [ed] Kirsten Beedholm, Niels Buus, Susanne Malchau, Inger Moos, Ulli Zeitler, Århus, Danmark: The Center for Innovation in Nursing Education , 2006, p. 141--150Conference paper, Oral presentation only (Other academic)
Place, publisher, year, edition, pages
Århus, Danmark: The Center for Innovation in Nursing Education, 2006
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-6043 (URN)87-989918-9-2 (ISBN)
Conference
4th International Research and Development Conference, Aarhus, 24 - 26 Aug 2005
Available from: 2009-03-18 Created: 2009-03-18 Last updated: 2017-10-18Bibliographically approved
Organisations

Search in DiVA

Show all publications