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  • 1.
    Carlsson, Eva
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Eldh, Ann Catrine
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ehrenberg, Anna
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Accuracy and continuity in discharge information for patients with eating difficulties after stroke2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 1-2, p. 21-31Article in journal (Refereed)
    Abstract [en]

    Aims: To describe the accuracy and continuity of discharge information for patients with eating difficulties after stroke.

    Design: Prospective, descriptive.

    Methods: The study investigated a sample of 15 triads, each including one patient with stroke along with his patient record and discharge summary and two nursing staff in the municipal care to whom the patient was discharged. Data were collected by observations of patients' eating, record audits and interviews with nurses. Data were analysed using content analysis and descriptive statistics.

    Results: Accuracy of recorded information on patients' eating difficulties and informational continuity were poor, as was accuracy in the transferred information according to nursing staff's perceptions. All patients were at risk of undernutrition and in too poor a state to receive rehabilitation. Nevertheless, patients' eating difficulties were described in a vague and unspecific language in the patient records. Co-ordinated care planning and management continuity related to eating difficulties were largely lacking in the documentation. Despite their important role in caring for patients with eating difficulties, little information on eating difficulties seemed to reach licensed practical nurses in the municipalities.

    Conclusions: Comprehensiveness in the documentation of eating difficulties and accuracy of transferred information were poor based on record audits and as perceived by the municipal nursing staff. Although all patients were at risk of undernutrition, had multiple eating difficulties and were in too poor a state for rehabilitation, explicit care plans for nutritional problems were lacking.

    Relevance to clinical practice: Lack of accuracy and continuity in discharge information on eating difficulties may increase risk of undernutrition and related complications for patients in continuous stroke care. Therefore, the discharge process must be based on comprehensive and accurate documentation.

  • 2.
    Carlsson, Eva
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Health Sciences, Örebro University Hospital, Örebro, Sweden.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Eldh, Ann Catrine
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Ehrenberg, Anna
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Information transfer and continuity of care for stroke patients with eating difficulties from the perspectives of nursing staff in Swedish elderly care2012In: Nursing informatics ... : proceedings of the ... International Congress on Nursing Informatics, 2012, p. 61-64Conference paper (Refereed)
    Abstract [en]

    Continuity of care is a key issue in the care for elderly people, for example, those having experienced stroke, particularly with regards to informational and managerial continuity based on patient record data. The study aim was to explore municipal nursing staff's (n=30) perceptions of discharge information provided to them for stroke patients with eating difficulties. Structured interviews were used and data were analysed by content analysis and descriptive statistics. Results showed that nursing staff perceived informational continuity and accuracy of information on patients' eating difficulties as poor and that little information on eating difficulties reached licensed practical nurses, who instead relied on their own assessments of patients' eating ability. Co-ordinated care planning and management continuity were largely lacking, increasing the risk for undernutrition and related complications for the patients.

  • 3.
    Eldh, Ann Catrine
    Örebro University, Department of Health Sciences.
    Patient participation: what it is and what it is not2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In general, patient participation is regarded as being informed and partaking in decision making regarding one’s care and treatment. This interpretation is common in legislation throughout the Western world and corresponding documents guiding health care professionals, as well as in scientific studies. Even though this understanding of the word participation can be traced to a growing emphasis on individuals’ autonomy in society and to certain dictionary defi nitions, there are other ways of understanding participation from a semantic point of view, and no trace of patients’ descriptions of what it is to participate can be found in these definitions.

    Hence, the aim of this dissertation was to understand patients’ experience of the phenomenon of patient participation. An additional aim was to understand patients’ experience of non-participation and to describe the conditions for patient participation and non-participation, in order to understand the prerequisites for patient participation.

    The dissertation comprises four papers. The philosophical ideas of Ricoeur provided a basis for the studies: how communication can present ways to understand and explain experiences of phenomena through phenomenological hermeneutics. The first and second studies involved a group of patients living with chronic heart failure. For the fi rst study, 10 patients were interviewed, with a narrative approach, about their experience of participation and non-participation, as defi ned by the participants. For the second study, 11 visits by three patients at a nurse-led outpatient clinic were observed, and consecutive interviews were performed with the patients and the nurses, investigating what they experience as patient participation and non-participation. A triangulation of data was performed to analyse the occurrence of the phenomena in the observed visits. For paper 3 and 4, a questionnaire was developed and distributed among a diverse group of people who had recent experience of being patients. The questionnaire comprised respondent’s description of what patient participation is, using items based on findings in Study 1, along with open-ended questions for additional aspects and general issues regarding situations in which the respondent had experienced patient participation and/or non-participation.

