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      Caring science research in the ambulance services: an integrative systematic review

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          Abstract

          Background

          The ambulance services are associated with emergency medicine, traumatology and disaster medicine, which is also reflected in previous research. Caring science research is limited and, since no systematic reviews have yet been produced, its focus is unclear. This makes it difficult for researchers to identify current knowledge gaps and clinicians to implement research findings.

          Aim

          This integrative systematic review aims to describe caring science research content and scope in the ambulance services.

          Data sources

          Databases included were MEDLINE (PubMed), CINAHL, Web of Science, Pro QDiss, LibrisDiss and The Cochrane Library. The electronic search strategy was carried out between March and April 2015. The review was conducted in line with the standards of the PRISMA statement, registration number: PROSPERO 2016: CRD42016034156.

          Review methods

          The review process involved problem identification, literature search, data evaluation, data analysis and reporting. Thematic data analysis was undertaken using a five‐stage method. Studies included were evaluated with methodological and/or theoretical rigour on a 3‐level scale, and data relevance was evaluated on a 2‐level scale.

          Results

          After the screening process, a total of 78 studies were included. The majority of these were conducted in Sweden (n = 42), fourteen in the United States and eleven in the United Kingdom. The number of study participants varied, from a case study with one participant to a survey with 2420 participants, and 28 (36%) of the studies were directly related to patients. The findings were identified under the themes: Caregiving in unpredictable situations; Independent and shared decision‐making; Public environment and patient safety; Life‐changing situations; and Ethics and values.

          Conclusion

          Caring science research with an explicit patient perspective is limited. Areas of particular interest for future research are the impact of unpredictable encounters on openness and sensitivity in the professional–patient relation, with special focus on value conflicts in emergency situations.

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          Most cited references 93

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          Lifeworld-led healthcare is more than patient-led care: an existential view of well-being.

          In this paper we offer an appreciation and critique of patient-led care as expressed in current policy and practice. We argue that current patient-led approaches hinder a focus on a deeper understanding of what patient-led care could be. Our critique focuses on how the consumerist/citizenship emphasis in current patient-led care obscures attention from a more fundamental challenge to conceptualise an alternative philosophically informed framework from where care can be led. We thus present an alternative interpretation of patient-led care that we call 'lifeworld-led care', and argue that such lifeworld-led care is more than the general understanding of patient-led care. Although the philosophical roots of our alternative conceptualisation are not new, we believe that it is timely to re-consider some of the implications of these perspectives within current discourses of patient-centred policies and practice. The conceptualisation of lifeworld-led care that we develop includes an articulation of three dimensions: a philosophy of the person, a view of well-being and not just illness, and a philosophy of care that is consistent with this. We conclude that the existential view of well-being that we offer is pivotal to lifeworld-led care in that it provides a direction for care and practice that is intrinsically and positively health focused in its broadest and most substantial sense.
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            A critical review of patient satisfaction

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              Integrative nursing research--an important strategy to further the development of nursing science and nursing practice.

               M Kirkevold (1997)
              In this paper it is argued that integrative nursing research has a great potential for clarifying the theoretical perspective and substance of the nursing discipline as well as making research-based knowledge more accessible to clinical nurses. Two general kinds of integrative research are introduced and illustration provided of how these have been practiced within nursing. Significant strengths and weaknesses in current practice is highlighted. It is argued that nursing should pay more attention to this kind of research, specifically in terms of developing sound methodological approaches and overcoming the traditional schism between empirical and theoretical research. Sound integrative nursing research promises to improve the development of nursing science as well as making the products of nursing research more easily available for clinical nurses.
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                Author and article information

                Contributors
                Role: Professorbirgitta.wireklint.sundstrom@hb.se
                Role: Associate Professor
                Role: Associate Professor
                Role: Medicine Doctor
                Journal
                Scand J Caring Sci
                Scand J Caring Sci
                10.1111/(ISSN)1471-6712
                SCS
                Scandinavian Journal of Caring Sciences
                John Wiley and Sons Inc. (Hoboken )
                0283-9318
                1471-6712
                25 September 2018
                March 2019
                : 33
                : 1 ( doiID: 10.1111/scs.2019.33.issue-1 )
                : 3-33
                Affiliations
                [ 1 ] PreHospen – Centre for Prehospital Research University of Borås Borås Sweden
                [ 2 ] Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
                [ 3 ] Faculty of Health and Life Sciences Linnaeus University Växjö Sweden
                [ 4 ] Division of Emergency Medical Services Kalmar County Hospital Kalmar Sweden
                [ 5 ] Division of Nursing Department of Neurobiology, Care Sciences and Society Karolinska Institutet Huddinge Sweden
                [ 6 ] Academic EMS Stockholm Sweden
                [ 7 ] The Ambulance Medical Service in Stockholm (AISAB) Stockholm Sweden
                [ 8 ] Department of Clinical Science and Education Karolinska Institutet Södersjukhuset Stockholm Sweden
                Author notes
                [* ] Correspondence to:

                Birgitta Wireklint Sundström, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, SE‐501 90 Borås, Sweden.

                E‐mail: birgitta.wireklint.sundstrom@ 123456hb.se

                Article
                SCS12607
                10.1111/scs.12607
                7432173
                30252151
                © 2018 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                Page count
                Figures: 2, Tables: 1, Pages: 31, Words: 16857
                Product
                Categories
                Review Article
                Review Articles
                Custom metadata
                2.0
                March 2019
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.5 mode:remove_FC converted:24.07.2020

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