Publications
-
Liepelt, Silje; Sundal, Hildegunn & Kirchhoff, Ralf
(2026).
Exploring a root cause analysis team's experience with involving patients and next of kin after a sentinel event.
Frontiers in Health Services.
6.
doi:
10.3389/frhs.2026.1825372.
Full text in Research Archive
Show summary
Background There is a growing recognition among healthcare providers and policymakers of the importance of involving patients and their next of kin in root cause analysis (RCA) to improve patient safety and healthcare quality. However, such involvement is intricate and challenging. This study explored how the involvement of patients and next of kin influenced the RCA team's understanding of a fatal sentinel event in maternity care. Method The study was a qualitative exploratory single-case study combining document analysis with interviews with six RCA team members. The selected case came from a Norwegian hospital responding to a sentinel event involving the unexpected death of a child during childbirth. The study addressed the following research questions: What were the team's experiences of involving patients and next of kin in the RCA process? Data collection included twelve interviews with six RCA team members, which were analysed using reflexive thematic analysis. Results Four main themes were identified. These concerned: (1) uncertainty regarding whether bereaved parents should be involved in the RCA process; (2) challenges associated with conducting interviews with the parents; (3) incorporation of patient and next-of-kin perspectives into the RCA report; and (4) the RCA team's learning process following involvement of the parents. Conclusion The findings suggest that involving patients and next of kin in RCA processes may contribute perspectives that strengthen organisational learning and understanding of sentinel events. Future research should explore how RCA frameworks can be systematically adapted to accommodate the involvement of bereaved relatives across different healthcare contexts.
-
Sundal, Hildegunn
(2026).
Nursing Students’ Lived Experiences of Caring for Paediatric Patients in a General Paediatric Medical Ward: A Hermeneutic Phenomenological Study.
Klinisk Sygepleje.
ISSN 0902-2767.
40(3),
p. 1–12.
doi:
10.18261/ks.40.3.3.
Full text in Research Archive
Show summary
Although the study of paediatric nursing is a requirement for a bachelor’s degree in nursing in the EU, new nurses in a paediatric ward have described limited training in paediatric nursing, thus highlighting the importance of hands-on learning in professional education.
This study explored nursing students’ lived experiences of caring for paediatric patients in a general paediatric medical ward.
A qualitative design with a hermeneutic phenomenological approach was used. Individual in-depth interviews were conducted with eight female Norwegian nursing students, and a thematic analysis inspired by Max van Manen’s method was performed.
Three essential themes emerged: from uncertainty to understanding care, complexity in care involving close collaboration and communication, and a collaborative community contributing to competence in care.
Nursing students’ paediatric practice prepared them to provide care to paediatric patients in a general paediatric medical ward. These findings support the implementation of clinical practice in paediatric wards in nursing education.
-
Vasset, Frøydis Perny & Sundal, Hildegunn
(2026).
Paediatric nursing in bachelor's degree programmes.
Social Sciences & Humanities Open (SSHO).
13(June).
doi:
10.1016/j.ssaho.2026.102742.
Full text in Research Archive
Show summary
Purpose
The purpose of this study was to examine the emphasis on paediatric nursing in Norwegian nursing education.
Method
In this study, a mixed-method explanatory sequential design was employed. Mixed-method research involves the collection of both quantitative and qualitative data. Design theory emphasizes that a significant amount of published research in the social and human sciences incorporates mixed methods. This study employed a mixed method explanatory sequential design with 18 survey respondents and text analysis. Findings highlight the impact of cohort size and specialist teachers, but are limited by sample size and institutional variability.
Results
The study findings indicate that the size of the nursing student cohort has an impact on paediatric nursing practices. Compared with larger cohorts, smaller student cohorts demonstrated more positive outcomes. Furthermore, the research revealed that specialist teachers in paediatric nursing played a significant role in the quality of education provided. The incorporation of simulated case scenarios, particularly those involving interprofessional collaboration, proved to be beneficial in teaching paediatric nursing to nursing students.
Conclusion
Due to the lack of emphasis on paediatric nursing within nursing faculties and inadequate internship opportunities for students, the importance of this area of nursing has been overlooked in nursing education. Nursing students have limited and varied exposure to the care of sick children during their training. There is a need for increased attention to paediatric nursing in nursing education.
-
Sundal, Hildegunn & Vasset, Frøydis Perny
(2025).
Pediatric nursing training in nursing studies : a qualitative study.
Nordisk sygeplejeforskning.
ISSN 1892-2678.
15(3),
p. 1–11.
doi:
10.18261/nsf.15.3.2.
Full text in Research Archive
Show summary
Background: In recent years, the focus on paediatric nursing in bachelor’s programmes has diminished, with less theoretical and practical training.
Objective: This study explores the experiences of third-year nursing students in a paediatric nursing programme.
Method: In a qualitative study characterised by a hermeneutical approach, 13 nursing students were interviewed, and the interviews were analysed using systematic text condensation.
Results: Students learned about paediatric nursing in the educational institution through paediatric nursing instruction and training in the exercise department. The students learned about paediatric nursing outside the educational institution by interviewing paediatric nurses and parents, whom they knew privately, about their experiences of sick children, as well as through visits and one day of clinical practice.
Conclusion: The students highlighted that they experienced useful learning in the Children’s Project but overall learned too little about paediatric nursing.
-
Sundal, Hildegunn
(2025).
How Adults Make Meaning of a Childhood Hospitalisation That Excluded Their Parents: A Retrospective Study.
Scandinavian Journal of Caring Sciences.
ISSN 0283-9318.
39(1).
doi:
10.1111/scs.70015.
Full text in Research Archive
Show summary
Introduction:
Parents were routinely excluded when a child was hospitalised, a practice that continued from the end of the 19th century until the mid-20th century. The inclusion of parents became more frequent in the period leading up to the 1970s and 1980s, marking a gradual change from previous practice. Children whose parents were excluded during a hospitalisation were in a vulnerable situation. Today, those children are adults, and some have died.
This study explores how these adults find meaning in their past experiences of having been hospitalised as children without their parents.
Method:
The study employed a qualitative design with a hermeneutic phenomenological approach. Eleven adults provided written narratives.
Results:
The findings show that the participants' adult lives are characterised to varying degrees by attachment and separation challenges. They also vacillate between trust and mistrust and have issues related to loneliness as a companion, being vulnerable, mastery of vulnerability and a life with physical limitations.
Conclusion:
To varying degrees, the participants linked their emotional challenges to having been hospitalised without their parents when they were children. The majority described their adult lives as being different from the lives of other people, who do not have similar feelings.
-
Sundal, Hildegunn
(2025).
Lived experiences of being hospitalised as a child without parents : a retrospective study.
Scandinavian Journal of Caring Sciences.
ISSN 0283-9318.
39(3).
doi:
10.1111/scs.70087.
Full text in Research Archive
Show summary
Introduction:
In the past, hospitals strictly excluded parents when their children were hospitalised. This practice persisted well into the mid-20th century, and parents' visits were limited through the 1970s and 1980s. This study aimed to explore the childhood experiences of adults who were hospitalised as children without their parents.
Method:
This qualitative study adopted a hermeneutic phenomenological approach. The data, comprised of written narratives from 11 Norwegian participants, were analysed using holistic, selective and detailed approaches inspired by van Manen.
Results.
