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Gifford, Mervyn
Publications (10 of 22) Show all publications
Hugelius, K., Adolfsson, A., Örtenwall, P. & Gifford, M. (2017). Being Both Helpers and Victims: Health Professionals' Experiences of Working During a Natural Disaster. Prehospital and Disaster Medicine, 32(2), 117-123
Open this publication in new window or tab >>Being Both Helpers and Victims: Health Professionals' Experiences of Working During a Natural Disaster
2017 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 32, no 2, p. 117-123Article in journal (Refereed) Published
Abstract [en]

Background: In November 2013, the Haiyan typhoon hit parts of the Philippines. The typhoon caused severe damage to the medical facilities and many injuries and deaths. Health professionals have a crucial role in the immediate disaster response system, but knowledge of their experiences of working during and in the immediate aftermath of a natural disaster is limited. Aim The aim of this study was to explore health professionals' experiences of working during and in the immediate aftermath of a natural disaster.

Method: Eight health professionals were interviewed five months after the disaster. The interviews were analyzed using phenomenological hermeneutic methods.

Results: The main theme, being professional and survivor, described both positive and negative emotions and experiences from being both a helper, as part of the responding organization, and a victim, as part of the surviving but severely affected community. Sub-themes described feelings of strength and confidence, feelings of adjustment and acceptance, feelings of satisfaction, feelings of powerless and fear, feelings of guilt and shame, and feelings of loneliness.

Conclusion: Being a health professional during a natural disaster was a multi-faceted, powerful, and ambiguous experience of being part of the response system at the same time as being a survivor of the disaster. Personal values and altruistic motives as well as social aspects and stress-coping strategies to reach a balance between acceptance and control were important elements of the experience. Based on these findings, implications for disaster training and response strategies are suggested. Hugelius K , Adolfsson A , Örtenwall P , Gifford M . Being both helpers and victims: health professionals' experiences of working during a natural disaster.

Place, publisher, year, edition, pages
New York, USA: Cambridge University Press, 2017
Keywords
disaster medicine; disasters; health professionals; phenomenological hermeneutic method; relief work
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-54391 (URN)10.1017/S1049023X16001412 (DOI)000398228600002 ()28043240 (PubMedID)2-s2.0-85007572037 (Scopus ID)
Note

Funding Agencies:

Fortifikationsföreningens Forskningsfond (Foundation of Fortification-Related Research)

Örebro County Council Research Committee (Örebro, Sweden)

Available from: 2017-02-07 Created: 2017-01-10 Last updated: 2017-10-18Bibliographically approved
Rasoal, D., Skovdahl, K., Gifford, M. & Kihlgren, A. (2017). Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review. HEC Forum, 29(4), 313-346
Open this publication in new window or tab >>Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review
2017 (English)In: HEC Forum, ISSN 0956-2737, E-ISSN 1572-8498, Vol. 29, no 4, p. 313-346Article, review/survey (Refereed) Published
Abstract [en]

This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different coun-tries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a ‘‘bot-tom-up’’ perspective might give healthcare personnel opportunities to think and reflect more than a ‘‘top-down’’ perspective. A ‘‘bottom-up’’ approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a ‘‘top-down’’ approach risks removing such moral responsibility.

Place, publisher, year, edition, pages
Dordrecht, Netherlands: Springer, 2017
Keywords
Ethics, health personnel, moral case deliberation, ethics consultation, ethics committees, ethics rounds, ethical reflection
National Category
Medical and Health Sciences Medical Ethics
Identifiers
urn:nbn:se:oru:diva-64288 (URN)10.1007/s10730-017-9325-4 (DOI)000415616200004 ()28600658 (PubMedID)2-s2.0-85020624322 (Scopus ID)
Funder
Stiftelsen Olle Engkvist Byggmästare
Note

Funding Agency:

Örebro University

Available from: 2018-01-16 Created: 2018-01-16 Last updated: 2019-04-10Bibliographically approved
Hugelius, K., Gifford, M., Örtenwall, P. & Adolfsson, A. (2017). Health among disaster survivors and health professionals after the Haiyan Typhoon: a self-selected Internet-based web survey. International Journal of Emergency Medicine, 10(1), Article ID 13.
Open this publication in new window or tab >>Health among disaster survivors and health professionals after the Haiyan Typhoon: a self-selected Internet-based web survey
2017 (English)In: International Journal of Emergency Medicine, ISSN 1865-1372, E-ISSN 1865-1380, Vol. 10, no 1, article id 13Article in journal (Refereed) Published
Abstract [en]

Background: Natural disasters affected millions of people worldwide every year. Evaluation of disaster health and health response interventions is faced with several methodological challenges. This study aimed (1) to describe survivors' and health professionals' health, 30 months after a natural disaster using a web-based self-selected Internet sample survey designed and (2) to evaluate the health effects of disaster response interventions, in the present study with a focus on disaster radio.

