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Nurses' experiences of preventing pressure ulcers in somatic inpatient care : Literature based study
No full textBackground: Pressure ulcers are a significant issue in somatic inpatient care, causing patient suffering and increasing healthcare costs. Nurses have a central role in preventing pressure ulcers by performing risk assessments, implementing preventive measures, and involving patients in their care. However, organizational challenges and resource shortages hinder effective prevention. Aim: The aim of this study was to describe nurses’ experiences of preventing pressure ulcers in somatic inpatient care. Method: The method used was based on analysis of qualitative research: to contribute to evidence-based nursing based on analysis of qualitative research (Friberg, 2017). The analysis of scientific articles resulted in three themes and seven subthemes. Results: The three themes were: Challenges in identifying at-risk patients, Inadequate organizational conditions, and Leading care that addresses the patient’s overall needs. The results show that nurses face difficulties using risk assessment tools due to lack of training and tool adaptability. Organizational challenges such as resource shortages, high workloads, and limited time further delay preventive efforts. Additionally, involving patients in care and interdisciplinary collaboration were highlighted as essential but often insufficiently implemented. Conclusion: Nurses play a crucial role in preventing pressure ulcers, but improvements in education, resources, and interdisciplinary teamwork are necessary. Organizational support and patient-centered approaches can enhance care quality, reduce patient suffering, and promote sustainability in healthcare. Strengthening nurses’ competencies and creating supportive environments are key to addressing these challenges.Syftet med denna litteraturbaserade studie var att beskriva sjuksköterskors erfarenheter av att förebygga trycksår inom somatisk slutenvård. Resultatet visade att sjuksköterskor mötte flera utmaningar i det förebyggande arbetet. En utmaning låg i svårigheten att identifiera riskpatienter, vilket delvis berodde på att riskbedömningsinstrument inte alltid var anpassade till patienternas individuella behov och att kunskapen om hur dessa riskbedömningsinstrument användes var begränsad. Vidare framkom det att otillräckliga organisatoriska förutsättningar såsom otydliga rutiner, otillräckliga resurser och tidsbrist försvårade sjuksköterskors förebyggande arbete. Dessutom framhölls vikten av att sjuksköterskor hade en nyckelroll i att leda vården med ett holistiskt perspektiv som beaktade hela patientens behov. Detta innebar att sjuksköterskor aktivt involverade patienten i det förebyggande arbetet genom att tillhandahålla information, stöd och utbildning för att öka patientens delaktighet. Samtidigt ansvarade sjuksköterskor för att samordna insatser mellan olika yrkesgrupper för att säkerställa att vården var effektiv och täckte hela spektrumet av patientens behov. Samarbetet mellan olika yrkesgrupper möjliggjorde en holistisk vårdplanering, där varje yrkesgrupps kompetens integrerades för att optimera det förebyggande arbetet och förbättra patientens resultat. Slutsatser som kunde dras var att sjuksköterskor mötte flera utmaningar i sitt arbete med förebyggandet av trycksår. Svårigheter att identifiera riskpatienter, bristande resurser och organisatoriska hinder var faktorer som påverkade vårdens kvalitet negativt. En samordnad och personcentrerad vård, där både patienter och andra yrkesgrupper inkluderades, var avgörande för att effektivisera förebyggandet av trycksår och minska patientens lidande. Vidare beskrevs trycksår som en vårdskada orsakad av långvarigt tryck på huden, vilket kunde leda till svåra komplikationer. Trycksår var vanligt förekommande inom somatisk slutenvård, särskilt hos patienter med nedsatt rörlighet, undernäring eller hög ålder. För att förebygga trycksår användes riskbedömningsinstrument och tryckavlastande hjälpmedel. Trots detta var det en utmaning att förebygga trycksår på grund av organisatoriska hinder och resursbrist. För att besvara studiens syfte valdes en kvalitativ metod grundad på analys av kvalitativ forskning, enligt Friberg (2017). Tio vetenskapliga studier, som belyser sjuksköterskors erfarenheter, analyserades och gemensamma teman samt underteman identifierades för att besvara studiens syfte. I diskussionen framkom det att organisatoriska förändringar och kontinuerlig utbildning kunde stärka sjuksköterskors förutsättningar att förebygga trycksår inom somatisk slutenvård. Det betonades även att en mer normmedveten och hållbar vård kunde minska patientens lidande och främja en jämlik vård
