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Holmström, Inger
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Publications (10 of 19) Show all publications
Röing, M. & Holmström, I. (2014). Involving patients in treatment decisions: a delicate balancing act for Swedish dentists. Health Expectations, 17(4), 500-510
Open this publication in new window or tab >>Involving patients in treatment decisions: a delicate balancing act for Swedish dentists
2014 (English)In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 17, no 4, p. 500-510Article in journal (Refereed) Published
Abstract [en]

Background: This study focuses on patients' participation in treatment decisions related to the delivery of oral health care in the social welfare state of Sweden. In 1985, the National Dental Service Act gave dental patients the right to take an active role in decisions regarding their treatment and, in doing so, strengthened them as consumers. Little is known how dentists in Sweden have adapted to this change.

Objective: This study explores how dentists in Sweden perceive and experience involving patients in dental treatment decisions.

Design: Data were collected from open-ended interviews with nineteen dentists, and an inductive qualitative content analysis was chosen to analyse the transcribed interviews.

Findings: Involving patients in treatment decisions appeared to be delicate balancing acts between the ideals of patient involvement and the reality of how it is practised in Sweden. These balancing acts in turn revealed obstacles to patient involvement and the role that economy can play on the decisions of some patients regarding their treatment.

Conclusions: This study has given insight into a relationship in which some dentists in Sweden find it hard to adapt to and change their professional role with patients who appear to act more as consumers. For these dentists, better practice of patient involvement may require adoption of a more consumerist approach. However, in situations where economy influences patients' treatment choices, the ideals of patient involvement may remain unattainable.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keywords
consumer; content analysis; dentist's professional role; informed decision making; professionals-as-agents; qualitative research approach; shared decision making; Sweden
National Category
Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-25585 (URN)10.1111/j.1369-7625.2012.00778.x (DOI)000340094700005 ()22512804 (PubMedID)2-s2.0-84904410087 (Scopus ID)
Funder
Swedish Research Council
Note

Funding Agency:

Faculty of Medicine, Uppsala University, Sweden

Available from: 2012-08-30 Created: 2012-08-30 Last updated: 2018-05-29Bibliographically approved
Holmström, I. K., Bastholm-Rahmner, P., Bernsten, C., Röing, M. & Björkman, I. (2014). Swedish teenagers and over-the-counter analgesics: Responsible, casual or careless use. Research in Social and Administrative Pharmacy, 10(2), 408-418
Open this publication in new window or tab >>Swedish teenagers and over-the-counter analgesics: Responsible, casual or careless use
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2014 (English)In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 10, no 2, p. 408-418Article in journal (Refereed) Published
Abstract [en]

Background: Teenagers in Sweden were given greater access as consumers of OTC drugs in 2009 after the reregulation of the pharmacy market, which allowed for the establishment of private pharmacies and sale of specific over-the-counter (OTC) drugs in retail stores and gas stations. Increased access to OTC drugs could provide new opportunities for self-care but attenuates the opportunity for the traditional expert surveillance of pharmacists, thus increasing the possibility of inappropriate OTC drug use.

Objectives: Views of 16-19 year old Swedish teenagers on OTC drugs, with special regard to analgesic drugs were explored and described, based on the following questions: How and where did they acquire their knowledge and attitudes regarding OTC drugs? What perceptions did they have about the use of OTC drugs?

Methods: A qualitative approach with a descriptive design was chosen. Data were collected in 2011 with 10 focus group discussions with high school students aged 16-19 years from different parts of Sweden. A total of 77 teenagers participated, 33 males and 44 females. A manifest qualitative content analysis was performed.

Results: While most teenagers appeared to have responsible attitudes toward OTC drugs and their use, some teenagers had attitudes that ranged from casual to careless. The focus group discussions also revealed knowledge gaps among teenagers regarding OTC drugs, and the significant influence of parents and peers on their OTC drug use.

