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  • 1.
    Sundqvist, Ann-Sofie
    Örebro University, School of Health Sciences.
    Perioperative patient advocacy: having the patient's best interests at heart2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Patient advocacy implies taking action on someone else’s behalf, and has been described as a key element of nurses’ professional care. In the perioperative setting, it involves not only critical decision making, but also all the small things that the nurses do for the sake of the patients during their working day. Since previous research on the advocacy role of a registered nurse anesthetist (RNA) is sparse, and has not been conducted in a Swedish context, this thesis was intended to contribute to a greater understanding of advocacy in the perioperative context. The overall aim was therefore to explore the characteristics and consequences of perioperative patient advocacy (Study I), and to describe RNAs’ views of advocacy in anesthetic nursing through interviews (Study II), a questionnaire (Study III), and observations (Study IV).

    The synthesis of the characteristics and consequences of perioperative patient advocacy was interpreted in this thesis as the RNAs having the patient’s best interests at heart, in that they (1) had control of the situation, (2) preserved human values, and finally (3) were emotionally affected, as the results from the four studies suggested this as the core of perioperative patient advocacy.

    Perioperative patient advocacy is not always perceived as easy. In praxis, it is linked to the code of ethics outlined by the International Council of Nurses, which states that all registered nurses, regardless of their working context, shall respect human rights, promote health, prevent illness, and ensure that the individual receives accurate and sufficient information. This thesis elaborates on how this is done by describing how RNAs exert perioperative patient advocacy and how they interact in order to facilitate the best possible care for the patient. The results deepen the understanding of perioperative patient advocacy from the RNA’s perspective and contribute to a new insight in the RNA’s professional role.

    List of papers
    1. Perioperative Patient Advocacy: An Integrative Review
    Open this publication in new window or tab >>Perioperative Patient Advocacy: An Integrative Review
    2016 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 31, no 5, p. 422-433Article in journal (Refereed) Published
    Abstract [en]

    Purpose: The purpose of this review was to identify the characteristics and consequences of perioperative patient advocacy.

    Design: An integrative review method was employed.

    Methods: A database search to identify peer-reviewed articles that focused on perioperative patient advocacy was conducted in PubMed and CINAHL, followed by a manual search for additional articles. Studies were selected if they reported original empirical research findings with regard to perioperative patient advocacy. The data abstraction and synthesis were achieved with an inductive qualitative content analysis.

    Finding: The analysis resulted in seven categories, two subthemes, and one main theme. The main theme, “Doing good for another human being—a balancing act between philanthropy and personal gratification,” was the core of perioperative patient advocacy.

    Conclusion: Perioperative patient advocacy is part of the professional role of the perioperative nurse, and it affects the perioperative nurse emotionally. This advocacy shares similarities with descriptions of patient advocacy in general nursing.

    Place, publisher, year, edition, pages
    New York, USA: Elsevier, 2016
    Keywords
    Advocacy, integrative review, perioperative nursing
    National Category
    Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-49820 (URN)10.1016/j.jopan.2014.12.001 (DOI)000385340100010 ()27667349 (PubMedID)2-s2.0-84962502652 (Scopus ID)
    Projects
    Anestesisjuksköterskan, patientens advokat
    Note

    Funding Agencies:

    Örebro University

    Research Committee at Örebro County Council, Örebro, Sweden OLL-426621

    Available from: 2016-04-14 Created: 2016-04-14 Last updated: 2017-11-30Bibliographically approved
    2. Holding the patient's life in my hands: Swedish registered nurse anaesthetists' perspective of advocacy
    Open this publication in new window or tab >>Holding the patient's life in my hands: Swedish registered nurse anaesthetists' perspective of advocacy
    2014 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 2, p. 281-288Article in journal (Refereed) Published
    Abstract [en]

    Background: Anaesthesia often induces a state of unconsciousness that includes inability to communicate and influence the situation. The patient has to rely on the nurse anaesthetist to speak up for her/him as well as maintain her/his dignity and safety. Consequently, the nurse anaesthetist can be likened to the patient's advocate.

    Aim: The aim of the study was to describe advocacy in anaesthesia care during the perioperative phase from the perspective of the registered nurse anaesthetist.

    Method: Data for this qualitative descriptive study were collected during March and April, 2011. Individual interviews were conducted with a purposive sample of 20 nurse anaesthetists from two hospitals in Sweden. The audio-taped interviews were transcribed verbatim and analysed by means of qualitative content analysis.

    Findings: The main theme, Holding the patient's life in my hands, described the nurse anaesthetists' perception of advocacy and comprised three subthemes: providing dignified care, providing safe care and a moral commitment.

    Conclusion: Acting as the patient's advocate includes important health and well-being issues and could be stressful for the nurse anaesthetists'. A work environment where the nurse anaesthetists' can make their voices heard and feel that their opinion regarding the patient's best interests is taken seriously would be desirable, as all health professionals should ideally focus on those in their care.