    The findings show additional aspects to patient participation: patient participation is being provided with information and knowledge in order for one to comprehend one’s body, disease, and treatment and to be able to take self-care actions based on the context and one’s values. Participation was also found to include providing the information and knowledge one has about the experience of illness and symptoms and of one’s situation. Participation occurs when being listened to and being recognised as an individual and a partner in the health care team. Non-participation, on the other hand, occurs when one is regarded as a symptom, a problem to be solved. To avoid non-participation, the information provided needs to be based on the individual’s need and with recognition of the patient’s knowledge and context.

    In conclusion, patient participation needs to be reconsidered in health care regulations and in clinical settings: patients’ defi nitions of participation, found to be close to the dictionaries’ description of sharing, should be recognised and opportunities provided for sharing knowledge and experience in two-way-communication.

    List of papers
    1. The phenomena of participation and non-participation in health care: experiences of patients attending a nurse-led clinic for chronic heart failure
    Open this publication in new window or tab >>The phenomena of participation and non-participation in health care: experiences of patients attending a nurse-led clinic for chronic heart failure
    2004 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, no 3, p. 239-246Article in journal (Refereed) Published
    Abstract [en]

    Background: Patient participation is stressed in the health care acts of many western countries yet a common definition of the concept is lacking. The understanding of experiences of patients with chronic heart failure (CHF) who attend nurse-led specialist clinics, a form of care suggested as beneficiary to this group, may promote a better understanding of participation. Aim: To investigate the meanings of participation and non-participation as experienced by patients living with CHF. Methods: Narrative interviews analysed in the phenomenological hermeneutic tradition inspired by Ricoeur where the interpretation is made in the hermeneutic circle, explaining and understanding the experienced phenomena. Findings: Participation was experienced as to “be confident”, “comprehend” and “seek and maintain a sense of control”. Non-participation was experienced as to “not understand”, “not be in control”, “lack a relationship” and “not be accountable”. The findings indicate that the experiences of participation and non-participation can change over time and phases of the disease and treatment. Conclusion: The study suggests an extended view on the concept of participation. Patients' experiences of participation in health care can vary and should therefore be an issue for dialogue between nurses and patients with CHF in nurse-led specialist clinics.

    National Category
    Social Sciences Interdisciplinary Nursing
    Research subject
    Nursing Science
    Identifiers
    urn:nbn:se:oru:diva-3169 (URN)10.1016/j.ejcnurse.2004.05.001 (DOI)
    Available from: 2006-11-14 Created: 2006-11-14 Last updated: 2018-01-13Bibliographically approved
    2. The meaning of patient participation for patients and nurses at a nurse-led clinic for chronic heart failure
    Open this publication in new window or tab >>The meaning of patient participation for patients and nurses at a nurse-led clinic for chronic heart failure
    2006 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, no 1, p. 45-53Article in journal (Refereed) Published
    Abstract [en]

    BackgroundThe legislation of many Western countries emphasizes active patient participation. Patients with chronic heart failure (CHF), however, have experienced participation differently from the general interpretation of legal definitions. Education improves uptake of self-management strategies yet knowledge is lacking about support of patients' own resources in CHF.

    AimTo explore the phenomena of patient participation and non-participation as shown in patient visits to a nurse-led clinic for CHF and as experienced by the patients and nurses.

    MethodsData triangulation of field notes from participatory observations and texts from narrative interviews with the patients and assigned nurse specialists. Data were analyzed according to the phenomenological hermeneutic tradition.

    FindingsPatients' experience of participation and non-participation was interpreted as “Being responsible and accepting responsibility” and “Lacking an equal relationship while being controlled”, respectively. Nurses experienced patient participation as “Getting information and security to act” and patient non-participation as “Not accepting”.

