| 91. |
- Sundin, Karin, et al.
(författare)
-
Communicating with people with stroke and aphasia : understanding through sensation without words.
- 2000
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 9:4, s. 481-488
-
Tidskriftsartikel (refereegranskat)abstract
- To illuminate the phenomena of 'communicating with people with stroke and aphasia without words', 10 care providers particularly successful at communicating with stroke and aphasia patients who were working at a stroke rehabilitation ward narrated their experiences of communicating with such patients. A phenomenological hermeneutic approach, inspired by Ricoeur's philosophy, was used in the analysis. Two main themes were found: facilitating openness and being in wordless communication. The care providers sensed the feelings of the patients and experienced similar feelings themselves, thus, the communication is guided by the shared feelings between the care provider and the patient, i.e. communion. For this 'communication through sensation' to take place, the following factors were found to be necessary: creative closeness in combination with protective distance; striving for satisfaction and against exhaustion and desperation; meeting the patient halfway to gain understanding; exhibiting attention and accessibility to the patient; and trust and confidence for both care providers and patients. The findings were interpreted and discussed in the light of works by Levinas, Lögstrup and Stern.
|
|
| 92. |
- Sundin, Karin, et al.
(författare)
-
The meaning of skilled care providers' relationship with stroke and aphasia patients
- 2001
-
Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 11:3, s. 308-321
-
Tidskriftsartikel (refereegranskat)abstract
- Little is known about the reciprocal influence of communication difficulties on the care relationship. To illuminate care providers' lived experiences of relationships with stroke and aphasia patients, narrative interviews were conducted with providers particularly successful at communicating with patients. A phenomenological hermeneutic analysis of the narratives revealed three themes: Calling forth responsibility through fragility, restoring the patient's dignity, and being in a state of understanding. The analysis disclosed caring with regard to the patient's desire, which has its starting point in intersubjective relationship and interplay, in which nonverbal communication is essential--that is, open participation while meeting the patient as a presence. Thus, care providers prepare for deep fellowship, or communion, by being available. They described an equality with patients, interpreted as fraternity and reciprocity, that is a necessary element in presence as communion. The works of Marcel, Hegel, Stern, and Ricoeur provided the theoretical framework for the interpretation.
|
|
| 93. |
- Sundin, Karin, et al.
(författare)
-
Understanding between care providers and patients with stroke and aphasia : A phenomenological hermeneutic inquiry.
- 2002
-
Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 9:2, s. 93-103
-
Tidskriftsartikel (refereegranskat)abstract
- Understanding between care providers and patients with stroke and aphasia: a phenomenological hermeneutic inquiry The present study illuminates the understanding in communication between formal care providers and patients with stroke and aphasia. Five care providers and three such patients participated in the study. Video recordings were made during conversations about pictures (n = 15), and the care providers were also interviewed (n = 15) after the video-recorded conversations. A phenomenological hermeneutic method of interpretation of the interview text was used. The findings showed that a range of conditions for 'understanding and being understood' in the communication on the part of the care providers exists. These different conditions are: lacking both knowledge and understanding; having knowledge but not necessarily accompanied by understanding; and being in understanding. Within the condition 'being in understanding', the care providers create a feeling of at-homeness in a relaxed atmosphere and thus have the opportunity to be in 'understanding and being understood' together with the patient. The condition 'being in understanding' appears in connection with the care providers' creating of a 'calm liturgy of caring' by mediating humility and calm vitality affects to the patients, and further, when needed, being present on the level of mystery, i.e. caring communion.
|
|
| 94. |
- Söderlund, Mona, et al.
