| 11. |
- Gransjön Craftman, Åsa, et al.
(författare)
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Caring for older people with dementia reliving past trauma
- 2020
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 27:2, s. 621-633
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Tidskriftsartikel (refereegranskat)abstract
- Background: The occurrence of behavioural changes and problems, and degree of paranoid thoughts, are significantly higher among people who have experienced extreme trauma such as during the Holocaust. People with dementia and traumatic past experiences may have flashbacks reminding them of these experiences, which is of relevance in caring situations. In nursing homes for people with dementia, nursing assistants are often the group of staff who provide help with personal needs. They have firsthand experience of care and managing the devastating outcomes of inadequate understanding of a person's past experiences.Aim: The aim was to describe nursing assistants' experiences of caring for older people with dementia who have experienced Holocaust trauma.Research design: A qualitative descriptive and inductive approach was used, including qualitative interviews and content analysis.Participants and research context: Nine nursing assistants from a Jewish nursing home were interviewed. Ethical considerations: The study was approved by the Regional Ethical Review Board, Stockholm.Findings: The theme 'Adapting and following the survivors' expression of their situation' was built on two categories: Knowing the life story enables adjustments in the care and Need for flexibility in managing emotional expressions.Discussion and conclusion: The world still witnesses genocidal violence and such traumatic experiences will therefore be reflected in different ways when caring for survivors with dementia in the future. Person-centred care and an awareness of the meaning of being a survivor of severe trauma make it possible to avoid negative triggers, and confirm emotions and comfort people during negative flashbacks in caring situations and environments. Nursing assistants' patience and empathy were supported by a wider understanding of the behaviour of people with dementia who have survived trauma.
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| 12. |
- Gustafsson, Christine, 1967-, et al.
(författare)
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Municipal Night Nurses’ Experience of the Meaning of Caring
- 2009
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 16:5, s. 599-612
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to elucidate municipal night registered nurses’ (RNs) experiences of the meaning of caring in nursing. The research context involved all night duty RNs working in municipal care of older people in a medium-sized municipality located in central Sweden. The meaning of caring in nursing was experienced as: caring for by advocacy, superior responsibility in caring, and consultative nursing service. The municipal night RNs’ experience of caring is interpreted as meanings in paradoxes: ‘being close at distance’, the condition of ‘being responsible with insignificant control’, and ‘being interdependently independent’. The RNs’ experience of the meaning of caring involves focusing on the care recipient by advocating their perspectives. The meaning of caring in this context is an endeavour to grasp an overall caring responsibility by responding tovocational and personal demands regarding the issue of being a RN, in guaranteeing ethical, qualitative and competent care for older people.
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| 13. |
- Gustafsson, Gabriella, et al.
(författare)
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Burnout and perceptions of conscience among health care personnel : a pilot study.
- 2010
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 17:1, s. 23-38
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Tidskriftsartikel (refereegranskat)abstract
- Although organizational and situational factors have been found to predict burnout, not everyone employed at the same workplace develops it, suggesting that becoming burnt out is a complex, multifaceted phenomenon. The aim of this study was to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among two groups of health care personnel from the same workplaces, one group on sick leave owing to medically assessed burnout (n = 20) and one group who showed no indications of burnout (n = 20). The results showed that higher levels of stress of conscience, a perception of conscience as a burden, having to deaden one's conscience in order to keep working in health care and perceiving a lack of support characterized the burnout group. Lower levels of stress of conscience, looking on life with forbearance, a perception of conscience as an asset and perceiving support from organizations and those around them (social support) characterized the non-burnout group.
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| 14. |
- Heijkenskjold, Katarina Bredenhof, et al.
(författare)
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The patient's dignity from the nurse's perspective
- 2010
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 17:3, s. 313-324
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to understand how nurses experience patients' dignity in Swedish medical wards. A hermeneutic approach and Flanagan's critical incident technique were used for data collection. Twelve nurses took part in the study. The data were analysed using hermeneutic text interpretation. The findings show that the nurses who wanted to preserve patients' dignity by seeing them as fellow beings protected the patients by stopping other nurses from performing unethical acts. They regard patients as fellow human beings, friends, and unique persons with their own history, and have the courage to see when patients' dignity is violated, although this is something they do not wish to see because it makes them feel bad. Nurses do not have the right to deny patients their dignity or value as human beings. The new understanding arrived at by the hermeneutic interpretation is that care in professional nursing must be focused on taking responsibility for and protecting patients' dignity.
