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  • 1.
    Andersson, Petra Lilja
    et al.
    Lund Univ, Dept Hlth Sci, Lund, Sweden..
    Ahlner-Elmqvist, Marianne
    Lund Univ, Dept Hlth Sci, Lund, Sweden..
    Johansson, Unn-Britt
    Sophiahemmet Univ Coll, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci, Danderyd Hosp, Div Med, Stockholm, Sweden..
    Larsson, Maria
    Karlstad Univ, Dept Nursing, Karlstad, Sweden..
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nursing students' experiences of assessment by the Swedish National Clinical Final Examination2013In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 33, no 5, p. 536-540Article in journal (Refereed)
    Abstract [en]

    The Swedish National Clinical Final Examination (NCFE) was established in 2007 in order to examine nursing students' clinical competence upon completing their Bachelor's degree in nursing. The NCFE constitutes an innovative method of examination, divided into two parts: a written and bedside test. The aim of this study was to evaluate nursing students' experiences of being assessed by means of the NCFE, in order to obtain information that could be used to improve the examination. A survey was conducted using a questionnaire with open-ended questions concerning the written and the bedside part of the NCFE. The answers from 577 third-year nursing students were analysed using content analysis. The nursing students regarded the NCFE as promoting further learning and as an important means of quality assurance. Its comprehensive nature was perceived to tie the education together and contributed to the students' awareness of their own clinical competence. The strengths of the NCFE especially highlighted were its high degree of objectivity and the fact that it took place in a natural setting. However, the students felt that the NCFE did not cover the entire nursing programme and that it caused stress. It thus appears to be important to reconsider the written theoretical part of the examination and to standardise the bedside part. (C) 2011 Elsevier Ltd. All rights reserved.

  • 2.
    Blomqvist, Marjut
    et al.
    Department of Psychiatry, Central County Hospital Halmstad, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    "Family in the waiting room": A Swedish study of nurses' conceptions of family participation in acute psychiatric in-patient setting2011In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 20, p. 185-194Article in journal (Refereed)
    Abstract [en]

    Family plays an important role in the care provided for patients in all areas of nursing. However, relatively few studies deal with the focus of the present study: the ways that nurses experience family participation in acute psychiatric inpatient settings. Data were collected by interviewing 18 nurses who had experience working in such settings. A phenomenographical approach was used to analyse the interviews. Three descriptive categories were found: family participation as a part of the caring process, barriers to family participation, and nurses' resources in family participation. The findings show that the nurses' conceptions of family participation varied, and that the family was not always a priority in this caring context. The implementation of family participation was often only based on the nurses' own interests and insights. This could mean that family participation differed substantially, depending on which nurse a family encountered, and which unit the patient was admitted at. Finally, nurses had little professional autonomy, and organizational support and education were also lacking.

  • 3.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Department of Women's and Children's health, Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. School of Social and Health Sciences, Örebro University, Örebro, Sweden.
    Nissen, Eva
    Department of Women's and Children's health, Karolinska Institutet, Stockholm, Sweden.
    Psychometric properties of the Swedish Child-Birth Self-efficacy Inventory (Swe-CBSEI)2014In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 14, no 1, article id 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Previous research has reported that women who are admitted to delivery wards in early labour process before an active stage of labour has started run an increased risk of instrumental deliveries. Therefore, it is essential to focus on factors such as self-efficacy that can enhance a woman's own ability to cope with the first stage of labour. However, there was no Swedish instrument measuring childbirth self-efficacy available. Thus, the aim of the study was to translate the Childbirth Self-efficacy Inventory and to psychometrically test the Swedish version on first- time mothers within the Swedish culture.

    METHODS: The method included a forward-backward translation with face and content validity. The psychometric properties were evaluated using a Principal Component Analysis and by using Cronbach's alpha coefficient and inter-item correlations. Descriptive statistics and non-parametric tests were used to describe and compare the scales. All data were collected from January 2011 to June 2012, from 406 pregnant women during the gestational week 35-42.

    RESULTS: The Swedish version of the Childbirth Self-Efficacy Inventory indicated good reliability and the Principal Component Analysis showed a three-component structure. The Wilcoxon Signed-Ranks Test indicated that the women could differentiate between the concepts outcome expectancy and self-efficacy expectatancy and between the two labour stages, active stage and the second stage of labour.

    CONCLUSIONS: The Swedish version of Childbirth Self-efficacy Inventory is a reliable and valid instrument. The inventory can act as a tool to identify those women who need extra support and to evaluate the efforts of improving women's self-efficacy during pregnancy. © 2014 Carlsson et al.; licensee BioMed Central Ltd.

  • 4.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Halland Hospital Halmstad, Halmstad, Sweden & Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nissen, Eva
    Karolinska Institutet, Stockholm, Sweden.
    The relationship between childbirth self-efficacy and aspects of well-being, birth interventions and birth outcomes2015In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, no 10, p. 1000-1007Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: this study aimed to examine how women׳s childbirth self-efficacy beliefs relate to aspects of well-being during the third trimester of pregnancy and whether there was any association between childbirth self-efficacy and obstetric factors.

    DESIGN: a cross-sectional design was used. The data was obtained through the distribution of a composite questionnaire and antenatal and birth records.

    SETTING: data were recruited from antenatal health-care clinics in Halland, Sweden.

    PARTICIPANTS: a consecutive sample of 406 pregnant women was recruited at the end of pregnancy at gestational weeks of 35-42.

    MEASUREMENTS: five different measures were used; the Swedish version of Childbirth Self-Efficacy Inventory, the Wijma Delivery Expectancy/Experience Questionnaire, the Sense of Coherence Questionnaire, the Maternity Social Support Scale and finally the Profile of Mood States.

    FINDINGS: results showed that childbirth self-efficacy was correlated with positive dimensions as vigour, sense of coherence and maternal support and negatively correlated with previous mental illness, negative mood states and fear of childbirth. Women who reported high childbirth self-efficacy had less epidural analgesia during childbirth, compared to women with low self-efficacy.

    KEY CONCLUSIONS: this study highlights that childbirth self-efficacy is a positive dimension that interplays with other aspects and contributes to well-being during pregnancy and thereby, acts as an asset in the context of childbirth. © 2015 Elsevier Ltd.

  • 5.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Sahlberg-Blom, Eva
    Hälsoakademin, Örebro University, Örebro, Sweden.
    Nissen, Eva
    Karolinska Institutet, Stockholm, Sweden.
    Maintaining power: Women's experiences from labour onset before admittance to maternity ward2011In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 1, p. 86-92Article in journal (Refereed)
    Abstract [en]

    Background: in Sweden pregnant women are encouraged to remain at home until the active phase of labour. Recommendation is based on evidence, that women who seek care and are admitted in the latent phase of labour are subjected to more obstetric interventions and suffer more complications than women who remain at home until the active phase of labour. The aim of this study was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset until admission to labour ward. Method: interviews were conducted with 19 women after they had given birth to their first child. A Constructivist Grounded theory method was used. Findings: 'Maintaining power' was identified as the core category, explaining the women's experience of having enough power, when the labour started. Four related categories: to share the experience with another', to listen to the rhythm of the body', to distract oneself and to be encased in a glass vessel', explained how the women coped and thereby maintained power. Conclusions: the first time mothers in this study, who managed to stay at home during the latent phase of labour, had a sense of power that was expressed as a driving force towards the birth, a bodily and mental strength and the right to decide over their own bodies. This implies that women who maintain power have the ability to make choices during the birth process. The professionals need to be sensitive, supportive and respectful to women's own preferences in the health-care encounter, to promote the existing power throughout the birthing process. © 2010 Elsevier Ltd.

  • 6.
    Forsberg, Elenita
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fors, Uno
    Department of Learning, Informatics, Management & Ethics, Karolinska Institutet, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    VP-based Final Examination: a model to reach advanced level standards for the degree of paediatric nursing in Sweden2010In: MEDINFO 2010: proceedings of the 13th World Congress on Medical Informatics / [ed] Charles Safran; S Reti; Heimar F Marin, Amsterdam: IOS Press, 2010Conference paper (Refereed)
    Abstract [en]

    Web-SP is a system for virtual patient, developed at Karolin- ska Institutet (KI) in Sweden. In this study, we examine Web- SP cases for assessing paediatric nursing students.To investi- gate the possibility of using Web-SP for assessing clinical reasoning skills and to study students acceptance and to de- termine whether the skills required of experienced paediatric registered nurses could be adequately assessed by the system. The intervention included a two-part of exams. The results show high levels of acceptance of the Web-SP as an examin- ation method. Students also thought it was a good way to practice their clinical skills. Findings have relevance in the development of clinical information systems where clinical decision making is important.