    Place, publisher, year, edition, pages
    Hoboken: Wiley-Blackwell, 2014
    Keywords
    advanced practice nursing, nurse anaesthetist, advocacy, content analysis, nursing
    National Category
    Nursing
    Research subject
    Caring sciences
    Identifiers
    urn:nbn:se:oru:diva-34993 (URN)10.1111/scs.12057 (DOI)000334503400009 ()23713584 (PubMedID)2-s2.0-84898893862 (Scopus ID)
    Available from: 2014-05-09 Created: 2014-05-09 Last updated: 2018-06-07Bibliographically approved
    3. Protective Nursing Advocacy: Translation and Psychometric Evaluation of an Instrument and a Descriptive Study of Swedish Registered Nurse Anesthetists' Beliefs and Actions
    Open this publication in new window or tab >>Protective Nursing Advocacy: Translation and Psychometric Evaluation of an Instrument and a Descriptive Study of Swedish Registered Nurse Anesthetists' Beliefs and Actions
    2018 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 1, p. 58-68Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To translate and adapt the Protective Nursing Advocacy Scale (PNAS) into a Swedish version (PNAS-Swe), evaluate its psychometric properties, and describe registered nurse anesthetists' (RNAs) advocacy beliefs and actions from a protective perspective.

    Design: A cross-sectional design was used.

    Methods: First, the PNAS was translated into Swedish. Next, the content and construct validity of the PNAS four subscales was evaluated. Finally, the PNAS-Swe was used to describe Swedish RNA beliefs and actions regarding protective nursing advocacy.

    Finding: The final PNAS-Swe has 29 items in four subscales. The RNAs reported that they feel that they should provide protective nursing advocacy for their patients. There were no differences in gender, or associations with age, or work experience regarding their advocacy beliefs or actions.

    Conclusions: The PNAS-Swe is valid for use in a Swedish context. Protective nursing advocacy is important to the RNAs, which is in congruence with earlier qualitative studies.

    Place, publisher, year, edition, pages
    WB Saunders, 2018
    Keywords
    nursing advocacy, Protective Nursing Advocacy Scale, psychometrics, Rasch analysis
    National Category
    Nursing
    Research subject
    Caring Sciences w. Medical Focus
    Identifiers
    urn:nbn:se:oru:diva-57127 (URN)10.1016/j.jopan.2016.10.002 (DOI)000425223700009 ()29362048 (PubMedID)2-s2.0-85011295515 (Scopus ID)
    Note

    Funding Agencies:

    Örebro University  

    Research Committee at Region Örebro County 

    Available from: 2017-04-20 Created: 2017-04-20 Last updated: 2018-03-06Bibliographically approved
    4. Registered nurse anaesthetists practicing of perioperative patient advocacy: an observational study
    Open this publication in new window or tab >>Registered nurse anaesthetists practicing of perioperative patient advocacy: an observational study
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-57177 (URN)
    Available from: 2017-04-24 Created: 2017-04-24 Last updated: 2017-10-18Bibliographically approved
  • 2.
    Sundqvist, Ann-Sofie
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Perioperativt patientföreträdarskap: vad innebär det?2018Conference paper (Refereed)
  • 3.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Att hålla patientens liv i sin hand: svenska anestesisjuksköterskors uppfattning av att vara patientens företrädare2013Conference paper (Refereed)
  • 4.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Att hålla patientens liv i sin hand: svenska anestesisjuksköterskors uppfattning av att vara patientens företrädare2013Conference paper (Refereed)
  • 5.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Protective nursing advocacy: translation and psychometric evaluation of an instrument and a descriptive study of Swedish nurse anesthetists’ beliefs and actions2018Conference paper (Refereed)
  • 6.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Department of Cardiothoracic and Vascular Surgery.
    Anderzen-Carlsson, Agneta
    Örebro University Hospital. Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Protective Nursing Advocacy: Translation and Psychometric Evaluation of an Instrument and a Descriptive Study of Swedish Registered Nurse Anesthetists' Beliefs and Actions2018In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 1, p. 58-68Article in journal (Refereed)
    Abstract [en]

    Purpose: To translate and adapt the Protective Nursing Advocacy Scale (PNAS) into a Swedish version (PNAS-Swe), evaluate its psychometric properties, and describe registered nurse anesthetists' (RNAs) advocacy beliefs and actions from a protective perspective.

    Design: A cross-sectional design was used.

    Methods: First, the PNAS was translated into Swedish. Next, the content and construct validity of the PNAS four subscales was evaluated. Finally, the PNAS-Swe was used to describe Swedish RNA beliefs and actions regarding protective nursing advocacy.

    Finding: The final PNAS-Swe has 29 items in four subscales. The RNAs reported that they feel that they should provide protective nursing advocacy for their patients. There were no differences in gender, or associations with age, or work experience regarding their advocacy beliefs or actions.

    Conclusions: The PNAS-Swe is valid for use in a Swedish context. Protective nursing advocacy is important to the RNAs, which is in congruence with earlier qualitative studies.

