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Publications (10 of 14) Show all publications
Rejnö, Å., Ternestedt, B.-M., Nordenfelt, L., Silfverberg, G. & Godskesen, T. E. (2020). Dignity at stake: Caring for persons with impaired autonomy. Nursing Ethics, 27(1), 104-115
Open this publication in new window or tab >>Dignity at stake: Caring for persons with impaired autonomy
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2020 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 27, no 1, p. 104-115Article in journal (Refereed) Published
Abstract [en]

Dignity, usually considered an essential ethical value in healthcare, is a relatively complex, multifaceted concept. However, healthcare professionals often have only a vague idea of what it means to respect dignity when providing care, especially for persons with impaired autonomy. This article focuses on two concepts of dignity, human dignity and dignity of identity, and aims to analyse how these concepts can be applied in the care for persons with impaired autonomy and in furthering the practice of respect and protection from harm. Three vignettes were designed to illustrate typical caring situations involving patients with mild to severely impaired autonomy, including patients with cognitive impairments. In situations like these, there is a risk of the patient's dignity being disrespected and violated. The vignettes were then analysed with respect to the two concepts of dignity to find out whether this approach can illuminate what is at stake in these situations and to provide an understanding of which measures could safeguard the dignity of these patients. The analysis showed that there are profound ethical challenges in the daily care of persons with impaired autonomy. We suggest that these two concepts of human dignity could help guide healthcare professionals to develop practical skills in person-centred, ethically grounded care, where the patient's wishes and needs are the starting point.

Keywords
Caring, cognitive impairment, dignity, theoretical analysis, vignettes
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-14737 (URN)10.1177/0969733019845128 (DOI)000510996500010 ()2-s2.0-85079017638 (Scopus ID)
Note

Funders: Skaraborg Institute for Research and Development (06-1045); the foundation for Gösta Svensson’s memory; Agneta Prytz Folkes and Go¨sta Folkes Foundation.

Available from: 2019-12-06 Created: 2019-12-06 Last updated: 2020-03-09Bibliographically approved
Forsgren Gebring, S., Christensson, T., Rudolfsson, G. & Rejnö, Å. (2020). To Attend or Not: The Reasoning Behind Nursing Students' Attendance at Lectures : A Qualitative Study. Scandinavian Journal of Educational Research
Open this publication in new window or tab >>To Attend or Not: The Reasoning Behind Nursing Students' Attendance at Lectures : A Qualitative Study
2020 (English)In: Scandinavian Journal of Educational Research, ISSN 0031-3831, E-ISSN 1470-1170Article in journal (Refereed) Epub ahead of print
Abstract [en]

There is a rising tendency for students in higher education not to attend lectures. Therefore, the aim of the study was to describe the reasoning behind nursing students’ decisions on whether or not to attend lectures. This qualitative study was performed in a nursing education programme at a Swedish University. One hundred and thirty-one students participated. Data were collected through a questionnaire comprising open-ended questions. Qualitative content analysis was performed. The results are presented in eight categories: four concerning reasons for attending lectures and four concerning reasons for not attending lectures. Decisions, both to attend and to not attend lectures, were based on conscious choices guided by the students’ self-governing of their own personal needs for learning. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

National Category
Nursing
Identifiers
urn:nbn:se:hv:diva-15045 (URN)10.1080/00313831.2020.1727004 (DOI)000514508600001 ()2-s2.0-85079709427 (Scopus ID)
Available from: 2020-03-16 Created: 2020-03-16 Last updated: 2020-03-16
Rejnö, Å., Nasic, S., Bjälkefur, K., Bertholds, E. & Jood, K. (2019). Changes in functional outcome over five years after stroke. Brain and Behavior, 9(6), Article ID e01300.
Open this publication in new window or tab >>Changes in functional outcome over five years after stroke
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2019 (English)In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 9, no 6, article id e01300Article in journal (Refereed) Published
Abstract [en]

Objectives: Data on the long‐term time course of poststroke functional outcome is limited. We investigated changes in functional outcome over 5 years after stroke in a hospital based cohort.

Materials and Methods: Consecutive patients who were independent in activities of daily living (ADL) and admitted to a Stroke Unit at Skaraborg Hospital, Sweden for a first acute stroke from 2007 to 2009 (n = 1,421) were followed‐up after 3 months and thereafter annually over 5 years using a postal questionnaire. Clinical variables at acute stroke and 3 months post stroke were obtained from the Swedish Stroke Register. ADL dependency was defined as dependence in dressing, toileting or indoor mobility.