Conclusions: This study provides insight into how vulnerable some teenagers could be as new consumers of OTC drugs and suggested that educational efforts could be geared toward parents as well as teenagers. (C) 2014 Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
New York: Elsevier, 2014
Keywords
Teenagers, OTC drugs, Analgesics, Sweden, Qualitative content analysis
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-34855 (URN)10.1016/j.sapharm.2013.06.004 (DOI)000332532000012 ()
Available from: 2014-04-28 Created: 2014-04-25 Last updated: 2018-06-05Bibliographically approved
Larsson, J. & Holmström, I. (2013). How excellent anaesthetists perform in the operating theatre: a qualitative study on non-technical skills. British Journal of Anaesthesia, 110(1), 115-121
Open this publication in new window or tab >>How excellent anaesthetists perform in the operating theatre: a qualitative study on non-technical skills
2013 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 110, no 1, p. 115-121Article in journal (Refereed) Published
Abstract [en]

Background Teaching trainees to become competent professionals who can keep the complex system of anaesthesia safe is important. From a safety point of view, non-technical skills such as smooth cooperation and good communication deserve as much attention as theoretical knowledge and practical skills, which by tradition have dominated training programmes in anaesthesiology. This study aimed to describe the way excellent anaesthetists act in the operating theatre, as seen by experienced anaesthesia nurses.                                                                                                     

Methods The study had a descriptive and qualitative design. Five focus group interviews with three or four experienced Swedish anaesthesia nurses in each group were conducted. Interviews were analysed by using a qualitative method, looking for common themes.                                                                                                                  

Results Six themes were found: (A) structured, responsible, and focused way of approaching work tasks; (B) clear and informative, briefing the team about the action plan before induction; (C) humble to the complexity of anaesthesia, admitting own fallibility; (D) patient-centred, having a personal contact with the patient before induction; (D) fluent in practical work without losing overview; and (F) calm and clear in critical situations, being able to change to a strong leading style.                                                                                                                  

Conclusions Experienced anaesthesia nurses gave nuanced descriptions of how excellent anaesthetists behave and perform. These aspects of the anaesthetist's work often attract too little attention in specialist training, notwithstanding their importance for safety and fluency at work. Creating role models based on studies like the present one could be one way of increasing safety in anaesthesia.   

Place, publisher, year, edition, pages
Oxford University Press, 2013
National Category
Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-25587 (URN)10.1093/bja/aes359 (DOI)000312639000019 ()23048067 (PubMedID)2-s2.0-84871181333 (Scopus ID)
Note

Funding Agency:

Faculty of Medicine at Uppsala University

Available from: 2012-08-30 Created: 2012-08-30 Last updated: 2017-12-07Bibliographically approved
Lannerstrom, L., Wallman, T. & Holmström, I. K. (2013). Losing independence: the lived experience of being long-term sick-listed. BMC Public Health, 13(745), 1-10
Open this publication in new window or tab >>Losing independence: the lived experience of being long-term sick-listed
2013 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, no 745, p. 1-10Article in journal (Refereed) Published
Abstract [en]

Background: Sickness absence is a multifaceted problem. Much is known about risk factors for being long-term sick-listed, but there is still little known about the various aftermaths and experiences of it. The aim of this qualitative study was to describe, analyze and understand long-term sickness-absent people's experiences of being sick-listed.

Methods: The design was descriptive and had a phenomenological approach. Sixteen long-term sickness-absent individuals were purposively sampled from three municipalities in Sweden in 2011, and data were collected through semi-structured, individual interviews. The interview questions addressed how the participants experienced being sick-listed and how the sick-listing affected their lives. Transcribed interviews were analysed using Giorgi's phenomenological method.

Results: The interviews revealed that the participants' experiences of being sick-listed was that they lost their independence in the process of stepping out of working society, attending the mandatory steps in the rehabilitation chain and having numerous encounters with professionals. The participants described that their life-worlds were radically changed when they became sick-listed. Their experiences of their changing life-worlds were mostly highly negative, but there were also a few positive experiences. The most conspicuous findings were the fact that stopping working brought with it so many changes, the participants' feelings of powerlessness in the process, and their experiences of offensive treatment by and/or encounters with professionals.

Conclusions: Sick-listed persons experienced the process of being on long-term sickness absent as very negative. The negative experiences are linked to consequences of stopping to work, consequences of social insurance rules and to negative encounters with professionals handling the sickness absence. The positive experiences of being sick-listed were few in the present study. There is a need to further examine the extent of these negative experiences are and how they affect sick-listed people's recovery and return to work. Long-term sickness absence; sick leave; experiences; interviews; phenomenology; Sweden.