Nurses' experiences of using digital care meetings with patients in regional primary care : A Literature Review
No full textBackground: Digital meetings have become a natural part of healthcare, especially in recent years, such as after the global COVID-19 pandemic. In primary care, this development has been an important step toward increasing accessibility to healthcare. For nurses, who play a central role in these meetings, e-health presents new challenges but also offers many opportunities. Nurses must be aware of factors such as maintaining nurturing communication and ensuring person-centered care to prevent patients suffering in healthcare. Aim: The purpose of this study was to highlight nurses’ experiences of using digital care meetings with patients in regional primary care. Method: The method used was a literature review. An analysis of eight scientific qualitative studies and two with mixed methods resulted in two themes and five subthemes. Results: The two themes identified were: A feeling of being between the old and the new and A new way of communicating. The findings indicate that digital healthcare meetings are an excellent complement to physical meetings, offering opportunities to reach more patients. However, challenges arise in establishing the same level of personal connection as in face-toface meetings. Nurses also reported a need for additional training and support to effectively manage technological tools. Conclusion: Digital healthcare meetings can enhance accessibility to care, but technical and educational barriers must be addressed to fully realize their potential. The transition to digital healthcare is not a straightforward path towards progress. Under de senaste åren har digitala vårdmöten blivit en naturlig del av sjukvården, särskilt efter den globala covid-19 pandemin. I regional primärvård har detta varit ett viktigt steg framåt för att öka tillgängligheten till vård. För sjuksköterskor, som ofta är en central del i dessa möten, innebär det nya utmaningar och möjligheter. Deras roll handlar inte bara om att använda tekniken utan också om att skapa trygghet och förtroende hos patienterna, något som kan vara svårare att förmedla genom en skärm. Digitala vårdmöten gör det möjligt för patienter att få vård utan att lämna hemmet, vilket kan vara en stor fördel, till exempel för äldre eller personer i glesbygdsområden. Syftet i denna studie var att belysa sjuksköterskors erfarenheter av att använda digitala vårdmöten med patienter inom regional primärvård. Genom att analysera både statistiska data och intervjustudier skapades en helhetsbild av kunskapsläget. Resultaten visar att sjuksköterskor erfar att digitala vårdmöten är ett utmärkt komplement till fysiska besök och ger möjligheten att nå fler patienter. Samtidigt framkom det att tekniken kan göra det svårt att skapa samma personliga kontakt som vid fysiska möten. Många sjuksköterskor upplever också att det behövs mer utbildning och stöd för att hantera tekniska verktyg på ett effektivt sätt. Metoden som användes i denna studie var en litteraturöversikt, den inkluderade både kvantitativ och kvalitativ forskning från två databaser, Cinahl och PubMed. Slutsatsen som dragits i studien är att digitala vårdmöten har potential att öka tillgången till vård för patienter. Samtidigt framkom det att digitala vårdmöten kan innebära hinder, där tekniska problem eller bristande kunskap kan utgöra begränsningar för vårdtillgången. Resultatet kan tydliggöra att användningen av digitala vårdmöten inte är en helt oproblematisk utveckling, utan präglas av både möjligheter och utmaningar. Framtidens vård är både digital och mänsklig
Clients' Experiences and Satisfaction with an Integrated Intensive Outpatient Program for Substance Use Disorders
