Papers by Ingegerd Bergbom
Intensive and Critical Care Nursing, Aug 1, 2021
The aim was to investigate older patient recovery (65 years+) up to two years following discharge... more The aim was to investigate older patient recovery (65 years+) up to two years following discharge from an intensive care unit (ICU) using the Recovery After Intensive Care (RAIN) instrument and to correlate RAIN with the Hospital Anxiety and Depression Scale (HAD). Methods: An explorative and descriptive longitudinal design was used. Eighty-two patients answered RAIN and HAD at least twice following discharge. Demographic and clinical data were collected from patient records. Results: Recovery after the ICU was relatively stable and good for older patients at the four data collection points. There was little variation on the RAIN subscales over time. The greatest recovery improvement was found in existential ruminations from 2 to 24 months. A patient that could look forward and those with supportive relatives had the highest scores at all four measurements. Having lower financial situation was correlated to poorer recovery and was significant at 24 months. The RAIN and HAD instruments showed significant correlations, except for the revaluation of life subscale, which is not an aspect in HAD. Conclusion: The RAIN instrument shows to be a good measurement for all dimensions of recovery, including existential dimensions, which are not covered by any other instrument.
International journal for human caring, Jun 1, 2021
Healthcare professionals encounter patients' and relatives' expressions of doubt, despair... more Healthcare professionals encounter patients' and relatives' expressions of doubt, despair, and hope in relation to illness and suffering. These feelings and experiences are often challenging for patients, relatives, and carers to face. The article's purpose is to describe and discuss how the meaning of doubt, despair, dread, and belief can be understood through Kierkegaard's and Spinoza's philosophical thoughts, thus contributing to a deeper understanding of caring and knowledge in caring science. Dread, doubt, and despair have their roots in grief and powerlessness but are also connected to belief and faith, which create an inner strength that can alleviate suffering.
DOAJ (DOAJ: Directory of Open Access Journals), 2012
Background: The research is a theory based clinical application research with a participant orien... more Background: The research is a theory based clinical application research with a participant orientation. Aims: The aim of the study is to describe meaning of the concepts 'care for' and 'not care for' from the carer's perspective. Methodology: The critical incident method was chosen as data collection. The interpretation of data was made using hermeneutic text interpretation in four readings. Results: To 'care for' means seeing the patient as a fellow human being which is understood as; to see the patient, to allow the immediately given and to think about the patient. To 'not care for' means seeing the patient as an object which is understood as not listening to the patient and closing the eyes to the patient's wishes. Conclusions To 'care for' as an aspect of caring is understood as an inner ethical attitude that includes responsibility and respect for the human being, an inner ethical attitude in the meaning of seeing your fellow being with love and mercy. Seeing the patient as an object means that caring has been reduced to actions and work tasks without a deeper meaning.
Journal of Nursing Management, Mar 1, 1997
The purpose of this paper is to describe part two of the Zebra system-the activity study: how suc... more The purpose of this paper is to describe part two of the Zebra system-the activity study: how such a study can be conducted, which requirements must be met and how the data are processed and can be used. The activity studies described were conducted in two of the wards of the oncology department in the University Hospital of Lund, Sweden. The results of the studies make it possible to calculate the distribution of different activities for nurses and practical nurses during 24 hours and the total nursing care minutes per patient and category of care. Together with the patient classification, part one in the Zebra system, it is possible to calculate nursing costs per patient stay and the patients'staffing requirements. It will be possible to relate nursing costs and staffing requirements to actual nursing care given instead of fixed standard costs and staffing figures.
Journal of Nursing Management, Nov 1, 1998
To examine whether patient classification carried out in accordance with the Oulu Patient Classif... more To examine whether patient classification carried out in accordance with the Oulu Patient Classification (OPC) method can measure the patient's caring needs in a reliable manner as seen from the patient's perspective. On the basis of earlier research it can be established that there are differences between nurses' and patients' assessments of patients' caring needs. Research on patients' assessments of perceived caring needs and the care they receive in connection with patient classification does not seem to have interested researchers in caring science. The reliability from the patient's perspective is gauged by comparing the patient's perceived caring needs with the nurse's patient classification during a 24-h bed-day. Data was collected during a semi-structured interview with a total of 73 patients. Documentary analysis was carried out on the basis of patient classifications by 30 ward nurses. On the basis of the degree of correspondence between nursing care intensity experienced by the patients and the nurses' patient classification it was decided whether the patients' caring needs had been met. The results indicate, however, that patient classification as a gauging method has a built-in reductive function regarding the patient's need for care and nursing care intensity. Nevertheless the OPC offers possibilities from a patient perspective of providing an overall picture of the patient's nursing care intensity and can therefore serve as a reliable basis for decisions concerning staff planning.
