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Melander, S., Dahl, O., Falk, A.-C., Lindström, V., Andersson, E., Gustavsson, P. & Rudman, A. (2024). Critical incidents and post-traumatic stress symptoms among experienced registered nurses during the COVID-19 pandemic: A cross-sectional study. International Journal of Nursing Studies Advances, 6, Article ID 100194.
Open this publication in new window or tab >>Critical incidents and post-traumatic stress symptoms among experienced registered nurses during the COVID-19 pandemic: A cross-sectional study
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2024 (English)In: International Journal of Nursing Studies Advances, E-ISSN 2666-142X, Vol. 6, article id 100194Article in journal (Refereed) Published
Abstract [en]

Background: Registered nurses working on the frontline during the COVID-19 pandemic encountered significant challenges, including exposure to critical incidents. Critical incidents refer to sudden unexpected clinical events that surpass an individual's ability to cope, leading to considerable psychological distress, which could potentially result in the development of post-traumatic stress disorder symptoms. Research has shown a high prevalence of post-traumatic stress disorder symptoms among healthcare workers, particularly those in close contact with COVID-19 patients.

Objective: To assess the levels of post-traumatic stress symptoms among registered nurses in relation to exposure to working conditions during the COVID-19 pandemic, such as how much their work was affected by the pandemic, re-deployment, working hours hindering sufficient recovery between shifts and critical incidents.

Design: Cross sectional study.

Setting(s): The registered nurses working in multiple health care services covering all 21 geographic regions in Sweden.

Participants: A total of 1,923 registered nurses, who are part of a Swedish national cohort and have been followed since their nursing education, were invited to participate in a survey in late September 2021 (15 to 19 years post graduation).

Methods: The data were analyzed using descriptive statistics, unpaired t-tests, and one-way analysis of variance. Cohen's d was employed to quantify differences in mean levels between subgroups.

Results: The response rate were 56.5 %. Over 50 % of experienced registered nurses reported significant disruptions to their work environments. In total, 85 % of registered nurses were exposed to at least one critical incident in their work during the pandemic, with 60 % facing organisational changes and nearly 50 % experiencing emotionally distressing situations. The exposure to work situations involving critical incidents consistently demonstrated strong associations with higher levels of post-traumatic stress disorder symptoms compared to those not exposed, with effect sizes ranging from moderate to high.

Conclusions: This study underscores the profound impact that working conditions, such as redeployment and exposure to critical incidents, have on the mental health of registered nurses. We offer valuable insights into registered nurses’ pandemic-related challenges, highlighting the need for support and interventions to prevent and manage critical incidents, ultimately promoting their well-being. We also highlight the significance of thorough workforce readiness planning for future pandemics and other challenging health care scenarios, such as staff shortage. © 2024 The Author(s)

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
COVID-19, Critical incidents, Mental Health, Nurses, Occupational health, Post-traumatic stress disorders, Psychological, Quantitative methodology, Work environment
National Category
Nursing
Identifiers
urn:nbn:se:du-48513 (URN)10.1016/j.ijnsa.2024.100194 (DOI)001223818000001 ()38746821 (PubMedID)2-s2.0-85189825584 (Scopus ID)
Available from: 2024-05-14 Created: 2024-05-14 Last updated: 2024-06-20Bibliographically approved
Rudman, A., Frögéli, E. & Skyvell Nilsson, M. (2024). Gaining acceptance, insight and ability to act: A process evaluation of a preventive stress intervention as part of a transition-to-practice programme for newly graduated nurses. Journal of Advanced Nursing, 80(2), 597-611
Open this publication in new window or tab >>Gaining acceptance, insight and ability to act: A process evaluation of a preventive stress intervention as part of a transition-to-practice programme for newly graduated nurses
2024 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 80, no 2, p. 597-611Article in journal (Refereed) Published
Abstract [en]

