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  • 1.
    Ehrenberg, Anna
    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.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nyexaminerade sjuksköterskors användning av forskningsresultat och tillämpning av evidensbaserad vård2013In: Verksamhetsförlagd utbildning i högskolans vårdutbildningar – Att stödja lärande den 13-14 november 2013 i Skövde: Sammanfattningar av föredrag, 2013Conference paper (Other (popular science, discussion, etc.))
  • 2.
    Eldh, Ann Catrine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hälleberg-Nyman, M.
    Örebro universitet.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hommel, A.
    Lunds universitet.
    Rycroft-Malone, J.
    Bangor University.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Onset prevention of incontinence in orthopaedic nursing and rehabilitation: a multifaceted undertaking2015Conference paper (Refereed)
  • 3.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Caring by the book2011In: Nursing Standard, ISSN 0029-6570, E-ISSN 2047-9018, Vol. 25, no 29Article in journal (Refereed)
  • 4.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nyutbildade sjuksköterskors användning av forskningsresultat2012Conference paper (Other academic)
  • 5.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Registered nurses' research use: A national survey on extent, patterns, intentions and associated factors in undergraduate education and the first years of clinical practice2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The gap between research and practice is well-known and has been addressed globally.The application of research-based knowledge in clinical practice has the potential to improve care quality and patient safety. Knowledge and abilities for critical reflection and implementation of new knowledge into practice are among the educational goals for today’s nursing education. Knowledge about newly graduated nurses’ extent of research use (RU) in clinical practice, as well as factors associated with nurses’ RU the first years postgraduation is scarce, however. The overall aim of this thesis was to study registered nurses’ self-reported instrumental, conceptual and persuasive RU(IRU, CRU and PRU) the first 3 years postgraduation, change in RU over time and associated factors. A further aim was to study nursing students’ intentions to use research in future practice and whether intention and educational factors could predict subsequent RU behavior. Methods: Data derived from the national LANE(Longitudinal Analysis of Nursing Education) survey study and its three cohorts of nursing students (subsequently registered nurses), graduating in 2002, 2004 and 2006(the EX2002, EX2004 and EX2006 cohorts). Data were analyzed using quantitative methods. Results: In Study I, the nurses’ RU extent was studied at year 1 and 3 (Y1 and Y3) postgraduation in the EX2004 (Y1) and EX2002 (Y3) cohorts. IRU was reported as most prevalent, occurring on about half of the working shifts, followed by CRU and PRU. Using cluster analysis, seven clusters of nurses were identified at both Y1 and Y3, where each cluster represented a specific RU profile. Cluster profiles with low or very low RU across all three RU kinds predominated (45.5% at Y1, 51.6% at Y3). In Study II, the extent of RU was studied at Y2 (EX2004). Furthermore, changes in RU between Y1 and Y2 were studied in relation to changes in working conditions. No significant differences in mean values were found between the time points. The seven cluster profiles were also identified at Y2, with most individuals tending to present the same profile over time. In addition, low users at Y1 tended to become even lower users at Y2 where overall low users constituted 54.9% of the cluster sample.Change towards overall low RU was not associated with changes in working conditions. In Study III, individual, work contextual and educational determinants of overall low RU were investigated at Y2 (EX2004). Through multivariate logistic regression modeling, six determinants were identified: work in the psychiatric setting, role ambiguity, sufficient staffing, low work challenge, being male and low student activity. In Study IV, nursing students’ IRU intentions were studied as a predictor and mediating variable for their IRU behavior at Y1 (EX2006). Intended IRU on more than half or almost every working shift was reported by 34% of the sample. A statistical full mediation model was set-up and tested, showing a direct effect from intention on subsequent behavior. Furthermore, intention acted as a mediating variable for the effects from capability beliefs and perceived support for RU during undergraduate studies. Conclusions: The extent of RU was rated relatively low, which is worrying considering today’s demand for research-based nursing practice. Multiple factors were associated with the nurses’ extent of RU the first years postgraduation, individual as well as educational and work contextual. Undergraduate education, both campus and clinical education, needs a clear focus on how to promote high RU intentions while the healthcare organization needs to provide the right conditions for supporting RU among nursing students and newly graduated nurses. The cluster analysis brought a new perspective into this field of research by illustrating a multidimensional and nuanced picture of RU.

