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Nurses' perceptions of climate and environmental issues: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature272072
Source
J Adv Nurs. 2015 Aug;71(8):1883-91
Publication Type
Article
Date
Aug-2015
Author
Anna Anåker
Maria Nilsson
Åsa Holmner
Marie Elf
Source
J Adv Nurs. 2015 Aug;71(8):1883-91
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Climate change
Humans
Nursing Staff - psychology
Qualitative Research
Sweden
Abstract
The aim of this study was to explore nurses' perceptions of climate and environmental issues and examine how nurses perceive their role in contributing to the process of sustainable development.
Climate change and its implications for human health represent an increasingly important issue for the healthcare sector. According to the International Council of Nurses Code of Ethics, nurses have a responsibility to be involved and support climate change mitigation and adaptation to protect human health.
This is a descriptive, explorative qualitative study.
Nurses (n = 18) were recruited from hospitals, primary care and emergency medical services; eight participated in semi-structured, in-depth individual interviews and 10 participated in two focus groups. Data were collected from April-October 2013 in Sweden; interviews were transcribed verbatim and analysed using content analysis.
Two main themes were identified from the interviews: (i) an incongruence between climate and environmental issues and nurses' daily work; and (ii) public health work is regarded as a health co-benefit of climate change mitigation. While being green is not the primary task in a lifesaving, hectic and economically challenging context, nurses' perceived their profession as entailing responsibility, opportunities and a sense of individual commitment to influence the environment in a positive direction.
This study argues there is a need for increased awareness of issues and methods that are crucial for the healthcare sector to respond to climate change. Efforts to develop interventions should explore how nurses should be able to contribute to the healthcare sector's preparedness for and contributions to sustainable development.
PubMed ID
25810044 View in PubMed
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Carbon footprint of telemedicine solutions--unexplored opportunity for reducing carbon emissions in the health sector.

https://arctichealth.org/en/permalink/ahliterature262422
Source
PLoS One. 2014;9(9):e105040
Publication Type
Article
Date
2014
Author
Asa Holmner
Kristie L Ebi
Lutfan Lazuardi
Maria Nilsson
Source
PLoS One. 2014;9(9):e105040
Date
2014
Language
English
Publication Type
Article
Keywords
Carbon Footprint - economics - statistics & numerical data
Climate Change - economics
Cost-Benefit Analysis
Delivery of Health Care - economics
Health Care Sector - economics
Hospitals, University
Humans
Sweden
Telemedicine - economics
Travel - economics
Videoconferencing - economics
Abstract
The healthcare sector is a significant contributor to global carbon emissions, in part due to extensive travelling by patients and health workers.
To evaluate the potential of telemedicine services based on videoconferencing technology to reduce travelling and thus carbon emissions in the healthcare sector.
A life cycle inventory was performed to evaluate the carbon reduction potential of telemedicine activities beyond a reduction in travel related emissions. The study included two rehabilitation units at Umeå University Hospital in Sweden. Carbon emissions generated during telemedicine appointments were compared with care-as-usual scenarios. Upper and lower bound emissions scenarios were created based on different teleconferencing solutions and thresholds for when telemedicine becomes favorable were estimated. Sensitivity analyses were performed to pinpoint the most important contributors to emissions for different set-ups and use cases.
Replacing physical visits with telemedicine appointments resulted in a significant 40-70 times decrease in carbon emissions. Factors such as meeting duration, bandwidth and use rates influence emissions to various extents. According to the lower bound scenario, telemedicine becomes a greener choice at a distance of a few kilometers when the alternative is transport by car.
Telemedicine is a potent carbon reduction strategy in the health sector. But to contribute significantly to climate change mitigation, a paradigm shift might be required where telemedicine is regarded as an essential component of ordinary health care activities and not only considered to be a service to the few who lack access to care due to geography, isolation or other constraints.
Notes
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PubMed ID
25188322 View in PubMed
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Building COPD care on shaky ground: a mixed methods study from Swedish primary care professional perspective.

https://arctichealth.org/en/permalink/ahliterature290073
Source
BMC Health Serv Res. 2017 07 10; 17(1):467
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
07-10-2017
Author
Sara Lundell
Malin Tistad
Börje Rehn
Maria Wiklund
Åsa Holmner
Karin Wadell
Author Affiliation
Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, 901 87, Umeå, Sweden. sara.lundell@umu.se.
Source
BMC Health Serv Res. 2017 07 10; 17(1):467
Date
07-10-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Communication
Cost-Benefit Analysis
Delivery of Health Care - organization & administration
Female
Health Knowledge, Attitudes, Practice
Health Personnel - psychology
Humans
Interviews as Topic
Male
Middle Aged
Primary Health Care
Pulmonary Disease, Chronic Obstructive - therapy
Qualitative Research
Quality of Health Care
Surveys and Questionnaires
Sweden
Abstract
Chronic obstructive pulmonary disease (COPD) is a public health problem. Interprofessional collaboration and health promotion interventions such as exercise training, education, and behaviour change are cost effective, have a good effect on health status, and are recommended in COPD treatment guidelines. There is a gap between the guidelines and the healthcare available to people with COPD. The aim of this study was to increase the understanding of what shapes the provision of primary care services to people with COPD and what healthcare is offered to them from the perspective of healthcare professionals and managers.
The study was conducted in primary care in a Swedish county council during January to June 2015. A qualitatively driven mixed methods design was applied. Qualitative and quantitative findings were merged into a joint analysis. Interviews for the qualitative component were performed with healthcare professionals (n = 14) from two primary care centres and analysed with qualitative content analysis. Two questionnaires were used for the quantitative component; one was answered by senior managers or COPD nurses at primary care centres (n = 26) in the county council and the other was answered by healthcare professionals (n = 18) at two primary care centres. The questionnaire data were analysed with descriptive statistics.
The analysis gave rise to the overarching theme building COPD care on shaky ground. This represents professionals driven to build a supportive COPD care on 'shaky' organisational ground in a fragmented and non-compliant healthcare organisation. The shaky ground is further represented by uninformed patients with a complex disease, which is surrounded with shame. The professionals are autonomous and pragmatic, used to taking responsibility for their work, and with limited involvement of the management. They wish to provide high quality COPD care with interprofessional collaboration, but they lack competence and are hindered by inadequate routines and lack of resources.
There is a gap between COPD treatment guidelines and the healthcare that is provided in primary care. To facilitate implementation of the guidelines several actions are needed, such as further training for professionals, additional resources, and improved organisational structure for interprofessional collaboration and patient education.
Notes
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PubMed ID
28693473 View in PubMed
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