No full textBackground: Comorbidity between substance use dis-orders and other mental health conditions is common,yet existing treatments often fail to address its full spec-trum. Opportunities for integrated treatment are limited,and the effects of such treatment remain relatively unex-plored. This study explores the experiences of individualswith substance use disorders who successfully completeda four-month integrated intensive program at an outpatientaddiction-care clinic in western Sweden. Method: An anonymous survey combining quanti-tative measures and qualitative open-ended questions wasused to evaluate the experiences of 65 clients (out of 117)who completed the program between 2015 and 2021. Results: The findings revealed that most clients ex-pressed high levels of satisfaction with the program. Themean scores for the questions ranged from 9.17 to 9.35, in-dicating a generally positive experience. The standard de-viations were relatively low (1.17 to 1.34), suggesting con-sistency in responses. The median scores for all questionswere 10, with ranges indicating that most participants ratedtheir experiences at the highest level. The analysis identi-fied three key categories of clients’ experiences: (1) strongrelationships and a comprehensive treatment approach; (2)engaged, knowledgeable staff who lead with warmth; and(3) opportunities for self-development through novel expe-riences. Conclusion: Clients who successfully completed thefour-month integrated intensive program reported high sat-isfaction levels, positive relationships with staff, and valu-able self-development insights. However, the high dropoutrate limited gaining an understanding of the barriers to pro-gram completion, highlighting the need for further researchaimed at enhancing retention rates and developing moreeffective integrated treatment interventions for individualswith substance use disorders.CC-BY 4.0</p
Oral healthcare for older adults in Swedish municipal healthcare : a qualitative study of healthcare professionals’ experiences
No full textIntroduction Oral health is multi-faceted and influences a person’s daily life, and numerous potential barriers and factors can challenge and pose barriers to good oral health. Shortages of healthcare professionals or incorrect care practices can be barriers to performing good oral healthcare. A knowledge gap has been identified in qualitative research on description of healthcare professionals’ experiences of oral healthcare among older adults in municipal healthcare. Aim To describe healthcare professionals’ experiences of oral healthcare among older adults in Swedish municipal healthcare. Design and methods The study employed a qualitative design guided by a secondary qualitative analysis method comprising inductive qualitative content analysis. Data were collected through semi-structured individual interviews with healthcare professionals. Results Good relationships and mutual trust create the conditions for delivering good oral healthcare. Knowledge provides confidence and trust in performing oral healthcare, experiences and strategies influence the individual adaptation of oral healthcare, and priorities and collaboration influence oral healthcare provision. Conclusion and implications The performance of oral healthcare is complex and cannot be achieved without establishing a relationship with the older adult who needs care. Oral healthcare includes prerequisites such as routines, sufficient time, work-time planning, and collaboration between healthcare professionals. Registered nurses positively experience opportunities to collaborate with other healthcare professionals regarding oral healthcare and are seen as leaders in the Fundamentals of Care and are sharing good examples of oral healthcare in palliative care.CC BY 4.0</p
From Defining to Applying Concepts : A Practice-Based Study Focused on Strengthening Students' Use of Chemistry Concepts
No full textSyftet med studien är att få mer kunskap om hur en undervisningsdesign, baserad på hur elever lär sig naturvetenskap och de faktorer de själva anser är viktiga för sitt lärande, gör det möjligt för dem att tillämpa olika kemiska begrepp. Studien genomfördes som en designstudie med fem lektionstillfällen som observerats. Undervisningsdesignen bygger på tre huvudmoment med tydliga syften, baserade på en teori av Mortimer och Scott (2003) samt en tidigare kartläggning av elevers upplevelser av kemiundervisning (Johansson & Holm,2023). Kartläggningen visade att eleverna efterfrågar variation, konkreta upplevelser och samarbete i undervisningen. Kartläggningen visade också att elever har svårt att se kopplingen mellan kemiska begrepp och sin vardag. De genomförda lektionerna i denna studie behandlar begrepp inom områden som vattnets egenskaper, vattnets kretslopp, luftens sammansättning, lufttryck och väder samt vattenföroreningar. Resultaten visar att eleverna efter studien kan definiera fler begrepp och att deras förmåga att tillämpa vissa begrepp i nya sammanhang utvecklades. Att använda begreppen till nya sammanhang visade sig dock vara utmanande och kan påverkas av faktorer som exempelvis lärarens stöd under processen.