Aim: To investigate how NGNs perceived and applied an intervention for preventing stress-related ill health embedded in a transition-to-practice programme when entering their professional life. Design: A qualitative exploratory descriptive design was selected for this study to gain insights and perspectives on the adoption and utilization of the intervention. Methods: In this qualitative methodology process evaluation, semi-structured and audio-recorded interviews were conducted with a sample of 49 nurses. Data were collected between December 2016 and July 2017, and were sorted in NVivo 12 Plus, followed by thematic analysis. Results: The analysis resulted in three change processes stimulated by the intervention: (a) Building acceptance of being new; (b) Gaining insight into professional development and health and (c) Practical steps for skills development, healthy habits and better-organized work. In addition to the three themes, barriers that hindered the progression of the processes were also described. Each process influenced the development of the others by stimulating a deeper understanding, motivation to change and courage to act. Several barriers were identified, including the use of cognitively demanding intervention tools, fatigue, high work demands, inconvenient work hours and a hostile social climate on the ward. Conclusion: This process evaluation showed that newly graduated nurses used knowledge from the intervention and adopted new behaviours largely in accordance with how the intervention was intended to work. Impact: When entering a new profession, it is crucial to receive a well-thought-out, structured and targeted introduction to the new professional role, tasks and work group. Nurses stated that the intervention increased their understanding of the role as new nurses and their insight into how to develop skills that promoted better functioning and recovery. The intervention also stimulated the development of new health behaviour and some new learning strategies. © 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
intervention, interviews, introduction, nurses, onboarding, prevention, proactive behaviour, process evaluation, recovery, stress
National Category
Nursing
Identifiers
urn:nbn:se:du-46751 (URN)10.1111/jan.15820 (DOI)001044146500001 ()37550853 (PubMedID)2-s2.0-85167362290 (Scopus ID)
Available from: 2023-08-21 Created: 2023-08-21 Last updated: 2024-06-14Bibliographically approved
Ericsson, C. R., Lindström, V., Rudman, A. & Nordquist, H. (2024). "It's about making a difference": Interplay of professional value formation and sense of coherence in newly graduated Finnish paramedics. International Emergency Nursing, 77, Article ID 101541.
Open this publication in new window or tab >>"It's about making a difference": Interplay of professional value formation and sense of coherence in newly graduated Finnish paramedics
2024 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 77, article id 101541Article in journal (Refereed) Epub ahead of print
National Category
Nursing
Identifiers
urn:nbn:se:du-49736 (URN)10.1016/j.ienj.2024.101541 (DOI)39561583 (PubMedID)2-s2.0-85209236756 (Scopus ID)
Available from: 2024-11-27 Created: 2024-11-27 Last updated: 2024-12-03
Söderström, M., Epstein, M., Rudman, A., Tucker, P. & Dahlgren, A. (2024). Promoting sleep and recovery among new nurses in relation to work stress and shift work: A process evaluation of a proactive intervention. Journal of Sleep Research, 33(S1)
Open this publication in new window or tab >>Promoting sleep and recovery among new nurses in relation to work stress and shift work: A process evaluation of a proactive intervention
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2024 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 33, no S1Article in journal, Meeting abstract (Other academic) Published
National Category
Occupational Health and Environmental Health Nursing
Identifiers
urn:nbn:se:du-50150 (URN)10.1111/jsr.14291 (DOI)001319389402360 ()
Note

Abstracts for the 27th Congress of the European Sleep Research Society, 24 – 27 September 2024, Seville, Spain

Available from: 2025-02-10 Created: 2025-02-10 Last updated: 2025-02-10Bibliographically approved
Wallin, L., Gustafsson, P., Boström, A.-M., Ehrenberg, A. & Rudman, A. (2024). The use of evidence-based practice process by experienced registered nurses during the COVID-19 pandemic: A longitudinal national cohort study. In: : . Paper presented at Knowledge Utilization (KU) Colloquium 2024, June 24-26th 2024, Uppsala, Sweden.
Open this publication in new window or tab >>The use of evidence-based practice process by experienced registered nurses during the COVID-19 pandemic: A longitudinal national cohort study
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2024 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Nursing
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-49893 (URN)
Conference
Knowledge Utilization (KU) Colloquium 2024, June 24-26th 2024, Uppsala, Sweden
Available from: 2024-12-26 Created: 2024-12-26 Last updated: 2025-01-08Bibliographically approved
Rudman, A., Boström, A.-M. -., Wallin, L., Gustavsson, P. & Ehrenberg, A. (2024). The use of the evidence-based practice process by experienced registered nurses to inform and transform clinical practice during the COVID-19 pandemic: A longitudinal national cohort study. Worldviews on Evidence-Based Nursing, 21(1), 14-22
Open this publication in new window or tab >>The use of the evidence-based practice process by experienced registered nurses to inform and transform clinical practice during the COVID-19 pandemic: A longitudinal national cohort study
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2024 (English)In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 21, no 1, p. 14-22Article in journal (Refereed) Published
Abstract [en]