The essential theme, Enduring life in hospital, yielded five subthemes: feeling abandoned, the significant moments with mother and father, being at the mercy of the carers, the burden of disease and treatment and uplifting moments in everyday life.
Conclusion:
Undergoing hospitalisation as children without the presence of their parents afforded the participants experiences that have shaped their lives. The study highlights the significance of healthcare professionals supporting adults who were hospitalised as children without their parents and providing adapted care during their future encounters with the healthcare system. The study also emphasises the importance of including parents in children's hospital admissions today.
-
Vasset, Frøydis Perny; Ulvund, Ingeborg & Sundal, Hildegunn
(2024).
Methods to learn clinical pediatric nursing for nurse students.
In David, Liliana (Eds.),
Nursing studies : a path to success.
IntechOpen.
ISSN 9780854662449.
doi:
10.5772/intechopen.1004207.
Full text in Research Archive
Show summary
It is useful to learn about somatically ill children when implementing project-based learning. The students interview children’s nurses/parents with sick children and this enables/strengthens the students’ learning. Students learned pediatric nursing after completing the pediatric project, which is part of the nursing program. Some students learned in an international clinical placement in a pediatric ward. Combined learning from inside and outside educational institutions is useful. How can nursing students learn pediatric nursing in nursing education in the future, with large cohorts of nurses and few internships? This chapter is composed of several studies, both quantitative studies with questionnaires from 159 nursing students and qualitative studies with individual interviews of 18 nursing students after international clinical placement in a pediatric ward and eight nurses who had an international clinical placement in a pediatric ward as nurse students. And some studies about simulation in nursing studies and studies about clinical practice in other countries.
-
Vasset, Frøydis Perny & Sundal, Hildegunn
(2024).
Paediatric nursing: Implementation and evaluation of project-based learning in nursing studies.
Social Sciences & Humanities Open (SSHO).
10.
doi:
10.1016/j.ssaho.2024.101022.
Full text in Research Archive
Show summary
Aim: To help provide learning outcomes in the field of paediatric nursing, which emphasizes obtaining experience from practice.
Background: Researchers have argued that different projects, scientific writing, and the use of scientific articles in
a project can be a form of communication, stimulate students’ learning and be a valuable tool for teachers’
assessments.
Method: A total of 159 nursing students from the second and third years of study were divided into eight groups
with several subgroups. Each subgroup had three to six small groups (a-f) with approximately four people in each
group (table 2). The small groups provided written material on questions about their experiences with Project
children.
Results: The participants had little hospital practice with children in their nursing education. They believed that
they should learn more paediatric nursing in their bachelor’s education. Furthermore, they were very satisfied
with the project’s children and moderately satisfied with the information they obtained. Interviews and discussions with nurses/relatives who worked with sick children were very useful. They received help from teachers
and spent time searching for scientific articles to use in the project. Overall, they wanted more face-to-face
communication with the teachers who guided Project children.
Discussion and conclusion: Larger student classes and an increasing number of elderly patients in the municipality
and hospital may contribute to students having less practice with children in their education. It may be helpful to
interview people with paediatric experience
-
Sundal, Hildegunn
(2024).
Asthma as a child : continuous attentiveness to breathing to participate in everyday activities – need for support.
Journal of Research in Nursing.
ISSN 1744-9871.
29(7),
p. 503–512.
doi:
10.1177/17449871241264742.
Full text in Research Archive
Show summary
Background:
Asthma is one of the most common chronic diseases in childhood.
Aims:
This study explores the experiences of participating in everyday activities among children with asthma.
Methods:
The study employed a qualitative design and was grounded in a hermeneutic-phenomenological approach. The data were collected through in-depth interviews with four children aged 9–12 diagnosed with asthma.
Results:
One theme was ‘heavy breathing stopping the body in motion’, and subthemes were as follows: ‘experiencing intrusive wheezing’, ‘calming one’s breath to participate’ and ‘being sick and refraining from participating’. Another theme was ‘help in everyday life and support to participate’, and subthemes were as follows: ‘taking the necessary asthma medicine’, ‘being understood and met as sick’ and ‘adapting one’s leisure activities’.
Conclusions:
To participate in everyday activities, children with asthma require insight into and an understanding of the importance of taking asthma medicine as recommended. They also need help in everyday life and support to participate in everyday activities. Children taking care of their own illnesses and listening to their bodies provide them with the greatest degree of participation in activities in their everyday lives. These findings represent an important contribution to the understanding of nursing care for children with asthma.
-
Sundal, Hildegunn & Alteren, Johanne
(2024).
Lack of hands-on competence in future paediatric nursing : examining student nurses’ paediatric competence after graduation – a hermeneutic study.
The Nordic Journal of Nursing Research (NJNR).
ISSN 2057-1585.
44,
p. 1–6.
doi:
10.1177/20571585241252880.
Full text in Research Archive
Show summary
Paediatric nursing training has been reduced in scope, which has become a concern in nursing education. Little is known regarding students’ experiences and what they learn about children as patients during courses. For the students in this study, paediatric nursing training consists of a 1-day observation practice. The aim of the present study was to examine this observation practice in paediatric nursing and discuss the consequences of the reduction of practical training for the level of knowledge of student nurses after graduation. A descriptive and interpretative design with a hermeneutical approach was employed to examine students’ experience in hospitals. Individual interviews were conducted with 11 students, and the data analysis followed Brinkmann and Kvale's three levels of interpretation. The study was reported in accordance with the COREQ checklist. Three themes emerged: ‘preparing the child for a procedure or treatment’; ‘the importance of the care provided by parents’; and ‘the lack of hands-on paediatric nursing training for students’. This study has implications for nursing in terms of paediatric competence. The findings suggest that students receive insufficient practical training in paediatric nursing. A discussion is required regarding paediatric nursing in nursing education, as well as how to meet national and international requirements.
-
Lorentzen, Isabelle Lindseth & Sundal, Hildegunn
(2024).
Anestesisykepleieres erfaringer med samarbeid og arbeidsdeling ved sjekkliste for trygg kirurgi.
Inspira – tidsskrift for anestesi-, operasjon- og intensivsykepleiere.
ISSN 0809-9707.
19(1),
p. 1–16.
doi:
10.23865/inspira.v19.5436.
Full text in Research Archive
Show summary
Bakgrunn: Anestesisykepleiere jobber i operasjonsteam med å ivareta operasjonspasienten ved kirurgiske inngrep. For å ivareta pasientsikkerheten ved kirurgiske inngrep benyttes sjekkliste for trygg kirurgi. Verktøyet er tenkt benyttet ved alle kirurgiske inngrep, men studier viser at den ikke alltid benyttes som anbefalt.
Hensikt: Studiens hensikt var å få kunnskap om anestesisykepleieres erfaringer med samarbeid og arbeidsdeling i operasjonsteamet ved bruk av sjekkliste for trygg kirurgi. Metode: Det ble benyttet individuelle dybdeintervju av seks anestesisykepleiere. Analyse av datamaterialet ble utført ved hjelp av systematisk tekstkondensering.
Resultat: Tre tema og syv undertema ble identifisert: 1) Ansvarsdeling i operasjonsteamet: ivareta sjekklistens tre deler og uklare rutiner for utførelse. 2) Kommunikasjonens betydning: tørre å ta plass, situasjoner som utfordret, og å se hverandre. 3) Å skape uoppmerksomhet: samtidighetskonflikt og mangelfull utførelse, og barrierer for å gjennomføre.