Effect of hot isostatic pressing on the low-cycle fatigue behavior of laser powder bed fusion manufactured 21-6-9 austenitic stainless steel
No full text21-6-9 stainless steel manufactured by powder bed fusion (PBF-LB/M) is expected to be used for aerospace parts due to its high strength and elevated temperature durability, coupled with the possibility to manufacture complex shapes. Defects, such as pores and lack of fusion (LoF), can be formed in PBF-LB/M manufactured material, which can be detrimental to important dynamic mechanical properties like fatigue strength. However, hot isostatic pressing (HIP) has shown great potential in closing and healing such defects. In this study, an investigation of the effects of HIP treatment on the low-cycle fatigue (LCF) properties and microstructure of PBF-LB/M manufactured 21-6-9 material was performed. It was found that the effects of HIP treatment are similar to that of solution heat treatment regarding grain coarsening and grain sensitization. In addition, HIP successfully closed the pores, reducing the defect density. The stress relief heat-treated (SR) specimens exhibited lower LCF strength than wrought material, but after HIP treatment, LCF strength was equal to wrought material. The HIP treatment consequently improved the strain-controlled LCF strength but decreased the tensile strength and hardness around 30%. CC-BY 4.0</p
Microstructure and mechanical properties of Ti-6Al-4V alloy fabricated using powder bed fusion : laser beam additive manufacturing process: Effect of hot isostatic pressing
No full textPowder bed fusion laser beam (PBF-LB) is one of the most widespread and highly researched additive manufacturing (AM) methods, spanning multiple industries. Its feedstock material is metallic powder, where a conventional particle size range is 15–50 μm. The present study focuses on Ti-6Al-4V powder with a wider particle size distribution (15–90 μm). Two process themes are evaluated: one minimising porosity and one maximising build rate through a fast laser scanning speed. The effect of two hot isostatic pressing (HIP) heat treatments on mechanical properties, one below and one above the β-transus, are compared to those of as-built and stress relieved material. Room temperature impact toughness and tensile testing are used to compare the materials by determining UTS and Yield strength, elongation and reduction of area for the different process conditions and post build heat treatments. The minimal porosity theme reaches properties comparable to conventional manufacturing processes at all heat treatment temperatures (i.e., UTS >860 MPa, 0.2 % Yield >795 MPa). The high productivity theme treated below β-transus provides further improvement in overall reduction of area (>45 %) and elongation (>20 %) with respect to the minimal porosity theme, by showing a bi-modal microstructure that is the result of a recrystallisation process. This phenomenon is triggered by the closure of lack of fusion (LoF) defects via hot isostatic pressing, due to a higher dislocation density at the tip of these particular defects. Impact energy for this condition increases whilst hardness and texture become less pronounced. It is demonstrated that in those cases where a fast scanning speed creates LoF defects, those can assist in modifying microstructure during the consolidation process which has a positive effect on ductility.CC BY 4.0</p
Axial plasma spraying of aqueous solution precursors : A facile approach for columnar thermal barrier coatings
No full textThermal barrier coatings (TBC) are an essential part of modern gas turbines for aviation and power generation. As such, there is an incessant demand for improved TBC performance and longevity. Of the possible coating microstructures, the columnar structure first produced by electron beam physical vapour deposition was found to be most durable. The subsequently developed suspension plasma spray coatings are seen as an alternative method for producing columnar TBCs but typically utilise flammable solvents to achieve such structures. Aqueous solution precursors have also been used as a feedstock to deposit yttria stabilised zirconia (YSZ) TBCs; however, columnar structures have proven elusive, with solution precursor plasma spray (SPPS) deposition conditions and throughputs involving radial feed spray torches also being industrially unattractive. This study illustrates the first columnar coatings of single-layer yttria stabilised zirconia from an aqueous solution precursor using an axial feed capable plasma torch. Coatings have been shown to be columnar structured over a robust operating window, fully tetragonal in phase constitution and capable of being deposited at rates that can be commercially interesting. These initial results lay a great foundation for further TBC development utilizing an aqueous, powder-free, feedstock. CC BY 4.0</p
Alleviating Foreign Language Anxiety : A Qualitative Study on Classroom Situations and Effective Teacher Strategies
