Lived experiences of being cared for by ambulance clinicians when experiencing breathlessness—A phenomenological study

Kauppi, Wivica; Axelsson, Christer; Herlitz, Johan; Jiménez-Herrera, María; Palmér, Lina

doi:10.1111/scs.13108

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…69 There is clearly a need, and value being attributed, to patientcentred, humanistic, and emotional intelligence aspects of paramedic care being provided alongside the technical aspects. 15,[70][71][72][73] The concept of self-efficacy noted in these findings is also acknowledged within existing formal theories and models of health behaviours, particularly Social Cognitive Theory. 74,75 Such formal theories are intended to be generalisable and predictive.…”

Section: Relation To Existing Research and Theorymentioning

confidence: 74%

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Patients’ experiences of non-conveyance following an Australian ambulance service paramedic response: A constructivist grounded theory exploration

King

Oprescu²,

Lord

et al. 2023

Paramedicine

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Understanding patient experience is associated with quality, safe, and effective healthcare. However, there is a scarcity of knowledge explaining how patients experience non-conveyance, a setting where individuals receive unscheduled ambulance service response and paramedic-led care that results in a decision to not attend a hospital emergency department (ED). This research project aimed to investigate patients’ experiences of non-conveyance within an Australian ambulance service setting. Constructivist Grounded Theory methods were used to generate and analyse data from in-depth, semi-structured interviews with 21 participants who received paramedic-led healthcare from an Australian ambulance service between August 2020 and October 2021 that resulted in non-conveyance. A substantive theory centred on ‘Restoring self-efficacy’ was generated. It comprises three categorical concepts and their interconnected relationships, explaining how patients experience non-conveyance. ‘Losing independence’ conceptualises how a precipitating event forces patients to realise their circumstantial vulnerabilities, motivating action to seek support that leads to ambulance service response. ‘Restoring self-confidence’ emerged as the core concept, central to overall experience and a key influence on patients navigating the non-conveyance decision. When patients perceive that they have received professionally thorough and compassionate healthcare from paramedics, they form a trusting partnership resulting in the interpretation that their circumstances do not require conveyance to ED. With this reconstructed perspective, patients demonstrate increased ability for ‘Self-management’, by continuing to cope with their circumstances on their own after the episode of care. This paper provides a theoretical model for understanding how patients experience non-conveyance. Experience is influenced by dynamic, complex factors associated with restoring self-efficacy in relation to managing a health topic of interest. Restoration of self-efficacy was influenced by the patients’ interpretation of their interactions with paramedics. Future research may consider investigating the impacts of applying this knowledge to paramedic education and practice, and to quality indicators surrounding non-conveyance situations.

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Section: Relation To Existing Research and Theorymentioning

confidence: 74%

“…69 There is clearly a need, and value being attributed, to patient-centred, humanistic, and emotional intelligence aspects of paramedic care being provided alongside the technical aspects. 15,70–73…”

Section: Discussionmentioning

confidence: 99%

Patients’ experiences of non-conveyance following an Australian ambulance service paramedic response: A constructivist grounded theory exploration

King

Oprescu²,

Lord

et al. 2023

Paramedicine

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“…A relationship is characterized for example by presence, listening, and seeing -concepts that are part of the caring sciences (Dahlberg & Ekman, 2017). The opposite has been shown to torment patients (Alharbi et al, 2014;Kauppi et al, 2023;Källerwald, 2007). In caring sciences, the importance of interhumanity is highlighted.…”

Section: Suffering From Carementioning

confidence: 99%

Living with a venous leg ulcer: Lived experiences and the presence of self-care in daily life