Methods: A web-based survey was used to conduct a cross-sectional study approximately 30 months after typhoon Haiyan. The GHQ-12, EQ-5D-3L, and EQ-VAS instruments were used in addition to study-specific questions. A self-selected Internet sample was recruited via Facebook.

Results: In total, 443 survivors, from what 73 were health professionals, participated in the study. The Haiyan typhoon caused both physical and mental health problems as well as social consequences for the survivors. Mental health problems were more frequently reported than physical injuries. Health professionals reported worse overall health and a higher frequency of mental health problems compared to other survivors.

Conclusions: There were short-term and long-term physical, psychological, and social consequences for the survivors as a result of the Haiyan typhoon. Mental health problems were more frequently reported and lasted longer than physical problems. Health professionals deployed during the disaster reported worse health, especially concerning mental health problems. The survey used was found useful to describe health after disasters. Keywords: Disaster, Natural disaster, Disaster medicine, Disaster response, Mental health, Health professionals

Place, publisher, year, edition, pages
Springer London, 2017
Keywords
Disaster, Natural disaster, Disaster medicine, Disaster response, Mental health, Health professionals
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-56979 (URN)10.1186/s12245-017-0139-6 (DOI)000397596400001 ()28357722 (PubMedID)2-s2.0-85016604249 (Scopus ID)
Note

Funding Agencies:

Region Örebro County Council 

Lars Hiertas Minnesfond

Örebro University

Available from: 2017-04-10 Created: 2017-04-10 Last updated: 2017-10-12Bibliographically approved
Kihlgren, A., Svensson, F., Lövbrand, C., Gifford, M. & Adolfsson, A. (2016). A Decision support system (DSS) for municipal nurses encountering health deterioration among older people. BMC Nursing, 15, Article ID 63.
Open this publication in new window or tab >>A Decision support system (DSS) for municipal nurses encountering health deterioration among older people
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2016 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 15, article id 63Article in journal (Refereed) Published
Abstract [en]

Backgrund: This study is part of a larger project called ViSam and includes testing of a decision support system developed and adapted for older people on the basis of M (R) ETTS (Rapid Emergency Triage and Treatment System). The system is designed to allow municipal nurses to determine the optimal level of care for older people whose health has deteriorated. This new system will allow more structured assessment, the patient should receive optimal care and improved data transmission to the next caregiver.

Methods: This study has an explanatory approach, commencing with quantitative data collection phase followed by qualitative data arising from focus group discussions over the RNs professional experience using the Decision Support system. Focus group discussions were performed to complement the quantitative data to get a more holistic view of the decision support system.

Results: Using elements of the decision support system (vital parameters for saturation, pain and affected general health) together with the nurses' decision showed that 94 % of the older persons referred to hospital were ultimately hospitalized. Nurses felt that they worked more systematically, communicated more effectively with others and felt more professional when using the decision support system.

Conclusions: The results of this study showed that, with the help of a decision support system, the correct patients are sent to the Emergency Department from municipal home care. Unnecessary referrals of older patients that might lead to poorer health, decreased well-being and confusion can thus be avoided. Using the decision support system means that healthcare co-workers (nurses, ambulance/emergency department/district doctor/SOS alarm) begin to communicate more optimally. There is increased understanding leading to the risk of misinterpretation being reduced and the relationship between healthcare co-workers is improved. However, the decision support system requires more extensive testing in order to enhance the evidence base relating to the vital parameters among older people and the use of the decision support system.

