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  • 1.
    Bergsten, Ulrika
    et al.
    Jönköping University, Jönköping, Sweden.
    Bergman, Stefan
    Spenshult Hospital, Oskarström, Sweden.
    Fridlund, Bengt
    Jönköping University, Jönköping, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    "Striving for a good life" - the management of reumatoid arthritis as experienced by patients2011In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 5, p. 95-101Article in journal (Refereed)
    Abstract [en]

    Aim:

    To generate a theoretical model how patients experience their management of rheumatoid arthritis (RA) in everyday life.

    Method:

    An explorative design with the grounded theory approach was used by interviewing 16 informants with RA.

    Results:

    The generated theoretical model emerged in a core category-Striving for a good life with two categories; making use of personal resources and grasping for support from others, which formed the base of managing RA. When relating these categories together, four dimensions emerged which characterised patients' different ways of managing RA: mastering, relying, struggling and being resigned.

    Discussion:

    The management of RA incorporated the use of personal resources and the grasping for support from others. Both self-management strategies and patients' need of support were highlighted as aspects that were of importance when managing RA. Patients' experiences of their need of support to manage RA give extended knowledge that is of importance for nurses and other healthcare providers. The relationship between patients and healthcare providers is always the key to a good encounter. Interventions to increase self-management in RA have to incorporate this knowledge when trying to increase patients' self-efficacy and with their experience of support.

  • 2.
    Jansson, Inger
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Bahtsevani, Christel
    Faculty of Health and Society, Malmö University.
    Pilhammar, Ewa
    Gothenburg University,The Sahlgrenska Academy, Institute of Health and Care Sciences.
    Forsberg, Anna
    Gothenburg University,The Sahlgrenska Academy, Institute of Health and Care Sciences, and Department of Surgery, Sahlgrenska University Hospital.
    Factors and conditions that influence the implementation of standardized nursing care plans2010In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 4, p. 25-34Article in journal (Refereed)
    Abstract [en]

    Rationale and aim: There is a lack of evidence about how to successfully implement standardized nursing care plans (SNCP) in various settings. The aim of this study was to use the “Promotion Action on Research Implementation in Health Services framework” (PARIHS) to explore important factors and conditions at hospital wards that had implemented SNCPs.

    Method. We employed a retrospective, cross-sectional design and recruited nurses from four units at a rural hospital and seven units at a university hospital in the western and southern region of Sweden where SNCPs had been implemented. Outcome was measured by means of a questionnaire based on the PARIHS-model.

    Result: In total, 137 nurses participated in the study. The main factors that had motivated the nurses to implement SNCPs were that they were easy to understand and follow as well as corresponding to organisational norms. The SNCPs were normally based on clinical experience, although research more frequently formed the basis of the SNCPs at the university hospital. Internal facilitators acted as important educators, who provided reminders to use the SNCP and feedback to the SNCP users. The patient experience was not considered valuable. Those who claimed that the implementation was successful were generally more positive in all measurable aspects. The use of SNCPs was rarely evaluated.

    Conclusions: Clinical experience was considered important by the nurses, while they attributed little value to the patient experiences. Successful implementation of research based SNCPs requires internal facilitators with knowledge of evidence-based nursing.

  • 3.
    Jansson, Inger
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Pilhammar, Ewa
    Göteborg University, Institute of Health and Care Sciences.
    Forsberg, Anna
    Göteborg University, Institute of Health and Care Sciences.
    Obtaining a Foundation for Nursing Care at the Time of Patient Admission: A Grounded Theory Study2009In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 3, p. 56-64Article in journal (Refereed)
    Abstract [en]

    The nursing process can be viewed as a problem-solving model, but we do not know whether use of the whole process including care plans with interventions based on nursing diagnoses improves nurses' ability to carry out assessments. Therefore, the aim of this study was to illuminate and describe the assessment and decision-making process performed by nurses who formulated individual care plans including nursing diagnosis, goals and interventions or who used standardized care plans when a patient was admitted to their ward for care, and those who did not. Data collection and analysis were carried out by means of Grounded theory. Nurses were observed while assessing patients, after which they were interviewed. The main concern of all nurses was to obtain a foundation for nursing care based on four strategies; building pre-understanding, creating a caring environment, collecting information on symptoms and signs and performing an analysis from different perspectives. It appeared that the most important aspect for nurses who did not employ care plans was the medical reason for the patient's admission. The nurses who employed care plans discussed their decisions in terms of nursing problems, needs and risks. The results indicate that nurses who formulated care plans were more aware of their professional role.

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