Background: During the COVID-19 pandemic, many registered nurses (RNs) worked on the frontline caring for severely ill patients. They did so with limited knowledge of how to treat and prevent the disease. This extreme situation puts pressure on RNs to find evidence on which to base the care of their patients. Aims: To examine: (1) the extent to which evidence-based practice (EBP) process was applied by Swedish RN cohorts 15–19 years after graduation during the pandemic, (2) whether there was any change to their EBP process from pre-pandemic to late pandemic, (3) the relationship between RNs' use of the EBP process and the duration of exposure to work situations severely affected by the COVID-19 pandemic, and (4) whether level of education, position and care setting were associated with the extent of RNs' EBP process. Methods: In 2021, the level of EBP activities was investigated among 2237 RNs 15–19 years after graduation. The scale used to measure EBP consisted of six items of the EBP process. Unpaired t-tests or one-way analysis of variance (ANOVA) were used in the analysis. Results: RNs used the EBP process to a moderate extent to inform and transform their clinical practice. There was a minor but significant decrease in practicing the EBP process from pre-pandemic to late in the pandemic. RNs who were most affected by the pandemic scored higher on the scale than less-affected colleagues. RNs in nonclinical positions reported more EBP activities, as did RNs in management positions. RNs working in outpatient settings reported more EBP activities than their colleagues in hospitals. Linking Evidence to Action: It is imperative that RNs hone their skills in EBP if they are to be prepared for future healthcare crises. Healthcare providers have a duty to facilitate the development of EBP and, in this regard, RNs in clinical positions in hospitals need particular support. © 2023 The Authors. Worldviews on Evidence-based Nursing published by Wiley Periodicals LLC on behalf of Sigma Theta Tau International.

Place, publisher, year, edition, pages
John Wiley and Sons Inc, 2024
Keywords
COVID-19 pandemic, evidence-based practice, longitudinal cohort study, registered nurses, repeated measures, survey
National Category
Nursing
Identifiers
urn:nbn:se:du-47509 (URN)10.1111/wvn.12692 (DOI)001123763800001 ()38084830 (PubMedID)2-s2.0-85179311803 (Scopus ID)
Available from: 2023-12-18 Created: 2023-12-18 Last updated: 2024-02-12
Johansson, F., Rozental, A., Edlund, K., Grotle, M., Rudman, A., Jensen, I. & Skillgate, E. (2024). Trajectories of procrastination among Swedish University students over one academic year: a cohort study. BMC Psychology, 12(1), Article ID 559.
Open this publication in new window or tab >>Trajectories of procrastination among Swedish University students over one academic year: a cohort study
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2024 (English)In: BMC Psychology, E-ISSN 2050-7283, Vol. 12, no 1, article id 559Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Procrastination is common among university students and associated with adverse outcomes such as physical and mental health problems. According to the Temporal motivation theory procrastination may vary over time depending on the temporal proximity to goals and deadlines.

AIMS: To determine if mean procrastination levels among university students varies over an academic year, and if trajectories of procrastination are moderated by gender identity, perfectionistic strivings, and/or perfectionistic concerns.

SAMPLE: Swedish university students (n = 1410).

METHODS: The cohort was followed with web-surveys at four time-points over one academic year (Late semester, Mid semester, After semester, and Early semester). Generalized Estimating Equations were used to estimate mean levels of self-rated procrastination at the different time-points.

RESULTS: We found only small fluctuations in mean procrastination levels over the academic year. Participants with high perfectionistic concerns demonstrated higher mean procrastination levels at all time-points, but neither gender identity, perfectionistic concerns nor perfectionistic strivings affected the slope of the mean procrastination trajectories.

CONCLUSIONS: In this cohort of Swedish university students, self-rated procrastination levels were stable over the academic year. Perfectionistic concerns, but not gender identity or perfectionistic strivings, was associated with higher levels of procrastination.