  • 6.
    Forsman, Henrietta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gustavsson, Petter
    Rudman, Ann
    Wallin, Lars
    Newly graduated nurses’ research use in clinical practice – a pattern-oriented approach2008In: Knowledge Translation 2008: Forum for the Future, Banff, Kanada, 2008Conference paper (Refereed)
  • 7.
    Forsman, Henrietta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rudman, Ann
    Gustavsson, Petter
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Low research use among newly graduated nurses: a threat to patient safety?2011In: Medicinska Riksstämman 2011, Stockholm, 2011Conference paper (Other academic)
    Abstract [sv]

    Background: The application of research-based knowledge in clinical practice has the potential to improve quality of care, effectiveness and safety. However, the gap between research and practice is well-known and has been addressed globally. Among the educational goals of nursing education are abilities of critical reflection and implementation of new knowledge into practice. Knowledge about the extent of newly graduated nurses’ research use (RU) in clinical practice and factors that can hinder or facilitate their RU is however scarce. Aim: The overall aim of the thesis presented here was to study nurses’ self-reported RU the first three years postgraduation, change in RU over time and associated factors. Further, the aim was to study nursing students’ RU intentions and whether intention and educational factors could predict RU behavior. Methods: Data derive from the LANE study, a national and longitudinal survey study comprising three cohorts of nursing students, subsequently nurses, graduating in 2002, 2004 and 2006. Outcome measures were instrumental, conceptual and persuasive RU (IRU, CRU and PRU) at one, two and three years postgraduation (Y1, Y2, Y3), as well as IRU intention in last term of undergraduate studies. Results: At all time points, IRU was reported as most prevalent, followed by CRU and finally PRU. About one third of the respondents reported IRU on half or more than half of the working shifts. Seven different RU profiles across the three kinds of RU were identifed. The two clusters representing overall low RU were predominating, representing about half or more of the samples. Low users tended to become even lower over time between Y1 and Y2. A number of individual, organizational and educational factors were found as significantly related to overall low RU at Y2. IRU intention in last term of undergraduate studies showed that 34% of the sample intended to use research to a larger extent and IRU intention predicted IRU behavior at Y1. In addition, intention acted as a mediating factor for the effects from a number of other educational factors on IRU behavior. Implications: The results constitute unique knowledge. Considering today’s demand for evidence-based nursing practice, the relatively low extent of RU is worrying and may impact patient safety. Multiple factors were associated with the extent of RU the first years postgraduation and results have implications both for undergraduate nursing education and the healthcare organization.

  • 8.
    Forsman, Henrietta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gustavsson, Petter
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rudman, Ann
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Research use in clinical practice: extent and patterns among nurses one and three years postgraduation2009In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 6, p. 1195-1206Article in journal (Refereed)
    Abstract [en]

    Aim.  This paper is a report of a study of nurses’ research use in clinical practice one and three years postgraduation in Sweden.

    Background.  Internationally, learning to critically appraise and use research is an educational objective within nursing training, with the aim of promoting research use in nursing practice. The extent to which these skills is acquired and used among relatively newly graduated nurses is largely unexplored, however.

    Method.  A descriptive study was conducted in 2006 using a national longitudinal survey of two nursing cohorts one (n = 1,365) and three (n = 933) years postgraduation. The self-reported extent of instrumental, conceptual and persuasive research use was measured. Data were analysed using both variable- and pattern-oriented approaches based on cluster analysis.

    Results.  Research use was reported to occur in about half or fewer of the working shifts. In both samples, seven clusters of nurses with different research use profiles were identified. Clusters representing overall low and very low users in all three types of research use were predominant both at one (45·6%) and three (51·6%) years postgraduation, whereas clusters of nurses reporting overall high research use were uncommon. The proportion of very low users was larger 3 years after graduation than 1 year after graduation.