  • 7.
    Forsberg, Elenita
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Georg, Carina
    Dept. of Neurobiology, Care Sciences and Society (NVS), Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fors, Uno
    Dept. of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.
    Virtual patients for assessment of clinical reasoning in nursing: A pilot study2011In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 31, no 8, p. 757-762Article in journal (Refereed)
    Abstract [en]

    In different nursing programmes, one important learning outcome is clinical reasoning (CR) skills. However, to date, there is limited number of methods available for assessment of CR skills; especially for distance-based courses. This study investigates students' opinions about the feasibility of using Virtual Patients (VPs) for assessing CR in nursing education. VPs were introduced as an assessment tool in three different nursing courses at two universities, comprising 77 students in total. Students' overall acceptance of this assessment tool, including its applicability to the practise of nursing and the potential of VP-based assessment as a learning experience, were investigated using questionnaires. Course directors used the Web-SP system to assess students' interactions with VPs and their answers regarding diagnoses, caring procedures and their justifications. Students' found the VP cases to be realistic and engaging, and indicate a high level of acceptance for this assessment method. In addition, the students' indicated that VPs were good for practising their clinical skills, although some would prefer that the VP system be less "medical" and asked for more focus on nursing. Although most students supplied correct diagnoses and made adequate clinical decisions, there was a wide range in their ability to explain their clinical reasoning processes. (C) 2010 Elsevier Ltd. All rights reserved.

  • 8.
    Forsberg, Elenita
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Fors, Uno
    Inst. Data och systemvetenskap, Stockholms Universitet.
    VP based examination in paediatric nursing2011In: Assessment for Quality: from knowledge to professional competence : programme & abstracts, Stockholm: Karolinska Institutet , 2011Conference paper (Other academic)
  • 9.
    Forsberg, Elenita
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). CLINTEC, Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hult, Håkan
    Karolinska Institutet, Stockholm, Sweden.
    Fors, Uno
    Stockholm University, Stockholm, Sweden.
    Assessing progression of clinical reasoning through Virtual Patients2014In: Ottawa Conference Abstracts: Ottawa, Ontario, Canada: April 25-29, 2014: Transforming Healthcare through Excellence and Evaluation: 16th Ottawa Conference: 12th Canadian Conference on Medical Education, 2014, p. 71-72Conference paper (Refereed)
    Abstract [en]

    Background

    There have been discussions to use more formative assessments in health care education to contribute to students’ deep learning. Feedback is important, but a lot of student’s do not do anything with it. Thus, interventions which force students to reflect the new knowledge need to be introduced.

    In order to explore if formative VP-based exams had an impact on development of clinical reasoning ability and achievement of clinical decision making, we let postgraduate pediatric nurse students complete self-evaluation forms in connection with three VP- based assessments to follow their progress.

    Summary of Work

    After performed assessment and before answering the self-evaluation form, the students’ were asked to take part of the feedback section of the VP-system and the recommended interactions in the VP system. Data was conducted using content analysis with a deductive approach. Kolb’s’ model of Learning Cycle guided the analysis.

    Summary of Results

    The result showed a perceived progression of clinical reasoning skills by the students. After the first assessment the students described uncertainty and that knowledge gaps were exposed, at the second exam the awareness of clinical reasoning was obvious and the students were more certain of knowing how. Finally, self-efficacy in patient solving was expressed.

    Conclusions

    VP-based assessments with self-evaluation early in the education resulted in a gain of students’ own identification of the concept of clinical reasoning, awareness of what to focus on, and pay attention to during clinical practice.

    Take-home Messages

    VP with reflective tools is excellent to use in formative assessments to identify progress and to visualize the expected clinical competence.

  • 10.
    Forsberg, Elenita
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Hult, Håkan
    Dept. of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
    Fors, Uno
    Dept. of Computer and Systems Sciences (DSV), Stockholm University, Kista, Sweden.
    Assessing progression of clinical reasoning through virtual patients: An exploratory study2016In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 16, no 1, p. 97-103Article in journal (Refereed)
    Abstract [en]

    To avoid test-driven learning, there have been discussions regarding the use of more formative assessments in health care education to promote students' deep learning. Feedback is important in formative assessment, but many students ignore it; therefore, interventions should be introduced which stimulate them to reflect on the new knowledge.

    The aim for this study was to explore if Virtual Patient (VP)-based formative assessments, in connection with self-evaluations, had an impact on postgraduate pediatric nursing students' development of clinical reasoning abilities. Students' self-evaluations served as the basis for measuring progress. Data was analysed using deductive content analysis.

    The findings showed a clear progression of the clinical reasoning ability of the students. After the first assessment, the students described feelings of uncertainty and that their knowledge gaps were exposed. At the mid-course assessment the awareness of improved clinical reasoning was obvious and the students were more certain of knowing how to solve the VP cases. In the final assessment, self-efficacy was expressed.

    VP-based assessments, in connection with self-evaluations, early in the education resulted in a gain of students' own identification of the concept of clinical reasoning, awareness of what to focus on during clinical practice and visualised expected clinical competence. © 2015 Elsevier Ltd. All rights reserved.

  • 11.
    Forsberg, Elenita
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Dept. of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hult, Håkan
    Dept. of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
    Fors, Uno
    Dept. of Computer and Systems Sciences (DSV), Stockholm University, Stockholm, Sweden.
    Clinical reasoning in nursing, a think-aloud study using virtual patients – A base for an innovative assessment2013In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 4, p. 538-542Article in journal (Refereed)
    Abstract [en]

    In health-care education, it is important to assess the competencies that are essential for the professional role. To develop clinical reasoning skills is crucial fornursing practice and therefore an important learning outcome in nursing education programmes. Virtual patients (VPs) are interactive computer simulations of real-life clinical scenarios and have been suggested for use not only for learning, but also for assessment of clinical reasoning. The aim of this study was to investigate how experienced paediatric nurses reason regarding complex VP cases and how they make clinical decisions. The study was also aimed to give information about possible issues that should be assessed in clinical reasoning exams for post-graduate students in diploma specialist paediatric nursing education. The information from this study is believed to be of high value when developing scoring and grading models for a VP-based examination for the specialist diploma in paediatricnursing education. Using the think-aloud method, data were collected from 30 RNs working in Swedish paediatric departments, and child or school health-care centres. Content analysis was used to analyse the data. The results indicate that experienced nurses try to consolidate their hypotheses by seeing a pattern and judging the value of signs, symptoms, physical examinations, laboratory tests and radiology. They show high specific competence but earlier experience of similar cases was also of importance for the decision making. The nurses thought it was an innovative assessment focusing on clinical reasoning and clinical decision making. They thought it was an enjoyable way to be assessed and that all three main issues could be assessed using VPs. In conclusion, VPs seem to be a possible model for assessing the clinical reasoning process and clinical decision making, but how to score and grade such exams needs further research. © 2013 Elsevier Ltd. All rights reserved.

  • 12.
    Forsberg, Elenita
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hult, Håkan
    Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden .
    Fors, Uno
    Department of Computer and Systems Sciences (DSV), Stockholm University, Stockholm, Sweden .
    Evaluation of a novel scoring and grading model for VP-based exams in postgraduate nurse education2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1246-1251Article in journal (Refereed)
    Abstract [en]

    For Virtual Patient-based exams, several scoring and grading methods have been proposed, but none have yet been validated. The aim of this study was to evaluate a new scoring and grading model for VP-based exams in postgraduate paediatric nurse education.The same student group of 19 students performed a VP-based exam in three consecutive courses. When using the scoring and grading assessment model, which contains a deduction system for unnecessary or unwanted actions, a progression was found in the three courses: 53% of the students passed the first exam, 63% the second and 84% passed the final exam. The most common reason for deduction of points was due to students asking too many interview questions or ordering too many laboratory tests.The results showed that the new scoring model made it possible to judge the students' clinical reasoning process as well as their progress. © 2015 Elsevier Ltd.