Place, publisher, year, edition, pages
London, United Kingdom: BioMed Central, 2016
Keywords
Elderly, Emergency care, Decision-making, Nursing homes and referral
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-53490 (URN)10.1186/s12912-016-0184-0 (DOI)000387609500001 ()27833455 (PubMedID)2-s2.0-84994497582 (Scopus ID)
Note

This paper present independent researcher funded by the Region Örebro lanand ViSam project, Örebro municipal and The Faculty of Medicine at Örebro University.

Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-07-17Bibliographically approved
Hugelius, K., Gifford, M., Örtenwall, P. & Adolfsson, A. (2016). Disaster Radio for Communication of Vital messages and Health-related Information: Experiences from the Haiyan typhoon, The Philippines. Disaster Medicine and Public Health Preparedness, 10(4), 591-597
Open this publication in new window or tab >>Disaster Radio for Communication of Vital messages and Health-related Information: Experiences from the Haiyan typhoon, The Philippines
2016 (English)In: Disaster Medicine and Public Health Preparedness, ISSN 1935-7893, Vol. 10, no 4, p. 591-597Article in journal (Refereed) Published
Abstract [en]

Objective: Crisis communication is seen as an integrated and essential part of disaster management measures. After Typhoon Haiyan (Yolanda) in the Philippines 2013, radio was used to broadcast information to the affected community. The aim of this study was to describe how disaster radio was used to communicate vital messages and health-related information to the public in one affected region after Typhoon Haiyan.

Methods: Mixed-methods analysis using qualitative content analysis and descriptive statistics was used to analyze 2587 logged radio log files.

Results: Radio was used to give general information and to demonstrate the capability of officials to manage the situation, to encourage, to promote recovery and foster a sense of hope, and to give practical advice and encourage self-activity. The content and focus of the messages changed over time. Encouraging messages were the most frequently broadcast messages. Health-related messages were a minor part of all information broadcast and gaps in the broadcast over time were found.

Conclusion: Disaster radio can serve as a transmitter of vital messages including health-related information and psychological support in disaster areas. The present study indicated the potential for increased use. The perception, impact, and use of disaster radio need to be further evaluated.

Place, publisher, year, edition, pages
New York, USA: Cambridge University Press, 2016
Keywords
Communication, disaster, natural disasters, health communication, psychosocial support
National Category
Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-47270 (URN)10.1017/dmp.2015.188 (DOI)000381283000015 ()26940871 (PubMedID)2-s2.0-84960112370 (Scopus ID)
Available from: 2016-01-01 Created: 2016-01-01 Last updated: 2017-10-18Bibliographically approved
Biswas, A., Dalal, K., Abdullah, A. S., Gifford, M. & Halim, M. (2016). Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study. F1000 Research, 5, Article ID 2417.
Open this publication in new window or tab >>Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study
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2016 (English)In: F1000 Research, E-ISSN 2046-1402, Vol. 5, article id 2417Article in journal (Refereed) Published
Abstract [en]

Background: Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community.

Methods: The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed.

Results: The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications. There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment.

Conclusions: The rural community lacks adequate knowledge on maternal complications. Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths.

Place, publisher, year, edition, pages
London, United Kingdom: Faculty of 1000 Ltd., 2016
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:oru:diva-54776 (URN)10.12688/f1000research.9445.1 (DOI)27853517 (PubMedID)
Available from: 2017-01-17 Created: 2017-01-17 Last updated: 2018-10-08Bibliographically approved
Hugelius, K., Adolfsson, A., Gifford, M. & Örtenwall, P. (2016). Social media can be used to recruit study participants in disaster research. In: : . Paper presented at 2nd Global Conference on Emergency Nursing & Trauma Care, Sitges, Spain, 22-24 September, 2016.
Open this publication in new window or tab >>Social media can be used to recruit study participants in disaster research
2016 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-52945 (URN)
Conference
2nd Global Conference on Emergency Nursing & Trauma Care, Sitges, Spain, 22-24 September, 2016
Available from: 2016-10-13 Created: 2016-10-13 Last updated: 2017-10-18Bibliographically approved
Dalal, K., Rahman, F., Gifford, M. & Rahman, A. (2016). The magnitude of injury problems among child labourers in a rural community of Bangladesh: findings from an injury surveillance system. International Health, 8(1), 73-76
Open this publication in new window or tab >>The magnitude of injury problems among child labourers in a rural community of Bangladesh: findings from an injury surveillance system
2016 (English)In: International Health, ISSN 1876-3405, Vol. 8, no 1, p. 73-76Article in journal (Refereed) Published
Abstract [en]

Background: Child labour is an important topic in contemporary society. In this study we have tried to explore the magnitude of injury problems among child labourers in Bangladesh using an injury surveillance system.