    Conclusions.  The low extent of reported research use, raises the question of whether scientific perspectives included in nursing education are translated into clinical application. The pattern-oriented approach illustrates the complexity of research use and identification of typical research use profiles in specific contexts may have potential to guide interventions aimed at supporting evidence-based practice.

  • 9.
    Forsman, Henrietta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gustavsson, Petter
    Rudman, Ann
    Ehrenberg, Anna
    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.
    A longitudinal study of nurses' research use the first two years post-graduation.2009In: The 2009 Knowledge Utilization Colloqium, Wales, 2009Conference paper (Refereed)
  • 10.
    Forsman, Henrietta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rudman, Ann
    Gustavsson, Petter
    Ehrenberg, Anna
    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.
    Nurses' research utilization two years after graduation: a national survey ofassociated individual, organizational, and educational factors2012In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 7, article id 46Article in journal (Refereed)
    Abstract [en]

    Background. Nurses' research utilization (RU) as part of evidence-based practice is strongly emphasized in today's nursing education and clinical practice. The primary aim of RU is to provide high-quality nursing care to patients. Data on newly graduated nurses' RU are scarce, but a predominance of low use has been reported in recent studies. Factors associated with nurses' RU have previously been identified among individual and organizational/contextual factors, but there is a lack of knowledge about how these factors, including educational ones, interact with each other and with RU, particularly in nurses during the first years after graduation. The purpose of this study was therefore to identify factors that predict the probability for low RU among registered nurses two years after graduation.

    Methods. Data were collected as part of the LANE study (Longitudinal Analysis of Nursing Education), a Swedish national survey of nursing students and registered nurses. Data on nurses' instrumental, conceptual, and persuasive RU were collected two years after graduation (2007, n = 845), together with data on work contextual factors. Data on individual and educational factors were collected in the first year (2002) and last term of education (2004). Guided by an analytic schedule, bivariate analyses, followed by logistic regression modeling, were applied.

    Results. Of the variables associated with RU in the bivariate analyses, six were found to be significantly related to low RU in the final logistic regression model: work in the psychiatric setting, role ambiguity, sufficient staffing, low work challenge, being male, and low student activity.

    Conclusions. A number of factors associated with nurses' low extent of RU two years postgraduation were found, most of them potentially modifiable. These findings illustrate the multitude of factors related to low RU extent and take their interrelationships into account. This knowledge might serve as useful input in planning future studies aiming to improve nurses', specifically newly graduated nurses', RU.

  • 11.
    Forsman, Henrietta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rudman, Ann
    Gustavsson, Petter
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wallin, Lars
    Nurses’ use of research findings in clinical practice - a prospective study of the first two years post-graduation2009In: Conference on Advances in Health Care Science Research, Stockholm, 2009Conference paper (Other academic)
  • 12.
    Forsman, Henrietta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rudman, Ann
    Gustavsson, Petter
    Ehrenberg, Anna
    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.
    Use of research by nurses during their first two years after graduating2010In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 66, no 4, p. 878-890Article in journal (Refereed)
    Abstract [en]

    Aim. This paper reports on a study of research use among nurses two years after graduation, as well as changes over time in research use in relation to changes in working conditions. 

    Background. The demand for evidence-based practice is widely expressed, and newly graduated nurses should possess the skills to provide high-quality care based on the best knowledge available. The way in which nurses use research during the first few years after graduating is, however, largely unknown. 

    Method. As part of a national longitudinal survey, nurses reported their extent of instrumental, conceptual and persuasive research use in 2006 (n = 1365) and 2007 (n = 1256). Data were analysed cross-sectionally and prospectively, using variable- and pattern-oriented methods. 

    Results. Instrumental research was reported most frequently, on about half of the working shifts. Seven profiles of research use were found, showing structural stability over time when compared with results from year 1. Most typically, nurses maintained the same profile over time; moreover, low users tended to become even lower users. Two years after graduation, 54 center dot 9% reported overall low use. Changes in working conditions did not explain the decrease in research use. 