Results: The proportions of survivors who reported ADL dependency remained stable throughout follow‐up (19%–22%). However, among survivors who were ADL independent at 3 months, about 3% deteriorated to dependency each year. Deterioration was predicted by age (HR 1.11; 95% CI 1.08–1.13), diabetes (HR 1.65; 95% CI 1.12–2.44), NIHSS score (HR 1.07; 95% CI 1.04–1.10), and self‐perceived unmet care needs one year post stroke (HR 2.01; 95% CI 1.44–2.81). Transitions from ADL dependency to independence occurred mainly during the first year post stroke. Improvement was negatively predicted by living alone before stroke (HR 0.41 95% CI 0.19–0.91), NIHSS score (HR 0.90; 95% CI 0.86–0.95) and ischemic stroke (vs. hemorrhagic stroke), HR 0.39; 95% CI 0.17–0.89.

Conclusion: Transitions between ADL independence and dependency occur up to 5 years after stroke. Some of the factors predicting these transitions are potentially modifiable

Keywords
functional outcome, quality register, longitudinal study, stroke
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-13860 (URN)10.1002/brb3.1300 (DOI)000471830600006 ()2-s2.0-85067551531 (Scopus ID)
Note

Funders: Skaraborg Institute for Research and Development, (06-1045);Medical Fund at the Skaraborg Hospital; the Research Fund at the Skaraborg Hospital;the Skaraborg Research and Development Council; and the Swedish stroke association

Available from: 2019-05-24 Created: 2019-05-24 Last updated: 2020-02-03Bibliographically approved
Rejnö, Å. & Berg, L. (2019). Communication, the key in creating dignified encounters in unexpected sudden death: With stroke as example. Indian Journal of Palliative Care, 25(1), 9-17
Open this publication in new window or tab >>Communication, the key in creating dignified encounters in unexpected sudden death: With stroke as example
2019 (English)In: Indian Journal of Palliative Care, ISSN 0973-1075, E-ISSN 1998-3735, Vol. 25, no 1, p. 9-17Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to illuminate the communication and its meaning in unexpected sudden death with stroke as example, as experienced by stroke team members and next of kin. Subject and Methods: The study has a qualitative design. Secondary analysis of data from four previous interview studies with stroke team members; physicians, registered nurses, and enrolled nurses from the stroke units (SU) and next of kin of patients who had died due to acute stroke during hospital stay were utilized. <b>Results:</b> Communication is revealed as the foundation for care and caring with the overarching theme foundation for dignified encounters in care built-up by six themes illuminating the meaning of communication in unexpected sudden death by stroke. <b>Conclusion:</b> Communication shown as the foundation for dignified encounters in care as experienced by stroke team members and next of kin enables the patient to come forth as a unique person and uphold absolute dignity in care. Acknowledging the next of kin&#39;s familiarity with the severely ill patient will contribute to personalizing the patient and in this way be the ground for a person centeredness in care despite the patients&#39; inability to defend their own interests. Through knowledge about the patient as a person, the foundation for dignified care is given, expressed through respect for the patient&#39;s will and desires and derived through conversations between carers and next of kin.

Keywords
Communication, next of kin, person-centered care, stroke team members, supplementary secondary analysis
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-13512 (URN)10.4103/IJPC.IJPC_117_18 (DOI)000457428800003 ()30820095 (PubMedID)2-s2.0-85061013206 (Scopus ID)
Available from: 2019-02-27 Created: 2019-02-27 Last updated: 2020-02-05Bibliographically approved
Berndtsson, I., Karlsson, M. & Rejnö, Å. (2019). Nursing students' attitudes toward care of dying patients: A pre- and post-palliative course study. Heliyon, 5(10), Article ID e02578.
Open this publication in new window or tab >>Nursing students' attitudes toward care of dying patients: A pre- and post-palliative course study
2019 (English)In: Heliyon, ISSN 2405-8440, Vol. 5, no 10, article id e02578Article in journal (Refereed) Published
Abstract [en]

Background: Many nursing students are not prepared to encounter death and care for patients who are at the end of life as newly educated nurses. The Frommelt Attitude Toward Care of Dying Scale (FATCOD) has been used to assess nursing students' attitudes during their education and changes have been noted.

Objective: To examine nursing students' attitudes towards care of dying patients before and after a course in palliative care.

Design: A descriptive study with a pre and post design.

