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Biomedical subjects

I B Engberg

Publications and source records attributed to I B Engberg.

14 recordsLinked to original sources
PubMed1999

Acute confusion and unreal experiences in intensive care patients in relation to the ICU syndrome. Part II.

The intensive care unit syndrome (ICU syndrome) is defined as an altered emotional state occurring in a highly stressful environment, which may manifest itself in various forms such as delirium, confusion, crazy dreams or unreal experiences. The purpose of this part of a study of patients' experiences is to describe and illuminate patients' experiences of acute confusion, disorientation, wakefulness, dreams and nightmares during and after their stay in the ICU. The data were obtained from 19 ventilated patients, who were interviewed twice and had stayed at least 36 hours in the ICU, the first interview being about one week after discharge from the ICU, and the second 4-8 weeks later. The hermeneutic approach used when interpreting and analysing the text from the interviews revealed that patients' experiences of unreal experiences were often associated with intense fear. Intense or continuous unbearable fear seems to result in frightening unreal experiences, which further increase the level of fear. Care actions or caring relationships with relatives or nurses can reduce this fear, which can help to prevent the occurrence and/or duration and intensity of the unreal experiences. Trust and confidence in nurses or significant others and feelings of self-control or trust in self-control seemed to reduce the risk of unreal experiences so that adverse stimuli might only trigger a mild confusion.

Acute Disease↗
PubMed1999

An evaluation of patients' quality of life before, 6 weeks and 6 months after total hip replacement surgery.

Annually, throughout the world, more than 800,000 primary total hip replacement surgery procedures are performed on patients suffering from hip joint arthrosis. Since 1991, approximately 11,000 of these procedures are performed annually in Sweden. This study aimed to investigate any changes in the patients' life quality 6 weeks and 6 months after their total hip replacement surgery had been performed, compared to that immediately prior to the operation. It also aimed to examine the reason for surgery, the types of prostheses used, postoperative pain, complications and the actual usage of ambulation support. The Sickness Impact Profile self-appraisal instrument, together with personal patient interviews have been used as the basis of the research. A total of 51 patients responded to the quality of life instrument prior to their operation, 47 of these participated 6 weeks after the operation, and 40 patients 6 months after the operation. Significant differences in patients' total, physical and psychosocial quality of life 6 months postoperatively compared to the situation prior to the operation were found, but not between the situation before and 6 weeks after the total hip replacement surgery. The majority of patients were of the opinion that it was more important that the pain had disappeared or decreased, than any overall increase in the quality of life. Postoperative complications occurred within 6 weeks, and even after 6 months some patients still suffered from these.

Activities of Daily Living↗
PubMed1999

The patient's perceived caring needs: measuring the unmeasurable.

The aim of this study is to elucidate the phenomenon of the caring need in the life-world of the patient and, on the basis of this, to compare patients' perceived caring needs with the six areas of need contained in a new instrument for patient classification, the Oulu Patient Classification (OPC). A total of 75 patients were interviewed and the data were analysed by means of a phenomenological-hermeneutical method. Seventeen perceived caring needs emerged from the process of interpretation. The patients experienced themselves as an indivisible unit that contained existential/spiritual needs and desires. The patients' caring needs are constituted from their problems, needs and desires, where human desire for life, love and meaningfulness may, express itself as bodily, psychical and existential/spiritual needs. A comparison between the patients' perceived caring needs and the OPC shows that patients' existential/spiritual needs do not emerge clearly enough and that the instrument should be supplemented by a caring perspective.

Activities of Daily Living↗
PubMed1998

Measuring the unmeasurable: a caring science perspective on patient classification.

AIMS: To give a short historical survey of patient classification and its motives, to analyse patient classification and especially the instrument, The Oulu Patient Classification more closely from a caring science perspective. BACKGROUND: A survey of topical literature and research on patient classification show that economic and administrative justifications predominate and the caring science connection is weak, almost non-existent. ORIGINS OF INFORMATION: Topical literature and research on patient classification and the instrument, The Oulu Patient Classification. DATA ANALYSIS: Topical literature and research were evaluated from a caring science perspective in accordance with Eriksson's theory of caring and the basic concept of man as an entity of body, soul and spirit. KEY ISSUES: Patient classification is used in staff planning and is also justified from the viewpoint of content, that is, as a method of guaranteeing good quality in the care of patients and as an expression of the prevalent caring ideology. The concept of man is reduced in current literature and research on patient classification. The Oulu Patient Classification is based on a humanistic view of man, but man's spiritual and existential needs do not emerge clearly from the manual of the instrument. CONCLUSIONS: It is essential for patient classification to start from a caring perspective. Correctly dimensioned staffing based on patient classification is a prerequisite for good care. This should be combined with a caring culture that considers the whole complexity of man in order to make good care possible.

Activities of Daily Living↗
PubMed1998

A comparison between patients' experiences of how their caring needs have been met and the nurses' patient classification--an explorative study.

AIM: 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. BACKGROUND: 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. METHODS: 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. FINDINGS: 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. CONCLUSIONS: 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.

Diagnosis-Related Groups↗
PubMed1997

How to translate nursing care into costs and staffing requirements: part two in the Zebra system.

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.

