| 281. |
- Henoch, Ingela, 1956, et al.
(författare)
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Development of an existential support training program for healthcare professionals
- 2015
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Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 13:6, s. 1701-1709
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Our aim was to describe the developmental process of a training program for nurses to communicate existential issues with severely ill patients.METHOD: The Medical Research Council (MRC) framework for the development and evaluation of complex interventions was used to develop a training program for nurses to communicate about existential issues with their patients. The steps in the framework were employed to describe the development of the training intervention, and the development, feasibility and piloting, evaluation, and implementation phases. The development and feasibility phases are described in the Methods section. The evaluation and implementation phases are described in the Results section.RESULTS: In the evaluation phase, the effectiveness of the intervention was shown as nurses' confidence in communication increased after training. The understanding of the change process was considered to be that the nurses could describe their way of communicating in terms of prerequisites, process, and content. Some efforts have been made to implement the training intervention, but these require further elaboration.SIGNIFICANCE OF RESULTS: Existential and spiritual issues are very important to severely ill patients, and healthcare professionals need to be attentive to such questions. It is important that professionals be properly prepared when patients need this communication. An evidence-based training intervention could provide such preparation. Healthcare staff were able to identify situations where existential issues were apparent, and they reported that their confidence in communication about existential issues increased after attending a short-term training program that included reflection. In order to design a program that should be permanently implemented, more knowledge is needed of patients' perceptions of the quality of the healthcare staff's existential support.
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| 282. |
- Henoch, Ingela, 1956, et al.
(författare)
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Patients’, family members’ and healthcare staffs’ opinions about existential issues as a base for an educational intervention
- 2011
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Ingår i: BMJ Supportive & Palliative Care. - : BMJ. - 2045-4368 .- 2045-435X. ; 1:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective To explore patients', family members' and healthcare staff's opinions about existential issues important to patients with cancer and their relatives. Methods Two integrative literature reviews were conducted about existential issues among cancer patients and relatives, and interventions to meet these issues. Four focus groups were conducted with healthcare staff working with cancer patients at different stages about patients' existential issues, and staff's responsibility when existential issues are raised. Results In the patient review, existential issues were divided into two themes: struggle to maintain self-identity and threats to self-identity. Relatives' existential issues concerned living both in and beyond the presence of death, with reminders of death, compelling them to respond to life close to death and seek support. Few interventions directed to patients or relatives applicable to everyday healthcare practice were found. Focus groups with staff revealed four categories of patients' existential issues, life and death, meaning, freedom of choice, relationships and solitude. According to staff, their responsibility concerned achieving an encounter with the patient. Conclusion Results from three studies are congruent in that, patients, relatives and staff agree, although in different ways, about the importance of existential issues to patients and relatives. Healthcare staff was aware of the importance of existential issues and are to some extent confident about how to act when these issues are raised by the patients. Ongoing studies The project group now continues implementing findings from these studies in an educational intervention to healthcare staff in different settings, and planning interventions to patients and relatives.
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| 283. |
- Henoch, Ingela, 1956, et al.
(författare)
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The Swedish Version of the Frommelt Attitude Toward Care of the Dying Scale : Aspects of Validity and Factors Influencing Nurses' and Nursing Students' Attitudes.
- 2014
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Ingår i: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 37:1, s. E1-E11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language. OBJECTIVES:: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients. METHODS:: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used. RESULTS:: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients. CONCLUSIONS:: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients. IMPLICATION FOR PRACTICE:: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.
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| 284. |
- Henoch, Ingela, 1956, et al.
(författare)
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Training Intervention for Health Care Staff in the Provision of Existential Support to Patients With Cancer : A Randomized, Controlled Study
- 2013
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Ingår i: Journal of Pain and Symptom Management. - : Elsevier. - 0885-3924 .- 1873-6513. ; 46:6, s. 785-794
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Tidskriftsartikel (refereegranskat)abstract
- Context: When a patient receives a cancer diagnosis, existential issues become more compelling. Throughout the illness trajectory, patients with cancer are cared for in oncology wards, by home care teams or in hospices. Nurses working with these patients are sometimes aware of the patients' existential needs but do not feel confident when discussing these issues.Objectives: To determine the effects of a training intervention, where the focus is on existential issues and nurses' perceived confidence in communication and their attitude toward caring for dying patients.Methods: This was a randomized, controlled trial with a training intervention comprising theoretical training in existential issues combined with individual and group reflection. In total, 102 nurses in oncology and hospice wards and in palliative home care teams were randomized to a training or non-training group. Primary outcomes, confidence in communication, and attitude toward the care of dying patients were measured at baseline, immediately after the training, and five to six months later.Results: Confidence in communication improved significantly in the training group from baseline (before the training) to both the first and second follow-up, that is, immediately after the training and five months later. The attitude toward caring for the dying did not improve in the training group.Conclusion: This study shows that short-term training with reflection improves the confidence of health care staff when communicating, which is important for health care managers with limited resources. Further studies are needed to explore how patients experience the communication skills of health care staff after such training.