Settings & participants: Nursing students (n = 73) enrolled in a mandatory palliative course in the nursing programme at a Swedish university.

Methods: Data were collected before and after a palliative care course using FATCOD and qualitative open-ended questions. Data from FATCOD were analysed using descriptive and analytical statistics. The open-ended questions were analysed with qualitative content analysis.

Results: The students' mean scores showed a statistically significant change toward a more positive attitude toward care of dying. Students with the lowest pre-course scores showed the highest mean change. The qualitative analysis showed that the students had gained additional knowledge, deepened understanding, and increased feelings of security through the course.

Conclusions: A course in palliative care could help to change nursing students' attitudes towards care of patients who are dying and their relatives, in a positive direction. A course in palliative care is suggested to be mandatory in nursing education, and in addition to theoretical lectures include learning activities such as reflection in small groups, simulation training and taking care of the dead body.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Attitudes, Education, End of life, Health profession, Medicine, Nursing, Nursing education, Nursing students, Palliative care, Work integrated learning
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-14705 (URN)10.1016/j.heliyon.2019.e02578 (DOI):000494641300124 ()31667412 (PubMedID)2-s2.0-85072935231 (Scopus ID)
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2020-02-23Bibliographically approved
Rejnö, Å. & Berg, L. (2018). Communication as a Key in Creating Dignified Encounters in Unexpected Sudden Death by Stroke. Paper presented at 10th World Research Congress of the European Association for Palliative Care (EAPC). Palliative Medicine: A Multiprofessional Journal, 32(1_suppl), 154-154, Article ID P253.
Open this publication in new window or tab >>Communication as a Key in Creating Dignified Encounters in Unexpected Sudden Death by Stroke
2018 (English)In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 32, no 1_suppl, p. 154-154, article id P253Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Background: Communication is present in all encounters in care and of importance to create a caring relation. A good relation between patients, next of kin and health care staff is crucial, not least in times of rapid changes in health and when questions about life and death are at stake such as in palliative care.

Aims: The aim of this study was to illuminate communication and its meaning in unexpected sudden death with stroke as example, as experienced by next of kin and stroke team members.

Methods: The design of the study is a secondary analysis of qualitative data as proposed by Heaton, from a project on unexpected sudden death by stroke. Material from four interview studies from the project with all in all twelve next of kin of patients who had died due to the acute stroke during hospital stay and twenty-seven stroke team members from stroke units were utilized. Data were analysed with qualitative content analysis according to Krippendorf and Baxter.

Results: The analysis reveals communication as the foundation for care and caring. The overarching theme foundation for dignified encounters in care is built up by six themes illuminating the meaning of communication in unexpected sudden death by stroke; creating relationship, information enabling understanding, giving ground for unanimity, personalizing the patient, preconditioning for decisions and giving and experiencing support.

Conclusions: Communication and its meaning in unexpected sudden death as experienced by next of kin and stroke team members enables dignified encounters in care. Through the next of kin knowledge about the severely ill patient, possibility to preserve and uphold absolute dignity and dignity of identity is given, expressed through respect for the patient's will and desire and derived through talks between carers andnext of kin. Communication is one key to create dignified encounters inpalliative care when unexpected sudden death occurs. It gives ground for unanimity about care and possibility to maintain and uphold dignity incare when acknowledging the next of kin familiarity with the patient.This gives ground for a person centeredness in palliative care despite the patients sever illness.

Keywords
Communication, stroke, sudden death
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-13380 (URN)10.1177/0269216318769196 (DOI)
Conference
10th World Research Congress of the European Association for Palliative Care (EAPC)
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-08Bibliographically approved
Rejnö, Å. & Berg, L. (2018). Creating dignified encounters in unexpected sudden death by stroke: communication as the key. Paper presented at ESOC 2018 - 4th European Stroke Organisation Conference,16-18 May, Gothenburg, Sweden. European Stroke Journal, 3(1_suppl.), Article ID AS13-002.
Open this publication in new window or tab >>Creating dignified encounters in unexpected sudden death by stroke: communication as the key
2018 (English)In: European Stroke Journal, ISSN 2396-9873, E-ISSN 2396-9881, Vol. 3, no 1_suppl., p. -292, article id AS13-002Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background and Aims: Communication is present in all encounters in stroke care and of importance to create a caring relation. A good relation between patients, next of kin and health care staff is crucial, not least in unexpected sudden death by stroke. The aim of the study was to illuminate communication and its meaning in unexpected sudden death by stroke, as experienced by next of kin and stroke team members. Method: The design is a secondary analysis of qualitative data from a project on unexpected sudden death by stroke. Material from four interview studies from the project with all in all twelve next of kin of patients who had died due to the acute stroke during hospital stay and twentyseven stroke team members from stroke units were utilized. Data were analysed with qualitative content analysis. Results: The analysis reveals communication as the foundation for care and caring in acute stroke care. The overarching theme foundation for dignified encounters in care is built up by six themes illuminating the meaning of communication in unexpected sudden death by stroke. Conclusion: Communication and its meaning in unexpected sudden death by stroke as experienced by next of kin and stroke team members is one key to create dignified encounters in care when unexpected sudden death by stroke occurs. It gives ground for unanimity about care and possibility to maintain and uphold dignity in care when acknowledging the next of kin familiarity with the patient, giving ground for a person centeredness despite the patients sever illness.