    Conclusion. The results support previous claims of a gap between research and clinical practice. The predominance of overall low users is alarming and requires further research, including investigation of individual and organizational factors, to study their impact on nurses' research use.

  • 13.
    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.

  • 14.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Brorsson, Anna Lena
    Uppsala University; Karolinska Institute and Hospital.
    Granstam, Elisabet
    Uppsala University/County Council of Västmanland; Västmanland County Hospital.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Patients’ experiences before starting anti-VEGF treatment for sight-threatening diabetic macular oedema: A qualitative interview study2018In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, no 1, p. 11-17Article in journal (Refereed)
    Abstract [en]

    The diabetic complication macular oedema (DME) is a growing problem worldwide because of the increasing number of patients suffering from diabetes mellitus (DM). DME is treated with injections of anti-vascular endothelial growth factor (anti-VEGF) in the eye. This real-world study aimed to describe patients’ experiences before they received their first injection in the eye. Twenty-one men and women aged 49 to 86 years were interviewed. The interviews were analysed using qualitative content analysis. Two categories and an overall theme ‘to be at a crossroads and a crucial phase in life with an uncertain outcome’ were found. The participants expressed thoughts and concerns at different levels, practical concerns about the treatment procedure, and other existential thoughts regarding hope for improved visual acuity or fear of deterioration. Cooperation between eye clinics and diabetes clinics should be strengthened to clarify who is responsible for providing the information and support required by patients.

  • 15.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patient reported outcomes and visual function among patients with diabetes related macular edema2016Conference paper (Refereed)
  • 16.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jani, Siba
    Modher Raghib, Aseel
    Granstam, Elisabet
    Visual functioning and health-related quality of life in diabetic patients about to undergo anti-vascular endothelial growth factor treatment for sight-threatening macular edema2015In: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 29, no 8, p. 1183-1190Article in journal (Refereed)
    Abstract [en]

    Purpose

    To examine patient-reported outcome (PRO) in a selected group of Swedish patients about to receive anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME).

    Material and methods

    In this cross-sectional study, 59 patients with diabetes mellitus, who regularly visited the outpatient eye-clinics, were included. Sociodemographic and clinical data were collected and the patients completed PRO measures before starting anti-VEGF treatment. PRO measures assessed eye-specific outcomes (NEI-VFQ-25) and generic health-related quality of life (SF-36).

    Results

    The participants consisted of 30 men and 29 women (mean age, 68.5 years); 54 (92 %) patients had type 2 diabetes; Five (9%) patients had moderate or severe visual impairment; 28 (47 %) were classified as having mild visual impairment. Some of the patients reported overall problems in their daily lives, such as with social relationships, as well as problems with impaired sight as a result of reduced distance vision.

    Conclusions

    Further studies are needed to investigate PRO factors related to low perceived general health in this patient population. It is important to increase our understanding of such underlying mechanisms to promote improvements in the quality of patient care.

  • 17.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindholm Olinder, Anna
    Gkretsis, Dimitrios
    Eriksson, Jan W
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Patient-reported outcomes and visual acuity after 12 months of anti-VEGF-treatment for sight-threatening diabetic macular edema in a real world setting2016In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 121, p. 157-165Article in journal (Refereed)
    Abstract [en]

    Aims

    To examine objective visual acuity measured with ETDRS, retinal thickness (OCT), patient reported outcome and describe levels of glycated hemoglobin and its association with the effects on visual acuity in patients treated with anti-VEGF for visual impairment due to diabetic macular edema (DME) during 12 months in a real world setting.

    Methods

    In this cross-sectional study, 58 patients (29 females and 29 males; mean age, 68 years) with type 1 and type 2 diabetes diagnosed with DME were included. Medical data and two questionnaires were collected; an eye-specific (NEI VFQ-25) and a generic health-related quality of life questionnaire (SF-36) were used.

    Results

    The total patient group had significantly improved visual acuity and reduced retinal thickness at 4 months and remains at 12 months follow up. Thirty patients had significantly improved visual acuity, and 27 patients had no improved visual acuity at 12 months. The patients with improved visual acuity had significantly improved scores for NEI VFQ-25 subscales including general health, general vision, near activities, distance activities, and composite score, but no significant changes in scores were found in the group without improvements in visual acuity.

