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  • 1.
    Cacciatore, J.
    et al.
    Arizona State University.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Rådestad, I.
    Sophiahemmet University College.
    Fatherhood and suffering: a qualitative exploration of Swedish men's experiences of care after the death of a baby2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 5, p. 664-670Article in journal (Refereed)
    Abstract [en]

    Background: This study was designed to evaluate fathers' experiences of stillbirth and psychosocial care.

    Methods: Data were collected between 27 March 2008 and 1 April 2010 via a questionnaire posted on the homepage of the Swedish National Infant Foundation. The responses to the following open-ended questions were analyzed using content analysis: "Are you grateful today for anything that health care professionals did in connection with the birth of your child?" and " Are you sad, hurt or angry today about something personnel did in connection with the birth of your baby?"

    Results: 113/131 (86%) fathers reported feelings of being grateful. Only 22/131 (16%) fathers reported feeling sad, hurt, or angry. Fathers expressed gratitude when health care professionals treated their newborn " with respect and without fear" , " with extraordinary reverence" , and when their fatherhood was validated by providers. They were also grateful when providers helped them to create memories of their baby. Fathers also reported feeling sad, hurt, or angry when providers were nonchalant and indifferent and when they perceived providers to be uncaring and disrespectful toward their baby.

    Conclusion: Bereaved fathers experience overall gratitude for person-centered psychosocial care in the aftermath of stillbirth, particularly when they feel validated as a grieving father and their child is acknowledged with reverence. Clinical implications: Health care professionals should support fathers by treating the baby who died with respect and dignity and by validating and acknowledging both his grief experiences and his fatherhood just as they would for a grieving mother.

  • 2.
    Eriksson, Henrik
    et al.
    Röda Korset Högskola.
    Salzmann-Erikson, Martin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Cyber nursing: Health 'experts' approaches in the post-modern era of virtual encounters2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 3, p. 335-344Article in journal (Refereed)
    Abstract [en]

    Background. The imperative to gather information online and to become an ‘expert’ by locating effective advice for oneself and others is a fairly new support phenomenon in relation to health advice. The creation of new positions for health ‘experts’ within the space of the Internet has been addressed as a cybernursing activity. A focused analysis of communication in health forums might give insight into the new roles that are available for healthexperts in cyberspace.

    Aim. The aim of this study is to describe approaches to being an ‘expert’ in lifestyle health choice forums on the Internet and to elaborate on the communicative performances that take place in the forums.

    Method. An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online. 2640 pages of data from two health Internet forums were gathered and analyzed.

    Findings. The results reveal three distinctive types of experts that emerge in the forums: (1) those that build their expertise by creating a presence in the forum based on lengthy and frequent postings, (2) those who build a presence through reciprocal exchanges with individual posters with questions or concerns, and (3) those who build expertise around a “life long learning” perspective based on logic and reason.

    Discussion. The results suggest that experts not only co-exist in the forums, but more importantly they reinforce each others’ positions. This effect is central; alongside one another, the posts of the three types of experts we identify constitute a whole for those seeking the forum for advice and support. Users are provided with strong opinions and advice, support and Socratic reasoning, and a problem-oriented approach. The Internet is now an integral part of everyday living, not least of which among those who seek and offer support in cyberspace. As such, cyber nursing has become an important activity to monitor, and formal health care professionals and nursing researchers must stay abreast of developments.

  • 3.
    Forsman, Henrietta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Gustavsson, Petter
    Inst för klinisk neurovetenskap, Karolinska Institutet.
    Rudman, Ann
    Inst för klinisk neurovetenskap, Karolinska Institutet.
    Nursing students’ intentions to use research as a predictor of use one year post graduation: a prospective study2012In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 49, no 9, p. 1155-1164Article in journal (Refereed)
    Abstract [en]

    Background. Graduating nursing students are expected to have acquired the necessary skills to provide research-based care to patients. However, recent studies have shown that new graduate nurses report their extent of research use as relatively low. Because behavior intention is a well-known predictor of subsequent behavior, this gives reasons to further investigate graduating nursing students’ intentions to use research in clinical practice after undergraduate study.

    Objectives. To investigate graduating nursing students’ intentions to use research in clinical practice and, furthermore, to investigate whether intention in itself and as a mediating variable can predict subsequent research use behavior in clinical practice one year post graduation.

    Design. A follow-up study was performed of graduating nursing students in their final semester of undergraduate study (2006) and at one year post graduation (2008). Data were collected within the larger national survey LANE (Longitudinal Analysis of Nursing Education).

    Participants. A sample of 1319 respondents was prospectively followed.

    Methods. Graduating nursing students’ intentions to use research instrumentally were studied as a predictor of their subsequent instrumental research use one year post graduation. A statistical full mediation model was tested to evaluate the effects of intention and factors from undergraduate study on subsequent research use in daily care.

    Results. Thirty-four percent of the nursing students intended to use research on more than half or almost every working shift in their future clinical practice. Intention showed a direct effect on research use behavior. In addition, significant indirect effects on research use were shown for capability beliefs (regarding practicing the principles of evidence-based practice) and perceived support for research use (from campus and clinical education), where intention acted as a mediating factor for those effects.

