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  • 1. Båtelson, Karin
    et al.
    Engström, Ingemar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Petersson, Göran
    Replik till Hans Wingstrand et al angående vårdens IT-system [Reply to Hans Wingstrand et al regarding healthcare IT systems]: "Viktigt med avvägning mellan patientsäkerhet och integritet" ["Important to balance patient safety and privacy"]2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, article id DD9CArticle in journal (Refereed)
  • 2.
    de Snoo-Trimp, Janine
    et al.
    VU University Medical Centre, Department of Medical Humanities and the Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
    Widdershoven, Guy
    VU University Medical Centre, Department of Medical Humanities and the Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
    Svantesson, Mia
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center, Region Örebro County, Örebro, Sweden; Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
    de Vet, Riekie
    Department of Medical Humanities, VU University Medical Centre, Amsterdam, Netherlands; Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
    Molewijk, Bert
    Department of Medical Humanities, VU University Medical Centre, Amsterdam, Netherlands; Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
    What Outcomes do Dutch Healthcare Professionals Perceive as Important Before Participation in Moral Case Deliberation?2017In: Bioethics, ISSN 0269-9702, E-ISSN 1467-8519, Vol. 31, no 4, p. 246-257Article in journal (Refereed)
    Abstract [en]

    Background: There has been little attention paid to research on the outcomes of clinical ethics support (CES) or critical reflection on what constitutes a good CES outcome. Understanding how CES users perceive the importance of CES outcomes can contribute to a better understanding, use of and normative reflection on CES outcomes.

    Objective: To describe the perceptions of Dutch healthcare professionals on important outcomes of moral case deliberation (MCD), prior to MCD participation, and to compare results between respondents.

    Methods: This mixed-methods study used both the Euro-MCD instrument and semi-structured interviews. Healthcare professionals who were about to implement MCD were recruited from nursing homes, hospitals, psychiatry and mentally disabled care institutions.

    Results: 331 healthcare professionals completed the Euro-MCD instrument, 13 healthcare professionals were interviewed. The outcomes perceived as most important were more open communication', better mutual understanding', concrete actions', see the situation from different perspectives', consensus on how to manage the situation' and find more courses of action'. Interviewees also perceived improving quality of care, professionalism and the organization as important. Women, nurses, managers and professionals in mentally disabled care rated outcomes more highly than other respondents.

    Conclusions: Dutch healthcare professionals perceived the MCD outcomes related to collaboration as most important. The empirical findings can contribute to shared ownership of MCD and a more specific use of MCD in different contexts. They can inform international comparative research on different CES types and contribute to normative discussions concerning CES outcomes. Future studies should reflect upon important MCD outcomes after having experienced MCD.

  • 3.
    Engström, Ingemar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ingemar Engström, Svenska Läkaresällskapet [Ingemar Engström, Swedish Society of Medicine]: [Plånboken bör inte få avgöra tillgång till nya effektiva läkemedel The wallet should not determine access to new and effective drugs]2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, article id DEU6Article in journal (Refereed)
  • 4.
    Engström, Ingemar
    et al.
    Örebro University, School of Medical Sciences. Universitetssjukvårdens forskningscent­rum (UFC), Region Örebro County, Örebro, Sweden.
    Bengtsson, Saskia
    Mobila geriatriska teamet, Länssjukhuset Ryhov, Jönköping, Sweden.
    Vården börjar alltid med mötet2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, no 42, article id ERRMArticle in journal (Refereed)
    Abstract [sv]

    Patient care always starts with an encounter Being a doctor is essentially a moral enterprise and all kinds of care begin with the encounter with the patient. This encounter occurs at the intersection of the patient's need for assistance and the doctor's professional knowledge. The meeting can be characterised by paternalism, autonomy or participation. It is important to regard the patient as a person and explore his or her perceptions, apprehensions and expectations early in the meeting. All decisions in medicine rely on both facts and values. It is, therefore, important that both the doctor's and the patient's values and preferences are out in the open. The medical encounter is always asymmetrical, which necessitates that the power perspective be acknowledged.