  • 13.
    Forsberg, Elenita
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hult, Håkan
    Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
    Fors, Uno G.H.
    Department of Computer and Systems Sciences (DSV), Stockholm University, Stockholm, Sweden.
    Using VPs for assessment of clinical competence in postgraduate Paediatric Nurse Education2012In: Assessment of Competence in Medicine and the Healthcare Professions, 2012Conference paper (Refereed)
  • 14.
    Göransson, Carina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Örebro University, Örebro, Sweden.
    Wengström, Yvonne
    Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Blomberg, Karin
    Örebro University, Örebro, Sweden.
    The elderly persons´ experiences of reporting health status in an ICT-platform2015In: Abstracts: 19th International Philosophy of Nursing Society (IPONS) conference: August 24-26, 2015 Karolinska Institutet, Stockholm, Sweden: Technology, Health Care and Person-centeredness: Beyond Utopia and Dystopia. Thinking the Future, Stockholm: Karolinska Institutet , 2015, p. 19-20Conference paper (Refereed)
    Abstract [en]

    Background

    More and more elderly persons are living in their own home and with support from home care due to health deterioration. This puts demands on society and especially health care to support health and self-care for the elderly persons. Therefore its essential to develop new innovative solutions which both enhance communication between the elderly person and the nurse and also increase the elderly persons´ involvement in their everyday care. An information- and communication technology (ICT)-platform was developed with content from the perspective from elderly persons, health care professionals and the literature. The platform is developed in collaboration with a Swedish company specialized in health care management consulting and new innovative care (Health Navigator). The aim with the project is to describe experiences an ICT-platform with focus on user friendly and acceptability by elderly persons living in own homes with assistance of home care nurses.

    Method

    The study has a mixed methods approach advocated for the evaluation of new technologies within health care. The design is underpinned by the Medical Research Council´s complex intervention framework.

    Elderly persons > 65 years, living in own homes, with assistance from home care nurses have regularly reported health status for three months. They have also access to evidence-based self-care advice with links to web-based pages and graph on reported health status. The home care nurse receive an alarm according to a risk assessment model and can instant  contact the elderly persons for discussion the health concerns.

    Individual interviews with the elderly persons are conducted after the intervention on the experience of using the ICT-platform, with focus on user friendly and acceptability .

    Results

    Preliminary results will be presented of the elderly persons experiences with focus on user friendly and acceptability of using an ICT-platform from reporting health status, using self-care advice and graph of reported health status.

  • 15.
    Göransson, Carina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Wengström, Yvonne
    Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Langius-Eklöf, Ann
    Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Irene
    School of Life Sciences, University of Skövde, Skövde, Sweden.
    Kihlgren, Annica
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Blomberg, Karin
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Perspectives of health and self-care among older persons – To be implemented in an interactive information and communication technology-platform2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 23-24, p. 4745-4755Article in journal (Refereed)
    Abstract [en]

    Aim and objectives: To acquire knowledge regarding the contents to be implemented in an interactive information and communication technology-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves. Background: The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals. Design: Descriptive qualitative design. Methods: This study was based on three samplings: a scoping review of the literature (n = 20 articles), interviews with healthcare professionals (n = 5) and a secondary analysis of interviews with older persons (n = 8) and nursing assistants (n = 7). The data were analysed using qualitative content analysis. Results: Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons. Conclusions: The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive information and communication technology-platform for use in regular daily care assessments. Descriptions of self-care were limited indicating a possible gap in knowledge that requires further research. Relevance to clinical practice: Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing. © 2017 John Wiley & Sons Ltd

  • 16.
    Göransson, Carina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Kihlgren, Annica
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Wengström, Yvonne
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden & Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Blomberg, Karin
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Increased well-being and participatory care for older adults with support of an interactive web-based platform2014In: Book of Abstracts: Nobel Day Festivities 10th of December 2014, 2014, p. 12-12Conference paper (Refereed)
  • 17.
    Göransson, Carina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wengström, Yvonne
    Karolinska institutet, Huddinge, Sweden.
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Blomberg, Karin
    Örebro University, Örebro, Sweden.
    Feasibility and acceptability of an interactive ICT-platform in older adults for participatory care2015In: ACENDIO 2015: eHealth and Nursing: Knowledge for Patient Care / [ed] Fintan Sheerin, Walter Sermeus & Anna Ehrenberg, Dublin: Association for Common European Nursing Diagnoses, Interventions and Outcomes , 2015, p. 328-330Conference paper (Refereed)
    Abstract [en]

    Background

    The increasing ageing population puts demands on society and particularly on health care system to promote a health related qualityof life. Thus, it is necessary to develop strategies that promote self-care among older adults that enable them to live in their own homes as long as possible and to make them feel safe and involved in their care. In order to encourage their participationin their care, new innovative solutions are needed. The market of information-and communication technology (ICT)-based platforms directed to the health care arena has exploded during recent years. Despite the large range of products few are developed withinteractive components. In collaboration within a multicenter research group and a Swedish health care company (Health Navigator) an ICT-platform is developed for use in a mobile phone or tablet that includes an interactive mobile application for reporting problems and concerns. This platform is unique through the real-time communication enabling rapid management of early-detected problems.

    Aim

    The aim with the project is to evaluate an ICT-platform by older adults living in own homes with assistance from home care nurses in a community in Sweden.

    Method

    The study is prospective and has a mixed methods approach advocated for the evaluation of new technologies within healthcare. This includes a quantitative approach to evaluate effects, qualitative methods such as interviews and focus group discussions to evaluate how patients and health care professionals perceive the intervention. The design is underpinned by the Medical Research Council’s complex intervention evaluation framework. Thirty older adults >65 years or above, living in their own homes, with assistance from home care nurses have through an application in a tablet reported health status twice a week and when needed during three months. They have continuous access to evidence based self-care advice directly related to their reported problems and concerns. The risk assessment model sends alarms to involved nurses via text messaging (SMS). This initiates an interaction between the nurse and the older adult who is contacted by telephone to discuss the reported problems. Furthermore, the nurses in charge can also log into a web-interface and view the reports of the participants. Individually interviews with the older adults and focus groups interviews with nurses are conducted after the study period. Questionnaires are given to the older adults before intervention, after the study ́s completed and after six months with primarily main outcomes as self-care, health literacy and well-being. A control group with older adults 65 years and above is used as a comparison.

    Results

    Preliminary results will be presented with focus on feasibility, acceptability and benefit of the ICT-platform from the perspective of older adults and home care nurses. Additional logged data on the frequency of symptom reports, alerts, and page views will also be presented.

    Summary

    An interactive ICT-platform is developed and used by older adults to report problems and concerns which enabling rapid management of early-detected problems. This study aims to evaluate the ICT-platform by thirty older adults living in own home with assistance from home care nurses.

  • 18.
    Göransson, Carina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Wengström, Yvonne
    Sektionen för omvårdnad, Institutionen för neurobiologi, vårdvetenskap och samhälle, Karolinska Institutet, Stockholm, Sverige & Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Kihlgren, Annica
    Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Blomberg, Karin
    Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Ökat välbefinnande och delaktighet hos äldre personer via en interaktiv webbaserad plattform2014In: De ska va gôtt å leva: Vårdforskningens dag: 16 oktober 2014, 2014, p. 18-18Conference paper (Refereed)
  • 19.
    Göransson, Carina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Institutionen för hälsovetenskap och medicin, Örebro universitet, Örebro, Sverige.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Wengström, Yvonne
    Örebro universitet, Örebro, Sverige & Karolinska Institutet, Stockholm, Sverige.
    Kihlgren, Annica
    Örebro universitet, Örebro, Sverige.
    Blomberg, Karin
    Örebro universitet, Örebro, Sverige.
    Ökat välbefinnande och delaktighet hos äldre personer via interaktiv webbaserad plattform2014In: FoUU-dagen 2014: En upptäcktsfärd genom hallänningens liv, 2014, p. 21-21Conference paper (Refereed)
  • 20.
    Göransson, Carina
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Öman, Anders
    Medicinkliniken, Länssjukhuset Halmstad.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    När söker patienter med kroniskt obstruktiv lungsjukdom för akuta exacerbationer?2010Other (Other academic)
    Abstract [en]