    ConclusionConflicting values of patients and nurses, which were interpreted with respect to participation and non-participation, presumably might influence patient information and education negatively. The issue of participation should be raised as a means of attaining concordance and to facilitate patient participation with education specifically tailored to the individual patient's needs.

    National Category
    Social Sciences Interdisciplinary Nursing
    Research subject
    Nursing Science
    Identifiers
    urn:nbn:se:oru:diva-3170 (URN)10.1016/j.ejcnurse.2005.06.002 (DOI)
    Available from: 2006-11-14 Created: 2006-11-14 Last updated: 2018-01-13Bibliographically approved
    3. Additional understanding of participation in health care: findings from a patient survey
    Open this publication in new window or tab >>Additional understanding of participation in health care: findings from a patient survey
    (English)Manuscript (Other academic)
    National Category
    Social Sciences Interdisciplinary Nursing
    Research subject
    Nursing Science
    Identifiers
    urn:nbn:se:oru:diva-3171 (URN)
    Available from: 2006-11-14 Created: 2006-11-14 Last updated: 2018-01-13Bibliographically approved
    4. Conditions for patient participation and non-participation in health care
    Open this publication in new window or tab >>Conditions for patient participation and non-participation in health care
    2006 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 5, p. 503-514Article in journal (Refereed) Published
    Abstract [en]

    This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making.

    National Category
    Social Sciences Interdisciplinary Nursing
    Research subject
    Nursing Science
    Identifiers
    urn:nbn:se:oru:diva-3172 (URN)10.1191/0969733006nej898oa (DOI)
    Available from: 2006-11-14 Created: 2006-11-14 Last updated: 2018-01-13Bibliographically approved
  • 4.
    Eldh, Ann Catrine
    et al.
    Örebro University, School of Health and Medical Sciences.
    Carlsson, Eva
    Seeking a balance between employment and the care of an ageing parent2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 2, p. 285-293Article in journal (Refereed)
    Abstract [en]

    Rationale: A growing number of middle-aged people are engaged in informal care of their parents while employed. To provide support as employers, co-workers or staff, health care professionals need insight into the experiences of people managing these responsibilities. Aim: To elucidate the experience of providing informal care to an ageing parent while managing the responsibilities of a working life. Methods: Narrative interviews were performed with 11 persons with experience of the phenomenon. Transcribed interviews were analysed with phenomenological hermeneutics. Ethics: Informed consent was given prior to the interviews. The study was approved by a research ethics committee. Findings: Providing informal care to an ageing parent while also pursuing a working life implies seeking balance: a balance between providing support to the parent's needs and one's responsibilities at work. Being employed supports this balance as it provides both fulfilment and refuge. Being capable of managing both roles grants a sense of satisfaction, supporting one's sense of balance in life. The balance can be supported by sharing the responsibility of caring for the ageing parent with others. Study limitations: Despite perceived saturation and an effort to provide for the possibility to consider internal consistency, the findings should be considered as a contribution to the understanding of the phenomenon, as experienced by individuals in their life world. Conclusions: It is essential to recognise the impact that providing care for an ageing parent may have on the lives of a growing number of people, particularly if they have employment responsibilities. Acknowledgement by others supports one's ability to attain balance; as co-workers and managers, we can acknowledge the efforts of an informal caregiver and as health care staff recognise the valuable contribution made by people in mid-life who provide informal care for their ageing parents.

  • 5.
    Eldh, Ann Catrine
    et al.
    Örebro University, Department of Health Sciences.
    Ehnfors, Margareta
    Örebro University, Department of Nursing and Caring Sciences.
    Ekman, Inger
    The meaning of patient participation for patients and nurses at a nurse-led clinic for chronic heart failure2006In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, no 1, p. 45-53Article in journal (Refereed)
    Abstract [en]

    BackgroundThe legislation of many Western countries emphasizes active patient participation. Patients with chronic heart failure (CHF), however, have experienced participation differently from the general interpretation of legal definitions. Education improves uptake of self-management strategies yet knowledge is lacking about support of patients' own resources in CHF.

    AimTo explore the phenomena of patient participation and non-participation as shown in patient visits to a nurse-led clinic for CHF and as experienced by the patients and nurses.