Methods: An injury surveillance system (ISS) was performed under the Prevention of Child Injuries through Social intervention and Education (PRECISE) project in Bangladesh during 2006–2010 in three sub-districts covering a population of more than 700 000. We used the ISS for assessing child labour. Appropriate epidemiological methods were considered in the study.

Results: Considering the reported main occupation of the children, 30% of children from the surveillance households were identified as child labourers. More than two thirds of child labourers were educated to primary or secondary level. The majority of boys worked as unskilled labourers and girls were employed in domestic work. The incidence of injury and deaths among child labourers was estimated as 24 per 100 000 children years. More than 19 injury related illnesses of moderate to severe intensity were found among 1000 child labourers in a year. Fractures, sprains, dislocations, cuts/wounds, animal bites, abrasions or lacerations, burns, head injuries and internal organ injuries are most common among child labourers.

Conclusions:Working children are at risk of injury, death and illness in Bangladesh. Child labourers are now even more clearly tied to quantified morbidity and mortality.

Place, publisher, year, edition, pages
Oxford, United Kingdom: Oxford University Press, 2016
Keywords
Bangladesh, child labour, injury, morbidity, mortality
National Category
Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:oru:diva-47968 (URN)10.1093/inthealth/ihv026 (DOI)000369224200012 ()25935871 (PubMedID)
Note

Funding Agency:

Swedish Research Link Program VR348-2009-6532

Available from: 2016-02-04 Created: 2016-02-04 Last updated: 2018-07-09Bibliographically approved
Hugelius, K., Gifford, M., Örtenwall, P. & Adolfsson, A. (2016). ”The turning point of everything”: Health professionals experiences of working during a natural disaster. In: : . Paper presented at 2nd Global Conference on Emergency Nursing & Trauma Care, Sitges, Spain, 22-24 September, 2016.
Open this publication in new window or tab >>”The turning point of everything”: Health professionals experiences of working during a natural disaster
2016 (English)Conference paper, Oral presentation only (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-52944 (URN)
Conference
2nd Global Conference on Emergency Nursing & Trauma Care, Sitges, Spain, 22-24 September, 2016
Available from: 2016-10-13 Created: 2016-10-13 Last updated: 2018-07-17Bibliographically approved
Hugelius, K., Gifford, M., Örtenwall, P. & Adolfsson, A. (2016). "To silence the deafening silence": Survivor's needs and experiences of the impact of disaster radio for their recovery after a natural disaste. International Emergency Nursing, 28, 8-13
Open this publication in new window or tab >>"To silence the deafening silence": Survivor's needs and experiences of the impact of disaster radio for their recovery after a natural disaste
2016 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 28, p. 8-13Article in journal (Refereed) Published
Abstract [en]

In the aftermath of the Haiyan typhoon, disaster radio was used to spread information and music to the affected population. The study described survivors' experiences of being in the immediate aftermath of a natural disaster and the impact disaster radio made on recovery from the perspective of the individuals affected. Twenty eight survivors were interviewed in focus groups and individual interviews analyzed with phenomenological-hermeneutic method. Being in disaster mode included physical and psychosocial dimensions of being in the immediate aftermath of the disaster. Several needs among the survivors were expressed. Disaster radio contributed to recovery by providing facts and information that helped the survivor to understand and adapt. The music played contributed to emotional endurance and reduced feelings of loneliness. To re-establish social contacts, other interventions are needed. Disaster radio is a positive contribution to the promotion of survivors' recovery after disasters involving a large number of affected people and severely damaged infrastructure. Further studies on the use and impact of disaster radio are needed.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Disaster, needs, psychosocial support, radio, recovery, biopsychosocial model
National Category
Nursing
Research subject
Caring sciences; Medicine
Identifiers
urn:nbn:se:oru:diva-47268 (URN)10.1016/j.ienj.2015.11.009 (DOI)000383526700002 ()26724170 (PubMedID)
Available from: 2016-01-01 Created: 2016-01-01 Last updated: 2017-12-01Bibliographically approved
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