    Chronic obstructive pulmonary disease (COPD) is expected to be the third common disease worldvide and third common cause of death in Sweden 2020.The main cuase is smoking and build up an irreversible respiratory obstruction of the small bronchioles. With time some patiens have frequent acute exacerbations wich demand repeatedly need of treatment. Studies have shown different factors of individual-and organization which influence on patients needs of care due to acute exacerbation.The aim of this study was to investigate connection for patients with COPD when they seek emergency ward due to acute exacerbation and their early need for care. Data was collected between january-may 2009. All consecutive patients who seek acute to emergency ward due to acute exacerbation was included. Patient´s medical records was examined for socio-demographic and clinical characteristics, which time they seek and early care. A questionnaire was constructed based on literature and own empirical experience.Only in-patiens have sureyed regard to lack of registratin routine for patients who was directly discharged. 160 patients seek of current diagnosis related groups of whom 98 had COPD and 30 meet inclusionscriteria. Distributed on 17 women and 13 men. Most patients seek daytimes and nearly as often weekdays as weekends. Patients with shorter duration of disease seek day and night while patiens with longer duration seek daytime. This studie is based on a small sample and only discern some trends. However,it show new aspect regarding timeaspect when patients with COPD seek due to acute exacerbation. Further research is required for improve patients coping and optimize organization

     

  • 21.
    Högman, Marie-Louise
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nurses' Perceptions of the Electronic Patient Record Based on Patient Safety2011In: ACENDIO 2011: E-health and Nursing - How Can E-health Promote Patient Safety? / [ed] Fintan Sheerin, Walter Sermeus, Kaija Saranto Elvio H. Jesus, Dublin: ACENDIO , 2011, p. 162-167Conference paper (Refereed)
  • 22.
    Johansson, Unn-Britt
    et al.
    Sophiahemmet Högskola och Karolinska Institutet, Institutionen för kliniska vetenskaper, Enheten för medicin, Danderyds sjukhus.
    Larsson, Maria
    Karlstads universitet .
    ziegert, kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Östlinder, Gerthrud
    Svensk sjuksköterskeförening .
    Nationell klinisk slutexamination för sjuksköterskeexamen - ett verktyg för en säker och likvärdig bedömning av klinisk komptens: Profession, organisation och lärande2010In: Symposium, Stockholm: Svenska läkaresällskapet , 2010Conference paper (Refereed)
    Abstract [sv]

    Nationell klinisk slutexamination för sjuksköterskeexamen startade hösten 2003 som ett projekt i samarbete mellan fyra lärosäten och Svensk sjuksköterskeförening. Läkarnas s.k. AT-prov har delvis utgjort modell för examinationen. En styrelse är bildad med ansvar för samordning, kvalitetssäkring och vidareutveckling. Idag är mer än hälften (n=13) av de lärosäten som bedriver sjuksköterskeprogram (n=25) involverade i examinationen. Deltagandet sker enligt avtal för att åstadkomma en nationell kvalitetskontroll med tydlig verksamhetsförankring av sjuksköterskans kliniska kompetens. Examinationen som genomförs i slutet av sista terminen avser att möta Socialstyrelsens och verksamhetens krav på nyexaminerad sjuksköterska. Examinationen består av en skriftlig och en praktisk del, och skall kunna genomföras oavsett i vilken klinisk verksamhet studenten fullgör sin sista termin, under förutsättning att den kliniska verksamheten motsvarar den grundutbildade sjuksköterskans kompetensområde. Den skriftliga delen består av två patientfall som studenten analyserar.  I den praktiska delen bedöms studenten enligt särskild instruktion av en ”bedömningsansvarig sjuksköterska” i samband med vård av en utvald patient. Bedömningen avslutas med en dialog mellan student, bedömningsansvarig sjuksköterska och examinator. Examinationen följer intentionerna i Bolognaprocessen d.v.s. utbildningarna och utbildningsnivåer ska vara jämförbara med varandra oavsett var utbildningen genomförs. Högskoleverkets utvärdering av sjuksköterskeutbildningarna visar också på behov av att utveckla framförallt kliniska examinationer.  

     

    Styrelsen har under vårterminen 2010 genomfört en enkätutvärdering. Syftet var att utvärdera om Nationell klinisk slutexamination mäter den kliniska kompetens som krävs för en nyexaminerad sjuksköterska på grundnivå utifrån förväntade krav på yrkeskompetens enligt Kompetensbeskrivning för legitimerad sjuksköterska (Socialstyrelsen, 2005) och Högskoleförordningens examensordning (SFS 2006:1053). Enkäten riktades till fyra grupper; rättande lärare av skriftlig del, bedömningsansvarig sjuksköterska vid praktiskt prov, klinisk lärare/examinator praktiskt prov och sjuksköterskestudent. Under symposiet kommer enkätutvärderingen att presenteras och diskuteras. Nationell klinisk slutexamination för sjuksköterskeexamen tillhör en av de mest välutvecklade, standardiserade, systematiskt prövade examinationer som sjuksköterskestudenter genomgår. 

  • 23.
    Johansson, Unn-Britt
    et al.
    Sophiahemmet University, Stockholm, Sweden & Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Lilja Andersson, Petra
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Larsson, Maria
    Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Ahlner-Elmqvist, Marianne
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Use of a National Clinical Final Examination in a Bachelor´s Programme in Nursing to Assess Clinical Competence-Students´, Lecturers´and Nurses´Perceptions2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 7, p. 501-511Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of this study was to evaluate the perceptions of students, lecturers, nurses and clinical lecturers regarding the ability of the National Clinical Final Examination (NCFE) to assess clinical competence, and whether the assessment was consistent with the qualifications for a Bachelor of Science in Nursing as outlined by the Swedish Higher Education Authority. The NCFE is divided into two parts (written and bedside) and aims to evaluate third-year nursing students’ clinical competence. Methods: Data were collected at 10 universities using study-specific questionnaires. The total response rate was 84% (n = 1652). Results: The clinical lecturers indicated that there was a need for improvement in the written part of the examination in order to adequately assess clinical competence. Regarding the bedside part the clinical lecturers, nurses and students perceived that the bedside part of the examination assessed whether the student had the clinical competence required by a newly registered nurse. Conclusion: The two-part examination described in this study was perceived as useful for assessing clinical competence and for the qualification requirements for a Bachelor of Science in Nursing as outlined by the Swedish Higher Education Authority. However, especially the written part requires further development. The model and form of assessment ought to be applicable to graduate nursing programme internationally.

  • 24.
    Kihlgren, Annica
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Sunvisson, Helena
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Mamhidir, Anna-Greta
    Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden & Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Referrals to Emergency Departments: The Process and Factors That Influence Decision-Making among Community Nurses2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 5, p. 366-374Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe the basis on which municipal care registered nurses (RN) make decisions and their experiences when referring older persons from nursing homes to emergency departments (EDs). RNs in the community are to ensure that older adults receive good care quality in nursing home. This study used a descriptive design with a qualitative content analysis. The analysis of the data from the 13 interviews revealed one theme “Shared responsibilities in the best interests of the older person reduce feelings of insufficiency”. The content was formulated, which revealed the RNs’ feelings, reasoning and factors influencing them and their actions in the decision-making situation, before the patients were referred to an emergency department. Complex illnesses, non-adapted organizations, considerations about what was good and right in order to meet the older person’s needs, taking account of her/his life-world, health, well-being and best interests were reported. Co-worker competencies and open dialogues in the “inner circle” were crucial for the nurses’ confidence in the decision. Hesitation to refer was associated with previous negative reactions from ED professionals. The RN sometimes express that they lacked medical knowledge and were uncertain how to judge the acute illness or changes. Access to the “outer circle”, i.e. physicians and hospital colleagues, was necessary to counteract feelings of insecurity about referrals. When difficult decisions have to be made, not only medical facts but also relationships are of importance. To strengthen the RNs’ and staff members’ competence by means of education seems to be important for avoiding unnecessary referrals. Guidelines and work routine need to be more transparent and referrals due to the lack of resources are not only wasteful but can worsen the older persons’ health.

  • 25.
    Kristén, Lars
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Parker, James
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Challenges for Intervention Research in Health and Lifestyle Research – A Systematic Meta-literature Review2015Conference paper (Refereed)
    Abstract [en]

    Introduction

    Health and well-being are two concepts that are widely discussed within today’s society. A major perspective in health and lifestyle research is to investigate what determinants are associated with health. When it comes to the delivery of health interventions several different approaches have been suggested.

    Methods

    The meta-synthesis was chosen for synthesis of research studies using a health and lifestyle the review format and analyse meta-questions. The process included the following five phases:

    1. Literature search for articles.

    2. Selection of relevant articles after repeated reading and appraisal of the articles.

    3. Extraction of data from each article and creating a list of findings as key phrases, ideas and concepts for each individual study.