    MethodsData triangulation of field notes from participatory observations and texts from narrative interviews with the patients and assigned nurse specialists. Data were analyzed according to the phenomenological hermeneutic tradition.

    FindingsPatients' experience of participation and non-participation was interpreted as “Being responsible and accepting responsibility” and “Lacking an equal relationship while being controlled”, respectively. Nurses experienced patient participation as “Getting information and security to act” and patient non-participation as “Not accepting”.

    ConclusionConflicting values of patients and nurses, which were interpreted with respect to participation and non-participation, presumably might influence patient information and education negatively. The issue of participation should be raised as a means of attaining concordance and to facilitate patient participation with education specifically tailored to the individual patient's needs.

  • 6.
    Eldh, Ann Catrine
    et al.
    Örebro University, Department of Health Sciences.
    Ehnfors, Margareta
    Örebro University, Department of Nursing and Caring Sciences.
    Ekman, Inger
    The phenomena of participation and non-participation in health care: experiences of patients attending a nurse-led clinic for chronic heart failure2004In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 3, no 3, p. 239-246Article in journal (Refereed)
    Abstract [en]

    Background: Patient participation is stressed in the health care acts of many western countries yet a common definition of the concept is lacking. The understanding of experiences of patients with chronic heart failure (CHF) who attend nurse-led specialist clinics, a form of care suggested as beneficiary to this group, may promote a better understanding of participation. Aim: To investigate the meanings of participation and non-participation as experienced by patients living with CHF. Methods: Narrative interviews analysed in the phenomenological hermeneutic tradition inspired by Ricoeur where the interpretation is made in the hermeneutic circle, explaining and understanding the experienced phenomena. Findings: Participation was experienced as to “be confident”, “comprehend” and “seek and maintain a sense of control”. Non-participation was experienced as to “not understand”, “not be in control”, “lack a relationship” and “not be accountable”. The findings indicate that the experiences of participation and non-participation can change over time and phases of the disease and treatment. Conclusion: The study suggests an extended view on the concept of participation. Patients' experiences of participation in health care can vary and should therefore be an issue for dialogue between nurses and patients with CHF in nurse-led specialist clinics.

  • 7.
    Eldh, Ann Catrine
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Ekman, Inger
    Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    A comparison of the concept of patient participation and patients' descriptions as related to healthcare definitions2010In: International Journal of Nursing Terminologies and Classifications, ISSN 2047-3087, E-ISSN 2047-3095, Vol. 21, no 1, p. 21-32Article in journal (Refereed)
    Abstract [en]

    Purpose: To depict what patients describe as patient participation and whether descriptions of patient participation are affected by gender, age, healthcare contact, and duration of disease.

    Data sources: Current patients (n= 362) responded to a questionnaire on participation.

    Data synthesis: Patients' descriptions focused on having knowledge, rather than being informed, and on interacting with health professionals, rather than merely partaking in decision making.

    Conclusions: Patients' descriptions of participation correspond with the International Classification of Functioning, Disability and Health's definition, which includes "being involved in a life situation." Healthcare legislation and professionals employ a narrower concept of patient participation as defined by, e.g., Medical Subject Headings.

    Practice implications: Findings suggest that health professionals need to embrace what patients describe as participation.

  • 8.
    Eldh, Ann Catrine
    et al.
    Örebro University, Department of Health Sciences.
    Ekman, Inger
    Ehnfors, Margareta
    Örebro University, Department of Health Sciences.
    Additional understanding of participation in health care: findings from a patient surveyManuscript (Other academic)
  • 9.
    Eldh, Ann Catrine
    et al.
    Capio St. Göran Hospital, Stockholm.
    Ekman, Inger
    Sahlgrenska Academy, Göteborg University, Institute of Health and Care Sciences, Göteborg.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Conditions for patient participation and non-participation in health care2006In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 5, p. 503-14Article in journal (Refereed)
    Abstract [en]

    This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making.

  • 10.
    Eldh, Ann Catrine
    et al.
    Örebro University, Department of Health Sciences.
    Ekman, Inger
    Ehnfors, Margareta
    Örebro University, Department of Health Sciences.
    Conditions for patient participation and non-participation in health care2006In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 5, p. 503-514Article in journal (Refereed)
    Abstract [en]

    This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making.