    Conclusions. Students rated a modest level of intention to use research evidence. Intentions close to graduation acted as an essential predictor of subsequent research use behavior, both through a direct effect and as a mediating variable. These findings give support for designing future interventions aiming at influencing students’ intention to use research to improve subsequent behavior. Focusing on strengthening students’ capability beliefs and providing support for research use appear as promising target activities.

  • 4. Harvey, Gill
    et al.
    Gifford, Wendy
    Cummings, Greta
    Kelly, Janet
    Kislov, Roman
    Kitson, Alison
    Pettersson, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Göteborgs universitet; Karolinska institutet.
    Wilson, Paul
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mobilising evidence to improve nursing practice: A qualitative study of leadership roles and processes in four countries2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 90, p. 21-30Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The approach and style of leaders is known to be an important factor influencing the translation of research evidence into nursing practice. However, questions remain as to what types of roles are most effective and the specific mechanisms through which influence is achieved.

    OBJECTIVES: The aim of the study was to enhance understanding of the mechanisms by which key nursing roles lead the implementation of evidence-based practice across different care settings and countries and the contextual factors that influence them.

    DESIGN: The study employed a qualitative descriptive approach.

    SETTINGS: Data collection was undertaken in acute care and primary/community health care settings in Australia, Canada, England and Sweden.

    PARTICIPANTS: 55 individuals representing different levels of the nursing leadership structure (executive to frontline), roles (managers and facilitators), sectors (acute and primary/community) and countries.

    METHODS: Individual semi-structured interviews were conducted with all participants exploring their roles and experiences of leading evidence-based practice. Data were analysed through a process of qualitative content analysis.

    RESULTS: Different countries had varying structural arrangements and roles to support evidence-based nursing practice. At a cross-country level, three main themes were identified relating to different mechanisms for enacting evidence-based practice, contextual influences at a policy, organisational and service delivery level and challenges of leading evidence-based practice.

    CONCLUSIONS: National policies around quality and performance shape priorities for evidence-based practice, which in turn influences the roles and mechanisms for implementation that are given prominence. There is a need to maintain a balance between the mechanisms of managing and monitoring performance and facilitating critical questioning and reflection in and on practice. This requires a careful blending of managerial and facilitative leadership. The findings have implications for theory, practice, education and research relating to implementation and evidence-based practice.

  • 5.
    Klingberg-Allvin, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Van Tam, Vu
    Thu Nga, Nguyen
    Ransjö-Arvidson, Anna-Berit
    Johansson, Annika
    Ethics of justice and ethics of care. Values and attitudes among midwifery students on adolescent sexuality and abortion in Vietnam and their implications for midwifery education: a survey by questionnaire and interview2007In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, no 1, p. 37-46Article in journal (Refereed)
    Abstract [en]

    Adolescent’s sexuality and related reproductive health and rights problems are sensitive issues in Vietnam. Globalisation has had an impact on the lifestyles of young people, and rising numbers of abortion and STI/HIV risks among youth are posing major health concerns in the country. These problems need to be addressed. Midwives belong to a key category of health personnel in Vietnam, whose task it is to promote adolescents’ sexual and reproductive health and prevent reproductive ill health. It is important to understand future midwives’ perceptions and attitudes in order to improve their education and training programmes. Aim: The aim of this study was to investigate Vietnamese midwifery students’ values and attitudes towards adolescent sexuality, abortion and contraception and their views on professional preparation. Methods: A quantitative survey including 235 midwifery students from four different secondary medical colleges in northern Vietnam was carried out in 2003. A qualitative study addressing similar questions was performed and 18 midwifery students were individually interviewed. Findings: Findings revealed a general disapproval of adolescent pre-marital sexual relations and abortion – ‘an ethics of justice’ - but also an empathic attitude and willingness to support young women, who bear the consequences of unwanted pregnancies and social condemnation – ‘an ethics of care’. Gender-based imbalance in sexual relationships, limited knowledge about reproductive health issues among youth, and negative societal attitudes were concerns expressed by the students. The students saw their future tasks mainly related to childbearing and less to other reproductive health issues, such as abortion and prevention of STI/HIV. Conclusion: Midwifery education in Vietnam should encourage value-reflective thinking around gender inequality and ethical dilemmas, in order to prepare midwives to address adolescents’ reproductive health needs.

  • 6.
    Lövgren, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Gustavsson, Petter
    Karolinska Institutet.
    Melin, Bo
    Karolinska Institutet.
    Rudman, Ann
    Karolinska Institutet.
    Neck/shoulder and back pain in new graduate nurses: a growth mixture modeling analysis2014In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 51, no 4, p. 625-639Article in journal (Refereed)
    Abstract [en]

    Background: Although it is well known that musculoskeletal disorders are common among registered nurses, little longitudinal research has been conducted to examine this problem from nursing education to working life.