  • 5.
    Engström, Ingemar
    et al.
    Psykiatriskt forskningscentrum, Örebro, Sweden.
    Lynøe, Niels
    Centrum för hälso-och sjukvårdsetik, Karolinska institutet, Stockholm, Sweden.
    Tio myter att avliva om medicinsk etik2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 40, p. 2419-21Article in journal (Refereed)
  • 6.
    Engström, Ingemar
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ågård, Anders
    Etiken och juridiken tydlig kring livsuppehållande behandling [Ethics and jurisprudence concerning life-sustaining treatment is clear]2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, article id DSCWArticle in journal (Refereed)
  • 7.
    Engström, Ingemar
    et al.
    Universitetssjukvårdens forskningscentrum, Region Örebro Län, Örebro, Sverige.
    Ågård, Anders
    Sahlgrenska universitetssjukhuset, Göteborg, Sverige.
    Läkarens viktiga möte med patienten2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, article id ESC3Article in journal (Refereed)
  • 8.
    Hansson, Anders
    et al.
    Research Unit and Section for General Practice, FoUU-centrum i Fyrbodal, Vänersborg, Sweden.
    Brodersen, John
    Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
    Reventlow, Susanne
    Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
    Pettersson, Monica
    Department of Vascular Surgery, Sahlgrenska University Hospital, Gothenburg, sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Opening Pandora's box: The experiences of having an asymptomatic aortic aneurysm under surveillance2012In: Health, Risk and Society, ISSN 1369-8575, E-ISSN 1469-8331, Vol. 14, no 4, p. 341-359Article in journal (Refereed)
    Abstract [en]

    Abdominal aortic aneurysm (AAA) is a ballooning-out of the aorta that does not normally give any symptoms. Undetected and untreated an aortic aneurysm can rupture, which in most cases is fatal. Mass screening of 65-year old men for the early detection of AAA and, in selected cases, operation seem to reduce mortality due to rupture, although, screening has not reduced the overall mortality in this group. In Västra Götaland, the southwest part of Sweden, screening for AAA amongst 65-year old men started in 2009. There are controversies within the medical community about the benefits and adverse effects of screening. In order to explore men's experiences of being screened and knowing they had an aortic aneurysm, we undertook a qualitative interview study with 15 men who in the screening programme were identified as having an aortic aneurysm and who were to be followed-up with annual ultrasonic examinations for an indeterminate number of years. The interviews were analysed for categories and themes using content analysis. The study found that the men were ambivalent about the knowledge that they had an AAA and about the follow-up monitoring. They appreciated having the knowledge but it was accompanied by worry, feelings of anxiety and existential thoughts about the fragility and finiteness of life. We recommend that before a screening programme is implemented, the psycho-social consequences should be thoroughly investigated. Participants should be given adequate and understandable information about the consequences of screening so that they can make an informed choice whether to participate or not.

  • 9.
    Heidenreich, Kaja
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Bremer, Anders
    Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden; PreHospen - Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Materstvedt, Lars Johan
    Department of Philosophy and Religious Studies, Faculty of Humanities, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Glasgow End of Life Studies Group, School of Interdisciplinary Studies, University of Glasgow, Dumfries, UK.
    Tidefelt, Ulf
    University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Svantesson, Mia
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center, Region Örebro County, Örebro, Sweden.
    Relational autonomy in the care of the vulnerable: health care professionals' reasoning in Moral Case Deliberation (MCD)2018In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 21, no 4, p. 467-477Article in journal (Refereed)
    Abstract [en]

    In Moral Case Deliberation (MCD), healthcare professionals discuss ethically difficult patient situations in their daily practice. There is a lack of knowledge regarding the content of MCD and there is a need to shed light on this ethical reflection in the midst of clinical practice. Thus, the aim of the study was to describe the content of healthcare professionals' moral reasoning during MCD. The design was qualitative and descriptive, and data consisted of 22 audio-recorded inter-professional MCDs, analysed with content analysis. The moral reasoning centred on how to strike the balance between personal convictions about what constitutes good care, and the perceived dissonant care preferences held by the patient. The healthcare professionals deliberated about good care in relation to demands considered to be unrealistic, justifications for influencing the patient, the incapacitated patient's nebulous interests, and coping with the conflict between using coercion to achieve good while protecting human dignity. Furthermore, as a basis for the reasoning, the healthcare professionals reflected on how to establish a responsible relationship with the vulnerable person. This comprised acknowledging the patient as a susceptible human being, protecting dignity and integrity, defining their own moral responsibility, and having patience to give the patient and family time to come to terms with illness and declining health. The profound struggle to respect the patient's autonomy in clinical practice can be understood through the concept of relational autonomy, to try to secure both patients' influence and at the same time take responsibility for their needs as vulnerable humans.