Konklusjon: Anestesisykepleierne erfarte samarbeid og arbeidsdeling med sjekklisten for trygg kirurgi som et felles ansvar. Ansvarsdeling og kommunikasjonens betydning ved gjennomføringen av sjekklisten var sentralt for å ivareta pasientens sikkerhet. Anestesisykepleierne erfarte at uoppmerksomhet skapes av situasjoner rundt pasienten, og at sjekklisten settes helt eller delvis til side. Graden av øyeblikkelig hjelp til pasienten bidrar til uklare rutiner for utførelse av sjekklisten.
-
Sundal, Hildegunn
(2023).
Home-like care: Collaboration between parents and nurses in everyday situations when children are hospitalized.
Journal of Child Health Care.
ISSN 1367-4935.
28(2024)(3),
p. 565–577.
doi:
10.1177/13674935221149778.
Full text in Research Archive
Show summary
When children are hospitalized, parents and nurses need to collaborate. This study aims to investigate how parents and nurses experience collaborating and sharing responsibilities and tasks when providing home-like care for hospitalized children in everyday situations. This qualitative study used a hermeneutic phenomenological approach with observations and interviews and was conducted in a general medical pediatric unit. Twelve parents of eleven hospitalized children between the ages of 1 and 6 years with various medical diagnoses and seventeen nurses who cared for those children participated in the study. Parents and nurses collaborated and shared responsibilities and tasks to provide home-like care for hospitalized children in everyday situations by making mealtimes seem familiar, maintaining customary sleeping patterns, adapting washing and dressing routines, and facilitating play and activity. Parents and nurses collaborated to maintain a familiar rhythm in an unfamiliar environment to enhance the children’s well-being. The nurses’ degree of involvement in the children’s everyday situations varied from little to moderate to strong, with parents assuming the main responsibilities. Nurses’ involvement in children’s everyday situations was variable, depending on the complexity of the situations.
-
Liepelt, Silje; Sundal, Hildegunn & Kirchhoff, Ralf
(2023).
Team experiences of the root cause analysis process after a sentinel event : a qualitative case study.
BMC Health Services Research.
23(1).
doi:
10.1186/s12913-023-10178-3.
Full text in Research Archive
Show summary
Background:
Root cause analysis (RCA) is a systematic approach, typically involving several stages, used in healthcare to identify the underlying causes of a medical error or sentinel event. This study focuses on how members of a Norwegian RCA team experience aspects of an RCA process and whether it complies with the Norwegian RCA method.
Method:
Based on a sentinel event in which a child died unexpectedly during childbirth in a Norwegian hospital in 2021, the following research questions are addressed: 1. What was the RCA team’s experience of the RCA process? 2. Was there compliance with the Norwegian RCA method in this case? A case study was chosen out of the desire to understand complex social phenomena and to allow in-depth focus on a case.
Results:
The result covered three main themes. The first theme related to the hospital’s management system and aspects of the case that made it challenging to follow all recommendations in the Norwegian RCA guidelines. The second theme encompassed external and internal assessment. The RCA team was composed of members with methodological and medical expertise. However, the police’s involvement in the case made it complex for the team to carry out the process. The third and final theme covered intrapersonal challenges RCA team members faced. Team members experienced various challenges during the RCA process, including being neutral, dealing with role-related challenges, grappling with ambivalence, and managing the additional time burden and resource constraints. As anticipated in the RCA guidelines, the team’s ability to remain neutral was tested.
Conclusion:
The findings of this study can help stakeholders better comprehend how an inter-professional RCA teamwork intervention can affect a healthcare organization and enhance the teamwork experience of healthcare staff while facilitating improvements in work processes and patient safety. Additionally, these results can guide stakeholders in creating, executing, utilizing, and educating others about RCA processes.
-
Sundal, Hildegunn & Ulvund, Ingeborg
(2022).
Experiences after international clinical placement as nursing students in a paediatric ward.
Nurse Education in Practice.
ISSN 1471-5953.
66(2023)(January),
p. 1–5.
doi:
10.1016/j.nepr.2022.103512.
Full text in Research Archive
Show summary
Aim:
The aim of this study is to investigate nurses’ experiences after participating in an international clinical placement programme as nursing students while staying for one to three weeks in a paediatric ward.
Background:
Student mobilisation is expected to increase the quality of education. Hence, offering international clinical placement programme in low- and high-income countries is a commonly used learning activity in bachelor programmes in nursing. Many studies have mainly examined the general experiences gained from international clinical placement programme but have not specifically focussed on the setting of paediatric wards in hospitals. Nursing students are required to acquire knowledge of paediatric nursing with children as patients.
Design and method:
In this qualitative study, a hermeneutic, phenomenological approach was adopted. Data were collected through individual interviews with eight nurses after they participated in an international clinical placement programme as nursing students in a paediatric ward.
Results:
Meetings with children’s destinies as patients were overwhelming, being an observer provided insights into and an overview of paediatric nursing, access to the resources required for treating children is limited, nurses had a different role and parents had an extended caring role.
Conclusion:
All participants gained knowledge of children as patients at a hospital and also gained knowledge of the parents’ and nurses’ roles and the treatment methods of various diseases that are relevant to paediatric nursing. This helped provide them with the cultural knowledge, awareness and sensitivity required, given the contrasting situation at their home country.
Keywords: nurse, nursing students, international clinical placement, paediatric nursing
-
-
Ulvund, Ingeborg; Dadi, Gezahegn Bekele & Sundal, Hildegunn
(2022).
Nurses benefit from international clinical placement as nurse students : a qualitative study.
Nurse Education Today.
ISSN 0260-6917.
121(2023)(February),
p. 1–6.
doi:
10.1016/j.nedt.2022.105663.
Full text in Research Archive
Show summary
Background:
A goal of studying abroad is increased cultural knowledge as well as strengthening the participants' disposition for active participation in society and in future careers. Empirical studies have shown a positive impact on nursing students', but little is known about the effects of international clinical placement on professional nursing. The aim was to investigate nurses' experiences after participating in international clinical placement as students, and how the stay influences their future career as professional nurses.
Design:
Qualitative design, and a hermeneutic phenomenological approach.
Methods:
Individual semi-structured interviews were conducted with a sample of eight nurses who had participated in an international clinical placement as nursing students and worked for at least two years as nurses. The participants were students at one University College in Norway. The data analysis method was inspired by Max van Manen's thematic analysis.
Results:
The international clinical placement promoted personal and professional development of importance to professional nursing practice. The informants benefited from increased global and cultural awareness and noted that mastering the emotional challenges during the placement strengthen their ability to manage demanding situations in nursing work. The students evaluated guided reflection before, during and after the stay to contributing to learning outcome.
Conclusion:
The potential for increased global and cultural competence and personal and professional development is high in international clinical placements. If the opportunity is taken, the participants' future careers can be affected in a way that benefits patients and colleagues. We recommend that educators and supervisors of students on international clinical placements should facilitate guided reflection to the participating students.
Keywords: international clinical, placement, nursing, reflection, cultural competence, professional development
-
Orseth, Wenche & Sundal, Hildegunn
(2021).
Intensivsykepleiernes erfaringer med teoretisk og praktisk opplæring for å gjennomføre inhalasjonssedering til respiratorpasienter i intensivavdelingen.