Keywords
Perfectionism, Procrastination, University students
National Category
Psychology
Identifiers
urn:nbn:se:du-49555 (URN)10.1186/s40359-024-02072-2 (DOI)001333692000001 ()39407255 (PubMedID)2-s2.0-85206539705 (Scopus ID)
Available from: 2024-10-22 Created: 2024-10-22 Last updated: 2024-11-29Bibliographically approved
Hernandez, I., Söderström, M., Rudman, A. & Dahlgren, A. (2024). Under pressure - Nursing staff's perspectives on working hours and recovery during the COVID-19 pandemic: A qualitative study. International Journal of Nursing Studies Advances, 7, Article ID 100225.
Open this publication in new window or tab >>Under pressure - Nursing staff's perspectives on working hours and recovery during the COVID-19 pandemic: A qualitative study
2024 (English)In: International Journal of Nursing Studies Advances, E-ISSN 2666-142X, Vol. 7, article id 100225Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The COVID-19 pandemic contributed to increased pressure on healthcare systems. During periods when the demands exceed the capacity of healthcare organizations, adaptive strategies are used to meet these demands. During the COVID-19 pandemic, working hours for nursing staff were reorganized and extended. This has posed challenges for recovery, which may be a key factor for maintaining health and safety under such conditions.

OBJECTIVES: The aim of the study was to bring insights into how nursing staff perceived their working hours and recovery during the COVID-19 pandemic, and if they experienced any changes in their sleep and well-being.

DESIGN: A qualitative descriptive design was chosen, as it is suitable for gaining insight into perceptions and experiences.

METHODS: Qualitative semi-structured interviews were conducted using an interview guide. The interviews were analyzed using thematic analysis. Sixteen registered nurses and six certified nursing assistants from four Swedish hospitals participated in the study.

RESULTS: The organization of working hours during the COVID-19 pandemic was considered suboptimal and resulted in more demanding working hours and poor recovery. Nursing staff experienced loss of control as they lost influence over working hours, working hours became more unpredictable and the boundaries between work and leisure became blurred. Nursing staff also experienced a decline in their health and well-being, including extreme fatigue, impaired sleep and physical/mental changes.

CONCLUSION: The strategies used by healthcare organizations to meet increasing demands during the COVID-19 pandemic contributed to impaired recovery and well-being of nursing staff, which could generate negative feedback loops contributing to depletion of resources at the organizational level.

Keywords
COVID-19, Fatigue, Nursing, Occupational stress, Personnel management, Shift work schedule, Sleep, Work-Life balance
National Category
Nursing
Identifiers
urn:nbn:se:du-49281 (URN)10.1016/j.ijnsa.2024.100225 (DOI)001278356700001 ()39139601 (PubMedID)2-s2.0-85199302504 (Scopus ID)
Available from: 2024-08-27 Created: 2024-08-27 Last updated: 2024-09-27Bibliographically approved
Ericsson, C. R., Rudman, A., Lindström, V. & Nordquist, H. (2024). 'We are expected to be problem solvers'-Paramedics' performance expectations through the lens of organizational socialization: An interview study. Nursing Open, 11(9), Article ID e70014.
Open this publication in new window or tab >>'We are expected to be problem solvers'-Paramedics' performance expectations through the lens of organizational socialization: An interview study
2024 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 11, no 9, article id e70014Article in journal (Refereed) Published
Abstract [en]

AIM: To explore Finnish paramedics' perceptions of work-related performance expectations in relation to work experience, and understand how organizational socialization contributes to understanding paramedics' performance expectations.

DESIGN: A qualitative design with a deductive-inductive approach utilizing a social constructivist framework. The organizational socialization framework by Wanberg was used as the theoretical basis.

METHODS: Data were collected between May and August 2023, using group and individual interviews of newly graduated (n = 9) and experienced paramedics (n = 13). Participants were recruited via social media channels. Data were first analyzed deductively, according to constructs of the organizational socialization framework (role clarity, task mastery, and social acceptance), then inductively, using codes not utilized in the deductive phase.

DATA SOURCES: Interviewed Finnish paramedics (N = 22), both newly graduated paramedics (n = 9) and experienced paramedics (n = 13). The interviews were performed remotely and then transcribed into text.

RESULTS: Our findings showed comparable performance expectations between newly graduated and experienced paramedics, mismatches in role clarity of paramedic work, challenges in both learning and upholding professional competence, and difficulties of social acceptance into the paramedic community. There were variations in how expectations were perceived between groups, indicating that experience might partly affect how paramedics identify and manage performance expectations. The organizational socialization framework enables the contextualization of these performance expectations.