  • 10.
    Pelto-Piri, Veikko
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Psychiatric Research Centre.
    Engström, Karin
    Barn- och ungdomsvetenskapliga institutionen, Stockholms universitet, Stockholm, Sweden.
    Engström, Ingemar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre, Örebro University Hospital, Region Örebro County, Örebro, Sweden.
    Paternalism, autonomy and reciprocity: ethical perspectives in encounters with patients in psychiatric in-patient care.2013In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 14, no 1, p. 49-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychiatric staff members have the power to decide the options that frame encounters with patients. Intentional as well as unintentional framing can have a crucial impact on patients' opportunities to be heard and participate in the process. We identified three dominant ethical perspectives in the normative medical ethics literature concerning how doctors and other staff members should frame interactions in relation to patients; paternalism, autonomy and reciprocity. The aim of this study was to describe and analyse statements describing real work situations and ethical reflections made by staff members in relation to three central perspectives in medical ethics; paternalism, autonomy and reciprocity.

    METHODS: All staff members involved with patients in seven adult psychiatric and six child and adolescent psychiatric clinics were given the opportunity to freely describe ethical considerations in their work by keeping an ethical diary over the course of one week and 173 persons handed in their diaries. Qualitative theory-guided content analysis was used to provide a description of staff encounters with patients and in what way these encounters were consistent with, or contrary to, the three perspectives.

    RESULTS: The majority of the statements could be attributed to the perspective of paternalism and several to autonomy. Only a few statements could be attributed to reciprocity, most of which concerned staff members acting contrary to the perspective. The result is presented as three perspectives containing eight values.Paternalism; 1) promoting and restoring the health of the patient, 2) providing good care and 3) assuming responsibility.Autonomy; 1) respecting the patient's right to self-determination and information, 2) respecting the patient's integrity and 3) protecting human rights.Reciprocity; 1) involving patients in the planning and implementation of their care and 2) building trust between staff and patients.

    CONCLUSIONS: Paternalism clearly appeared to be the dominant perspective among the participants, but there was also awareness of patients' right to autonomy. Despite a normative trend towards reciprocity in psychiatry throughout the Western world, identifying it proved difficult in this study. This should be borne in mind by clinics when considering the need for ethical education, training and supervision.

  • 11.
    Rasoal, Dara
    et al.
    Örebro University, School of Health Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Svantesson, Mia
    Örebro University, School of Health Sciences. Örebro University Hospital. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    ‘It’s like sailing’: experiences of the role as facilitator during moral case deliberation2017In: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 12, no 3, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Moral case deliberation is one form of clinical ethics support, and there seems to be different ways of facilitating thedialogue. This paper aimed to explore the personal experiences of Swedish facilitators of their role in moral casedeliberations. Being a facilitator was understood through the metaphor of sailing: against the wind or with it. Therole was likened to a sailor’s set of skills: to promote security and well-being of the crew, to help crew navigate theirmoral reflections, to sail a course into the wind against homogeneity, to accommodate the crew’s needs and just sail withthe wind, and to steer towards a harbour with authority and expertise. Balancing the disparate roles of being accom-modative and challenging may create a free space for emotions and ideas, including self-reflection and consideration ofmoral demands. This research opens the question of whether all these skills can be taught through systematic training orwhether facilitators need to possess the characteristics of being therapeutic, pedagogical, provocative, sensitive andauthoritarian.

  • 12.
    Rasoal, Dara
    et al.
    Örebro University, School of Health Sciences.
    Skovdahl, Kirsti
    Department of Nursing and Health Sciences, University College in Southeast Norway, Drammen, Norway.
    Gifford, Mervyn
    Örebro University, School of Health Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences.
    Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review2017In: HEC Forum, ISSN 0956-2737, E-ISSN 1572-8498, Vol. 29, no 4, p. 313-346Article, review/survey (Refereed)
    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.