Inspira – tidsskrift for anestesi-, operasjon- og intensivsykepleiere.
ISSN 0809-9707.
16(1),
p. 1–15.
doi:
10.23865/inspira.v16.2939.
Full text in Research Archive
Show summary
Bakgrunn: Intensivpasienter som ligger på respirator kan ha behov for sedering. De mest brukte
medikamentene kan føre til komplikasjoner som delir og forlenget tid på respirator. I 2005 kom det
et nytt filter som kan administrere sedative flyktige gasser som sevofluran og isofluran til respiratorpasienten
i intensivavdelingen. Dette filteret heter Anaesthetic Conserving Device (AnaConDa).
Disse gassene akkumuleres ikke i kroppen og kan redusere forekomsten av delir, føre til raskere
oppvåkningstid og kortere tid på respirator. Det har medført at intensivsykepleiere må lære en ny
sederingsmetode.
Hensikten med studien var å undersøke intensivsykepleierens erfaringer med teoretisk og praktisk
opplæring for å gjennomføre inhalasjonssedering til respiratorpasienter i intensivavdelingen.
Metode: Studien hadde et kvalitativt design, med semi-strukturerte intervjuer av 6 intensivsykepleiere
som hadde erfaring med opplæring og administrering av sevofluran og isofluran via AnaConDa.
Intervjumaterialet ble transkribert og analysert etter Malteruds tekstkondensering i fire trinn.
Resultater: Studien har tre hovedfunn: erfaringer knyttet til opplæring, erfaringer knyttet til
gjennomføring og erfaringer etter opplæring var avsluttet.
Konklusjon: Studien viser at intensivsykepleierne opplevde opplæring med teoretisk undervisning
sammen med å øve praktisk uten respiratorpasient som nødvendig, og at støtte under
gjennomføring av inhalasjonssedering på pasient var viktig. Behandling med inhalasjonsgass administrert
via AnaConDa til respiratorpasienter ga stort sett ønsket effekt. Det motiverte dem til å
fortsette å utøve for å bli trygg på bruken av AnaConDa.
Nøkkelord: AnaConDa, inhalasjonssedering, intensivavdeling, intensivsykepleier
-
Sundal, Hildegunn
(2020).
Children's co-determination during challenging procedures : nurses and parents experiences of caring under short-term hospital stays in Norway.
Journal of Pediatric Nursing : Nursing Care of Children and Families.
ISSN 0882-5963.
57(March–April),
p. e34–e39.
doi:
10.1016/j.pedn.2020.09.018.
Full text in Research Archive
Show summary
Background: Medical and clinical procedures can cause varying levels of discomfort to children.
Purpose: This study is to deepen the understanding of the lived experiences of parents and nurses related to challenging medical and clinical procedures performed on children during short-term hospital stays.
Design and Methods: This qualitative study, which comprises part of a larger study, adopted a hermeneutic phenomenological approach. The data were obtained through a combination of in-depth interviews and observations of twelve parents of eleven children and seventeen nurses. A narrative re-analysis was conducted of four challenging medical and clinical procedures. Four stories were written and subsequently analyzed as one narrative that represents the findings.
Results: The form of nurses' and parents' care for the children ranged from encouraging the children's consent and receptiveness to the procedures, to coercion. The analysis indicates that promoting the children's co-determination and participation in the procedures encouraged their consent and receptiveness and facilitated a successful outcome. In contrast, an absence of efforts to involve the children in the procedures contributed to the need for coercion to be employed by parents and nurses. Moreover, parental influence and the responsibilities of nurses had an impact on children's co-determination and participation.
Conclusions: Preparing parents and children before and during a procedure was important to minimize the degree of coercion of the children.
Practice implications: The findings of this study are relevant to clinical practice because they suggest preparing parents and children before and during a procedure situation.
Keywords: children in hospital, nurse, parents, lived experience, narrative, procedure situations, coercing, consent
-
Sundal, Hildegunn & Vatne, Solfrid
(2020).
Parents’ and nurses’ ideal collaboration in treatment-centered and home-like care of hospitalized preschool children : a qualitative study.
BMC Nursing.
19,
p. 1–10.
doi:
10.1186/s12912-020-00445-7.
Full text in Research Archive
Show summary
Background: The hospitalization of children requires collaboration between parents and nurses in partnerships. This study examines parents’ and nurses’ experiences of ideal collaboration in treatment-centered and home-like care of hospitalized preschool children.
Methods: This qualitative study is part of a larger study of 12 parents and 17 nurses who were responsible for 11 hospitalized children. Data collection took place at a Norwegian general paediatric unit, and the data were gathered from observations of and qualitative interviews with the parents and nurses. The analysis was conducted in six steps, in alignment with Braun and Clarke.
Results: Two essential themes emerged from the analysis. (1) Treatment-centered care focuses on the following tasks in building relationships – gaining trust, securing – gaining voluntariness, distracting and comforting, and securing and gaining voluntariness. The purpose of treatment-centered care is to perform diagnostic procedures and offer treatment. (2) Home-like care, the purpose of which is to manage a child’s everyday situations in an unfamiliar environment, focuses on the following tasks: making familiar meals, maintaining normal sleeping patterns, adjusting to washing and dressing in new situations, and normalizing the time in between. From this pattern, we chose two narratives that capture the essence of ideal collaboration between parents and nurses.
Conclusion: The ideal collaboration between nurses and parents is characterized by flexibility and reciprocity, and is based on verbal and action dialogues. In treatment-centered care, parent-nurse collaboration was successful in its flow and dynamic, securing the children’s best interests. Meanwhile, the achievement of the children’s best interest within home-like care varied according to the level of collaboration, which in turn was related to the complexity of the children’s everyday situations.
Keywords: children’s hospitalization, preschool, nurse-parent collaboration, qualitative design, field study, interview
-
Synnes, Oddgeir; Orøy, Aud Jorun; Råheim, Målfrid; Bachmann, Liv; Ekra, Else Mari Ruberg & Gjengedal, Eva
[Show all 12 contributors for this article]
(2020).
Finding ways to carry on : stories of vulnerability in chronic illness.
International Journal of Qualitative Studies on Health and Well-being.
ISSN 1748-2623.
15(1),
p. 1–13.
doi:
10.1080/17482631.2020.1819635.
Full text in Research Archive
Show summary
Purpose: In this study, we explore the lived experiences of chronic illness in four groups of patients; children with asthma, adolescents with diabetes, young adults with depression, and adult patients with chronic, obstructive pulmonary disease (COPD). Persons living with chronic illness are often designated as vulnerable. This study builds on the assumption that being vulnerable belongs to being human, and that vulnerability also might entail strength and possibilities for growth.
Methods: A narrative analysis was undertaken to illuminate how experiences of vulnerability were narrated across the four patient groups, presenting four individual stories, one from each of the patient groups.
Results/conclusion: The stories illuminate how living with a chronic illness implies differing capabilities and capacities dependent on the specific condition. At the same time the stories point to how various abilities and challenges in living with chronic illness can be alleviated or seen as resources. Considered together, the stories underscore how ´finding ways to carry on´ in chronic illness requires interpretational work. By calling upon resources among significant others, in the surroundings and in oneself, the narrator can find ways of interpreting living with chronic illness that might open towards a hopeful future.