National Category
Medical and Health Sciences Occupational Health and Environmental Health
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-30790 (URN)10.1186/1471-2458-13-745 (DOI)000323311900001 ()23938128 (PubMedID)
Available from: 2013-09-13 Created: 2013-09-13 Last updated: 2019-03-05Bibliographically approved
Ewertsson, M., Allvin, R., Holmström, I. & Blomberg, K. (2013). Nurse students’ experiences of learning in clinical skills laboratory: the bridge between university and clinical settings. In: Nordic Conference on Advances in Health Care Sciences Research 2013: . Paper presented at Nordic Conference on Advances in Health Care Sciences Research, 13-14 november, 2013, Lund.
Open this publication in new window or tab >>Nurse students’ experiences of learning in clinical skills laboratory: the bridge between university and clinical settings
2013 (English)In: Nordic Conference on Advances in Health Care Sciences Research 2013, 2013Conference paper, Oral presentation with published abstract (Refereed)
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-41713 (URN)
Conference
Nordic Conference on Advances in Health Care Sciences Research, 13-14 november, 2013, Lund
Available from: 2015-01-15 Created: 2015-01-15 Last updated: 2019-04-09Bibliographically approved
Röing, M., Rosenqvist, U. & Holmstrom, I. K. (2013). Threats to patient safety in telenursing as revealed in Swedish telenurses' reflections on their dialogues. Scandinavian Journal of Caring Sciences, 27(4), 969-976
Open this publication in new window or tab >>Threats to patient safety in telenursing as revealed in Swedish telenurses' reflections on their dialogues
2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 969-976Article in journal (Refereed) Published
Abstract [en]

Telenursing is a rapidly expanding actor in the Swedish healthcare system, as in other Western nations. Although rare, tragic events occur within this context, and are reminders of the importance of giving patient safety the highest priority. As telenurses' main sources of information are their dialogues with the callers, the provision of safe care can depend on the quality of this dialogue.

The aim of this study was to identify issues that could threaten patient safety in telenurses' dialogues with callers. As part of an educational intervention, a researcher visited a sample of six telenurses five to six times at their workplace to listen to and discuss, together with the telenurses, their dialogues with callers in stimulated recall sessions. Each call and the following discussion between researcher and telenurse was tape-recorded and transcribed as text, resulting in a total of 121 calls. Qualitative content analysis of the reflections and following discussions revealed that threats to patient safety could be related to the surrounding society, to the organisation of telenursing, to the telenurse and to the caller.

This study gives insight into significant problem areas that can affect patient safety in telenursing in Sweden. Issues that need to be focused on in telenursing educational programmes and future research are suggested, as well as the need for organisational development.

Keywords
telenursing, communication, patient safety, qualitative content analysis, Sweden
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:oru:diva-33286 (URN)10.1111/scs.12016 (DOI)000328140200023 ()23289826 (PubMedID)
Available from: 2014-01-24 Created: 2014-01-24 Last updated: 2017-12-06Bibliographically approved
Larsson, J. & Knutsson Holmström, I. (2012). Fenomenografi (1ed.). In: Maria Henricson (Ed.), Vetenskaplig teori och metod: från idé till examination inom omvårdnad (pp. 389-405). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Fenomenografi
2012 (Swedish)In: Vetenskaplig teori och metod: från idé till examination inom omvårdnad / [ed] Maria Henricson, Lund: Studentlitteratur AB, 2012, 1, p. 389-405Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2012 Edition: 1
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-26890 (URN)978-91-44-07135-0 (ISBN)
Available from: 2013-01-16 Created: 2013-01-16 Last updated: 2017-10-18Bibliographically approved
Ernesäter, A., Winblad, U., Engström, M. & Holmström, I. K. (2012). Malpractice claims regarding calls to Swedish telephone advice nursing: what went wrong and why?. Journal of Telemedicine and Telecare, 18(7), 379-383
Open this publication in new window or tab >>Malpractice claims regarding calls to Swedish telephone advice nursing: what went wrong and why?
2012 (English)In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 18, no 7, p. 379-383Article in journal (Refereed) Published
Abstract [en]

We analysed the characteristics of all malpractice claims arising out of telephone calls to Swedish Healthcare Direct (SHD) during 2003-2010 (n = 33). The National Board of Health and Welfare's (NBHW) investigations describing the causes of the malpractice claims and the healthcare providers' reported measures were analysed using Qualitative Content Analysis. The original telephone calls themselves, which had been recorded, were analysed using the Roter Interaction Analysis System (RIAS). Among the 33 cases, 13 patients died and 12 were admitted to intensive care. Failure to listen to the caller (n = 12) was the most common reason for malpractice claims, and work-group discussion (n = 13) was the most common measure taken to prevent future re-occurrence. Male patients (n = 19) were in the majority, and females (n = 24) were the most common callers. The most common symptoms were abdominal (n = 11) and chest pain (n = 6). Telenurses followed up on caller understanding in six calls, and mainly used closed-ended questions. Despite the severity of these malpractice claims, the measures taken mainly addressed active failure, rather than the latent conditions. Third-party communication should be regarded as a risk. When callers make repeated contacts, telenurses need to re-evaluate their need for care.