Keywords
Stroke, Communication
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-13355 (URN)10.1177/2396987318770127 (DOI)
Conference
ESOC 2018 - 4th European Stroke Organisation Conference,16-18 May, Gothenburg, Sweden
Available from: 2018-12-28 Created: 2018-12-28 Last updated: 2019-05-24Bibliographically approved
Rejnö, Å., Andersson, P. & Wester, P. (2018). "StrokeSverige" lär i webbaserad kompetensutbildning. In: Kristina Johansson (Ed.), VILÄR Abstraktbok: . Paper presented at VILÄR, 6-7 december 2018, Mölndal, Sverige (pp. 4-5). Trollhättan: Högskolan Väst
Open this publication in new window or tab >>"StrokeSverige" lär i webbaserad kompetensutbildning
2018 (Swedish)In: VILÄR Abstraktbok / [ed] Kristina Johansson, Trollhättan: Högskolan Väst , 2018, p. 4-5Conference paper, Oral presentation with published abstract (Other academic)
Abstract [sv]

Bakgrund

Verksamhetsintegrerat lärande omfattar lärande som sker integrerat mellan akademi och arbetsliv. Ofta är integrationen sådan att arbetslivet integreras i akademin. Det omvända är inte lika vanligt. Strokeenhetsvård är sedan 1980-talet ett internationellt evidensbaserat vårdkoncept som minskar mortalitet, institutionsboende och beroende i ADL efter stroke. För att en verksamhet ska få kalla sig strokeenhet ingår att vården ska bedrivas av ett multidisciplinärt team med expertkunnande inom stroke och rehabilitering. Strokekompetensutbildning med både teoretiska och praktiska moment som ger detta expertkunnande ges sedan av STROKE Riksförbundet och drivs lokalt. Antalet som genomgår utbildningen minskar på grund av vårdens pressadef örhållanden vilket gett svårigheter att organisera och driva utbildningen lokalt. Från centralt håll har oro uttryckts då strokekompetensen genom detta minskar vilket potentiellt leder till sämre vård. Syftet med presentationen är att visa hur lokalt drivna utbildningar i arbetslivet kan webbaseras i samarbete med akademin för att möjliggöra personalgruppers möjlighet till kompetenshöjning.

Metod

Utbildningen har digitaliserats för att ge förutsättningar för jämlik vård. Alla teoretiska moment har gjorts som filmade föreläsningar av personer med spetskompetens inom sitt område och en tredelad examination har tagits fram som säkerställer att utbildningen ger jämn och hög kvalitet.

Resultat

Utbildningen som använder det flippade klassrummet som teoretisk modell är nu en poänggivande högskoleutbildning som ges av Umeå universitet där teambased learning och constructive alignment varit ledord för uppbyggnaden. Utbildningen omfattar filmade föreläsningar, quiz och webbaserad examination som genomförs via lärplattformen, samt material för träffar där praktiska moment ingår som ordnas lokalt av respektive verksamhet, liksom material för såväl individuell examination som gruppexamination. Utöver detta finns länkar till referensmaterial samt fördjupningsmaterial.