Keywords: chronic illness, vulnerability, narrative analysis, life
-
Sundal, Hildegunn & Lykkeslet, Else
(2020).
«Sometimes falling out of normal life» : a qualitative study of children and their experiences with a life with allergy and asthma.
Nordisk sygeplejeforskning.
ISSN 1892-2678.
10(3),
p. 213–222.
doi:
10.18261/issn.1892-2686-2020-03-07.
Full text in Research Archive
Show summary
The combination of asthma and allergy is one of the most common chronic diseases in childhood. The aim of this article is to illuminate children’s experiences with allergies and asthma through their stories of everyday life. The study is grounded in a phenomenological philosophy of lifeworld and thus employs a qualitative design. The data were collected through qualitative in-depth interviews with four children, aged 9-12 years, with each child interviewed three times. A narrative analysis was conducted from the responses. Four stories, one from each child, were written and later analyzed as one narrative, representing the findings of the study. The main finding is that living with a disease may cause a child to fall out of normal life. This narrative contains three sub-narratives: everyday life with an intrusive disease, supporters in everyday life, and the hope to be included in normal life. Using a narrative analytical approach provided a cohesive story of the children’s experiences. In these narratives, the contexts of the children’s lives are prominent, yielding stories in which everyday life, the children’s lifeworld, emerges. These stories, in turn, offer healthcare professionals insight into the experiences of children living with chronic disease.
Keywords: children with allergy and asthma, everyday stories, narratives, phenomenology, qualitative design
-
Sundal, Hildegunn & Lykkeslet, Else
(2019).
Hospitalized children : parents' and nurses' collaboration in procedural situations.
Pediatric Nursing.
ISSN 0097-9805.
45(4),
p. 174–179.
Full text in Research Archive
Show summary
Background: When children are hospitalized, collaboration between parents and nurses is initiated. This qualitative study explored parents' and nurses' experiences of collaboration, and the sharing of responsibility and tasks in the care of hospitalized children regarding procedural and treatment situations. Methods: A hermeneutic, phenomenological approach was used, which included field study and interviews. Participants included 11 children hospitalized in a general medical pediatric unit with their parents (3 fathers and 9 mothers) and the 17 nurses (all female) who cared for them. The children were between 1 and 6 years old (3 boys and 8 girls), and had various medical diagnoses. Findings: Parents and nurses collaborated and shared responsibilities and tasks in caring for the children in procedural and treatment situations by building relationships with the children, motivating and distracting the children, and causing discomfort and comforting the children. In this way, while carrying out procedures and treating the children, nurses and parents alternated responsibilities and tasks. Caring in these situations was characterized by a dynamic and flexible collaboration for the children's best interests. Conclusions: This study reveals the dynamics of collaboration and a sharing of responsibility and tasks between parents and nurses. This study highlights that nurses must be aware of parents' contributions and competence in terms of collaboration in both procedural and treatment situations.
Keywords: children in hospital, care, treatment, procedure, collaboration, responsibility, nursing, parents
-
Sundal, Hildegunn; Petersen, Karin Anna & Boge, Jeanne Helene
(2019).
Exclusion and inclusion of parents of hospitalized children in Norway in the period 1877–2017.
BMC Nursing.
18(6).
doi:
10.1186/s12912-019-0330-6.
Full text in Research Archive
Show summary
Background: Today, Norwegian parents have the right to stay with their children when they are in hospital. This right is relatively new. The purpose of this article is to examine the nursing profession’s ideas on how parents should be included/excluded when their children are in hospital, and to examine the social and ideological conditions that made the nursing profession’s ideas on inclusion/exclusion practices possible.
Methods: The analyses are done in the tradition of the French philosopher Michel Foucault’s writings on how different kinds of knowledge have been used to discipline citizens. Such studies include analyses of descriptive and normative material and analyses of the ideological and social conditions that made the practices possible. The analyses are based on Norwegian textbooks on nursing.
Results: Parents are rarely mentioned in Norwegian nursing textbooks from the period 1877–1940, and they are not present in photos from hospitals. The exclusion of parents may be due to the absence of welfare services and the fear of parents transmitting diseases from the hospitals to the general population. The first Norwegian nursing textbook that argued for the importance of letting parents visit their children in hospital was published in 1941. In 1968, nursing textbooks started to argue for parents’ participation in the care. Since 1987, nursing textbooks have advocated full parental participation. The inclusion of parents was in accordance with humanistic ideology. The inclusion of parents occurred in a period of great nursing shortage. In this situation, it would have been of interest to entrust as much as possible of the nurse’s work to the family.
Conclusions: Our conclusion is that ideas break through when they are in line with social conditions. From 1877 to 1940 social and economic conditions made it difficult for parents to be with their children in hospital, and hygiene ideology/theory contributed to legitimization of the exclusion of the parents in the care. During the period 1941–2017 it has been economically advantageous for the hospitals that parents care for their children. Ideas on the vulnerable child and self-help ideology have contributed to legitimization of the inclusion of the parents.
Keywords: children, hospital, parents, exclusion, inclusion, Michel Foucault, discipline
-
-
Boge, Jeanne Helene; Storum, Hilde; Sundal, Hildegunn; Callewaert, Staf & Petersen, Karin Anna
(2016).
Muligheter og begrensninger ved analyser av sykepleiepraktikker i et Foucault-perspektiv.
Klinisk Sygepleje.
ISSN 0902-2767.
30(1),
p. 31–44.
doi:
10.18261/issn.1903-2285-2016-01-04.
Full text in Research Archive
Show summary
The reason for the article is discussions that have taken place in the praxeologiske research group at the University of Bergen about the differences between studies on nursing in a philosophical and a sosiological perspective. The purpose with this text is to discuss possibilities and limitations in doing studies on nursing practices in the perspective of the philosopher Michel Foucault. Three studies in nursing are used as examples. One of the studies was about body wash, the other about nursing documentation and the third about exclusion and inclusion of parents when children are in the hospital. The methodological basis for the studies were a discussion with Foucault on how he studied punishment. The articles conclusion is that researchers who go out into the world to examine how practices actually are being made, move out of philosophical methodology.
-
Sundal, Hildegunn; Petersen, Karin Anna & Boge, Jeanne Helene
(2016).
Fra 1960-tallet har det blitt forventet at
foreldre skal være inkludert i pleien av barn
på sykehus.
Barn – forskning om barn og barndom i Norden.
ISSN 0800-1669.
34(3),
p. 23–37.
doi:
10.5324/barn.v34i3.3626.
Full text in Research Archive
Show summary
I perioden 1877–1940 var foreldre sjelden nevnt i norske lærebøker i sykepleie når barn på sykehus var
omtalt. I 1941 utgis den første norske læreboken der det argumenteres for at foreldre bør få besøke
barna sine når de er på sykehus. På 1960-tallet tas dette videre og det argumenteres i lærebøkene for
at foreldre bør få delta i pleien av barn på sykehus. Siden slutten av 1980-tallet har det i norske lærebøker
i sykepleie vært argumentert for omfattende foreldredeltakelse når barn er på sykehus. I denne
artikkelen har vi undersøkt og drøftet mulighetsbetingelsene for inklusjonsargumentasjonen som oppstod
i norske lærebøker i sykepleie på midten av 1900-tallet. Vi har argumentert for at inklusjonsnormene
oppstod fordi det var til beste for barnet, men også samfunnsmessig og økonomisk fordelaktig
at foreldre var sammen med barna sine på sykehus. Analysene er gjort i forlengelsen av den franske
filosofen Michel Foucaults utlegninger om selvstyrt disiplinering.