Place, publisher, year, edition, pages
London, United Kingdoms: Sage Publications, 2012
National Category
Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-25558 (URN)10.1258/jtt.2012.120416 (DOI)000311522300003 ()22923361 (PubMedID)2-s2.0-84868326380 (Scopus ID)
Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2018-05-10Bibliographically approved
Larsson, J. & Holmström, I. (2012). Understanding anesthesia training and trainees. Current Opinion in Anaesthesiology, 25(6), 681-685
Open this publication in new window or tab >>Understanding anesthesia training and trainees
2012 (English)In: Current Opinion in Anaesthesiology, ISSN 0952-7907, E-ISSN 1473-6500, Vol. 25, no 6, p. 681-685Article in journal (Refereed) Published
Abstract [en]

Purpose of review: Patient safety is topical today. Competent professionals are necessary to keep anesthesia care safe, and teaching trainees is an important element in safety work. The purpose of this review is to present the latest research on anesthesia training and trainees.

Recent findings: Most trainees of today aim for excellence, for which personal qualities are as important as knowledge and skills. The definition of excellence is the first subject covered here. Trainees of today can train many procedural skills in a simulators setting, a step forward for patient safety. Several studies about simulator training are reported. A dimension of competence that has received much attention during the last years is anesthesiologists' nontechnical skills. Studies on anesthesiologists' nontechnical skills as a valuable tool for assessing trainees' progress in nontechnical skills are presented.

Summary: Much research about anesthesia training concerns simulator training and assessment of trainees' competence. More research is needed to understand the process of learning anesthesia.

Place, publisher, year, edition, pages
Philadelphia, USA: Lippincott Williams & Wilkins, 2012
Keywords
Anesthesiology, education, professional, professional competence
National Category
Nursing
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-25586 (URN)10.1097/ACO.0b013e328358e3c6 (DOI)000311030900009 ()23026803 (PubMedID)2-s2.0-84870255565 (Scopus ID)
Available from: 2012-08-30 Created: 2012-08-30 Last updated: 2017-12-07Bibliographically approved
Arving, C. & Holmström, I. (2011). Creating a new profession in cancer nursing?: Experiences of working as a psychosocial nurse in cancer care. Journal of Clinical Nursing, 20(19-20), 2939-2947
Open this publication in new window or tab >>Creating a new profession in cancer nursing?: Experiences of working as a psychosocial nurse in cancer care
2011 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 19-20, p. 2939-2947Article in journal (Refereed) Published
Abstract [en]

AIMS: To describe the nature of being a psychosocial nurse in cancer care.

BACKGROUND: Psychosocial nurses in cancer care are a new profession in cancer nursing in Sweden, with potential to offer unique support to patients regarding somatic and psychological needs. This new profession is hitherto unexplored.

DESIGN: A qualitative inductive interview approach was used.

METHODS: A strategic sample of five nurses working as psychosocial nurses in cancer care in Sweden was interviewed. A thematic stepwise analysis was performed.

RESULTS: The analysis revealed the twofold experience of being a psychosocial nurse in cancer care. The nurses felt as if they had two professions: nurse and therapist. They used skills from both professions to help the person, who had cancer and a psychosocial problem. It was stimulating to be able to combine the knowledge and practices of two professions. It was also difficult because they felt an uncertainty about what their roles and responsibilities really were.

CONCLUSIONS: This new profession seems to need role descriptions and formal education so that psychosocial nurses receive respect and appreciation in their new and relatively unknown work in cancer care. RELEVANCE TO CLINICAL PRACTICES: The adjustment to the cancer disease and treatment side effects can be difficult for the patients and their families, which has highlighted the need for psychosocial support. To meet this need the health care system has to provide such support. Nurses are available and can be successfully educated to handle psychosocial problems among cancer patients. A new profession among nurses is emerging, which the present study aimed at describing. The present findings have potential to make healthcare professionals grasp what the core of psychosocial cancer nursing is, as well as its potential and pitfalls.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2011
Keywords
cancer care; new profession; psychosocial nurse; qualitative study; working experience
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-25561 (URN)10.1111/j.1365-2702.2011.03709.x (DOI)000295096700026 ()21366744 (PubMedID)2-s2.0-80052564955 (Scopus ID)
Funder
Swedish Cancer SocietySwedish Research Council
Note

Funding Agency:

Uppsala University

Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2018-09-06Bibliographically approved
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