    4. Determining how the findings of the selected studies are related and translating findings into one another.

    5. Synthesizing the translations to produce a new theoretical interpretation.

    Results

    The search yielded a total of 561 unique citations and finally 24 citations remained. Of those 11 studies focused on health determinants, while 13 focused on interventions for health promotion. The meta-synthesis led to four recommendations for the design of future intervention studies. (1) scientific disciplines should collaborate in the design, implementation and evaluation of the study. (2) to use theoretical frameworks that focus on health determinants and to apply longitudinal studies with a repeated measures design.(3) involve behavioral interventions. (4) to design face-to-face intervention studies.

    Discussion

    Determinants was related to a physical active lifestyle, more specifically high quality school programs for physical education. It could be a starting point for a nationwide approach of daily physical activity in whole society. In all intervention studies physical activity behaviors were included as outcome or intervention program. It is therefore speculated that physical activity behavior could be discussed as one mediator between health determinants and health outcomes.

    References

    Bailey, R. (2006). Physical education and sport in schools: a review of benefits and outcomes. Journal of School Health, 76, 397-401.

    Dodge, R., Daly, A., Huyton, J., & Sanders, L. (2012). The challenge of defining wellbeing. International Journal of Wellbeing, 2, 222-235.

    Kahn, E. B., Ramsey, L. T., Brownson, R. C., Heath, G. W., Howze, E. H., Powell, K. E., & Corso, P. (2002). The effectiveness of interventions to increase physical activity: A systematic review. American journal of preventive medicine, 22, (4), 73-107.

    Paterson, B.L., Thorne, S., Canam, C., Jilings, C., (2001). Meta-Study of Qualitative Health Research: A Practical Guide to Meta-Analysis and Meta-Synthesis. Sage, Thousand Oaks,CA.

    Södergren, M. (2013). Lifestyle predictors of healthy ageing in men. Maturitas, 75, 113-117.

    Corresponding author email: Lars.Kristen@hh.se

  • 26.
    Kristén, Lars
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Parker, James
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Future challenges for intervention research in health and lifestyle research: A systematic meta-literature review2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, article id 27326Article in journal (Refereed)
    Abstract [en]

    The overall aim of this systematic meta-literature review was to (1) summarize the findings of review studies focusing on health determinants, (2) give an overview of intervention studies that have been used to facilitate health and lifestyle, and (3) provide recommendations for future studies in health promotion. A literature review, using a meta-method, was conducted to identify health and lifestyle research based on research articles related to health changes. The search yielded a total of 561 unique citations and finally 24 citations remained. Of those, 11 studies focused on health determinants, whereas 13 focused on interventions for health promotion. Results from this meta-synthesis led to four recommendations for the design of future intervention studies. (1) To increase the likelihood of capturing different biopsychosocial aspects of health, researchers from different scientific disciplines should collaborate in the design, implementation, and evaluation of the study. (2) It is recommended to use theoretical frameworks that focus on health determinants in longitudinal studies with a repeated measures design. (3) Studies should involve behavioral interventions. (4) Design face-to-face intervention studies where the participant can interact with other persons.

  • 27.
    Larsson, Glenn
    et al.
    Department of Ambulance, Region Halland, Halmstad, Sweden.
    Holmén, Anders
    Department of R&D, Region Halland, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Early Assessment of Patient´s Medical Condition in Ambulance Care Affects the Level of Care of Non Urgent Patients2016In: Nursing Informatics 2016: eHealth for All: Every Level Collaboration – From Project to Realization / [ed] Walter Sermeus, Paula M. Procter & Patrick Weber, Amsterdam: IOS Press, 2016, Vol. 225, p. 893-894Conference paper (Refereed)
    Abstract [en]

    The Rapid Emergency Triage and Treatment System (RETTS) is used by the Swedish ambulance care organization for assessment of patients medicalcondition. The aim of the present study was to evaluate prehospital assessment in collaboration with the ambulance nurse and primary health care physicians. If the patient's condition was priority GREEN by RETTS then the ambulance nurse decided to contact the primary care physicians for a dialogue and together they decided which level of care was the most appropriate for the patient's condition. 

    © 2016 IMIA and IOS Press

  • 28.
    Larsson, Glenn
    et al.
    Department of Ambulance and Prehospital Care, Region Halland, Halmstad, Sweden & Department of Orthopaedics, Lund University, Lund, Sweden.
    Holmén, Anders
    Department of R&D, Region Halland, Halmstad, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Early prehospital assessment of non-urgent patients and outcomes at the appropriate level of care: A prospective exploratory study2017In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 32, p. 45-49Article in journal (Refereed)
    Abstract [en]

    Introduction: The Ambulance Organization of Sweden provides qualified medical assessment and treatment by ambulance nurses based on patient needs regarding appropriate levels of care. A new model for patients with non-urgent medical conditions has been introduced. The main objective of this study was to examine early prehospital assessment of non-urgent patients, and its impact on the choice of the appropriate level of care.

    Methods: The study design was a 1-year, prospective study, involving an ambulance district in southwestern Sweden with a population of 78,000. Eligible patients were from18 years of age, assessed as priority GREEN by Rapid Emergency Triage and Treatment System (RETTS). Ambulance nurses contacted primary care physicians on decisions on whether a patient should be transported to a primary healthcare unit or an A&E. Data was collected from electronic health records from April 2014 to July 2015. A comparison was made with a retrospective control group without consulting a physician concerning the appropriate level of care.

    Results: 394 patients were included, 184 in the intervention group, and 210 in the control group. There were statistically significant differences in favor of the study group (p < 0.001) regarding no transport, or transport and admission to an A&E. The groups did not differ significantly regarding transport to a primary care unit.

    Conclusion: This prehospital assessment model indicates a decrease in ambulance transports to an A&E and admissions to a hospital ward. Collaboration between ambulance nurses and primary physicians affects the decision for the appropriate level of care for patients with a non-urgent condition. © 2017 Elsevier Ltd

  • 29.
    Lydell, Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hildingh, Cathrine
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Söderbom, Arne
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Future challenges for occupational health services can be prevented by proactive collaboration with the companies using the services: a participatory and reflection project2017In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 10, p. 217-225Article in journal (Refereed)
    Abstract [en]

    Background: There is clearly a need for research in the field of occupational health service (OHS) for applying new perspectives. Proactive collaboration is needed between the OHSs and the companies. The customers of the companies using the services should be able to safeguard themselves from the health problems caused by the work environment through proactive collaboration with the OHSs.

    Objective: The main purpose of this interdisciplinary study was to explore how the stakeholders reflected to create and agree on core values for future challenges in OHS, as seen from the perspectives of OHS professionals and customer companies.

    Methodology: An action research process was conducted. This study was divided into three phases. In phase I, the data were collected from interviews and diaries of interdisciplinary occupational health professionals (n=12). A focus group that sampled the eight managers of the customer companies was also included. In phase II, a questionnaire was developed with 24 questions focusing on examining the future challenges for OHS. The questionnaire was sent to customer companies (n=116). In phase III, a scoping review was undertaken.

    Results: Three categories emerged from the analysis: “Balancing complex situations” clarified the complexity regarding senior employees; “Working with a proactive approach” indicated the need for working with a new proactive approach supporting sustainable health; and “Collaborate internally and externally” showed good relationships between the customer and the OHS, which is a mutual responsibility to both the partners.

    Conclusion: The results outlined that it is necessary to take action to apply new proactive health promotions, with a focus on workplace health promotion. The results also indicated that interventions for senior employees are of importance. This study was done in collaboration with the stakeholders from the occupational health care service center and the managers from the customer companies. The use of a participatory research design, including close collaboration with the participants, allows the researchers to see the challenges.

     

  • 30.
    Lydell, Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hildingh, Cathrine
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Söderbom, Arne
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL).
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Health promotion – future challenges in occupational health services. A mixed method approach2015In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 25, no Suppl. 3, p. 355-355Article in journal (Refereed)
    Abstract [en]

    Background

    Occupational health services (OHS) are often working from a pathogenic perspective, seeing the customer as a patient. To meet the future challenges in a more holistic way there is a need of changing perspective. The occupational health services must promote health and prevent the problems before they appear.

    The study will answer the following questions: What experiences do the employees at an OHS have regarding their daily work? What experiences do the employers have regarding the OHS? What challenges do the employers see for the future and how can OHS be supportive?