-
Sundal, Hildegunn; Petersen, Karin Anna & Boge, Jeanne Helene
(2015).
Tenkning i sykepleie om eksklusjon av foreldre ved barns innleggelse i sykehus.
Nordisk tidsskrift for helseforskning.
ISSN 1504-3614.
11(2),
p. 76–85.
doi:
10.7557/14.3713.
Full text in Research Archive
Show summary
Analyses of textbooks in nursing, of photographs and numerous other documents suggest that parents had limited access to participate in the care for their hospitalized children in Norway in the period 1877-1940. The analyses are conducted in the tradition of the French philosopher Michel Foucault’s writings on discipline. In accordance with Foucault’s understanding, it seems logical that ideas about parenting exclusion had impact even within the hospital health care system in the current era, provided the general separation of parents and children in the modern industrial society at large. In this perspective, exclusion of parents in the hospital health care system may be considered a consequence of employers’ interests with regard to productivity, the lack of welfare services for parents, and the fear of parents transmitting infections from the hospitals.
-
Gjengedal, Eva; Ekra, Else Mari Ruberg; Hol, Hege Bente; Kjelsvik, Marianne; Lykkeslet, Else & Michaelsen, Ragnhild K A
[Show all 11 contributors for this article]
(2013).
Vulnerability in health care – reflections on encounters in every day practice.
Nursing Philosophy.
ISSN 1466-7681.
14(2),
p. 127–138.
doi:
10.1111/j.1466-769X.2012.00558.x.
Full text in Research Archive
Show summary
Vulnerability is a human condition and as such a constant human experience. However, patients and professional health care providers may be regarded as more vulnerable than people who do not suffer or witness suffering on a regular basis. Acquiring a deeper understanding of vulnerability would thus be of crucial importance for health care providers. This article takes as its point of departure Derek Sellman's and Havi Carel's discussion on vulnerability in this journal. Through different examples from the authors' research focusing on the interaction between health professionals and patients, existential, contextual, and relational dimensions of vulnerability are illuminated and discussed. Two main strategies in the professionals' interactions with patients are described. The strategy that aims at understanding the patients or families from the professional's own personal perspective oftentimes ends in excess attention to the professional's own reactions, thereby impairing the ability to help. The other strategy attempts to understand the patients or families from the patients' or families' own perspective. This latter strategy seems to make vulnerability bearable or even transform it into strength. Being sensitive to the vulnerability of the other may be a key to acting ethically.
-
Sundal, Hildegunn
(2001).
"Mors" uklare rolle når barnet er innlagt i sjukehus Unclear maternal roles when children are hospitalized?
Vård i Norden.
ISSN 0107-4083.
21(3),
p. 39–42.
Full text in Research Archive
Show summary
The paper describes a Norwegian study from 1998, (2) based on a phenomenological approach where six mothers are interviewed. The mothers stayed together with their children in hospital. The children were hospitalized for minor surgery. They stayed in ho spital for three to four days at a small section for children location at a ward for adults. The children were from four to eleven years old. This paper focuses division of labour and responsibility between mothers and nurses, during hospital stays for children. In Norway such interactions are regulated by law (1). The findings from this study indicate that the mothers take responsibility for basic mothering care. According to the mothers the nurses involvement in nursing care for the children is redu ced by the presence of the mothers in the ward.
View all works in NVA
-
-
Sundal, Hildegunn & Ulvund, Ingeborg
(2024).
Barn i hjem og helseinstitusjoner.
In Vasset, Frøydis Perny & Julnes, Signe Gunn (Ed.),
Avansert klinisk allmennsykepleie i kommune- og spesialisthelsetjenesten.
Fagbokforlaget.
ISSN 9788245043914.
p. 84–95.
Full text in Research Archive
-
Sundal, Hildegunn; Ulvund, Ingeborg; Orøy, Aud Jorun & Alteren, Johanne
(2023).
35 forskere deltok på helsefaglig fenomenologi-seminar på Molde campus.
Panorama : nettavis for Høgskolen i Molde.
Full text in Research Archive
-
Sundal, Hildegunn
(2023).
The significance for adult life – When children have been hospitalized without their parents.
Full text in Research Archive
-
Sundal, Hildegunn & Ulvund, Ingeborg
(2022).
International clinical placement as nursing students in a paediatric ward - registered nurses’ experiences.
Full text in Research Archive
-
Ulvund, Ingeborg & Sundal, Hildegunn
(2022).
Sykepleieres utbytte av kliniske studier som sykepleierstudent på en barneavdeling i et lavinntektsland.
Full text in Research Archive
Show summary
Begrunnelsen for å tilby internasjonale utvekslingsopphold for studenter er å øke kvaliteten på utdanningene. En vanlig læringsaktivitet på bachelorstudier i sykepleie er kliniske praksis i helse- og omsorgstjenesten. Tidligere studier har i hovedsak undersøkt de generelle erfaringene fra internasjonale kliniske utvekslingsprogram og har ikke spesifikt fokusert på erfaringer fra en barneavdelinger i sykehus. For sykepleierstudenter er det et krav at de tilegner seg kunnskap om barnesykepleie med barn som pasienter. Hensikten med studien er å undersøke sykepleieres erfaringer etter å ha deltatt i et internasjonalt utvekslingsprogram som sykepleierstudenter. Læringsaktivitetene omfattet en til to uker på en pediatrisk avdeling på et sykehus. I denne kvalitative studien ble en hermeneutisk, fenomenologisk tilnærming benyttet. Datainnsamlingen ble gjennomført ved individuelle intervjuer med åtte sykepleiere etter at de hadde deltatt i et internasjonalt utvekslingsprogram som sykepleierstudenter og hatt kliniske praksis på en barneavdeling. Funnene var at sykepleiere som studenter hadde opplevd «sterke møter med syke barn, fått innsikt i ukjente sykdommer og behandlinger og at personalet gjorde sitt beste». Studiens konklusjoner var: Studentene tilegnet seg kunnskap om barn som pasienter ved sykehus og behandlingsmetoder for ulike sykdommer som er relevante for barnesykepleie. Ved å sammenligne de nye erfaringene med erfaringer fra hjemlandet tilegnet studentene seg også kulturell kunnskap, bevissthet og sensitivitet. Denne kunnskapen benytter de i møte med pasienter som kommer fra andre land og gjør kunnskapen relevant og bærekraftig og er en nyskaping i det norske samfunnet med stor grad av innvandring.
-
Foldøy, Reidun Elise; Sundal, Hildegunn & Bergersen, Ida
(2022).
Var alene på sykehus som barn: - Det føltes utrygt.
[Internet].
kk.no.
Full text in Research Archive
-
Sundal, Hildegunn
(2019).
Challenging procedure situations in hospitals - caring between encouraging the child’s receptiveness and coercing the child.
Full text in Research Archive
-
Reitan, Laila Solli & Sundal, Hildegunn
(2019).
Sykepleiers erfaring med NEWS som scorings verktøy på sengepost for å oppdage pasienter med tidlig forverret sykdomstilstand.
Full text in Research Archive
-
Reitan, Laila Solli & Sundal, Hildegunn
(2019).