    Conclusions

    Our study revealed that anti-VEGF treatment improved visual acuity and central retinal thickness as well as patient-reported outcome in real world 12 months after treatment start.

  • 18.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindholm Olinder, Anna
    Gkretsis, Dimitrios
    Eriksson, Jan W.
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patient-reported outcomes: in patients with diabetic macular oedema treated with anti-VEGF2016In: The 16th European Doctoral Conference in Nursing Science, 2016Conference paper (Refereed)
  • 19.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lundberg, Pranee
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patientrelaterade utfallsmått vid införande av ny behandlingsform vid retinopati.2012In: SFSD (Svensk Förening för Sjuksköterskor i Diabetesvård) Symposium, Stockholm, 2012Conference paper (Refereed)
  • 20.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Quality of life among patients with diabetes macular edema2015Conference paper (Refereed)
    Abstract [en]

    Vision loss have a significant negative impact on quality of life. One of the most common causes of vision loss in patients with diabetes is diabetic macular edema - DME. Among DME patients, visual impairment is regarded as the most feared late diabetic complication. In January 2011 a new treatment for DME was approved, called anti-Vascular Endothelial Growth Factor, anti-VEGF- treatment. The treatment involves 3 injections every 4 weeks into the eye. The new treatment places increasing demands on the patient because of more visits and a stressful treatment. Beside that it is of great importance to learn more about the patient's experiences about the visual impairment and the new treatment.

    The aim of the study is to measure the effects of anti-VEGF treatment on vision related functioning, quality of life and sight-related variables.

    Fifty-nine patients are included in this longitudinal study at the eye clinics of two Swedish county hospitals. All patients who started anti-VEGF treatment were asked to participate.

    We have measured visual functioning with the eye-specific questionnaire - National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ-25), quality of life was measured with the general questionnaire Short Form- 36 (SF-36). Medical variables were collected at baseline, after 4 months and one year respectively.

    A large number of patients are affected by diabetes each year and may suffer from visual impairment. These patients may be treated with this new form of treatment. Therefore it is of great importance to examine the patient's experiences of treatment and self-percieved quality of life to be able to provide the best possible information and procedures at the eye clinics.

  • 21.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Visual functioning and quality of life among patients with diabetic macular edema2015Conference paper (Refereed)
    Abstract [en]

    Background

    One of the most common causes of vision impairment in patients with diabetes is diabetic macular edema (DME) and is regarded as the most feared late diabetic complication. In January 2011 a treatment for DME was approved, called anti-Vascular Endothelial Growth Factor treatment. The treatment involves an injection into the vitreous of the eye and places increasing demands on the patient because of more visits and a stressful treatment. Therefore it is of most importance to capturing patients’ thoughts and feelings, so called Patient reported Outcome (PRO).

    Aim

    To examine patient-reported outcome (PRO) in a selected group of Swedish patients with diabetes-related macula edema about to receive anti-vascular endothelial growth factor treatment for diabetic macular edema.

    Method

    Visual functioning was measured with National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ-25), quality of life was measured with Short Form- 36 (SF-36). The initial eye examination included measurement of visual acuity with the ETDRS, and retinal thickness by OCT. In addition, medical variables were collected. The data collection was performed at baseline, after 4 months and one year. In this abstract we reported the result from the baseline.

    Result

    The participants were 30 men and 29 women (mean age, 68.5 years) and 92% of them had type 2 diabetes. With NEI VFQ-25, the participants showed the lowest score for the subscale of general health (mean 35.65 ± 22.04) and the highest for dependency (mean 93.48 ± 18.12). For SF-36, the participants gave the lowest score in the subscale of general health (mean 56.55 ± 22.14) and the highest for the subscale of role emotional (mean 88.73 ± 22.32). The mean ETDRS score in the eye planned for treatment was 63.9 (± 13.2) and the mean central retinal thickness was 396 (± 129).