    Methods

    This study included a three-stage process; the first stage included qualitative data from diaries, collected during one and a half year, interviews with occupational health professionals (n = 12) in an occupational health service center as well as focus groups interviews with managers of the customer companies affiliated to the occupational health service center. The second stage was a quantitative part with a questionnaire to managers of the customer companies (n = 116) and the third stage will be a review of existing literature in occupational health.

    Results

    Findings from stage 1, 2 and 3 are presented in three categories:

    Balancing complex situations was e.g. about the difficulty between loyalty to the client and the company's profits and also that major changes in the workplace are leading to difficulties for many employees. Working with a proactive approach was e.g. about new approaches that are needed in the OHS. Collaborate internal and external showed e.g that more collaboration between companies, OHS and external actors was of importance.

    Conclusions

    • a. Change and apply new perspectives in occupational health services.

    • b. There is clearly a need for research in OHS using a comprehensive approach to health promotion.

    • c. There must be interactions between the occupational health services and the management of the customer companies for designing new proactive health promotion interventions.

    Key messages

    • It is significant for occupational health centers taking into account the importance of balancing complex situations, having a proactive approach and collaborating in working life

    • To change perspective and approaches in occupational health centers are of importance in order to meet future challenges in working life

    © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  • 31.
    Norell Pejner, Margaretha
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Care priorities: Registered nurses’ clinical daily work in municipal elderly care settings2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 388-395Article in journal (Refereed)
    Abstract [en]

    Common in Swedish elderly home care is that Registered Nurses work independently, and lead the care team without being a part of it. People involved in the care of the patient can be social services, physician, Registered Nurse (RN), nurses in inpatient care and family. Inaccording to current model for nursing documentation RNs interventions is described as participation, information/education, support, environment, general care, training, observation/surveillance, special care drug administration and coordination. Time pressure isperceived as high, but the nurses have the opportunity to influence their daily work situation and make priorities. The purpose of this study was to investigate how RNs prioritise interventions in municipal elderly care settings. A quantitative descriptive method was used for the study. Data were collected during the months of April and October 2004 – 2008, using a web-based form. The nurses filled in patient’s type of housing, performed interventions, and if the interventions were delegated. Interventions were described as keywords and wereattributed a certain amount of time, calculated in previous time studies. The inclusion criteria were: all patients 80 years of age and older, in a municipality in southwestern Sweden, who received some form of health care from a RN, or performed by non-certified staff by delegation. Results indicate that differences in priority could be observed, depending on the patient’s gender, or whether the patient was living in independent or sheltered housing. Drug administration was prioritised for female patients, while coordination became a priority for patients living in ordinary housing. Support received the highest priority, regardless if the patient lived in ordinary or sheltered housing. However, it is not entirely clear what support signifies in municipal health care settings, and this issue would therefore require further investigation. © 2012 Nordic College of Caring Science.

  • 32.
    Norell Pejner, Margaretha
    et al.
    Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Örebro University, Örebro, Sweden.
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Dealing with daily emotions – supportive activities for the elderly in a municipal care setting2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, no 9510Article in journal (Refereed)
    Abstract [en]

    There are diverse descriptions of supportive activities in nursing to be found in the literature. That which they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting registered nurses work in a consultative way and they describe a part of their tasks as being comprised of supportive activities without specifying what kind supportive activities they mean. The aim of the study was to explore the main concern of the support given by registered nurses to a group of patients in an elderly home care setting. The study was conducted using Grounded Theory (GT). Data was collected using non participant observations regarding the supportive activities of 12 registered nurses at the home of 36 patients between 80 and 102 years. The core category was about dealing with today's emotions. This was done by encouraging the situation and reducing patient's limitations, but situations also occurred in which there was a gap of support. Support was about capture the emotions that the patient expressed for the moment, but there were also situations in which registered nurses chose not to give support. In order to develop a holistic eldercare more knowledge is needed about the factors causing the registered nurses to choose not to provide support on some occasions. Copyright © 2012 N. Dauman & S. I. Erlandsson.

  • 33.
    Norell Pejner, Margaretha
    et al.
    Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Dealing with today’s emotions - supportive activities for the elderly in a municipal care setting2012Conference paper (Refereed)
    Abstract [en]

    Background; There are diverse descriptions of supportive activities in nursing to be found in the literature. That which they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting registered nurses work in a consultative way and they describe a part of their tasks as being comprised of supportive activities without specifying what kind supportive activities they mean. Aim; The aim of the study was to explore the main concern of the support given by registered nurses to a group of patients in an elderly home care setting. Method; The study was conducted using Grounded Theory (GT). Data was collected using non participant observations regarding the supportive activities of 12 registered nurses at the home of 36 patients between 80 and 102 years. Result; The core category was about dealing with today's emotions. This was done by encouraging the situation and reducing patient's limitations, but situations also occurred in which there was a gap of support. Support was about capture the emotions that the patient expressed for the moment, but there were also situations in which registered nurses chose not to give support. Conclution; The main purpose of supportive activities to a group of elderly persons in a municipal care setting is about dealing with today's emotions. The core category reflects the moment and emotions significance in the care of elderly. In some occasions it occurred a gap of support and this coincided with the inability of the RN to identify the patient’s inner needs. In order to develop a holistic elderly care more knowledge about psychological and spiritual needs is needed.

  • 34.
    Norell Pejner, Margaretha
    et al.
    Doktorand School of Health and Medical Sciences Örebro University, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    School of Health and Medical Sciences Örebro University, Sweden.
    Maintaining wellness in everyday life- supportive activities to elderly in municipal care setting2011Conference paper (Other academic)
    Abstract [en]

    Literature describes supportive activities in nursing in many different ways. In common they have that they are associated with good care outcomes, but may differ depending on the context in which it is given. In Swedish municipal elderly care setting registered nurses works consultative. They describes part of their tasks as supportive activities without specifying what or what kind of support that is meant and it looks as in this form of organization supportive activities expanded to not only include patients. The aim of the study was to obtain a deeper understanding of which support RN express to elderly and explore the main concern of support in municipal care setting. The study was conducted using Grounded Theory. Data was collected using non participant observations. The observations were concerning registered nurses supportive activities interacting with the patient. A total of 12 registered nurses participated in the study which was performed at the home of 36 patients between 80- 102 years. The main concern of registered nurses supportive activities was maintaining wellness in everyday life. This was made by support patient’s internal and external resources, but it also turned out to be situations where it was lack of support.

     

  • 35.
    Norell Pejner, Margaretha
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI). Örebro University, Örebro, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    Örebro University, Örebro, Sweden.
    Municipal Elderly Care – System For Registration of Registered Nurses' Priorities In Clinical Daily Work2010Conference paper (Refereed)
    Abstract [en]

    Aim: The purpose of the study was to investigate how RN prioritizes their activities in their clinical daily work in municipal elderly care setting. Study questions was: Where are the activities performed? How much nursing are performed of non certified personal? What activities are prioritized in time? Methods: The study used a quantitative descriptive method. Data collection took place during the months of April and October during 2004 –2008. For each patient the RN had a responsibility for during the corresponding measurement month, she/ he would fill in a web-based form with data on patient's gender, age, type of housing, performed actions, and if the actions were delegated. Actions were described as keywords in the web-based form and have been assigned a certain amount of time in minutes. The specified time for each keyword were calculated on the basis of data from previously conducted time studies in the municipality. A total of 4,000 different actions were clocked by RNs working in the same area and same organization. Each action was labeled with the related keyword and a mean time for each keyword was calculated. The web-based form summarizes delegated care time and the RN’s time separately. The web-based form also documented the action RN devoted most time to. All information was stored in a database. Result: Support was the activity RN prioritized in time in clinical daily work, but there was even difference in activities depending on patient’s gender or if the patient was living in sheltered or ordinary housing. Drug administration was prioritized for female patients, coordination for patients living in ordinary housing and monitoring for patients living in sheltered housing. RN spent more time to patients in sheltered than in ordinary housing, but the biggest difference was in the delegated time. Patient in sheltered housing received almost double position so much delegated health and care time than patients living in ordinary housing. Conclusion: The study shows that RN prioritized activities to patients 80 years and elderly depending of housing and gender. The activity that was most prioritized regardless housing or gender was support, but what support means in municipal health care setting is not clear and requires more knowledge.