  • 11.
    Eldh, Ann Catrine
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ekman, Inger
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences.
    Considering patient non-participation in health care2008In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 11, no 3, p. 263-271Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to depict patient non-participation as described by a diverse group with recent experiences of being patients. BACKGROUND: Patient participation is regarded as a primary condition for optimal quality of care, suggesting that non-participation should be avoided. A common understanding of the concept of patient non-participation is needed. A discrepancy in definitions of patient non-participation has been found in health-care interactions, health-care classifications and health-care research, and little is known of what patient non-participation represents to patients. STUDY DESIGN: A survey consisting of closed-ended and open-ended questions was administered to persons that had recently been patients to gather respondents' descriptions of what they considered as patient non-participation. Qualitative content analysis was used to analyse free-text descriptions, and descriptive statistics were used for the close-ended alternatives. FINDINGS: Lacking information (e.g. not being provided with appropriate information) and lacking recognition (e.g. not being listened to and/or lacking recognition as an individual with individual needs and concerns) were significant aspects of patient non-participation. Furthermore, non-participation encompassed facing organization-centred, as opposed to patient-centred, health care as well as feeling insecure in health care interactions. CONCLUSION: The findings provide input for a better understanding of what patients experience as non-participation. Organising for the caregivers to be able to thoroughly listen to the patients' illness narratives would easily reduce the risk of patient's experiencing what is described as non-participation and would provide a sound base for patient learning needs.

  • 12.
    Eldh, Ann Catrine
    et al.
    School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Hälleberg Nyman, Maria
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Forsman, Henrietta
    School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Hommel, Ami
    Lunds universitet, Lund, Sweden.
    Rycroft-Malone, Jo
    Bangor University, Bangor, UK.
    Wallin, Lars
    School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Onset prevention of incontinence in orthopaedic nursing and rehabilitation: a multifaceted undertaking2015In: Researching Complex Interventions in Health: The State of the Art, 2015Conference paper (Refereed)
  • 13.
    Eldh, Ann Catrine
    et al.
    Division of Nursing Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Luhr, Kristina
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Family Medicine Research Centre, Örebro County Council, Örebro, Sweden.
    Ehnfors, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The development and initial validation of a clinical tool for patients' preferences on patient participation: The 4Ps2015In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 18, no 6, p. 2522-2535Article in journal (Refereed)
    Abstract [en]

    Aims: To report on the development and initial testing of a clinical tool, The Patient Preferences for Patient Participation tool (The 4Ps), which will allow patients to depict, prioritize, and evaluate their participation in health care.

    Background: While patient participation is vital for high quality health care, a common definition incorporating all stakeholders' experience is pending. In order to support participation in health care, a tool for determining patients' preferences on participation is proposed, including opportunities to evaluate participation while considering patient preferences.

    Methods: Exploratory mixed methods studies informed the development of the tool, and descriptive design guided its initial testing. The 4Ps tool was tested with 21 Swedish researcher experts (REs) and patient experts (PEs) with experience of patient participation. Individual Think Aloud interviews were employed to capture experiences of content, response process, and acceptability.

    Results: 'The 4Ps' included three sections for the patient to depict, prioritize, and evaluate participation using 12 items corresponding to 'Having Dialogue', 'Sharing Knowledge', 'Planning', and 'Managing Self-care'. The REs and PEs considered 'The 4Ps' comprehensible, and that all items corresponded to the concept of patient participation. The tool was perceived to facilitate patient participation whilst requiring amendments to content and layout.

    Conclusions: A tool like The 4Ps provides opportunities for patients to depict participation, and thus supports communication and collaboration. Further patient evaluation is needed to understand the conditions for patient participation. While The 4Ps is promising, revision and testing in clinical practice is required.