Journal of Nursing Management, Sep 1, 1993
The Zebra system-a new patient classification system 229-237 When the economical systems in the h... more The Zebra system-a new patient classification system 229-237 When the economical systems in the health care field are becoming more like those in 'the market for goods and services' it is important that the patients' need of nursing care as well as the costs for the nursing care can be documented in a systematic and reliable way. One way of doing that is to use a patient classification system. In this article the most used patient classification system in Sweden-the Zebra system-will be presented. The Zebra system makes it possible both to describe the individual patients' dependency level and to calculate the patients' requirements of nursing care both in staffing terms and costs, per month, per year, per patient stay, per diagnosis or DRG. It gives possibilities for managers to analyze the patient distribution in different categories of care during different periods of time, or if the patients' need of nursing care can explain the staffing requirements during a certain period, or if the distribution of days in different categories of care are related to age groups or diagnosis or DRG.
Nordic journal of nursing research, Dec 1, 2001
In our western culture we have both a private and invisibly relation to the body and at the same ... more In our western culture we have both a private and invisibly relation to the body and at the same time a body fixation look for the complete body image. Many philosophers have reflected upon the human body and the relation between body and soul. The present study is a qualitative description of the lived body in everyday life. The point of departure is the idea that nurse students' experience of their own body influences their nursing praxis. The aim of the study was to describe how nurse students experience their lived body in different life situation. A phenomenological approach was used to provide a deeper understanding of the lived body, and a method that aims at describing a phenomenon's essence was applied in the analysis. Data were collected from twelve nurse students in the age between 20 and 44 years. All of them wrote narratives that describe the body in different life situations. The essence of the lived body as nurse students experience it is described as a expressive body, which tries to attain dignity. The essence is further understood through four constituents; the body's language, the body's power, the body's fear and the body's powerlessness. The conclusion of this phenomenological study is that nurse students have vivid experiences of their body and that the body to them is more than a physical thing.
Nursing in critical care, May 25, 2015
Background: Many patients lack a clear recollection from their stay in the intensive care unit (I... more Background: Many patients lack a clear recollection from their stay in the intensive care unit (ICU). Diaries have been introduced as a tool to complete memories and reduce the risk of posttraumatic stress disorder (PTSD). Aims: To describe and compare patients' memories and PTSD in relation to having received and read or not received a diary and patients' experiences of having received and read their diary, without having discussed the contents with ICU staff. Design: Descriptive and comparative. Methods: Patients received their diaries at ICU discharge. After 2 months patients answered the ICU Memory Tool, a screening instrument for PTSD (PTSS-14) and a questionnaire including space for own comments about the diaries. Results: Of 96 patients, 52(54%) received a diary, 44 did not. Patients with diaries had significantly longer stay and more mechanical ventilation. Of these, 40 patients responded to PTSS-14 and had evaluated and read the diary and 34 patients served as controls. No significant differences were found in presence/absence of memories between these groups. In the diary-group patients with emotional memories had lower APACHE. Feelings of being anxious or frightened were more common in the diary-group. At 2 months, 12% scored above cutoff on the PTSS14 with no difference between groups. The diaries were helpful for understanding the ICU-stay. Conclusions: Diaries seem valuable in understanding what happened, as an act of caring and as a tool for discussion with relatives and friends. Patients valued reading their diaries. None expressed the wish to have read the diary together with a member of staff. The diary and non-diary groups however reported similar memories. Relevance to clinical practice: Diaries seem to be valuable in understanding what happened, giving a feeling of trust and for talking about their ICU-stay. As many patients described stressful memories, sessions should be offered with ICU staff.