(författare)
-
Nurses’ movements within and between various paths when improving their communication skills : an evaluation of validation method training
- 2013
-
Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 3:2, s. 265-273
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To explore any changes in nurses’ skills at communicating with residents with dementia disease when using the validation method, as observed in one-to-one videotaped conversations.Background: Communication difficulties due to cognitive impairment among residents with dementia disease may complicate care situations. Training can improve nurses’ communication skills and increase care quality. The validation method aims to facilitate communication with residents with dementia disease through empathic and confirmatory approaches. Evaluations of the validation method have primarily focused on the residents’ perspective, and reports on nurses’ experiences are sparse. Improved communication and relationships with residents after validation method training have been described previously. Videotaped data could provide additional information about these earlier results.Design: A descriptive qualitative design.Methods: Eight nurses participated in a year of validation method training, including videotaped conversations with eleven residents. Videotapes with at least five months between the first and last recording were analysed and compared qualitatively.Results: The analysis revealed an overall pattern: nurses’ movements within and between various paths when improving their communication skills. This was based on three sub-patterns: from controlling communication towards developing attentiveness in communication, from ambiguous communication towards developing coherence in communication, and from being open and attentive towards having a refined attuned communication.Conclusions: All nurses developed their communication skills during the programme, albeit to different degrees. The findings are in congruence with the experiences described by nurses, and so it is reasonable to believe that the programme helped to improve the nurses’ skills in communicating with residents with dementia disease.Relevance to clinical practice: A validation method training programme could give nurses the possibility to develop their skills in communicating with residents with dementia disease.
|
|
| 95. |
- Söderlund, Mona, et al.
(författare)
-
Validation method training : nurses' experiences and ratings of work climate
- 2014
-
Ingår i: International Journal of Older People Nursing. - : Wiley-Blackwell. - 1748-3735 .- 1748-3743. ; 9:1, s. 79-89
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Training nursing staff in communication skills can impact on the quality of care for residents with dementia and contributes to nurses' job satisfaction. Changing attitudes and practices takes time and energy and can affect the entire nursing staff, not just the nurses directly involved in a training programme. Therefore, it seems important to study nurses' experiences of a training programme and any influence of the programme on work climate among the entire nursing staff. AIMS AND OBJECTIVES: To explore nurses' experiences of a 1-year validation method training programme conducted in a nursing home for residents with dementia and to describe ratings of work climate before and after the programme. DESIGN: A mixed-methods approach. METHODS: Twelve nurses participated in the training and were interviewed afterwards. These individual interviews were tape-recorded and transcribed, then analysed using qualitative content analysis. The Creative Climate Questionnaire was administered before (n = 53) and after (n = 56) the programme to the entire nursing staff in the participating nursing home wards and analysed with descriptive statistics. RESULTS: Analysis of the interviews resulted in four categories: being under extra strain, sharing experiences, improving confidence in care situations and feeling uncertain about continuing the validation method. The results of the questionnaire on work climate showed higher mean values in the assessment after the programme had ended. CONCLUSION: The training strengthened the participating nurses in caring for residents with dementia, but posed an extra strain on them. These nurses also described an extra strain on the entire nursing staff that was not reflected in the results from the questionnaire. The work climate at the nursing home wards might have made it easier to conduct this extensive training programme. IMPLICATIONS FOR PRACTICE: Training in the validation method could develop nurses' communication skills and improve their handling of complex care situations.
|
|
| 96. |
- Sørbye, Liv W, et al.
(författare)
-
Home care patients in four Nordic capitals : predictors of nursing home admission during one-year followup
- 2010
-
Ingår i: Journal of Multidisciplinary Healthcare. - 1178-2390. ; 3, s. 11-18
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to predict nursing home admission (NHA) for home care patients after a 12-month follow-up study. This Nordic study is derived from the aged in home care (AdHOC) project conducted in 2001–2003 with patients at 11 sites in Europe. The participants in the cohort study were randomly selected individuals, aged 65 years or older, receiving homecare in Oslo, Stockholm, Copenhagen, and Reykjavik. The Resident Assessment Instrument for Home Care (version 2.0) was used. Epidemiological and medical characteristics of patients and service utilization were recorded for 1508 home care patients (participation rate 74%). In this sample 75% were female. The mean age was 82.1 (6.9) years for men and 84.0 (6.6) for women. The most consistent predictor of NHA was receiving skilled nursing procedures at baseline (help with medication and injections, administration or help with oxygen, intravenous, catheter and stoma care, wounds and skin care) (adjusted odds ratio = 3.7, 95% confidence interval: 1.7–7.8; P < 0.001). In this Nordic material, stronger emphasizing on higher qualified nurses in a home care setting could prevent or delay NHA.
|
|
| 97. |
|
|
| 98. |
- Åhlin, Johan, et al.