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| 15. |
- Hellström, Ingrid, et al.
(författare)
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Ethical and methodological issues in interviewing persons with dementia
- 2007
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 14:5, s. 608-619
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Tidskriftsartikel (refereegranskat)abstract
- People with dementia have previously not been active participants in research, with ethical difficulties often being cited as the reason for this. A wider inclusion of people with dementia in research raises several ethical and methodological challenges. This article adds to the emerging debate by reflecting on the ethical and methodological issues raised during an interview study involving people with dementia and their spouses. The study sought to explore the impact of living with dementia. We argue that there is support for the inclusion of people with dementia in research and that the benefits of participation usually far outweigh the risks, particularly when a ;safe context' has been created. The role of gatekeepers as potentially responsible for excluding people with dementia needs further consideration, with particular reference to the appropriateness of viewing consent as a primarily cognitive, universalistic and exclusionary event as opposed to a more particularistic, inclusive and context relevant process.
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| 16. |
- Holmberg, Bodil, et al.
(författare)
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Elements of assisted bodily care : Ethical aspects
- 2020
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 27:6, s. 1377-1395
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many frail older persons who die in Swedish nursing homes need assisted bodily care. They must surrender their bodies to the authority of assistant nurses, which may affect their autonomy, and dignity of identity. While assistant nurses claim to support older persons’ wishes, older persons claim having exposedness to assistant nurses’ routines. The provider-receiverin congruence revealed here warrants investigation.Aim: To describe the elements of assisted bodily care, as performed in a nursing home.Research design: Data were collected through thirty-nine observations of assisted bodily care, analyzed with qualitative content analysis.Participants and research context: Seventeen older persons and twenty-two assistant nurses from a Swedish nursing home.Ethical considerations: The research was conducted in line with the Declaration of Helsinki,further approved by the regional ethics committee.Findings: Findings show, that assisted bodily care consists of assistant nurses’ practical work, performed at a high tempo. Still, assistant nurses attempt to adapt this work to older persons’wishes for self-determination, taking into account their day-to-day state of health. In spite of time pressure and occasional interruptions, there is room for consideration and affection in assisted bodily care.Discussion: Assistant nurses try to promote older persons’ dignity of identity, but sometimes fail, possibly due to lack of time. On the contrary, they seem to know older persons well enough to adapt assisted bodily care according to their preferences and support self-determination. This indicates that openness to older persons’ life-worlds may be more important than the amount of time available.Conclusions: Nursing home contexts might benefit from adopting a person-centered palliative care perspective, highlighting the value of relationships and shared decision-making. If so, older persons and assisted nurses could prepare agreement on practices and goals in assisted bodily care beforehand. Such routines may be time-saving and beneficial to all.
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| 17. |
- Holmberg, Bodil, et al.
(författare)
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End-of-life care in a nursing home : Assistant nurses' perspectives
- 2019
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 26:6, s. 1721-1733
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Worldwide, older persons lack access to palliative care. In Sweden, many older persons die in nursing homes where care is provided foremost by assistant nurses. Due to a lack of beds, admission is seldom granted until the older persons have complex care needs and are already in a palliative phase when they move in.OBJECTIVE: To describe assistant nurses' perspectives of providing care to older persons at the end of life in a nursing home.RESEARCH DESIGN: Data were collected in semi-structured individual interviews and analyzed with inductive qualitative content analysis. Participants and research context: Seven assistant nurses from a nursing home in Sweden were randomly selected. Ethical consideration: The research was approved by the local ethics committee.RESULTS: Three main categories emerged; "Death a natural part of life"; "The older person's well-being"; and "Care in the moment of death"; and seven sub-categories. The assistant nurses described themselves as knowing the older persons well enough to provide good end-of-life care. This was achieved by making small-talk while providing daily care. Relying on experience-based knowledge, they strove to provide end-of-life care built upon respect and engagement with the ambition to strengthen older persons' dignity, for example, by lowering the tempo of care at the end of life, in spite of organizational restrictions.DISCUSSION: The assistant nurses offered attentive end-of-life care, focusing upon bodily care. The existential needs of the older persons were not foregrounded.CONCLUSION: To develop their work, and to promote an ethical foundation for such care, assistant nurses might need support and education to be able to offer a care more in line with the aims of palliative care. Furthermore, the organization of care needs to promote, not impede, the realization of this development.