Surgical Science, 2012
Background: Patients with Abdominal Aortic Aneurysm can be treated with two different surgical me... more Background: Patients with Abdominal Aortic Aneurysm can be treated with two different surgical methods: Open Repair (OR) or Endovascular Aortic Repair (EVAR). These two different treatments can probably result in different sense of Health Related Quality of Life, both in a short term and a long term perspective. The purpose of this prospective study was to examine patients' Health Related Quality of Life after surgical treatment of Abdominal Aortic Aneurysm over two years using different instruments for the observations. Methods: Patients were invited consecutively to answer questionnaires before operation, and 1, 12 and 24 months after surgery. The study was conducted by using the Health Related Quality of Life questionnaires Short Form (SF-36) and Nottingham Health Profile (NHP). 76 patient (40 in the OR and 36 in the EVAR group) participated in the study. The mean age in the OR group were 68 years, range 52-80 and in the EVAR group 75 years, range 65-85. The results from these two groups of patients were compared to a matched reference group. Results: Both patients treated with EVAR and OR rated their Health Related Quality of Life significantly lower in the domain of Mental Health in relation to a matched reference population before surgery. This difference was not present two years after intervention. After one month Health related qualities of life were worse for the OR group. After two years significant improvements in relation to baseline were observed only among patients in the OR group. No such long-term benefits were seen in the EVAR group. Conclusions: As the component Mental Health seemed to be impaired for these study groups before surgery in relation to the matched reference group, nursing and doctors care actions may be of importance during the pre-operative phase. In the short perspective Health Related Quality of Life is worse for OR patients than the EVAR group but in the long term perspective improvements beyond preoperative status can only be seen with OR patients.
Intensive and Critical Care Nursing, Feb 1, 2010
The aim was to interpret the interplay between critically ill patients and their next of kin in a... more The aim was to interpret the interplay between critically ill patients and their next of kin in an ICU and to disclose a deeper understanding of the visiting situation. Method: A hermeneutic research design with non-participant observation was chosen as the data collection method. Ten observations of 10 patients and 24 loved ones over a 20-h period were conducted. The text describing the observations of the interplay was interpreted in accordance with Gadamer's thoughts. Data were analysed by considering the text as a play with scenes, actors and plots. Findings: Due to their medical condition the patients were unable to use their bodies in the usual way, which sends different signals to their loved ones, who in turn have difficulty deciding how to respond. Both parties become, in a manner of speaking, trapped or locked out by their own bodies. Conclusion: The physical environment became a hindrance to the interplay as it was designed for medical and technical use and thus did not promote healing. The professionals are important for interpreting the signals from both patients and next of kin, as well as for finding caring strategies, such as physical contact that promote interplay, which in turn strengthens connectedness.
Journal of hospital & medical management, 2017
Hospital clothing for both patients and staff can be seen as a part of the environment due to cov... more Hospital clothing for both patients and staff can be seen as a part of the environment due to cover requirements for good hygiene, procedures, and treatments including the care of the patient. Another reason for patient clothing is to signal equality in relation to care needs and to represent a basis for equivalent treatment. The clothing also facilitates control within the healthcare system since patients, visitors and staff can all be readily identified. From this point of view, patient clothing can contribute to objectification with a focus on disease and symptoms, and by doing so also contributes to optimal treatment of ill health. In general, clothing can be viewed as an embodiment of the self, closely associated with the individual's identity, personality, self-esteem and self-confidence. Selfperception is usually rooted in a healthy existence. In contrast, wearing hospital clothing may diminish personal identity and may contribute to the adoption of passive and dependent patient and illness-related behavior. Such a self-image may lead to an attitude that may impede well-being and the healing process. Patient clothing may also impact the relationship between patients, doctors and nursing staff. How and to what extent patient clothing affects the healing process and care and treatment relationships is unclear. The overarching purpose of this article is to discuss the relationships and role allocation created between patients and hospital staff when patients wear hospital clothing and by extension, the type of care provided and whether the potential for recovery of health is affected.
Journal of Nursing Management, Jul 1, 2002
Changes in patients' need of nursing care reflected in the Zebra system.
Ambulatory Surgery, Sep 1, 1995
Patients' opinions and experiences following ambulatory surgery for varicose veins, hallux valgus... more Patients' opinions and experiences following ambulatory surgery for varicose veins, hallux valgus correction, inguinal hernia or arthroscopic knee surgery, were assessed from a selfcare perspective. Almost all patients found it comfortable to be discharged the day of operation despite some discomfort and symptoms experienced at home. However, 9-32% of the patients lacked verbal and written postoperative information for self care about pain relief drugs, recommended and forbidden postoperative activities, care of the wound and personal hygiene. The need for verbal information and for getting questions answered by the physicians concerning the surgical procedure and complications before discharge was stressed by the patients.
Nursing open, Apr 28, 2022
AimsTo explore and gain an understanding of patients’ perceptions and experiences of their body a... more AimsTo explore and gain an understanding of patients’ perceptions and experiences of their body and bodily function in connection with open surgery of abdominal aortic aneurysm.BackgroundAfter the operation of an abdominal aortic aneurysm (AAA) it may be difficult for the patients to understand what the procedure means.DesignThe design was descriptive and based on an analysis of 13 audio‐taped consultations with patients undergoing open surgery for AAA at a Swedish university hospital. The patients’ age varied from 57–79 and the mean age was 71 (70.5 female).MethodsA hermeneutic approach was used whereby patients were interviewed and draw a picture of their thoughts and experiences of the surgery and what had been done in their bodies. Once patients had finished their drawings, the interviewer asked what thoughts and experiences they had of the AAA.ResultsPatients described experiences as a process of “going from broken to whole again.”