Nurse`s experiences with NEWS as a tool in early recognition of deterioration: “Before we didn`t count respiratory frequency".
Full text in Research Archive
-
Sundal, Hildegunn & Lykkeslet, Else
(2018).
Living with allergy and asthma : a qualitative study of children, aged 8-12 years, and their experiences of life.
Full text in Research Archive
Show summary
Asthma and allergy is one of the most common chronic diseases in childhood. This presentation focuses
on how children tell their everyday stories of living with allergy and asthma. The study is grounded in a
phenomenological philosophy of the lifeworld and, as such, has a qualitative design. Data were collected
through qualitative research interviews with four children, aged 8-12 years, each child being interviewed
three times. A narrative analysis was conducted. Four stories, one from each child, were written up as
findings, and later analyzed as one narrative. The main findings are: living with sickness makes you
sometimes fall out of normal life. This contains three minor narratives: everyday life with an intrusive
disease, supporters in everyday life, and hoping to be included in normal life. Using a narrative analytical
approach may yield a more coherent story of the children’s experiences. In these narratives the contexts
of the children’s lives are prominent, yielding stories in which everyday life, the children’s lifeworlds,
emerges. The stories may give healthcare professionals insight into and understanding of children living
with disease.
-
Reitan, Laila Solli & Sundal, Hildegunn
(2018).
«Sykepleierens erfaring med verktøyet NEWS i tidlig oppdagelse av forverret tilstand. Er NEWS bare et tall?».
Full text in Research Archive
Show summary
Hensikt:
Var å undersøke hvilke erfaringer sykepleiere har med NEWS som verktøy og implementeringsprossesen.
Bakgrunn: National Early Warning Score (NEWS) er et verktøy bestående av vitale målinger, som på en strukturert måte kan identifiserer pasienter med forverret tilstand. NEWS innføres på flere somatiske sykehus i forbindelse med pasientsikkerhetskampanjen Tidlig oppdagelse av forverret tilstand. Et sykehus i Norge startet med NEWS i 2016 og studien ble utført året etter.
Problemstilling: Hvilke erfaring har sykepleiere på sengepost med bruka av NEWS i Tidlig oppdagelse av forværret tilstand.
Metode: Kvalitative dybde intervju av 5 sykepleiere ble brukt for å få svar på problemstillingen
Resultat: Sykepleiere opplever at NEWS har ført til bedre rutiner, de er i forkant og er tryggere i sine vurderinger. Men de opplever manglende interesse og respons på høy NEWS fra legene.
Konklusjon: Sykepleierne ser NEWS som et hjelpemiddel i kliniske vurderinger. Men skal NEWS funger er de avhengig av at sykepleierne tar en høy NEWS på alvor og kontakter lege. Effekten er og avhengig av at legene responderer.
-
Sundal, Hildegunn & Hernæs, Nina
(2018).
Det var helt vanlig at barn lå alene på sykehus.
[Journal].
Sykepleien.no.
Full text in Research Archive
-
-
-
Sundal, Hildegunn
(2016).
Vil «fleksible sengeområde» ivareta
syke barn i det nye sjukehuset?
Romsdals Budstikke..
ISSN 0806-5160.
Full text in Research Archive
-
-
Sundal, Hildegunn & Hernæs, Nina
(2014).
Da barn lå alene på sykehus : foreldre var ekskludert når barn lå på sykehus : Hildegunn Sundal har forsket på hvorfor.
[Journal].
sykepleien.no.
Full text in Research Archive
-
-
Sundal, Hildegunn
(2014).
Doktorgrader : Hildegunn Sundal disputerte 30. mai 2014 for doktorgraden ved Universitetet i Bergen, Det medisinsk-odontologise fakultet.
Nordvestsykepleieren : medlemsblad for Møre og Romsdal.
16(2),
p. 04–04.
Full text in Research Archive
-
-
Sundal, Hildegunn
(2014).
Viktige foreldre : gir avlastning for pleierne når barn er på sjukehus.
[Journal].
Romsdals budstikke.
Full text in Research Archive
-
Sundal, Hildegunn; Lykkeslet, Else; Gjengedal, Eva & Blåka, Gunnhild
(2010).
Hospitalized children – How do parents and nurses experience their collaboration?
In Krycka, Kevin C (Eds.),
29th International Human Science Research Conference : Giving Voice to Experience. Seattle University, August 4-8, 2010.
Seattle University College of Arts and Sciences.
p. 66–67.
Full text in Research Archive
-
-
Sundal, Hildegunn; Lykkeslet, Else; Gjengedal, Eva & Blåka, Gunnhild
(2010).
Hospitalized children – How do parents and nurses experience their collaboration?
Full text in Research Archive
-
Gjengedal, Eva; Lykkeslet, Else; Orøy, Aud Jorunn; Michaelsen, Ragnhild K A; Sundal, Hildegunn & Skrondal, Torill Helene
[Show all 8 contributors for this article]
(2010).
Vulnerable groups’ experiences as basis for health care interaction.
In Krycka, Kevin C (Eds.),
29th International Human Science Research Conference : Giving Voice to Experience. Seattle University, August 4-8, 2010.
Seattle University College of Arts and Sciences.
p. 17–17.
Full text in Research Archive
Show summary
Vulnerability is a characteristic of human existence. Therefore, it plays an important part in almost all
human interaction, in particular with "significant others", like family members and health care workers. In
the context of the health care system some patient groups are regarded as particularly vulnerable, and
therefore represent a challenge for health care providers. For example, major mentally ill patients are
regarded as a particularly vulnerable group. Research in mental health care has indicated that the
professionals try to avoid conflicting situations with these patients, using various subtle or covert coercion
strategies. Such strategies may be regarded as indistinct and non-therapeutic. An alternative approach
would be to rely on empathy, self-reflection and self-limitation. Similar strategies may be found in other
situations with other groups. The aim of the panel presentation is to give voice to the experiences of
different groups who are considered as vulnerable and to professionals who are interacting with such
groups. Potential patterns in the experiences across the groups will be elaborated. Finally, the aim is to
discuss how knowledge about these experiences can contribute to improved interaction. There will be
given a short presentation of four phenomenological qualitative studies of interactions with vulnerable
groups along the lifespan. These groups are hospitalized children and their parents, persons with
dementia, hospitalized mentally ill persons, and intensive care providers’ interaction with families to
donor patients. Some findings from these studies will be presented as condensed descriptions illustrating
experience of vulnerability and fragility as well as challenges related to interaction. Further, experiences
with interactions across the different groups that seem to both fail and succeed will be visualized.
Preliminary results indicate that taking vulnerable patients’ experiences into consideration may ease their situation and improve quality of health care. These preliminary findings will be further elaborated in the
presentation.
-
-
Liepelt, Silje; Kirchhoff, Ralf; Sundal, Hildegunn & Dale, Karl Yngvar
(2025).
Healthcare Professionals’ Experience with Root Cause Analysis: A Case Study.
Norges teknisk-naturvitenskapelige universitet.
ISSN 9788232694297.
Full text in Research Archive
Show summary
Introduction: Over the past three decades, the emphasis in healthcare has gradually shifted from individual responsibility for safety, quality, and performance to a systems-based perspective for addressing variation and adverse events. Despite extensive efforts to improve patient safety, adverse events remain a persistent challenge, with the World Health Organization (WHO) estimating that approximately 10% of patients worldwide experience harm during hospitalization.
