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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: 2024-01-08Bibliographically 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., 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
Sundberg, T., Skillgate, E., Gustavsson, P. & Rudman, A. (2023). Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study. Scandinavian Journal of Public Health, Article ID 14034948231151992.
Open this publication in new window or tab >>Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study
2023 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, article id 14034948231151992Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: Back pain and neck/shoulder pain are common among nurses. The aim of this study was to investigate the association between nurses' exposure to a demanding psychosocial work environment during the first three years after graduation and the occurrence of severe back pain and neck/shoulder pain in the longer term, 11-15 years later.

METHODS: The Longitudinal Analysis of Nursing Education (LANE) study (nursing graduates from 26 Swedish universities in the years 2002, 2004 and 2006) was used to create two risk cohorts of nurses not reporting severe back pain (n=1764) or neck/shoulder pain (n=1707). Nurses exposed to a demanding psychosocial work environment for one, two or three of the first three years in their career were compared to nurses not having a demanding psychosocial work environment for any of these three years regarding the incidence of severe back pain or neck/shoulder pain at follow-up, 11-15 years later. Relative risks (RR) with 95% confidence intervals (CI) were calculated using binomial regression.

RESULTS: The RR (95% CI) of having severe back pain for nurses who had a demanding psychosocial work environment for one of the three years was 1.36 (0.82-2.28) and 2.08 (1.21-3.57) for two of the three years and 2.82 (1.43-5.55) for all three years. Corresponding RRs (95% CIs) for severe neck/shoulder pain were 1.35 (0.87-2.10), 1.49 (0.88-2.51) and 1.41 (0.62-3.20), respectively.

CONCLUSIONS: Nurses who were repeatedly exposed to a demanding psychosocial work environment early in their career reported severe back pain to a higher extent in the longer term.

Keywords
Work environment, back pain, neck pain, nursing
National Category
Occupational Health and Environmental Health Nursing
Identifiers
urn:nbn:se:du-45507 (URN)10.1177/14034948231151992 (DOI)000937257500001 ()36814114 (PubMedID)2-s2.0-85148723090 (Scopus ID)
Available from: 2023-02-27 Created: 2023-02-27 Last updated: 2023-03-23Bibliographically approved
Hörberg, A., Gadolin, C., Nilsson, M. S., Gustavsson, P. & Rudman, A. (2023). Experienced Nurses' Motivation, Intention to Leave, and Reasons for Turnover: A Qualitative Survey Study. Journal of Nursing Management, 2023, Article ID 2780839.
Open this publication in new window or tab >>Experienced Nurses' Motivation, Intention to Leave, and Reasons for Turnover: A Qualitative Survey Study
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2023 (English)In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 2023, article id 2780839Article in journal (Refereed) Published
Abstract [en]

There is a global nurse shortage, and researchers have made great efforts in trying to unveil the reasons for turnover and how to increase retention. However, such research has had a tendency to study variables related to intention to leave (ITL) or turnover as isolated phenomena. Objective. To simultaneously explore what factors motivate experienced nurses in the workplace and the underlying reasons for strong ITL and high staff turnover within the profession. Design. An inductive qualitative content analysis was used based on data from open-ended survey questions. The data originated from the longitudinal analyses of nursing education/employment/entry (LANE) in work-life study. The qualitative data analyzed in this study were distributed in October 2017-January 2018, to all nurses in three cohorts corresponding to 11-, 13- and 15-year postgraduation. Of the 2,474 nurses answering the survey, 1,146 (46%) responded to one or more of the open-ended questions. Results. The result showed that what motivates experienced nurses, their intention to leave (ITL), and reasons for turnover could be described in the form of five broad categories, namely, organizational characteristics, work characteristics, relationships at work, work recognition, and health issues. There was rarely a one single reason described, rather several reasons needed to be experienced over time for nurses to stay motivated or leave the profession. Conclusions. There is no single reason that makes nurses leave the profession, nor is there one single reason that makes them motivated to stay. Retention and turnover are complex processes and need to be addressed as this, not as a single isolated phenomenon.