Dimensions of Critical Care Nursing, Jul 1, 2020
Background: In clinical practice, nurses use their clinical gaze and make observations in order t... more Background: In clinical practice, nurses use their clinical gaze and make observations in order to assess patients' medical conditions and care needs. However, signs of developing intensive care unit delirium (ICUD) are often difficult to determine, as communication with patients is usually limited because of intubation and the seriousness of their medical condition(s). Usually, ICUD is screened and diagnosed with different, mainly nonverbal instruments, which presupposes that the observer is skilled and experienced in recognizing symptoms and signs of delirium. Objectives: The objectives were to investigate if there was a concordance between data from continuous clinical observations described in the researcher's logbook and patients' statements of their experiences of delirium during their ICU stay. Methods: Inclusion criteria were that the patients had been mechanically ventilated and had stayed in the ICU for a minimum of 36 hours. From this, a multiple-case design (n = 19), based on 1 to 3 hours of observations in the ICU and 2 interviews, was used. The first interview was conducted at the hospital approximately 6 to 14 days after discharge from the ICU, and the second, 4 to 8 weeks following the first interview in patients' homes. Two typical cases were identified and described by a cross-case procedure. Results: A concordance between observations and patients' statements was found. Subtle, as well as obvious, signs of delirium were possible to detect by attentive observations over time and listening to what patients were trying to convey with their speech and body language. Experiencing delirium seemed to indicate existential suffering where the abnormal became the normal and not being able to distinguish between reality and fantasies.
Journal of Vascular Nursing, Sep 1, 2019
Different surgical treatments for abdominal aortic aneurysm can lead to different perceptions of ... more Different surgical treatments for abdominal aortic aneurysm can lead to different perceptions of health and well-being. The aim of this study was to describe patients' well-being, sense of coherence (SOC), and experiences of surgery after open and endovascular treatment one month and one and 2 years after the procedure. Seventy six patients participated (40 open repair; 36 endovascular aneurysm repair). The study was conducted using the SOC questionnaire, and specific questions about patients' experiences of the surgical treatment and well-being. After 2 years, no patient regretted the operation or considered it to be the most difficult experience they had ever had. Twenty percent of the patients were worried about complications one month after the operation. Both groups experienced difficulty in returning to normal activity after surgery at one month. At one and 2 years after the surgery, patients in both groups stated that it was other things in life that affected their well-being. The endovascular aneurysm repair group reported a significant decrease in SOC from baseline until one year (P = .012) and 2 years (P = .033). The open repair group reported a significant decrease after one year (0.033). The operation did not affect patients' way of thinking about the disease. Patients in both groups stated that it was other circumstances in life that affected their well-being one and 2 years after the treatment, which could indicate that long-term follow-up would not be necessary from a patient perspective. The operation affects patients' well-being a short time after the operation.
Acta Anaesthesiologica Scandinavica
Follow‐up for heterogeneous intensive care patients presents challenges for rehabilitation interv... more Follow‐up for heterogeneous intensive care patients presents challenges for rehabilitation interventions and outcome measurements. The aim was to describe and explore characteristics and determinants for visiting/not visiting a nurse‐led clinic (NLC) at different time‐points, and to describe physical and mental health (HRQoL) over time.
Scandinavian Journal of Caring Sciences
In this article, Katie Eriksson's theory of caritative caring ethics and the theory of eviden... more In this article, Katie Eriksson's theory of caritative caring ethics and the theory of evidence, are described. Both theories are anchored in caritas, that is love, mercy and compassion. The theory of caritative caring ethics was first described by Eriksson in 1995, where seven assumptions or basic categories were elaborated. These were: the human being's dignity, the care relationship, invitation, responsibility, virtue, obligation or duty, and good and evil. Eriksson's theoretical contribution is that she makes a distinction between caring and nursing ethics, between inner and external ethics, and between natural and clinical ethics. Concerning the theory of evidence, Eriksson claims that a multidimensional scientific view of evidence in caring that focuses on the patient's world is necessary and vital. To see, realise, know, attest and revise constitute the ontological definitions of the concepts of evidence and evident. The theories are united by the core concept...
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Papers by Ingegerd Bergbom