No full textIn many foreign language classrooms today, students fear speaking in front of peers and teachers, experiencing anxiety when they are tasked with an oral presentation. The term Foreign Language Anxiety (FLA) was coined and developed by Horwitz et al. (1986) who described it as ''a distinct complex of self-perceptions, beliefs, feelings, and behaviors related to classroom language learning arising from the uniqueness of the language learning process''. This study aims to identify anxiety-inducing situations through teachers' perceptions and explore if English teachers use strategies to alleviate anxiety for their students. Eight English secondary and upper secondary school teachers participated in semi-structured interviews to contribute with their experiences and strategies. The interviews were analyzed through thematic analysis to gain insight into the participants' perspectives of language anxiety and how they would work with it. The results show that oral presentation tasks in the English subject are the most anxiety-inducing for students. The most prominent strategies used by the teachers to alleviate language anxiety were task strategies, motivational strategies, emotional strategies, and practice strategies
Nurses’ experiences of prescribing
No full textBakgrund: Förskrivningsrätten är ett viktigt verktyg i sjuksköterskans omvårdnadsarbete, den bidrar till bättre patientvård genom att möjliggöra snabbare tillgång till vård och behandling samt att patientens behov kan uppmärksammas och tillgodoses på ett mer effektivt sätt. Förskrivningsrätten har visats vara gynnsam för organisationen och stärker dessutom professionen genom ökad stolthet och arbetsglädje. Trots det har tidigare forskning påvisat att förskrivningsrätten inte används i sin fulla utsträckning. Förskrivningsrättens utformning kan variera mellan länder och utbildningsnivå. Distriktsjuksköterskan är en av dom professioner som kan erhålla förskrivningsrätt och har till syfte att arbeta hälsofrämjande samt sjukdomsförebyggande. Distriktsjuksköterskans kompetens tillsammans med förskrivningsrätten möjliggör nära vård som syftar till att vården ska vara god, nära och samordnad. Syfte: Att beskriva erfarenheter av förskrivningsrätt hos sjuksköterskor. Metod: Systematisk litteraturstudie baserat på kvalitativ forskning som analyserats enligt Bettany-Saltikov & McSherry’s (2016) niostegsmodell. Resultat: Erfarenheterna av förskrivningsrätten varierade vilket synliggjordes i två teman Förbättrad patientvård samt Professionsutveckling. Det första temat Förbättrad patientvård innehåller fyra subteman Synliggöra hela patienten, Stärkta relationer över tid, Tillgänglighet ger effektivare vård och Läkemedelkompetens gynnar säker vård. Det andra temat professionsutveckling innehåller fyra subteman Bemästra ansvaret, Betydelsen av fortbildning och gemensamt lärande, Behörig med begränsning och Bristande stöd från ledning. Slutsats: Sjuksköterskors erfarenhet av förskrivningsrätten innefattade både möjligheter och hinder i det hälsofrämjande arbetet. Hinder utgjordes av bristande organisatoriska förutsättningar samt behov av stöd kopplat till tilltron på den egna kompetensen. Möjligheterna bidrog till förbättrad omvårdnad, säkrare patientomhändertagande samt stärkt professionell status genom ökad självständighet i vårdprocessen.Background: Nurses prescribing is an important tool in nursing care, as it contributes to improved patient care by enabling faster access to treatment and healthcare services, while also allowing patient needs to be identified and addressed more effectively. Prescribing rights also benefit the healthcare organization and strengthen the nursing profession by increasing professional pride and job satisfaction. Despite these benefits, previous research has shown that nurse prescribing is not being fully utilized. The structure and scope of prescribing rights vary between countries and educational levels. In Sweden, district nurses are one of the professional groups with prescribing rights, with a primary focus on health promotion and disease prevention. The district nurse’s competence, combined with prescribing authority, enables the provision of close care that is intended to be accessible, high-quality, and well-coordinated. Aim: To describe nurses’ experiences of prescribing. Method: Systematic literature review based on qualitative research, analyzed according to Bettany-Saltikov & McSherry’s (2016) nine-step model. Results: Nurses’ experiences of prescribing varied and were categorized into two main themes: Improved patient care and Professional development. The first theme Improved patientcare, included four subthemes To acknowledge the patient as a whole, Strengthened relationships over time, Improved access leads to more efficient care and Medication competence supports safe care. The second theme professional development, included four subthemes Managing responsibility, The importance of continuing education and shared learning, Authorized with limitations and Lack of support from leadership. Conclusion: Nurses’ experiences of prescribing rights involved both opportunities and challenges in their health-promoting work. Challenges were related to inadequate organizational conditions and a need for support to build confidence in their own competence. Opportunities were found in enhanced nursing care, safer patient management, and a strengthened professional identity through increased independence in the care process