  • 13.
    Sandlund, Mikael
    et al.
    Institutionen för klinisk vetenskap, Umeå universitet, Umeå, Sverige.
    Bremer, Anders
    Institutionen för hälso- och vårdvetenskap, Linnéuniversitetet, Växjö, Sweden; Institutionen för hälso- och vårdvetenskap, Linnéuniversitetet, Kalmar, Sweden.
    Ågård, Anders
    Område medicin, Sahlgrenska universitetssjukhuset, Göteborg, Sverige.
    Engström, Ingemar
    Örebro University, School of Medical Sciences. Universitetssjukvårdens forskningscentrum, Region Örebro län, Örebro, Sverige.
    Sallin, Karl
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet, Uppsala, Sverige.
    Kontinuitet främjar personligt och professionellt ansvarstagande2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, article id ETHIArticle in journal (Refereed)
  • 14.
    Stenvinkel, Peter
    et al.
    Renal Medicine, CLINTEC, Stockholm, Sweden.
    Kindberg, Jonas
    Institutionen för vilt, fisk och miljö, Sveriges lantbruksuniversitet, Umeå, Sweden.
    Fröbert, Ole
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Kardiologiska kliniken .
    Biomimetik [Biomimetics]: att efterlikna naturen for att forebygga sjukdom [imitating nature to prevent disease]2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, article id DAYRArticle in journal (Refereed)
  • 15.
    Svantesson, Mia
    et al.
    Örebro University Hospital. Centre for Health Care Sciences, Örebro University Hospital, Örebro University, Örebro, Sweden; Karlskoga Hospital, Karlskoga, Sweden.
    Karlsson, Jan
    Örebro University Hospital. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden; Department of Medicine, Örebro University Hospital, Örebro, Sweden.
    Boitte, Pierre
    Dept Eth, Ctr Med Eth, Catholic Univ, Lille, France.
    Schildman, Jan
    NRW Jr Res Grp Med Eth End Life Norm & Empiricism, Inst Med Eth & Hist Med, Ruhr Univ Bochum, Bochum, Germany.
    Dauwerse, Linda
    Med Ctr, Inst Hlth & Care Res, Vrije Univ, Amsterdam, Netherlands; Dept Sociol, Vrije Univ, Amsterdam, Netherlands.
    Widdershoven, Guy
    Med Ctr, Inst Hlth & Care Res, Vrije Univ, Amsterdam, Netherlands; Dept Sociol, Vrije Univ, Amsterdam, Netherlands.
    Pedersen, Reidar
    Inst Hlth & Soc, Ctr Med Eth, Univ Oslo, Oslo, Norway.
    Huisman, Martijn
    Dept Epidemiol & Biostat, Vumc & Emgo, Amsterdam, Netherlands; Dep Med Humanities, Vumc & Emgo, Amsterdam, Netherlands .
    Molewijk, Bert
    Med Ctr, Inst Hlth & Care Res, Vrije Univ, Amsterdam, Netherlands; Dept Sociol, Vrije Univ, Amsterdam, Netherlands; nst Hlth & Soc, Ctr Med Eth, Univ Oslo, Oslo, Norway .
    Outcomes of Moral Case Deliberation: the development of an evaluation instrument for clinical ethics support (the Euro-MCD)2014In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 15, article id 30Article in journal (Refereed)
    Abstract [en]

    Background: Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers' experiences and perceived importance of outcomes of Moral Case Deliberation.

    Methods: A multi-item instrument for assessing outcomes of Moral Case Deliberation (MCD) was constructed through an iterative process, founded on a literature review and modified through a multistep review by ethicists and health care providers. The instrument measures perceived importance of outcomes before and after MCD, as well as experienced outcomes during MCD and in daily work. A purposeful sample of 86 European participants contributed to a Delphi panel and content validity testing. The Delphi panel (n = 13), consisting of ethicists and ethics researchers, participated in three Delphi-rounds. Health care providers (n = 73) participated in the content validity testing through `think-aloud' interviews and a method using Content Validity Index.

    Results: The development process resulted in the European Moral Case Deliberation Outcomes Instrument (Euro-MCD), which consists of two sections, one to be completed before a participant's first MCD and the other after completing multiple MCDs. The instrument contains a few open-ended questions and 26 specific items with a corresponding rating/response scale representing various MCD outcomes. The items were categorised into the following six domains: Enhanced emotional support, Enhanced collaboration, Improved moral reflexivity, Improved moral attitude, Improvement on organizational level and Concrete results.