  • 7.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
    Anderzén-Carlsson, Agneta
    Örebro University Hospital. Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Holding the patient's life in my hands: Swedish registered nurse anaesthetists' perspective of advocacy2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 2, p. 281-288Article in journal (Refereed)
    Abstract [en]

    Background: Anaesthesia often induces a state of unconsciousness that includes inability to communicate and influence the situation. The patient has to rely on the nurse anaesthetist to speak up for her/him as well as maintain her/his dignity and safety. Consequently, the nurse anaesthetist can be likened to the patient's advocate.

    Aim: The aim of the study was to describe advocacy in anaesthesia care during the perioperative phase from the perspective of the registered nurse anaesthetist.

    Method: Data for this qualitative descriptive study were collected during March and April, 2011. Individual interviews were conducted with a purposive sample of 20 nurse anaesthetists from two hospitals in Sweden. The audio-taped interviews were transcribed verbatim and analysed by means of qualitative content analysis.

    Findings: The main theme, Holding the patient's life in my hands, described the nurse anaesthetists' perception of advocacy and comprised three subthemes: providing dignified care, providing safe care and a moral commitment.

    Conclusion: Acting as the patient's advocate includes important health and well-being issues and could be stressful for the nurse anaesthetists'. A work environment where the nurse anaesthetists' can make their voices heard and feel that their opinion regarding the patient's best interests is taken seriously would be desirable, as all health professionals should ideally focus on those in their care.

  • 8.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    An observation study of Swedish registered nurse anesthetists perioperative patient advocacy2016Conference paper (Refereed)
  • 9.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Cardiothoracic and Vascular Surgery.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. Centre for Health Care Sciences.
    Perioperative patient advocacy: Doing good for another human being2016Conference paper (Refereed)
  • 10.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Perioperative patient advocacy: Doing good for another human being2015Conference paper (Refereed)
  • 11.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Anderzén-Carlsson, Agneta
    Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden.
    Perioperative Patient Advocacy: An Integrative Review2016In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 31, no 5, p. 422-433Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this review was to identify the characteristics and consequences of perioperative patient advocacy.

    Design: An integrative review method was employed.

    Methods: A database search to identify peer-reviewed articles that focused on perioperative patient advocacy was conducted in PubMed and CINAHL, followed by a manual search for additional articles. Studies were selected if they reported original empirical research findings with regard to perioperative patient advocacy. The data abstraction and synthesis were achieved with an inductive qualitative content analysis.

    Finding: The analysis resulted in seven categories, two subthemes, and one main theme. The main theme, “Doing good for another human being—a balancing act between philanthropy and personal gratification,” was the core of perioperative patient advocacy.

    Conclusion: Perioperative patient advocacy is part of the professional role of the perioperative nurse, and it affects the perioperative nurse emotionally. This advocacy shares similarities with descriptions of patient advocacy in general nursing.

  • 12.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Centre, Region Örebro County, Örebro, Sweden.
    Promoting person-centred care in the perioperative setting through patient advocacy: an observational study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 11-12, p. 2403-2415Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To examine the extent to which the findings from an integrative review regarding perioperative patient advocacy could be empirically supported, and to describe Swedish registered nurse anaesthetists' patient advocacy actions and interactions during the perioperative period.

    BACKGROUND: Patient advocacy is practiced by various health care professionals in promoting the well-being of patients. It is complex, and in a general health care context it has been described as supporting the patients both physiologically and psychologically. During general anaesthesia, the patient enters an unconscious state, and the registered nurse anaesthetist safeguards patient privacy and autonomy.

    DESIGN: Qualitative descriptive.

    METHODS: Individual, nonparticipant observations (n=16) with eight registered nurse anaesthetists. The observer followed the nurses unobtrusively by shadowing them during the perioperative phase on two separate occasions. The analysis was conducted with a directed content analysis in the light of four predetermined categories, identified in a previous integrative review of patient advocacy in the perioperative setting: protecting, value preserving, supporting, and informing.

    RESULTS: The predetermined categories were empirically supported. They were further refined by identifying 11 new subcategories leading to a conceptual extension of the theoretical frame. The registered nurse anaesthetists interacted with the patient and all members of the surgical team when practicing perioperative patient advocacy and the actions were mostly initiated by the registered nurse anaesthetists themselves.

    CONCLUSIONS: The findings offer a new insight into the registered nurse anaesthetist's professional role. The observations deepen the understanding of the registered nurse anaesthetists' perioperative patient advocacy actions, and can contribute to a more reflective and theory-oriented view of practice.

    RELEVANCE TO CLINICAL PRACTICE: The results from this study could be used to help registered nurse anaesthetists and their students understand practice in a more complete and insightful way.

  • 13.
    Sundqvist, Ann-Sofie
    et al.
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Holmefur, Marie
    Örebro University, School of Health Sciences.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Registered nurse anaesthetists practicing of perioperative patient advocacy: an observational studyManuscript (preprint) (Other academic)
1 - 13 of 13
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