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| 285. |
- Henoch, Ingela, 1956, et al.
(författare)
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Undergraduate nursing students' attitudes and preparedness toward caring for dying persons – A longitudinal study
- 2017
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Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 26, s. 12-20
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Tidskriftsartikel (refereegranskat)abstract
- Nursing education needs to prepare students for care of dying patients. The aim of this study was to describe the development of nursing students' attitudes toward caring for dying patients and their perceived preparedness to perform end-of-life care. A longitudinal study was performed with 117 nursing students at six universities in Sweden. The students completed the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) questionnaire at the beginning of first and second year, and at the end of third year of education. After education, the students completed questions about how prepared they felt by to perform end-of-life care. The total FATCOD increased from 126 to 132 during education. Five weeks' theoretical palliative care education significantly predicted positive changes in attitudes toward caring for dying patients. Students with five weeks' theoretical palliative care training felt more prepared and supported by the education to care for a dying patient than students with shorter education. A minority felt prepared to take care of a dead body or meet relatives. © 2017 Elsevier Ltd
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| 286. |
- Hense, Sabrina, et al.
(författare)
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Sleep duration and overweight in European children: is the association modified by geographic region?
- 2011
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Ingår i: AMER ACAD SLEEP MEDICINE. - : AMER ACAD SLEEP MEDICINE. - 0161-8105 .- 1550-9109. ; 34:7, s. 885-890
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Tidskriftsartikel (refereegranskat)abstract
- To investigate differences and a possible effect modification by geographical region in the association between sleep duration and overweight. Cross-sectional. Primary schools and preschools in 8 European countries. 7867 children aged 2 to 9 years. Not applicable. Nocturnal sleep duration was assessed as part of a parental 24-h recall. Height and weight were measured by standardized procedures across centers. Data on personal, social, environmental and behavioral factors were collected using a standardized parental questionnaire. Sleep duration differed (P < 0.001) between European regions and normal vs. overweight children. A dose-dependent inverse association between sleep duration and overweight could be seen, with crude odds ratios ranging from 1.73 (99% CI 1.33; 2.25) for sleeping between 10 and 11 h to 3.81 (99% CI 2.85; 5.09) for sleeping less than 9 h (reference category > 11 h). This persisted after adjustment, but remained significant only for sleeping less than 9 h per night (north: OR = 1.70; 99% CI 1.13; 2.58 vs. south: OR = 2.84; 99% CI 1.57; 5.12) if stratified by region. No effect modification by region could be found, but adjustment for region accounted for changes in the effect estimate for sleeping less than 9 h (OR = 2.22; 99% CI 1.64; 3.02). The association was stronger in school children than in preschool children. Geographic region and related aspects-even if they do not seem to modify the association between sleep and overweight-should in any case be taken in consideration as a confounding factor on this association.
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| 287. |
- Hermansson, Evelyn, 1940, et al.
(författare)
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Empowerment in the midwifery context - a concept analysis
- 2011
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 27:6, s. 811-816
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Tidskriftsartikel (refereegranskat)abstract
- Objective: the concept empowerment is difficult to understand, define and translate into different contexts. Therefore, the purpose of this paper was to analyze the empowerment concept in the midwifery context, focused on the childbearing period, aimed at clarifying its meaning in order to enable comprehension and use in clinical practice, education and research. Design: semi structured interviews and written text. Setting: prenatal clinics, delivery and maternity wards in western Sweden. Participants: nine midwives and 12 couples. Measurements and findings: a concept analysis was undertaken according to the hybrid model which consists of the theoretical, fieldwork and analytical phases. After a literature review, the concept was empirically elucidated in the fieldwork phase. The final step was to describe criteria and attributes, illustrative cases, antecedents and consequences of the concept. The following tentative criteria and attributes of empowerment in the midwifery context are described: developing a trustful relationship; starting an awareness process, making it possible to reflect on the changing situation; acting based on the parents' situation on their own terms, getting them involved and able to make informed choices; confirming the personal significance of becoming parents. Finally, empowerment in the midwifery context was redefined. Key conclusion: midwives use empowerment in education and research as well as strategies on both the micro and macro levels in practice. Implications for practice: empirical findings from the concept analysis confirm the concept's relevance in the midwifery context.
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| 288. |
- Hermansson, Evelyn, 1940, et al.