    Conclusions: A tentative instrument has been developed that seems to cover main outcomes of Moral Case Deliberation. The next step will be to test the Euro-MCD in a field study.

  • 16.
    Svantesson-Sandberg, Mia
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. University of Warwick, Coventry, UK.
    Griffiths, Frances
    University of Warwick, Coventry, UK.
    Bassford, Chris
    University of Warwick, Coventry, UK.
    Slowther, Anne
    University of Warwick, Coventry, UK.
    Values in conict during the decision making process surrounding admission to intensive care: Ethnographic study in six British hospitals2017Conference paper (Refereed)
  • 17.
    Werkander Harstäde, Carina
    et al.
    Centre for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Blomberg, Karin
    Örebro University, School of Health Sciences.
    Benzein, Eva
    Centre for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
    Östlund, Ulrika
    Centre for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden; Centre for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden; Centre for Research & Development, Uppsala University, Gävle, Sweden; Region Gävleborg, Gävle, Sweden.
    Dignity-conserving care actions in palliative care: an integrative review of Swedish research2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 8-23Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous research has proposed that persons in need of palliative care often have a loss of functions and roles that affects social and existential self-image. Moreover, these individuals also commonly suffer from complex multisymptoms. This, together with the situation of facing an impending death, can lead to a loss of dignity. Therefore, supporting these persons' dignity is a crucial challenge for professional nurses. The 'Dignity Care Intervention' addresses the multidimensionality of dignity by identifying patients' dignity-related concerns and suggests care actions to address them. At the present, the Dignity Care Intervention is adapted for implementation in Swedish care settings. Because expressions of dignity are influenced by culture, and an overview of care actions in a Swedish context is lacking, this integrative review aimed to find suggestions from Swedish research literature on what kind of care actions can preserve dignity.

    METHODS: An integrative literature review was conducted using the databases SwePub and SweMed+. Articles published from 2006 to 2015 and theses published from 2000 to 2015 were searched for using the terms 'dignity' and 'palliative care'. Result sections of articles and theses were reviewed for dignity-conserving care actions synthesised by thematic analysis and categorised under themes and subthemes in Chochinov's model of dignity.

    RESULTS: Fifteen articles and 18 theses were included together providing suggestions of care actions in all themes and subthemes in the dignity model. Suggested care actions included listening, communication, information, symptom control, facilitating daily living and including patients in decision-making. Additionally, nurses' perceptiveness towards the patients was a core approach.

    CONCLUSION: The review offers culturally relevant suggestions on how to address specific dignity-related concerns. The adapted Dignity Care Intervention will be a way for Swedish nurses to provide person-centred palliative care that will conserve patients' dignity.

  • 18. Åkerlund, Anna
    et al.
    Sundqvist, Martin
    Örebro University Hospital. Klinisk mikrobiologi, Laboratoriemedicinska Länskliniken, Örebro, Sweden.
    Hanberger, Håkan
    Åhrén, Christina
    Serrander, Lena
    Giske, Christian G.
    Svarstiderna kan kortas vid mikrobiologisk diagnostik av sepsis [Response times can be shortened in microbiological diagnosis of sepsis]: Bättre öppettider på laboratorier och aktiv rådgivning ger snabbare terapi [Better opening hours in laboratories and active advice enables faster therapy]2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, article id C73SArticle in journal (Refereed)
    Abstract [sv]

    Early and adequate antimicrobial therapy is lifesaving in patients with bloodstream infections (BSI). Continuous incubation and 24h availability of microbial pathogen identification in clinical microbiology laboratories shortens the time to report. To describe the current status in Swedish clinical microbiology laboratories, a web-based survey was performed. The survey showed major differences in availability both regarding laboratory opening hours and ability to incubate blood culture bottles outside working hours. It also showed differences in what was conveyed verbally to the clinician and in time to report of the bacterial species. Based on this survey, we debate how Swedish healthcare can improve the care of patients with BSI by offering a more rapid diagnostic process. This could be achieved through longer opening hours of the laboratory, better transport systems and blood culture cabinets positioned closer to the patient.

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