    Conclusions: Patients diagnosed with diabetes macula edema about to receive anti-VEGF treatment reported low general health. Hence, it is of most importance to follow up patients’ thoughts and feelings (PRO) after the treatment is performed in order to promote improvements in the quality of patient care.

  • 22.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Public Health and Caring Sciences, Uppsala, Sweden.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Public Health and Caring Sciences, Uppsala, Sweden.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Department of Ophthalmology, Västerås, Sweden.
    Anti-VEGF treatment for diabetic macular edema: a qualitative evaluation of patients experiences2013Conference paper (Refereed)
  • 23.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Uppsala universitet.
    Visual functioning and quality of life among patients with macular edema: a quantitative study2015Conference paper (Refereed)
  • 24.
    Hälleberg Nyman, M
    et al.
    Örebro universitet.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hommel, A.
    Lunds universitet.
    Rycroft-Malone, J.
    Bangor University.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Identifying the knowledge to translate: the example of urinary incontinence in older people2015Conference paper (Refereed)
    Abstract [en]

    Background: While urinary incontinence (UI) is a common and worrying issue among older people, promoting the use of evidence to prevent UI onset has rarely been studied. An earlier study that was conducted in nursing homes suggests that UI can be better assessed and managed, but the prevention of UI onset requires attention to the issue by staff within acute care settings. Aim: To report on the internal facilitators’ (IF) transition, identifying the 'know-do gap' between evidence and practice in UI prevention in orthopaedic care.

    Methods: The Onset PrevenTion of Incontinence in Orthopaedic Nursing and rehabilitation (OPTION) pilot was carried out in two Swedish orthopaedic units of different size and location. The pilot project included a programme to support nursing and rehab staff to facilitate knowledge translation (KT). Five IFs were interviewed at baseline, and one and three months after the intervention was completed, and non-participant observations were performed during the KT-intervention. Interviews and observations were triangulated, depicting when and how the IFs identified the present, local UI practice, the evidence on UI, and the know-do gap in preventing UI onset in older patients undergoing hip surgery.

    Results: Preliminary results indicate that before the study, neither the IFs nor their fellows at the units were aware that they could prevent UI onset. Rather, through mapping their context and matching the evidence provided by the dialogue with the experts in the KTintervention, the IFs became aware of which practice was evidence based and which evidence to implement, and how to facilitate KT and promote evidence use.

    Conclusion: The OPTION pilot indicates that KT can be promoted by tailored implementation strategies and tailoring evidence, supported by IFs awareness and understanding of the local know-do gap, and strategies to overcome barriers and promote use of evidence.

  • 25. Hälleberg Nyman, M
    et al.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ostaszkiewicz, J
    Hommel, A
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Urinary incontinence and its management in patients aged 65 and older in orthopaedic care: what nursing and rehabilitation staff know and do2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 21-22, p. 3345-3353Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To describe what nursing and rehabilitation staff know and do with regards to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery.

    BACKGROUND:

    Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent UI, there are indications that these guidelines are not applied in hospital care.

    DESIGN:

    A qualitative study with descriptive design was conducted in two orthopaedic units.

    METHODS:

    46 interviews and 36 observations of care were conducted from January to October 2014 and analysed with qualitative content analysis.

    RESULTS:

    Enrolled nurses performed most of the care related to bladder function, with focus on urinary catheterisation and preventing urinary tract infection and urinary retention. Registered nurses' role in urinary matters mainly comprised documentation, while the rehabilitation staff focused on making it possible for the patient to be independent in toileting. The nursing staff considered urinary incontinence a common condition for older people and that it was convenient for the patients to have an indwelling catheter or incontinence pad/pant, although they acknowledged some of the risks associated with these procedures.

    CONCLUSIONS:

    Urinary incontinence is not a priority in orthopaedic care, and urinary incontinence guidelines are not applied. Further, attitudes and actions are mainly characterised by a lack of urinary incontinence knowledge and the nursing and rehabilitation staff do not take a team approach to preventing and managing UI.