  • 36.
    Norell Pejner, Margaretha
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Kihlgren, Annica
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Older patients’ in Sweden and their experience of the emotional support received from the registered nurse – a grounded theory study2014In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 19, no 1, p. 79-85Article in journal (Refereed)
    Abstract [en]

    Objectives: This study intends to explore older patients’ experiences of the emotional support received from registered nurses (RNs). We also aimed to gain deeper knowledge about the process of how getting the support they need is managed by the patient.

    Methods: The study was conducted using the grounded theory method. Data were collected by interviewing 18 patients between 80 and 96 years old.

    Results: Reasons why older patients experienced the emotional support received from the RN are reflected in the categories ‘Meets my needs when I am irresolute’, ‘Meets my needs when I am vulnerable’ and ‘Meets my needs when I am in need of sympathy’. Reasons to the emotional support resulted in that patients experienced ‘A sense of being able to hand over’, which is therefore the core category of this study.

    Conclusion: Older patients’ experiences of emotional support are about obtaining relief. Patients were active participants and had strategies for which they wanted to share their emotions with the RN. In order to develop participatory care for older patients, we need more knowledge about how emotional support can be used as a nursing intervention. © 2014 Taylor & Francis.

  • 37.
    Norell Pejner, Margaretha
    et al.
    School of Health and Medical Sciences, Örebro University, Sweden.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Trying to cope with everyday life - Emotional support in municipal elderly care setting2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, article id 19613Article in journal (Refereed)
    Abstract [en]

    Emotional support is considered to be important to older patients because it is a contributing factor to experiencing goodhealth and it has been shown that it can prevent depression after a hip fracture. Opinions differ on whether emotionalsupport falls within the field of nursing, and studies also show that nurses in an elderly home care setting fail when it comesto giving emotional support. The aim of this study was to explore reasons for registered nurses to give emotional support toolder patients in a municipal home care setting. The study was conducted using Grounded Theory. Data collection wascarried out through interviews with 16 registered nurses. The inclusion criteria were emotional support given to patientsaged 80 years and above living in ordinary or sheltered housing and who were in need of help from both the home helpservice and registered nurses. The results show that the main concern of emotional support was ‘‘Trying to relieve thepatient from their emotions so they are able to cope with everyday life.’’ This core category illustrates how registered nursestried to support the patients’ own strength, so that they were able to move forward. Registered nurses consider that theycould support the patients because they give them access to, or could create access to, their emotions, but there were alsotimes when they felt helplessness and as a result, consciously opted out. The results also indicate that registered nurses werekeen to give emotional support. To develop patient-centered elderly care, more knowledge of emotional support and theelderly’s need for this support is required. © 2012 N. Dauman & S. I. Erlandsson.

  • 38.
    Pejner, Margaretha Norell
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    "It's amazing that I can take coverage!": emotional support to a group of older patients in municipal home care settingManuscript (preprint) (Other academic)
  • 39.
    Rodgers, Waymond
    et al.
    Hull University, Hull, United Kingdom.
    Hildingh, Cathrine
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). cathrine.hildingh@hh.se.
    Söderbom, Arne
    Halmstad University, School of Business, Engineering and Science, Centre for Innovation, Entrepreneurship and Learning Research (CIEL), Knowledge Entrepreneurship and Enterprise Research (KEEN).
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lydell, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Organizing Senior Employees Occupational Health Resource Management Service in Innovation and Entrepreneurial Context2016Conference paper (Refereed)
    Abstract [en]

    Changing the determinants of health also requires modifying aspects of the settings that has not been done sufficiently in occupational health service. The European Network for workplace health recommended a holistic approach in workplace health promotion including programs concerning individual’s lifestyle and safety management as well as psychosocial and organizational work factors. To this end, we utilize a decision making model that captures the key components of explain how the aging issues pertaining to healthcare employees employ their perception, information, and judgment on decision choices. We collected 116 questionnaire responses from affiliated to the occupational health care center in Sweden. We found that employees’ perception of health care challenges and staffing had a significant impact on their decision choices regarding whether to request, stimulate and collaborate on activities. Finally, our results indicated that aging options related to healthcare issues to request, stimulate and collaborate on activities influence employees’ decision choices.

  • 40.
    Sturesson, Anna
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Prepare the patient for future challenges when facing hemodialysis: nurses´ experiences2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 1, article id 22952Article in journal (Refereed)
    Abstract [en]

    Chronic kidney disease is a major health problem due to the significant financial burden for the healthcare system and likewise for the patient who needs the treatment. The patient’s whole life situation is turned upside down with chronic kidney disease when they are confronted with the forced change to start treatment with hemodialysis. Patients with chronic kidney disease experience a lack of adequate emotional support from nurses during the transition to hemodialysis. The purpose of this study was to explore nurses’ experiences of giving support to patients during the transition to hospital-bound hemodialysis. The study had a qualitative descriptive design with a content analysis approach; eight nurses from four hospitals in the south of Sweden participated. The results showed that the nurses gave threshold support with an openness and awareness of the patient’s individual needs during the transition, except that there seemed to be a lack of knowledge and ability to provide emotional support. Patient support during the transition could therefore be absent. Education, at local and national levels, is needed for the nurse to be able to give professional emotional support. Further research is also desired in order to provide nurses with the tools they need to give emotional support, which is of utmost importance. © 2014 A. Sturesson & K. Ziegert.

  • 41.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Changes and transitions of responsibility when next of kin becomes the caregivers2016Conference paper (Refereed)
    Abstract [en]

    Background

    In the ordinary everyday existence of individuals, life usually goes by without them reflecting on its fragility or their relationships. Individuals in a close relationship are united with each other in a mutual dependency and share memories from the past, perceptions of the present and dreams and hopes for the future. When one of them suddenly seriously ill and thereby assumes the role of seriously ill patient while the other takes on the role of close relative, their normal life is changed into an extraordinary situation. Everyday life can be complex when next of kin are preoccupied with taking responsibility of the care, which in turn lead to a changed life situation and restrictions in everyday life. The summary of the current knowledge highlighted the importance of understanding of next of kin´ coping approaches during responsibility for caring at home. 

    Aim and method

    This study explores the process of changes for next of kin´ in a care home for older relatives from the perspectives of the responsibility for caring. Data were collected using narrative interview with 8 next of kin’ at home. The following questions were asked: Please describe the changed situation you have gone through, when you having the difficult care situation and what did you do to cope with your situation? The individual interviews were nearly all transcribed verbatim, a few were listen to and taking notes during listening. The data set were analyzed by using thematic analysis.

    Findings and conclusion

    Four themes revealed from narrative interviews with the next of kin´. The four themes were: Sources of responsibility related to family interaction; Consequences of changes for everyday; Importance on maintaining their own conditions; Roles and relationships over time. Based on a synthesis of data the themes and basic transitions that emerged were termed “re-constructing roles and relationships”. This highlights the subtle and dynamic way of changes and reinforces the importance of understanding the transitions from multiple perspectives. The results of the study may encourage people to engage themselves in self-help activities and strengthen them to believe they are to care for each other.

  • 42.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Everyday Life among Next of Kin of Haemodialysis Patients2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Everyday life can be complex when next of kin of haemodialysis patients are preoccupied with taking care of the patient and his/her health, which implies the difficulties and requirements needed. The general aim of this thesis was to explore and describe everyday life among next of kin of haemodialysis patients with focus on the life situation, health, time and professional support. Two perspectives of the thesis was applied: a holistic perspective on the everyday life of next of haemodialysis patient and a social perspective with focus on human communication and understanding of next of kin’s experience of everyday life. A qualitative descriptive and explorative design, comprising a phenomenographic and content analysis was used in Studies I-IV. The data collected in the studies consisted of interviews with next of kin to haemodialysis patient and analysis of professional support for next of kin to chronic haemodialysis patients in nursing documentation from two hospitals in Sweden. The experience of time in everyday life among next of kin of haemodialysis patients demonstrated that time for them is minimised and life space contracted. Next of kin experienced ambivalence towards their own health, especially in cases of patients’ spouses When next of kin of haemodialysis patient’s became involved in the patients’ care, they experienced arduousness in relation to their own health as well as less uninterrupted time for themselves in everyday life, and their life situation was characterised by confinement and social isolation. They were aware of the prognosis of renal disease and the fact that haemodialysis is a life-sustaining treatment, which forced them to live for the moment. The everyday life among the next of kin changed when the family became involved in the care, which in turn lead to a changed life situation and restrictions in everyday life. Lack of knowledge in nursing documentation of professional support revealed necessity of the readiness of next of kin. It is therefore important to be familiar with this in the nursing process, especially when the patient and their next of kin need support and attention in everyday life.