Data Interpretation, Statistical↗
PubMed1996

Intensive care syndrome: a literature review.

The aim in this literature review is to describe the definitions, denominations, clinical signs and symptoms, explanations, causative factors and interrelationships of the intensive care syndrome discussed since 1950. It was found that there is no agreement about which symptoms should be included in the syndrome, when the syndrome may appear and how many patients may be affected. Furthermore, it is unclear what causes the development of the syndrome; most authors conclude that there are many reasons for it. The syndrome has generally been examined by using a medical or psychological approach, but during the last few years it has also been described and analysed from a nursing care perspective. From this nursing perspective the syndrome may be seen as an individual pattern developed by patients during their stay in an intensive care unit (ICU) and sometimes this pattern of clinical signs and symptoms lasts for a shorter or longer period even after discharge from the unit. From a wider viewpoint the development of the syndrome can be seen as an increase by degrees or as a vicious circle. finally, most authors agree that the ICU syndrome consists of, and is caused by, a complex interaction between many factors.

Critical Care↗
PubMed1996

Proportion of Swedish school nurses' time devoted to different health care activities.

School nurses play an important role in the preventive health care of children and adolescents. This study aimed to describe and investigate the school nurses' different activities and time spent on these activities. By completion of a time study record form all 26 school nurses, in a medium-sized town in Sweden, documented their activities during 10 working-days. Altogether 635 record forms were received. It was found that almost half of the school nurses' time was used for individual pupil activities, 17% for groups of pupils and 34% for administrative activities. School nurses spent 17% of all their working time at the school clinic, which in some way may reflect the pupils need of the nurse in the school. These results highlighted the importance of school nurses and resulted in internal structural changes of school nurses' working time.

Adolescent↗
PubMed1995

Prevalence of skin and genital mucous membrane irritations in patients confined to bed.

A comparative and prospective study of the skin and genital mucous membrane conditions of 50 intensive care patients, who were entirely confined to bed, was conducted. Skin and/or genital mucous membrane irritations were developed by 31 patients during their stay in the ICU. These patients had a significantly longer stay in bed in the ICU than those who did not develop such changes. Patients with lesions were significantly washed more often using the pH 8.5 soap than those without lesions. Erythematous was the most commonly observed symptom and the area between the buttocks and saccrum was the most affected.

Adolescent↗
PubMed1995

Patients' experiences of herpes zoster and postherpetic neuralgia.

The purpose of the study was to investigate retrospectively whether patients (n = 73) who had suffered another disease and/or experienced psychosocial stress at the time of the onset of herpes zoster had experienced a more severe clinical course of herpes zoster, and were more subject to the development of postherpetic neuralgia than other patients (n = 45) with herpes zoster. The interview questionnaire included questions about changes in the patients' daily lives due to neuralgia, and their current living circumstances. Significantly more of the patients who had had another disease and/or psychosocial stress at the time of the onset of herpes zoster reported severe pain during the acute phase of herpes zoster. They also reported pain to a greater extent at the time of the interview and mentioned that their lives had changed owing to postherpetic neuralgia. More of these patients reported that their habits and activities had been negatively affected and they also experienced their current situation as unsatisfactory. These results must, however, be interpreted with caution as the patients' recollection of other diseases and/or psychosocial stress and the patients' current mood due to postherpetic neuralgia at the time of the interview may have influenced the memory and the answers.

Activities of Daily Living↗
PubMed1994

Nursing discharge assessment of the patient post-inguinal herniorrhaphy in the ambulatory surgery setting.

Nursing discharge assessment and patient discomfort and complications after ambulatory inguinal herniorrhaphy were studied. Of 70 patients, 40 were contacted by telephone the first postoperative day at home. On postoperative day 1, 14 patients experienced discomfort and negative feelings of well-being such as pain and nausea. However, most patients (N = 38) reported that they had "felt well" or "quite well." The results show that the nursing assessment of patient postoperative condition is satisfactory in the immediate postoperative period. The telephone follow-up was appreciated by the patients, and it also brought new possibilities of evaluating the quality of nursing care.

Adult↗
PubMed1993

The Zebra system--a new patient classification system.

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.

Activities of Daily Living↗
PubMed1991

Giving up and withdrawal by ventilator treated patients: nurses' experience.

If a patient on admission to the Intensive Care Unit (ICU) already seems to have given up and behaves in a withdrawn manner the nurses usually interpret it as an expression of the patient's personality. However the nursing care activities are more or less characterized by uncertainty and fear of misjudgements due to difficulties in interpreting the patient's wishes and needs. If this syndrome of giving up and withdrawal develops during ventilator treatment in the ICU nurses interpret the patient's behaviour as a sign of depression caused by exhaustion, awareness of severe illness, injuries or disabilities or loss of hope, meaning and will to live. The nurses' reactions are either to wait for spontaneous changes in the patient's behaviour or to make more active interventions, trying to support the patient and alleviate his/her condition. Most nurses feel helpless and powerless not knowing how to lessen and relieve the patient's suffering. Caring for these patients is often frustrating, stress-evoking and tiring for the nurses, especially if this syndrome is present for a long period. It is therefore important to do further studies to increase knowledge about the syndrome and its effects.

Attitude to Death↗