    RELEVANCE TO CLINICAL PRACTICE:

    An increased focus on knowledge on urinary incontinence and evidence-based guidelines is needed. To secure evidence-based practice, the team of nursing and rehabilitation staff and managers must be aligned and work actively together, also including the patient in the team.

  • 26. Hälleberg Nyman, Maria
    et al.
    Forsman, Henrietta
    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.
    Ostaszkiewicz, Joanne
    Hommel, Ami
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Promoting evidence-based urinary incontinence management in acute nursing and rehabilitation care: A process evaluation of an implementation intervention in the orthopaedic context2019In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 25, no 2, p. 282-289Article in journal (Refereed)
    Abstract [en]

    RATIONALE, AIMS, AND OBJECTIVES:

    The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence-based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence-based practice for UI in patients aged 65 or older undergoing hip surgery.

    METHODS:

    A 3-month intervention was delivered in 2014 to facilitate the implementation of UI knowledge in orthopaedic units in 2 hospitals in Sweden. Each unit appointed a multidisciplinary team of nurses and physiotherapists or occupational therapists to facilitate the implementation. The teams were supported by external facilitators who shared knowledge about UI and implementation science. Interviews, nonparticipant observations, and audits of patient records were performed.

    RESULTS:

    Prior to the intervention, there was no use of guidelines regarding UI. The intervention raised the internal facilitators' awareness of UI risks associated with hip surgery. As internal facilitators shared this information with their peers, staff awareness of UI increased. The teams of internal facilitators described needing additional time and support from managers to implement evidence-based UI care. A management initiative triggered by the intervention increased the documentation of UI and urinary problems in 1 unit.

    CONCLUSION:

    To promote evidence-based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence-based management of UI.

  • 27.
    Karlberg, Malin
    et al.
    Örebro Universitet.
    Cronqvist, Agneta
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, Gunilla
    Möller, Margareta
    Eriksson, Mats
    Leading for reserach: An intervention to facilitate research utilization2016Conference paper (Refereed)
  • 28. Karlberg Traav, Malin
    et al.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Mats
    Cronqvist, Agneta
    First line nurse managers' experiences of opportunities and obstacles to support evidence-based nursing2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 4, p. 634-641Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim was to explore first line nurse managers’ experiences of opportunities and obstacles to support evidence‐based nursing.

    Design

    A qualitative study with a phenomenographical approach.

    Method

    Data were collected through focus group interviews with 15 first line nurse managers’ in four settings.

    Results

    The results are presented in four categories of description headed: Manage the everyday work vs. evidence‐based nursing; Uncertainties about evidence‐based nursing and nursing research; Time as a reality, as an approach; and Shaping awareness—towards an active approach to evidence‐based nursing. The overarching category of description has been formulated as follows: The internal relation—how active leadership influences evidence‐based nursing. The outcome space is presented as: The individual path—how to make vision and reality become a working entity around evidence‐based nursing.

  • 29. Orton, Marie-Louise
    et al.
    Andersson, Åsa
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet; Göteborgs universitet.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Linköpings universitet; Uppsala universitet.
    Nursing management matters for registered nurses with a PhD working in clinical practice2019In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 27, no 5, p. 955-962Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate what registered nurses (RNs) with a PhD working in clinical practice experience in terms of their role, function and work context.

    BACKGROUND: Previous studies have shown that RNs with a graduate degree contribute to better and safer care for patients. However, little is known about what further academic schooling of RNs, at PhD level, means for clinical practice.

    METHOD: Qualitative design, with semi-structured interviews and inductive content analysis.

    RESULTS: The main areas of responsibilities for RNs with a PhD working in clinical practice were related to practice development and implementation of research results. In their work, they experienced barriers to the full use of their competence; the expectations and prerequisites of the organization were not clearly defined, and they often lacked a mandate to create conditions for quality improvement of nursing care.

    CONCLUSIONS: RNs with a PhD can contribute to evidence-based practice (EBP), clinical training as well as the development of clinical research. Their roles and responsibilities need to be clarified and for this, they need support from managers.

    IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should partner with RNs with a PhD to support the EBP process and help structure nursing practice in more efficient ways. 