National Category
Nursing
Identifiers
urn:nbn:se:du-47083 (URN)10.1155/2023/2780839 (DOI)001069026700001 ()2-s2.0-85172791757 (Scopus ID)
Available from: 2023-10-06 Created: 2023-10-06 Last updated: 2023-10-09Bibliographically approved
Flinkman, M., Rudman, A., Pasanen, M. & Leino-Kilpi, H. (2023). Psychological capital, grit and organizational justice as positive strengths and resources among registered nurses: A path analysis. Nursing Open, 10(8), 5314-5327
Open this publication in new window or tab >>Psychological capital, grit and organizational justice as positive strengths and resources among registered nurses: A path analysis
2023 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 10, no 8, p. 5314-5327Article in journal (Refereed) Published
Abstract [en]

AIM: To examine registered nurses' individual strengths (psychological capital and grit) and an organizational resource (organizational justice) as well as associated work-related outcomes. In a time of a global nursing shortage, there is an urgent need to identify strengths and resources that can have a positive impact on the health, well-being and retention of registered nurses.

DESIGN: A cross-sectional survey.

METHODS: A nationwide convenience sample of 514 registered nurses responded to a survey. Data were collected using a self-reported questionnaire between March and May 2018. Data were analysed using descriptive statistics and multivariate path analysis.

RESULTS: Participants rated their psychological capital and grit moderately high. Grit and organizational justice were found to have significant direct effects on psychological capital. Furthermore, psychological capital had positive direct effects on engagement and the perception of well-conducted everyday nursing as well as negative direct effects on burnout, the stress of conscience and the intent to leave the profession.

CONCLUSION: The results suggest that nurse leaders and managers could consider improving registered nurses' well-being with two complementary approaches. It might be useful to reinforce positive, individual strengths, such as psychological capital, and at the same time create more favourable nursing work environments, for example by strengthening organizational justice.

IMPLICATIONS FOR THE PROFESSION: Psychological capital and grit are emerging concepts in nursing workforce research. Identifying registered nurses' positive strengths and resources is important for inventing interventions that enhance nurses' engagement and well-being as well as reduce turnover intentions.

IMPACT: Nurse leaders and managers play crucial roles in managing and developing registered nurses' individual strengths and organizational resources. This has gained even more importance now as the COVID-19 pandemic could have a long-term negative impact on nurses' well-being.

REPORTING METHOD: The study is reported following STROBE guidelines.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Keywords
PsyCap, grit, nursing, organizational justice, psychological capital, registered nurse, survey research
National Category
Nursing
Identifiers
urn:nbn:se:du-46000 (URN)10.1002/nop2.1769 (DOI)000981258500001 ()37128977 (PubMedID)2-s2.0-85158069507 (Scopus ID)
Available from: 2023-05-09 Created: 2023-05-09 Last updated: 2023-07-17Bibliographically approved
Flinkman, M., Coco, K., Rudman, A. & Leino-Kilpi, H. (2023). Registered nurses' psychological capital: A scoping review. International Journal of Nursing Practice
Open this publication in new window or tab >>Registered nurses' psychological capital: A scoping review
2023 (English)In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172XArticle, review/survey (Refereed) Published
Abstract [en]

Aims: The aim was to examine the extent and scope of empirical research concerning registered nurses' psychological capital. Background: In a time of global nursing shortage, identifying variables that could positively contribute to the retention of the nursing workforce is essential. Prior research has shown that psychological capital correlates positively with employees' better performance and well-being. Design: A scoping review. Data sources: A systematic literature search was conducted in the following databases: PubMed, CINAHL, PsycINFO, Web of Science and Scopus covering the period from 1 January 2005 to 7 May 2023. Review methods: The JBI methodological guidance for scoping reviews was followed. The results were summarized narratively. Results: A total of 111 studies reported in 114 peer-reviewed articles were included. Studies were carried out across 20 countries, with the majority from China (45), Australia (nine), Pakistan (nine), Canada (eight), South Korea (eight) and the United States (eight). A positive correlation was found between registered nurses' psychological capital and desirable work-related outcomes, such as work engagement, commitment and retention intention. Conclusion: A comprehensive overview of research evidence suggests that psychological capital is associated with many positive work-related outcomes and might therefore be a valuable resource for reducing nurse turnover. © 2023 The Authors. International Journal of Nursing Practice published by John Wiley & Sons Australia, Ltd.