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| 18. |
- Högberg, T., et al.
(författare)
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To be a nurse or a neigbour? : A moral concern for psychiatric nurses living next door to individuals with a mental illness
- 2005
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 12:5, s. 468-478
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Tidskriftsartikel (refereegranskat)abstract
- Several studies reveal that positive attitudes towards individuals with a mental illness are correlated with knowledge about mental illness. The aim of this study was to explore and describe psychiatric nurses’ experiences of living next to people with mental health problems. In addition, it sought to identify and describe how they handle situations arising in a neighbourhood where people with a mental illness live. Two men and seven women participated in the study. The constant comparative method of grounded theory was used for data collection and analysis. The process of ‘behaving as a nurse or not’ was identified as a core category. Four subcategories were identified: ‘receiving involuntary information’, ‘to take action or not’, ‘behaving as a mediator in the neighbourhood’ and ‘the freedom of choice’. The findings show that psychiatric nurses with professional knowledge about mental illness have moral concerns about their role as nurses during their leisure time. In conclusion, it is not obvious that psychiatric nurses want to live in the same neighbourhood as persons with a mental illness. However, this study shows that their knowledge about mental illness creates for them a moral dilemma consisting of a conflict between whether to care for these mentally ill persons or to preserve their own leisure time.
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| 19. |
- Juthberg, Christina, et al.
(författare)
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Perceptions of conscience in relation to stress of conscience
- 2007
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 14:3, s. 329-343
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Tidskriftsartikel (refereegranskat)abstract
- Every day situations arising in health care contain ethical issues influencing care providers' conscience. How and to what extent conscience is influenced may differ according to how conscience is perceived. This study aimed to explore the relationship between perceptions of conscience and stress of conscience among care providers working in municipal housing for elderly people. A total of 166 care providers were approached, of which 146 (50 registered nurses and 96 nurses' aides/enrolled nurses) completed a questionnaire containing the Perceptions of Conscience Questionnaire and the Stress of Conscience Questionnaire. A multivariate canonical correlation analysis was conducted. The first two functions emerging from the analysis themselves explained a noteworthy amount of the shared variance (25.6% and 17.8%). These two dimensions of the relationship were interpreted either as having to deaden one's conscience relating to external demands in order to be able to collaborate with coworkers, or as having to deaden one's conscience relating to internal demands in order to uphold one's identity as a `good' health care professional.
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| 20. |
- Lindahl, Elisabeth, et al.
(författare)
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Nurses' ethical reflections on caring for people with malodorous exuding ulcers.
- 2010
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 17:6, s. 777-790
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate nurses' reflections on obstacles to and possibilities for providing care as desired by people with malodorous exuding ulcers. Six nurses who took part in a previous study were interviewed. The participants were shown an illustration with findings from a study that elucidated the meaning of living with malodorous exuding ulcers. They were asked to reflect on the obstacles to and possibilities of providing the care desired by the patients. Twelve audio-recorded transcribed interviews were analysed using qualitative content analysis. Our interpretations of participants' reflections on the obstacles and possibilities while caring for such patients revealed one theme: striving to 'do good' and 'be good'. The obstacles were formulated as subthemes: experiencing clinical competence constraints, experiencing organizational constraints, experiencing ineffective communication, fearing failure, and experiencing powerlessness. The possibilities were formulated by the subthemes: spreading knowledge about ulcer treatments, considering wholeness, and creating clear channels of communication. A multiprofessional team could overcome the identified obstacles and provide structure, competencies, commitment and support to 'do good' for patients and 'be good' nurses.
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