  • 14.
    Hälleberg Nyman, Maria
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Institutionen för neurobiologi, vårdvetenskap och samhälle (NVS), Karolinska Institutet, Stockholm, Sweden.
    Forsman, Henrietta
    School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Hommel, Ami
    Department of Orthopaedics, Skåne University Hospital, Lund/Malmö, Sweden.
    Rycroft-Malone, Jo
    Centre for Health Related Research, School of Healthcare Sciences, Bangor University, Bangor, UK.
    Wallin, Lars
    Institutionen för neurobiologi, vårdvetenskap och samhälle (NVS), Karolinska Institutet, Stockholm, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Eldh, Ann Catrine
    Institutionen för neurobiologi, vårdvetenskap och samhälle (NVS), Karolinska Institutet, Stockholm, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Identifying the knowledge to translate: the example of urinary incontinence in older people2015In: Nordic Conference on Implementation of Evidence-Based Practice, 2015Conference paper (Refereed)
    Abstract [en]

    Background: While urinary incontinence (UI) is a common and worrying issue among older people, promoting the use of evidence to prevent UI onset has rarely been studied. An earlier study that was conducted in nursing homes suggests that UI can be better assessed and managed, but the prevention of UI onset requires attention to the issue by staff within acute care settings. Aim: To report on the internal facilitators’ (IF) transition, identifying the 'know-do gap' between evidence and practice in UI prevention in orthopaedic care.

    Methods: The Onset PrevenTion of Incontinence in Orthopaedic Nursing and rehabilitation (OPTION) pilot was carried out in two Swedish orthopaedic units of different size and location. The pilot project included a programme to support nursing and rehab staff to facilitate knowledge translation (KT). Five IFs were interviewed at baseline, and one and three months after the intervention was completed, and non-participant observations were performed during the KT-intervention. Interviews and observations were triangulated, depicting when and how the IFs identified the present, local UI practice, the evidence on UI, and the know-do gap in preventing UI onset in older patients undergoing hip surgery.

    Results: Preliminary results indicate that before the study, neither the IFs nor their fellows at the units were aware that they could prevent UI onset. Rather, through mapping their context and matching the evidence provided by the dialogue with the experts in the KTintervention, the IFs became aware of which practice was evidence based and which evidence to implement, and how to facilitate KT and promote evidence use.

    Conclusion: The OPTION pilot indicates that KT can be promoted by tailored implementation strategies and tailoring evidence, supported by IFs awareness and understanding of the local know-do gap, and strategies to overcome barriers and promote use of evidence.

  • 15.
    Letterstål, Anna
    et al.
    Dept Mol Med & Surg, Karolinska Univ Hosp, Karolinska Inst, Solna, Sweden.
    Eldh, Ann Catrine
    Örebro University, School of Health and Medical Sciences.
    Olofsson, Pär
    Dept Mol Med & Surg, Karolinska Univ Hosp, Karolinska Inst, Solna, Sweden.
    Forsberg, Christina
    Div Nursing, Dept Neurobiol Care Sci & Soc, Karolinska Inst, Huddinge, Sweden.
    Patients' experience of open repair of abdominal aortic aneurysm: preoperative information, hospital care and recovery2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 21-22, p. 3112-3122Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. The aim was to elucidate patients' lived experience of the care pathway of going through open surgery for abdominal aortic aneurysm. Background. Open surgical treatment has a great impact on patients' health-related quality of life both before and after treatment. The transition from being independent and asymptomatic to dependent on nursing care can be difficult. To facilitate this process and provide high-quality care, patients' needs must be better understood. Design. An exploratory descriptive design was chosen to describe and understand patients' lived experience. Method. Audio-taped interviews were performed three months postoperatively, covering the care pathway before and after surgery. Interviews were analysed with qualitative content analysis. Results. The informants made a transition from becoming aware of the deadly risk associated with abdominal aortic aneurysm to gradually understanding the physical and emotional impact of the surgical procedure during the recovery process. The experience of not understanding fully the risks of undergoing surgery or its consequences on daily life made the informants unprepared for complications and limitations during the recovery period. Many concerns emerged, with a need for more dialogue and opportunities to understand their own care than those provided by the health care staff. Conclusions. To facilitate the transition process, health care staff should consider patients' unpreparedness for the physical and emotional impact that can follow diagnosis and treatment for abdominal aortic aneurysm and recognise the need for dialogue to enhance participation during recovery. Relevance to clinical practice. Throughout the care pathway, patients' need for information and for opportunities to reflect on bodily and emotional reactions to the diagnosis and treatment of abdominal aortic aneurysm should be recognised by nurses and physicians to support patients getting realistic expectations of the consequences of treatment and facilitate participation in decisions concerning care and medical treatment.

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