Keywords
nursing, psychological capital, resilience, retention, scoping review, Australia, Canada, China, Cinahl, data source, empirical research, employee, evidence based nursing, human, Medline, nurse, nursing shortage, Pakistan, PsycINFO, registered nurse, review, Scopus, South Korea, systematic review, turnover rate, United States, Web of Science, wellbeing, work engagement
National Category
Nursing
Identifiers
urn:nbn:se:du-46636 (URN)10.1111/ijn.13183 (DOI)001033750300001 ()37485748 (PubMedID)2-s2.0-85165466984 (Scopus ID)
Available from: 2023-08-04 Created: 2023-08-04 Last updated: 2023-09-01
Tistad, M., Bergström, A., Elf, M., Eriksson, L., Gustavsson, C., Göras, C., . . . Wallin, L. (2023). Training and support for the role of facilitator in implementation of innovations in health and community care: a scoping review protocol.. Systematic Reviews, 12(1), Article ID 15.
Open this publication in new window or tab >>Training and support for the role of facilitator in implementation of innovations in health and community care: a scoping review protocol.
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2023 (English)In: Systematic Reviews, E-ISSN 2046-4053, Vol. 12, no 1, article id 15Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Implementing and sustaining innovations in clinical practice, such as evidence-based practices, programmes, and policies, is frequently described as challenging. Facilitation as a strategy for supporting implementation requires a facilitator, i.e. an individual with a designated role to support the implementation process. A growing number of studies report that facilitation can help tackle the challenges in implementation efforts. To optimise the potential contribution of facilitation as a strategy to improve the implementation of new practices, there is a need to enhance understanding about what training and support is required for individuals in the facilitator role. The objective of this scoping review is to map how facilitators have been trained for, and supported in, the facilitator role in implementation studies in health and community care. Specifically, the review aims to examine what is reported on training and support of facilitators in terms of learning outcomes, content, dose, mode of delivery, learning activities, and qualifications of the trainers and how the facilitators perceive training and support.

METHODS: This scoping review will follow the guidance of the Joanna Briggs Institute and the PRISMA Extension for Scoping Review checklist. We will include articles in which (a) facilitation is deployed as an implementation strategy, with identified facilitator roles targeting staff and managers, to support the implementation of specified innovations in health or community care, and (b) training and/or support of facilitators is reported. We will exclude articles where facilitation is directed to education or training in specific clinical procedures or if facilitation supports the implementation of general quality improvement systems. All types of peer-reviewed studies and study protocols published in English will be included. A systematic search will be performed in MEDLINE (Ovid), Embase (embase.com), Web of Science Core Collection, and CINAHL (Ebsco).

DISCUSSION: The proposed scoping review will provide a systematic mapping of the literature on the training and support of implementation facilitators and contribute useful knowledge within the field of implementation science to inform future facilitation initiatives.

SYSTEMATIC REVIEW REGISTRATION: Registered at Open Science Framework (registration https://doi.org/10.17605/OSF.IO/M6NPQ ).

Keywords
Community care, Evidence-based practice, Facilitation, Facilitator, Healthcare services, Implementation science, Supervision, Support, Training, i-PARIHS
National Category
Nursing
Identifiers
urn:nbn:se:du-45393 (URN)10.1186/s13643-023-02172-x (DOI)000924318500001 ()36721192 (PubMedID)2-s2.0-85147186976 (Scopus ID)
Available from: 2023-02-07 Created: 2023-02-07 Last updated: 2023-03-02Bibliographically approved
Singh, L., Kanstrup, M., Gamble, B., Geranmayeh, A., Göransson, K., Rudman, A., . . . Moulds, M. L. (2022). A first remotely-delivered guided brief intervention to reduce intrusive memories of psychological trauma for healthcare staff working during the ongoing COVID-19 pandemic: Study protocol for a randomised controlled trial. Contemporary Clinical Trials Communications, 26, Article ID 100884.
Open this publication in new window or tab >>A first remotely-delivered guided brief intervention to reduce intrusive memories of psychological trauma for healthcare staff working during the ongoing COVID-19 pandemic: Study protocol for a randomised controlled trial
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2022 (English)In: Contemporary Clinical Trials Communications, E-ISSN 2451-8654, Vol. 26, article id 100884Article in journal (Refereed) Published
Abstract [en]