(författare)
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The evolution of midwifery education at the master´s level: A study of Swedish midwifery education programmes after the implementation of the Bologna process
- 2013
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Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 33:8
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Tidskriftsartikel (refereegranskat)abstract
- In Europe,midwifery education has undergone a number of reforms in the past fewdecades. In several countries, it has shifted from vocational training to academic education. The higher education reform, known as the “Bologna process” aimed to create convergence in higher education among a number of European countries and enhance opportunities for mobility, employment and collaborative research. It also indicated a transparent and easily compared system of academic degrees, generating a new educational system in three cycles. This study explores the implementation of the process in Swedenwhen themidwifery educationwas transferred from diploma to postgraduate ormaster's level. The aimof this study was to analyse how the implementation of the Bologna process in the Swedish higher education system has impacted midwifery education programmes in the country. Descriptive statistics and content analysis were employed to analyse 32 questionnaire responses from teachers and the 2009–2010 curricula and syllabi of 11 postgraduate midwifery education programmes at Swedish universities and university colleges. The results revealed variations among the universities at the major subject into the three disciplines; midwifery, nursing and caring with different conceptualisations, even when the content was identical in the curricula to that of the midwifery professional knowledge base. Implementation of the new reform not only has accelerated the academisation process, but also puts higher demand on the students and requires higher competencies among teachers to involve more evidence-based knowledge, seminars, independent studies and a postgraduate degree project in the major subject. Thus the students earn not only a diploma in midwifery, but also a master's degree in the major subject, which affords the opportunity for an academic career. But still there is a tension between professional and academic education. ©
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| 289. |
- Herrmann, D., et al.
(författare)
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Repeatability of maternal report on prenatal, perinatal and early postnatal factors : findings from the IDEFICS parental questionnaire
- 2011
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Ingår i: International Journal of Obesity. - : Nature Publishing Group. - 0307-0565 .- 1476-5497. ; 35, s. S52-S60
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the repeatability of maternal self-reported prenatal, perinatal and early postnatal factors within the IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) study. Design: Data are from the baseline survey of the longitudinal cohort study IDEFICS in eight European countries. Subjects: A total of 420 parents from eight countries (43-61 per country) were asked to complete the parental questionnaire (PQ) twice at least 1 month apart. Measurements: The PQ assesses prenatal (maternal weight gain), perinatal (child's birth weight and length, Caesarean (C)-section, week of delivery) and early postnatal factors (exclusive breastfeeding, breastfeeding, introduction of solid food). Intra-class correlation coefficients (ICCs) were calculated to compare maternal reports on prenatal, perinatal and early postnatal factors between the first and second PQ. Results: In total, 249 data sets were considered for the analyses. Overall, maternal reports for prenatal and perinatal factors showed higher repeatability (ICC = 0.81-1.00, P <= 0.05 for all) than those for early infant nutrition (ICC = 0.33-0.88, P <= 0.05 for all). Perfect agreement was found for parental reports on C-section (ICCall = 1.00, P <= 0.05). There was stronger agreement for duration of breastfeeding (ICC = 0.71, P <= 0.05) compared with exclusive breastfeeding (ICC = 0.33, P <= 0.05). Maternal reports showed moderate correlation for the introduction of several types of food (cereals ICC = 0.64, P <= 0.05; fruits ICC = 0.70, P <= 0.05; meat ICC = 0.83, P <= 0.05; vegetables ICC = 0.75, P <= 0.05), and high correlation (ICC = 0.88, P <= 0.05) for cow's milk. Conclusion: Maternal reports on pregnancy and birth were highly reproducible, but parental recall of early infant nutrition was weaker and should be interpreted more cautiously. International Journal of Obesity (2011) 35, S52-S60; doi:10.1038/ijo.2011.35
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| 290. |
- Hertting, Anna, et al.
(författare)
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Assistant nurses in the Swedish healthcare sector during the 1990s: a hard-hit occupational group with a tough job.
- 2005
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 33:2, s. 107-13
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The aim of the study was to explore hospital-based assistant nurses' experiences of psychosocial "stressors", following a period of substantial layoffs (43%) and ongoing healthcare reorganizations. METHODS: An interview study was carried out with 11 assistant nurses working in the same hospital. The interviews took place in 1997, in connection with the last round of redundancies, and were followed up in 1998 and then in 2001. Interviews were audiotaped and transcribed; the content was then analysed. RESULTS: Two main themes were identified from the women's perceived stressors: (a) a hard-hit occupational group experiencing "energy-consuming adjustments", and a "weak position" at the continuing workplace. Job insecurity meant fear of losing valued work tasks in nursing care (de-skilling). The common feature was the duality in the women's descriptions of feeling qualified in nursing care but being treated like a maid, or having intimate practical knowledge but no formal competence; (b) a tougher but underpaid job including "heavy workload" concurrent with "organizational shortcomings", and "frozen salary trends" with a simultaneous feeling of lacking the power to improve their situation. CONCLUSIONS: Our results underscore the importance of the employer's attention to the remaining workers in connection with downsizing, particularly when the reduction of the workforce has been as dramatic as in this case. It is also important to understand the ongoing dilemma (strain) for the assistant nurses, who are faced with increasing demands for further formal qualifications in hospital care, while maintaining a strong occupational desire to keep their highly valued job working close to the patient.
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