    Original papers not included.

  • 43.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Going in Dialysis is Time to Live: Family’s Experiences of Everyday Life with Haemodialysis Treatment2010In: Proceedings of the Sustaining Everyday Life Conference: April 22–24 2009, Campus Norrköping, Sweden / [ed] Kristina Karlsson and Kajsa Ellergård, Linköping: Linköping University , 2010, p. 123-133Conference paper (Refereed)
    Abstract [en]

    Time is a central concept when attempting to capture how life develops as results of the interaction between the individual and those in his/her immediate environment. Chronic renal disease such as ESRD with chronic haemodialysis not only shortens life but also places everyday life on a thin line survival paramount. The haemodialysis is also a time-consuming treatment that makes it necessary to carefully plan of everyday life and involves next of kin to a large degree. The aim of this study was to explore the content of time in everyday life as experienced by the next of kin of haemodialysis patients. This study used explorative and descriptive design with a content analysis approach. The interviews, which were conducted in the informants’ homes, lasted 20-60 minutes and were audio-taped and transcribed verbatim in order to not to lose any information. Twenty next of kin were selected purposive with the criterion of having at least one year of experience as a next of kin of a patient on haemodialysis. The content of time in everyday life can be described as follows: fragmented time, vacuous time and uninterrupted time. Conclusion which illustrate how time is minimised and life space contracted for next of kin and their family. They were aware of the prognosis of renal disease and the fact that haemodialysis is life-sustaining treatment, which forced them to live for the moment. It is important to gain insight into how time influences the next of kin’s experiences of everyday life and how this knowledge can be communicated in the nursing science.

  • 44.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Journal club - a forum of discussion for scientific dialectics2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 2, p. 4652-Article in journal (Refereed)
    Abstract [en]

    In the sometimes hectic routines of daily academic work, it can be difficult to find opportunities for naturally creative encounters with our colleagues, where we can jointly focus methodological issues in research. Where do we find the time and place for constructive discussions on published research? And how can we foster such meetings?

    As a senior lecturer and researcher, I have a strong interest in research seminars in the field of clinical activity, as well as long-standing experience of coordinating and leading such seminars. I also gained extensive knowledge of seminar dynamics from my doctoral studies at the University of Linköping.

    Over the years, I have developed a particular way of working with seminars, aiming to contribute to the establishment of interdisciplinary research groups at the School of Health and Social Science, at Halmstad University. One of my ideas was to take advantage of the privileged position of our university, and the fact that it hosts a scientific journal and its Editor-in-Chief, Professor Lillemor Hallberg. This is why I started the Journal Club in 2006—the same year that the International Journal of Qualitative Studies on Health and Well-being was launched.

    Initially, I simply sent an invitation to my fellow researchers at the School of Health and Social Science, explaining the purpose of the meetings. The idea was to use the Journal Club to discuss selected articles from the International Journal of Qualitative Studies on Health and Well-being, and critically examine them.

    It is essential that the articles are distributed to participants well in advance, and that participants have had time to read the contents, so they are prepared to critically examine the aims, methods and results of the discussed articles.

    My vision with the meetings at the Journal Club was to give added impetus to scientific dialectics at the School, to develop a critical approach and deepen methodological understanding. We need a continuous reflection concerning qualitative research approaches and various standpoints with respect to research ethics, in order to increase methodological awareness in our research. In this way, the monthly seminars contribute to developing our competencies as researchers, as well as keeping our knowledge up-to-date.

    Another aim of the Journal Club is to be a discussion forum for interdisciplinary research issues, relating to health, life-styles, well-being and the quality of life. Uniting a critical mass at our school, and bringing about an engaging discussion, allows us to test our ideas in a stimulating dialogue with colleagues. It also provides an opportunity to widen and deepen our understanding of current issues.

    The Journal Club has met since the autumn term 2006, always on the same day of the week, at the same time and place, at the School of Health and Social Science. The objective is to give these encounters a “club feeling”, and to shape a tradition of a recurrent event at the School. Before each seminar at the Journal Club, an invitation is sent to all teaching and research staff at the School.

    The availability of the most recent articles from the International Journal of Qualitative Studies on Health and Well-being, combined with the Editor-in-Chief's contribution to the seminars, gives the meetings an additional dimension, and strengthens the impact that the Journal Club has at Halmstad University. The role of the Club is also strengthened by the important position that the International Journal of Qualitative Studies occupies on our own nursing programmes, both at junior and senior levels. The articles are widely used and discussed on our Nursing science and Methods courses.

  • 45.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Journal club - a forum of diskussion for scientific dialectics2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2631, Vol. 5, no 2, p. 1-Article in journal (Other academic)
    Abstract [en]

    In the sometimes hectic routines of daily academic work, it can be difficult to find opportunities for naturally creative encounters with our colleagues, where we can jointly focus methodological issues in research. Where do we find the time and place for constructive discussions on published research? And how can we foster such meetings?

  • 46.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Livet i skuggan av dialys: beskrivning av anhörigas vardag ; tema: välfärd och välbefinnande2007In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 84, no 3, p. 239-246Article in journal (Refereed)
  • 47.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Maintaining families´well-being in everyday life2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 2, p. 7206-7211Article in journal (Refereed)
    Abstract [en]

    The aim of this paper is to discuss how everyday life changes for the family in the event of chronic illness or disability. It changes physically due to loss of body function and socially due to time and other constraints related to treatment or lack of mobility. Equally important, there is a psychological impact due to the uncertainty of the future. The article will explore how family participation can help to maintain well-being in everyday life. The family should therefore focus on their own needs as much as on the needs of the family members who are ill. In order to maintain well-being in everyday life, it is crucial for the family to create routines and spend time doing things that they enjoy. By doing this, the family will create a rhythm of well-being regardless of the critical family situation. Family members and professional caregivers also need to come together at the beginning and during the illness or disability event to discuss changes that could be made day-to-day for all those involved, thereby making for an easier transition into care giving.

  • 48.
    Ziegert, Kristina
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Opportunities with integrated Cancer blog - a Swedish Pilot Project on Cancer Rehabilitation Process2013In: eHealth and Nursing: Innovation for the Future / [ed] Sheerin, F, Sermeus, W and Ehrenberg, A, 2013, p. 330-332Conference paper (Refereed)
  • 49.
    Ziegert, Kristina
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Vård av anhörig: ett livsstilval med konsekvenser för hälsan2010In: Hälsa och livsstil: forskning och praktiska tillämpningar / [ed] Lillemor R-M Hallberg, Lund: Studentlitteratur , 2010, 1, p. 289-305Chapter in book (Other academic)
  • 50.
    Ziegert, Kristina
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Ahlner Elmqvist, Marianne
    Department of Health Sciences, Lund University, Lund, Sweden.
    Johansson, Unn-Britt
    Karolinska Institutet, Stockholm, Sweden.
    Larsson, Maria
    Department of Nursing, Karlstad University, Karlstad, Sweden.
    Lilja Andersson, Petra
    Department of Health Sciences, Lund University, Lund, Sweden.
    How the Final Swedish Clinical Exam Prepares the Nursing Students for Their Future Challenges-Qualitative Analysis2014In: Creative Education, ISSN 2151-4755, E-ISSN 2151-4771, Vol. 5, no 21, p. 1887-1894Article in journal (Refereed)
    Abstract [en]

    The national clinical final examination (NCFE) plays an important role in order to measure the level of knowledge and performance of nursing students. Our findings indicate that the design of the NCFE is beneficial for the students’ clinical reasoning and problem solution in the caring situation. The aim of this study was to investigate the experiences of the NCFE from lecturers who corrected the written part examination. A further aim was to study the lectures and the RN during observation in the bedside part of the examination. The NCFE is divided into two parts: a theoretical (written) part and a practical (bedside) part. In nursing education it is essential to assess nursing competencies for the future professional role such as the assessment of clinical competence that has become central to evaluate what outcomes are assessed. In addition, it provides a valuable approach to measure the level of knowledge and performance of nursing students. Future development of the NCFE is necessary regarding the degree to which the examination meets learning objectives and educational results.

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