  • 30.
    Strandberg, Elisabeth
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Rudman, Ann
    Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Gustavsson, Petter
    Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    The concept of research utilization as understood by Swedish nurses: demarcations of instrumental, conceptual and persuasive research utilization2014In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 11, no 1, p. 55-64Article in journal (Refereed)
    Abstract [en]

    Background and Aims: The literature implies research utilization (RU) to be a multifaceted and complex phenomenon, difficult to trace in clinical practice. A deeper understanding of the concept of RU in a nursing context is needed, in particular, for the development of instruments for measuring nurses’ RU, which could facilitate the evaluation of interventions to support the implementation of evidence-based practice. In this paper, we explored nurses’ demarcation of instrumental RU (IRU), conceptual RU (CRU), and persuasive RU (PRU) using an item pool proposed to measure IRU, CRU, and PRU.

    Methods: The item pool (12 items) was presented to two samples: one of practicing registered nurses (n = 890) in Sweden 4 years after graduating and one of recognized content experts (n = 7). Correlation analyses and content validity index (CVI) calculations were used together with qualitative content analysis, in a mixed methods design.

    Findings: According to the item and factor analyses, CRU and PRU could not be distinguished, whereas IRU could. Analyses also revealed problems in linking the CRU items to the external criteria. The CVIs, however, showed excellent or good results for the IRU, CRU, and PRU items as well as at the scale level. The qualitative data indicated that IRU was the least problematic for the experts to categorize, whereas CRU and PRU were harder to demarcate.

    Conclusions: Our findings illustrate a difficulty in explicitly demarcating between CRU and PRU in clinical nursing. We suggest this overlap is related to conceptual incoherence, indicating a need for further studies. The findings constitute new knowledge about the RU concepts in a clinical nursing context, and highlight differences in how the concepts can be understood by RNs in clinical practice and experts within the field. We suggest that the findings are useful for defining RU in nursing and further development of measures of RU.

  • 31.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jensfelt, Marcus
    Flink, Maria
    Perceptions of knowledge, research use and evidence-based practice among Swedish medical social workers – a qualitative study2019Conference paper (Refereed)
    Abstract [en]

    Background and aim: With the intention to do more good than harm, it is important to rely on practice that is rooted in evidence-based guidelines so that clients are given the exact care they need. Thus, from a client safety perspective, the social worker needs to apply evidence-based practice (EBP). Learning more about the medical social workers’ perceptions of EBP has the potential to contribute to an increased understanding of how best available knowledge can be implemented in medical social work settings to provide high quality and safe practice to clients. Therefore the aim of this study was to explore medical social workers’ perceptions of evidence-based practice (EBP), including factors relevant for the successful implementation of evidence into medical social work practice.

    Methods: This is a qualitative study. Eight focus group interviews were conducted that included 27 medical social workers. Data were analyzed using qualitative content analysis.

    Results: Analysis resulted in two categories: “knowledge in practice” and “challenges in relation to the implementation of EBP” and four subcategories: “practice based on research evidence or experience”, “obtaining new evidence of practice”, “research and the social work context”, and “barriers and facilitating factors”. Participants tended to perceive EBP as theoretical and positivistic while perceiving their own knowledge as eclectic and experience-based. Although they perceived the relevance of research findings to their practice, they expressed a need for support to translate research into policy and practice. They also reported that studies about their specific work were scarce.

    Conclusion and implications: The facilitating factors suggested by the medical social workers which concerned, e.g., a specially designated person responsible for supporting the increased use of research findings, support for prioritization of time, increased opportunities for the sharing of knowledge, and time for consultations, need to be considered when promoting the implementation of EBP within medical social work settings. The medical social workers’ suggestion for the facilitation of knowledge exchange needs further investigation.

  • 32.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jensfelt, Marcus
    Karolinska University Hospital.
    Flink, Maria
    Karolinska University Hospital; Karolinska Institutet.
    Research use and evidence-based practice among Swedish medical social workers: a qualitative study2018In: Clinical social work journal, ISSN 0091-1674, E-ISSN 1573-3343Article in journal (Refereed)
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