Addressing the mental health needs of healthcare staff exposed to psychologically traumatic events at work during the COVID-19 pandemic is a pressing global priority. We need to swiftly develop interventions to target the psychological consequences (e.g., persistent intrusive memories of trauma). Interventions for healthcare staff must be brief, flexible, fitted around the reality and demands of working life under the pandemic, and repeatable during ongoing/further trauma exposure. Intervention delivery during the pandemic should be remote to mitigate risk of infection; e.g., here using a blend of digitalized self-administered materials (e.g., video instructions) and guided (remote) support from a researcher. This parallel groups, two-arm, randomised controlled trial (RCT) with healthcare staff working during the COVID-19 pandemic is the first evaluation of whether a digitalized form of a brief cognitive task intervention, which is remotely-delivered (guided), reduces intrusive memories. Healthcare staff (target N = 130 completers) who experience intrusive memories of work-related traumatic event(s) during the COVID-19 pandemic (≥2 in the week before inclusion) will be randomly allocated (1:1) to receive either the cognitive task intervention or an active (attention placebo) control, and followed up at 1-week, 1-month, 3-months, and 6-months post-intervention. The primary outcome will be the number of intrusive memories reported during Week 5; secondary and other outcomes include the number of intrusive memories reported during Week 1, and other intrusive symptoms. Findings will inform further development and dissemination of a brief cognitive task intervention to target intrusive memories.

Keywords
COVID-19, Digital intervention, Healthcare staff, Intrusive memories, Psychological trauma, Randomised controlled trial
National Category
Psychology
Identifiers
urn:nbn:se:du-39373 (URN)10.1016/j.conctc.2022.100884 (DOI)000820423400003 ()35036626 (PubMedID)2-s2.0-85124614442 (Scopus ID)
Available from: 2022-02-02 Created: 2022-02-02 Last updated: 2023-04-14Bibliographically approved
Ericsson, C. R., Lindström, V., Rudman, A. & Nordquist, H. (2022). Paramedics' perceptions of job demands and resources in Finnish emergency medical services: a qualitative study. BMC Health Services Research, 22(1), Article ID 1469.
Open this publication in new window or tab >>Paramedics' perceptions of job demands and resources in Finnish emergency medical services: a qualitative study
2022 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 22, no 1, article id 1469Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Paramedics' fatigue is rising. Stress factors show increased risk for burnout, fatigue, leaving the profession, decreased performance and risk for patient safety. Meanwhile, paramedics' strong community of practice, autonomy and a sense of professional respect are important factors in forming psychological resilience. We aimed to explore Finnish paramedics' perceptions of job demands and resources.

METHODS: Our study design was descriptive, inductive with a constructivist approach. Using reflexive thematic analysis, we analyse open-ended questions, from a web-based survey and essays written by Finnish paramedic masters-degree students. The study followed the SRQR checklist.

RESULTS: We identified paramedics' job demands as stress from a high workload, environmental factors and emotional burden. Performance expectations and a sense of inadequacy were further noted, as well as an organizational culture of hardiness, presenting lack of support and sense of inequality. Paramedics' job resources were pressure management strategies, which were expressed as positive coping mechanisms, agency to affect workload and professional self-actualization, expressed as psychologically safe work community, professional pride and internal drive to professional development.

CONCLUSIONS: Finnish paramedics exhibit resources and demands related to uncertainty and emotional burden as well as cultural hardiness and psychological safety in communities.

PATIENT OR PUBLIC CONTRIBUTION: This study was done based on survey data collected and analysed by the authors. No patient or public contribution was utilized for this study.

Keywords
Emergency medical services, Job demands, Job resources, Paramedics, Qualitative
National Category
Health Sciences
Identifiers
urn:nbn:se:du-43916 (URN)10.1186/s12913-022-08856-9 (DOI)000914639500004 ()36461045 (PubMedID)2-s2.0-85143356171 (Scopus ID)
Available from: 2022-12-06 Created: 2022-12-06 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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