Diskussion

Med noggrann planering, förankring och tydliga pedagogiska utgångspunkter kan utbildning utvecklas i samarbete mellan offentlig sektor och universitet/högskolor. Utbildningen är exempel på ett initiativ från arbetslivet där akademin är tydligt integrerad för att möjliggöra lärande för personer i arbetslivet. Genom digitaliseringen ges möjlighet för verksamheter att erbjuda personal utbildning inommer flexibla ramar och på tider som passar dem jämfört med traditionella kurser inom högre utbildning. Konceptet kan potentiellt användas för många verksamheter och visar på möjligheterna med digitalisering av högre utbildning för att nå ut till arbetslivet

Place, publisher, year, edition, pages
Trollhättan: Högskolan Väst, 2018
Keywords
Arbetsintegrerat arbete, utbildning i arbetslivet
National Category
Learning Nursing
Research subject
Work Integrated Learning; NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-13437 (URN)978-91-87531-46-0 (ISBN)978-91-87531-47-7 (ISBN)
Conference
VILÄR, 6-7 december 2018, Mölndal, Sverige
Available from: 2019-01-21 Created: 2019-01-21 Last updated: 2019-04-30Bibliographically approved
Rejnö, Å., Danielsson, E. & Berg, L. (2017). Combining Qualitative and Quantitative Content Analysis: A Way to Utilize Different Types of Data in Research of Ethical Problems in Acute Stroke Care. Sage Publications
Open this publication in new window or tab >>Combining Qualitative and Quantitative Content Analysis: A Way to Utilize Different Types of Data in Research of Ethical Problems in Acute Stroke Care
2017 (English)Other (Refereed)
Abstract [en]

Most people who experience an acute stroke survive, but a substantial number die as a result of it. Stroke is, according to the World Health Organization, the second leading cause of death globally. Research in the area of stroke has previously been less focused on situations when patients die due to an acute stroke in favor of research on medical treatments, rehabilitation, and living with the aftermath of stroke. Research focusing on ethical problems in the care of dying patients can be found both in general and in specific care contexts such as palliative, intensive, and non-hospital care, but knowledge concerning ethical problems in the area of stroke, or arising as a result of acute stroke, was lacking. Both these subjects, death due to acute stroke and ethical problems, were combined for the first author's (Å. R.) thesis. Individual interviews with stroke team members were performed guided by their answers in a three-part form filled out before the interviews. This case study provides an account of how qualitative and quantitative content analysis was used in combination to deepen the results from the study utilizing data obtained from both the three-part forms and the interviews performed. The case highlights some challenges faced when combining the two different types of data. It also gives examples of how the analysis was performed when combining qualitative and quantitative content analysis to support and further explore data.

Place, publisher, year, pages
Sage Publications, 2017. p. 17
Keywords
carers, stroke
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-11859 (URN)10.4135/9781526424877 (DOI)
Available from: 2017-11-30 Created: 2017-11-30 Last updated: 2017-12-01Bibliographically approved
Rejnö, Å., Nordin, P., Forsgren, S., Sundell, Y. & Rudolfsson, G. (2017). Nursing students’ attendance at learning activities in relation to attainment and passing courses: a prospective quantitative study. Nurse Education Today, 50(March), 36-41
Open this publication in new window or tab >>Nursing students’ attendance at learning activities in relation to attainment and passing courses: a prospective quantitative study
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2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 50, no March, p. 36-41Article in journal (Refereed) Published
Abstract [en]

Background

Students' motivation and ways of engaging in their schoolwork are important for their performance, including passing exams. Attendance at learning activities has also been argued to be of major importance, although no causal relationship with passing exams has been established in nursing education.

Objectives

The aim of this study was to describe the impact of attendance at nonmandatory learning activities on attainment, in terms of passing or failing of exams, in nursing education courses including both mandatory and non-mandatory activities.

Design

A prospective quantitative design.

Setting

The nursing education programme at a Swedish university.

Participants

Nursing students (n = 361) from two courses and four classes within the nursing programme.

Methods

Attendance was registered at every non-mandatory teaching activity by asking the students to note their attendance on a list. Data such as sex, age, and whether the students had passed the exam were also collected for each course and each semester separately.

Results

Increased participation was associated with an increasing proportion of students passing the exam. The chance of passing the exam increased by 13% for every additional learning occasion attended. Logistic regression showed an OR of 5.4 for an attendance of 100%.

Conclusions

An increase in attendance gave a higher proportion of exam passes. Encouraging students to attend non-mandatory learning activities could be of value, and potentially contribute to an increased graduation rate for nursing students.

Keywords
Attendance; Attainment; Examination pass; Nurse education; Prospective study
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-10419 (URN)10.1016/j.nedt.2016.11.025 (DOI)000393017300007 ()28012360 (PubMedID)2-s2.0-85006790591 (Scopus ID)
Available from: 2016-12-28 Created: 2016-12-28 Last updated: 2017-12-18Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6454-9575

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