    Objectives: The aim was to investigate the prevalence and incidence of neck/shoulder and back pain in nursing students in their final semester, and one and two years after graduation. Furthermore, to identify common trajectories of neck/shoulder and back pain, and explore sociodemographic and lifestyle-related factors, contextual factors and health outcome that might be characteristic of individuals in the various trajectories.

    Design: Longitudinal study following nursing students from their final year of studies, with follow-ups one and two years after graduation.

    Settings and participants: Nursing students who graduated from the 26 universities providing undergraduate nursing education in Sweden 2002 were invited to participate(N = 1700). Of those asked, 1153 gave their informed consent.

    Methods: The participants answered postal surveys at yearly intervals. Descriptive statistics were used to analyze prevalence and incidence of pain, and growth mixture modeling was applied to identify different homogeneous clusters of individuals following similar trajectories in pain development across time.

    Results: The prevalence of neck/shoulder and back pain remained constant over time(around 50% for neck/shoulder pain and just over 40% for back pain). Six different development trajectories for each symptom were found, reflecting patterns of stable pain levels or variation in levels over time: one symptom-free group, two decreasing pain groups, two increasing pain groups, and one chronic pain group. With few exceptions, the same factors (sex, children, chronic disease, working overtime, work absence, sickness presence, physical load, depression, self-rated health, sleep quality and muscular tension) were associated with neck/shoulder and back pain trajectories. Different types of physical load characterized new nurses with neck/shoulder pain and back pain respectively.

    Conclusions: The high prevalence of pain among nursing students and among new graduate nurses, suggests that it would be effective to implement preventive strategies already during nursing education, but they should also preferably continue after graduation. Many factors associated with pain in the neck/shoulder and back seem to be modifiable, and thereby constitute targets for preventive strategies.

  • 7. Rudman, Ann
    et al.
    Gustavsson, Petter
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Boström, Anne-Marie
    Wallin, Lars
    Karolinska Instiutet.
    Registered nurses' evidence-based practice: a longitudinal study of the first five years after graduation2012In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 49, no 12, p. 1494-1504Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The capacity to provide evidence-based practice is one of five core competencies that it is proposed all healthcare professions should possess to meet the needs of the 21st century healthcare system. New nurses are faced with a challenging work environment which, combined with shortcomings in undergraduate education and their limited clinical experience, may affect their evidence-based practice.

    OBJECTIVE: The aim of this study was to prospectively examine the extent of Swedish nurses' evidence-based practice during the first five years of professional life.

    DESIGN: An observational longitudinal study, with yearly data collections over the course of five years. SETTINGS: Data was collected in two national cohorts (named EX2004 and EX2006) of Swedish registered nurses. Nurses in EX2006 were followed yearly during the first three years after graduation and nurses in EX2004 yearly three to five years after graduation. They had completed a three year academic nursing program and mainly worked in in-patient care settings.

    PARTICIPANTS: Participants were recruited while studying at any of the 26 universities in Sweden. A total of 2107 (EX2006) and 2331 (EX2004) nursing students were eligible. 1207 and 1227 nurses were included in the current longitudinal samples. The nurses had a mean age of 31.2/33.9years old and a majority were female. The cohorts were representative of the general nursing population.

    METHODS: Data was self-reported and collected through annual postal surveys. Evidence-based practice was conceptualized as a process and measured with an instrument including six items. Data was analyzed using latent growth curve modeling.

    RESULTS: The extent of evidence-based practice was stable, between the two cohorts and over time. Individual differences existed and remained stable over time. However, the extent of practicing the different components of evidence-based practice on a monthly basis varied considerably, from 10% of the nurses (appraising research reports) to 80% (using information sources other than databases to search for knowledge).

    CONCLUSION: The extent of evidence-based practice remained unchanged during the first five years of professional life. It appears important to enhance both the contribution of undergraduate education and the contextual conditions in work life, in order to improve evidence-based practice among newly graduated nurses.

  • 8.
    Wallin, Lars
    Karolinska Institutet.
    Knowledge translation and implementation research in nursing2009In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, no 4, p. 576-87Article in journal (Refereed)
  • 9.
    Wallin, Lars
    et al.
    University of Alberta.
    Rudberg, Agneta
    Gunningberg, Lena
    Staff experiences in implementing guidelines for Kangaroo Mother Care: a qualitative study2005In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 42, no 1, p. 61-73Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate staff experiences in implementing guidelines for Kangaroo Mother Care in neonatal care. The study was part of a randomized controlled trial, the overall goal of which was to assess the impact of external facilitation. A total of eight focus group interviews were held at two intervention and two control units. The establishment of a change team to implement the guideline resulted in activities that impacted staff behaviour, which in turn was perceived to influence patients' well-being. The guideline and contextual factors, such as leadership and staff colleagues' attitudes, were of significant importance in that process. The study intervention-facilitation promoted implementation activities and was highly appreciated by the change teams. However, reviewing the development of events at one of the control units, the provided facilitation appeared to be no more effective than an improvement-focused organizational culture in which the nurse manager was actively involved in the change process. Overall, learning and behaviour change seemed to be a social phenomenon, something that greatly benefited from people's interaction with one another.

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