(författare)
-
Care providers' experiences of guidelines in daily work at a municipal residential care facility for older people
- 2014
-
Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 28:2, s. 355-363
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Guidelines are used as a way of promoting high-quality health care. Most research concerning guidelines has focused on physician behaviour and to improve one specific aspect of care. Care providers working within municipal residential care of older people have described that working with multiple guidelines sometimes exposed them to contradictory demands and trouble their conscience.AIM: To describe care providers' narrated experiences of guidelines in daily work at a municipal residential care facility for older people.DESIGN: A qualitative descriptive design was adopted.METHODS: Interviews with eight care providers were carried out between February and March 2012 and analysed by qualitative content analysis.RESULTS: Care providers described experiences that guidelines are coming from above and are controlling and not sufficiently anchored at their workplace. Furthermore, they described guidelines as stealing time from residents, colliding with each other, lacking practical use and complicating care, and challenging care providers' judgment. The overall understanding is that care providers describe experiences of struggling to do their best, prioritising between arcane guidelines while keeping the residents' needs in the foreground.CONCLUSION: In order to prevent fragmented use, guidelines have to be coordinated and adapted to the reality of daily practice before implementation. It seems essential to provide opportunities for discussions between care providers, registered nurses and management about how to make guidelines work within their daily practice. Sufficient support, knowledge and involvement are likely key issues that can help care providers to constructively work according to guidelines and thus, by extension, improve the quality of care.
|
|
| 99. |
- Åhlin, Johan, et al.
(författare)
-
Longitudinal relationships between stress of conscience and concepts of importance
- 2013
-
Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 20:8, s. 927-942
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this observational longitudinal cohort study was to describe relationships over time between degrees of stress of conscience, perceptions of conscience, burnout scores and assessments of person-centred climate and social support among healthcare personnel working in municipal care of older people. This study was performed among registered nurses and nurse assistants (n = 488). Data were collected on two occasions. Results show that perceiving one's conscience as a burden, having feelings of emotional exhaustion and depersonalization and noticing disturbing conflicts between co-workers were positively associated with stress of conscience. No significant changes were observed during the year under study, but degrees of stress of conscience and burnout scores were higher than in previous studies, suggesting that downsizing and increased workloads can negatively affect healthcare personnel. Following and expressing one's conscience in one's work, and perceiving social support from superiors are of importance in buffering the effects of stress of conscience.
|
|
| 100. |
- Åhlin, Johan, et al.
(författare)
-
Revalidation of the perceptions of conscience questionnaire (PCQ) and the stress of conscience questionnaire (SCQ)
- 2012
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 19:2, s. 220-232
-
Tidskriftsartikel (refereegranskat)abstract
- The Perceptions of Conscience Questionnaire (PCQ) and the Stress of Conscience Questionnaire (SCQ) have previously been developed and validated within the 'Stress of Conscience Study'. The aim was to revalidate these two questionnaires, including two additional, theoretically and empirically significant items, on a sample of healthcare personnel working in direct contact with patients. The sample consisted of 503 healthcare personnel. To test variation and distribution among the answers, descriptive statistics, item analysis and principal component analysis (PCA) were used to examine the underlying factor structure of the questionnaires. Support for adding the new item to the PCQ was found. No support was found for adding the new item to the SCQ. Both questionnaires can be regarded as valid for Swedish settings but can be improved by rephrasing some of the PCQ items and by adding items about private life to the SCQ.
|
|