Root cause analysis is widely used in healthcare as a structured method for investigating sentinel events—unexpected incidents resulting in severe harm or death. The method aims to identify systemic weaknesses in processes, communication, and organizational structures to facilitate targeted safety interventions. However, its effectiveness in driving long-term improvements has been debated, as many RCA efforts remain reactive rather than proactively strengthening healthcare systems.
Aim: To explore RCA and how healthcare professionals in a Norwegian hospital setting experience RCA following a sentinel event. The thesis sheds light on practical applications of RCA, considerin challenges and the potential for fostering improvements in patient safety.
Methods: A qualitative single-case design was employed to explore healthcare professionals’ experience with RCA in a specialized hospital setting. Data collected involved semistructured interviews with RCA team members and managers and document analysis of RCA reports, policies, and Norwegian guidelines. Data were analyzed using thematic analysis to identify key themes related to the RCA process.
Findings: Three articles present the findings, illustrating the complexities of implementing RCA in specialized healthcare. The dissertation highlights RCA’s potential to facilitate learning and improvement but also finds that resource constraints, inconsistent practices, and variations in implementation often hinder its effectiveness.
Conclusion: This study highlights the potential and limitations of RCA as a tool for improving patient safety. While RCA provides a structured approach to learning from adverse events, its impact is contingent on organizational commitment, the availability of resources, and the ability to integrate findings into broader safety initiatives. This thesis contributes to an understanding of how healthcare organizations can strengthen their adaptive capacity by critically examining RCA’s role within a resilience-based framework.
The findings emphasize the need for more proactive and integrative approaches to patient safety, ensuring that RCA identifies systemic weaknesses and drives meaningful and sustainable improvements in healthcare quality and safety.
-
Sundal, Hildegunn
(2014).
Inklusjon og eksklusjon av foreldre i pleie av barn innlagt på sykehus. Analysene er historiske og nåtidige og har utgangspunkt i norske lærebøker i sykepleie, bilder, litteratur og andre dokumenter fra perioden 1877-2013, og intervju og observasjoner med foreldre og sykepleiere ved en barneavdeling i 2007.
Universitetet i Bergen.
ISSN 9788230829004.
Full text in Research Archive
-
Sundal, Hildegunn; Boge, Jeanne Helene & Petersen, Karin Anna
(2014).
Inklusjon og eksklusjon av foreldre i
pleie av barn innlagt på sykehus
Analysene er historiske og nåtidige og har utgangspunkt i norske lærebøker i sykepleie, bilder, litteratur og andre dokumenter fra perioden 1877-2013, og intervju og observasjoner med foreldre og sykepleiere ved en barneavdeling i 2007.
Universitetet i Bergen.
ISSN 9788230829004.
Full text in Research Archive
Show summary
Bakgrunn
Det kan være vanskelig å vite hvordan det har seg at man tenker og handler som man gjør,
men det er sannsynlig at mitt faglige engasjement for barn på sykehus gjennom 20 år, både
som sykepleielærer og ph.d. student, har utspring i min mors fortellinger om hvordan det var å
være innlagt på tuberkulosesanatorium da hun var tenåring på 1940-tallet med foreldrene
V
langt borte, og hennes fortellinger om det å være ekskludert fra sykehuset som mor når mine
to søsken var innlagt ved et mindre sykehus på 1950-tallet. Hennes fortellinger gjorde et
sterkt inntrykk. På 1970-tallet, da jeg startet min sykepleieutdanning ble det gradvis vanlig at
foreldre fikk være sammen med barna sine på sykehus, og slik er det fortsatt. Dette ledet meg
til spørsmålsstillingene:
Hva er det som har gjort det mulig å inkludere foreldre i pleie av barn på sykehus på visse
tidspunkt og ekskludere foreldrene på andre tidspunkt i sykepleien? Når oppstod henholdsvis
eksklusjons- og inklusjonspraksisene og hvordan har de blitt praktisert?
Teoretisk perspektiv
Jeg har ikke funnet studier som kan svare meg på dette spørsmålet, men nordiske Foucaultinspirerte
sykepleiestudier om forholdet mellom praksiser og viten er bakgrunnen for at denne
studien er basert på en antagelse om at viten har vært brukt til å understøtte samfunnsnyttig
eksklusjon og inklusjon av foreldre når barn er på sykehus. Den franske filosofen Michel
Foucault skriver at både objektiverende og subjektiverende viten har blitt brukt til å
understøtte det som har blitt regnet for å være samfunnsnyttig i moderne vestlige demokratier.
Objektiverende viten har blitt brukt til å styre individene utenfra. Denne formen for styring
kaller Foucault disiplinering. Subjektiverende viten har blitt brukt til å få individer til å styre
seg selv og omtales i studiens sammenheng som selvstyring.
Metodologi og materiale
Jeg har brukt en dispositiv tilgang som det overgripende metodologiske analyseverktøyet i
min empiriske forskning om eksklusjon og inklusjon av foreldre i pleien når barn er innlagt på
sykehus. Jeg benytter i hovedsak begrepet dispositivitet fra det som omtales som Foucaults
genealogiske fase (1971-1984). Studiens empiriske objekt har slik blitt belyst ved en
dispositiv tilgang, med tilhørende arkeologiske og genealogiske undersøkelser av de praksiser
som viser seg som foreldres eksklusjon/ inklusjon i pleie når barn er på sykehus.
Analysene har tatt utgangspunkt i norske lærebøker i sykepleie fra perioden 1877-2013. I den
forbindelse har jeg beskrevet hva som har blitt skrevet og ikke skrevet om foreldre i
VI
lærebøkene. På bakgrunn av omtalen av foreldre i lærebøkene har jeg funnet frem til perioder
hvor det virker sannsynlig at foreldre har vært inkludert og ekskludert fra pleien av barn på
sykehus. Deretter har jeg analysert fortidige bilder og noveller og annet relevant materiale, og
nåtidige observasjonsnotater og transkriberte intervju fra en norsk barneavdeling, som kunne
understøtte og utfordre funnene i lærebøkene. Til å undersøke de samfunnsmessige
mulighetsbetingelsene for inklusjons- og eksklusjonspraksisene, har jeg analysert offentlig
tilgjengelige lover, forskrifter og regler, verk i generell historie, barndomshistorie,
sykepleiens historie, helsevesenets historie, sykehus- og hospitalhistoriske bøker og annet
materiale som kan skape forståelse for inklusjons- og eksklusjonspraksisene. Deretter har jeg
drøftet henholdsvis inklusjons- og eksklusjonspraksisene i lys av viten som var i spill i den
aktuelle epoken og som kunne være med på å understøtte praksisene. Disse analysene og
drøftelsene er gjort i lys av Foucaults utlegninger om disiplinering og selvforholdspraksiser.
-
Bakken, Hege; Sundal, Hildegunn & Valla, Astrid
(2000).
"Prosjekt barn". Kommunikasjon med og om barnet - som pasient i sykehus uten egen barneavdeling: en studie av pårørendes opplevelser ved å ha barnet sitt som pasient ved Fylkessykehuset i Molde.
Fylkessykehuset i Molde.
Full text in Research Archive
-
View all works in NVA
Published Sep. 3, 2018 3:03 PM
- Last modified Oct. 13, 2026 12:25 PM