Rosenburg

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[en] Aim: The overall aim of this thesis was to describe the lived experiences of patients with hard-to-heal venous leg ulcers before and after healing, as well as the understanding of the role and presence of self-care activities in ulcer management. Methods: The thesis is based on four studies, with differing designs. In Studies I and II, a phenomenological approach was used. To describe lived experiences of undergoing ulcer management, 16 persons were interviewed (I), and to describe lived experiences of daily life after healing,15 persons were interviewed (II). Study III was a registry-based, quantitative study. In total, data from 699 patients with venous leg ulcers(VLUs) were analyzed. Logistic regressions were performed to describe associations between advice given on self-care and its impact on ulcer healing. Study IV, which focused on patient experiences of the feasibility of an intervention for self-care, was based on eleven interviews with six patients with VLUs. The data from the interviews underwent qualitative content analysis. Results: Ulcer management aims at ulcer healing. In the protracted process, patients often experience hopelessness. When healing is slow, patients doubt the professionals’ knowledge. A patient’s trust in professionals and the entire healthcare system may erode if treatment and information vary between different professionals (Study I). Study II revealed that daily life after healing was still strongly affected by the ulcer. Memories from a lost period in life were ever-present. Life after healing was changed – for some, life was not very eventful. The patients’ own knowledge was often limited, and there was a struggle to do what was best for the own body to prevent a new ulcer. Study III revealed that advice on nutrition and physical activity had no impact on healing time. Only 44% of the sample were advised on both nutrition and physical activity. It was common to have an ulcer for a long time before seeking help; about half of the sample had an ulcer for >84 days before registration. Other findings were that the median age among the 699 patients was 77 years, the majority were female, and comorbidity was common. The intervention tested in Study IV offered welcomed information. However, even among those experiencing some sense of recognition, the link to their own situation and life was unclear. The technical solution with videos on a flash drive was difficult for most people to use. The importance of close cooperation with professionals was highlighted. Conclusion: Venous leg ulcers have a profound impact on patients and their life situations. Ulcer management can, in different ways, impose suffering on patients. Not being listened to or seen as a person is anexperience that leaves its marks on a patient. When healing is slow, and someone has to be blamed, relationships with professionals are damaged. The role of self-care is unclear for most patients, which makes self-care harder. Those who tried a video-based intervention for self-care showed difficulties in relating it to their own life. Enabling a caring relationship can enhance patients’ understanding of information and advice. Patients must be invited to share their own experiences, to create a foundation for self-care. The provision of advice alone is not the solution to the issues related to self-care.

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Situation awareness in Sweden’s emergency medical services: a goal-directed task analysis

Andersson,

Maurin Söderholm,

Andersson Hagiwara

et al. 2023

Discov Health Systems

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Situation awareness is knowing what is going on in the situation. Clinicians working in the emergency medical services (EMS) encounter numerous situations in various conditions, and to be able to provide efficient and patient safe care they need to understand what is going on and possible projections of the current situation. The design of this study encompassed a Goal-Directed Task analysis where situation awareness information requirements were mapped in relation to goals related to various aspects of the EMS mission. A group of 30 EMS subject matter experts were recruited and answered a web-based survey in three rounds related to what they though themselves or a colleague might need to achieve situation awareness related to the specific goals of various situations. The answers were analysed using content analysis and descriptive statistics. Answers reached consensus at a predetermined level of 75%. Those who reached consensus were entered into the final goal-directed task analysis protocol. The findings presented that EMS clinicians must rely on their own, or their colleagues prior experience or knowledge to achieve situation awareness. This suggests that individual expertise plays a crucial role in developing situation awareness. There also seems to be limited support for situation awareness from organizational guidelines. Furthermore, achieving situation awareness also involves collaborative efforts from the individuals involved in the situation. These findings could add to the foundation for further investigation in this area which could contribute to the development of strategies and tools to enhance situation awareness among EMS clinicians, ultimately improving patient care and safety.

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Lived experiences of being cared for by ambulance clinicians when experiencing breathlessness—A phenomenological study

Cited by 3 publications

References 28 publications

Patients’ experiences of non-conveyance following an Australian ambulance service paramedic response: A constructivist grounded theory exploration

Patients’ experiences of non-conveyance following an Australian ambulance service paramedic response: A constructivist grounded theory exploration

Living with a venous leg ulcer: Lived experiences and the presence of self-care in daily life

Situation awareness in Sweden’s emergency medical services: a goal-directed task analysis

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