CONCLUSIONS AND IMPLICATIONS: Paramedic work involves challenges to upholding clinical competence, aligning to a professional role, and social integration into the professional community. Our research contributes to understanding how paramedics perceive these challenges as performance expectations in different stages of their careers and how they could be managed utilizing a framework for organizational socialization. The socialization of paramedics into the workforce needs to account for these performance expectations, especially considering the changing paradigm of paramedic work, role, and societal expectations.

PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Keywords
ambulance nursing, education, emergency care, organisational development
National Category
Nursing
Identifiers
urn:nbn:se:du-49335 (URN)10.1002/nop2.70014 (DOI)001306215900001 ()39239758 (PubMedID)2-s2.0-85203314353 (Scopus ID)
Available from: 2024-09-11 Created: 2024-09-11 Last updated: 2024-10-01Bibliographically approved
Johansson, F., Rozental, A., Edlund, K., Côté, P., Sundberg, T., Onell, C., . . . Skillgate, E. (2023). Associations Between Procrastination and Subsequent Health Outcomes Among University Students in Sweden.. JAMA Network Open, 6(1), Article ID e2249346.
Open this publication in new window or tab >>Associations Between Procrastination and Subsequent Health Outcomes Among University Students in Sweden.
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2023 (English)In: JAMA Network Open, E-ISSN 2574-3805, Vol. 6, no 1, article id e2249346Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE: Procrastination is prevalent among university students and is hypothesized to lead to adverse health outcomes. Previous cross-sectional research suggests that procrastination is associated with mental and physical health outcomes, but longitudinal evidence is currently scarce.

OBJECTIVE: To evaluate the association between procrastination and subsequent health outcomes among university students in Sweden.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was based on the Sustainable University Life study, conducted between August 19, 2019, and December 15, 2021, in which university students recruited from 8 universities in the greater Stockholm area and Örebro were followed up at 5 time points over 1 year. The present study used data on 3525 students from 3 time points to assess whether procrastination was associated with worse health outcomes 9 months later.

EXPOSURE: Self-reported procrastination, measured using 5 items from the Swedish version of the Pure Procrastination Scale rated on a Likert scale from 1 ("very rarely or does not represent me") to 5 ("very often or always represents me") and summed to give a total procrastination score ranging from 5 to 25.

MAIN OUTCOMES AND MEASURES: Sixteen self-reported health outcomes were assessed at the 9-month follow-up. These included mental health problems (symptoms of depression, anxiety, and stress), disabling pain (neck and/or upper back, lower back, upper extremities, and lower extremities), unhealthy lifestyle behaviors (poor sleep quality, physical inactivity, tobacco use, cannabis use, alcohol use, and breakfast skipping), psychosocial health factors (loneliness and economic difficulties), and general health.

RESULTS: The study included 3525 participants (2229 women [63%]; mean [SD] age, 24.8 [6.2] years), with a follow-up rate of 73% (n = 2587) 9 months later. The mean (SD) procrastination score at baseline was 12.9 (5.4). An increase of 1 SD in procrastination was associated with higher mean symptom levels of depression (β, 0.13; 95% CI, 0.09-0.17), anxiety (β, 0.08; 95% CI, 0.04-0.12), and stress (β, 0.11; 95% CI, 0.08-0.15), and having disabling pain in the upper extremities (risk ratio [RR], 1.27; 95% CI, 1.14-1.42), poor sleep quality (RR, 1.09, 95% CI, 1.05-1.14), physical inactivity (RR, 1.07; 95% CI, 1.04-1.11), loneliness (RR, 1.07; 95% CI, 1.02-1.12), and economic difficulties (RR, 1.15, 95% CI, 1.02-1.30) at the 9-month follow-up, after controlling for a large set of potential confounders.

CONCLUSIONS AND RELEVANCE: This cohort study of Swedish university students suggests that procrastination is associated with subsequent mental health problems, disabling pain, unhealthy lifestyle behaviors, and worse psychosocial health factors. Considering that procrastination is prevalent among university students, these findings may be of importance to enhance the understanding of students' health.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:du-45004 (URN)10.1001/jamanetworkopen.2022.49346 (DOI)000919699600002 ()36598789 (PubMedID)2-s2.0-85145641700 (Scopus ID)
Available from: 2023-01-10 Created: 2023-01-10 Last updated: 2023-03-17Bibliographically approved
Projects
Sjuksköterskor i frontlinjen av COVID-19 pandemin
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6388-5155

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