| 1. |
- Hedman, Ragnhild, et al.
(author)
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Expressed Sense of Self by People With Alzheimer’s Disease in a Support Group Interpreted in Terms of Agency and Communion
- 2016
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In: Journal of Applied Gerontology. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 35:4, s. 421-443
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Journal article (peer-reviewed)abstract
- The self is constructed in cooperation with other people and social context influences how people perceive and express it. People with Alzheimer’s disease (AD) often receive insufficient support in constructing their preferred selves, but little is known about how they express themselves together with other people with AD. In accordance with Harré’s social constructionist theory of self, this study aimed to describe how five people with mild and moderate AD express their Self 2 (i.e., their personal attributes and life histories) in a support group with a facilitator experienced in communicating with people with AD. The participants’ expressions of their Self 2 were analyzed with qualitative abductive content analysis and interpreted in terms of agency and communion and a lack of agency and communion. The findings highlight the importance of supporting a sense of agency and communion when assisting people with AD in constructing their self.
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| 2. |
- Hedman, Ragnhild, 1962-, et al.
(author)
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How people with Alzheimer's disease express their sense of self : analysis using Rom Harré's theory of selfhood
- 2013
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In: Dementia. - : SAGE Publications. - 1471-3012 .- 1741-2684. ; 12:6, s. 713-733
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Journal article (peer-reviewed)abstract
- The aim of this study was to use Harré's social constructionist theory of selfhood to describe how people with mild and moderate Alzheimer's disease (AD) express their sense of self. The findings show that Self 1, the embodied sense of being a person, was expressed fluently by participants through the use of first-person indexicals. Self 2, the experienced personal attributes and life narrative, had undergone changes. Those changes were not entirely for the worse; participants had also developed new skills in managing life with AD. In a lifetime perspective, those changes were minor and participants perceived themselves to be basically the same people that they were before having AD. When constructing Self 3, the social personae, participants usually described being supported by others, but sometimes described being exposed to malignant positioning. They also feared that they might become more exposed to negative attitudes as their AD progressed. However, participants were understanding towards the offensive behaviours of others.
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| 3. |
- Hedman, Ragnhild, 1962-, et al.
(author)
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Sense of Self in Alzheimer’s Research Participants
- 2018
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In: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 27:2, s. 191-212
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Journal article (peer-reviewed)abstract
- The sense of self is vulnerable in people with Alzheimer's disease (AD), and might be positively and negatively influenced by research participation. The purpose of this study was to describe how people with AD express their experience of being a research participant with respect to their sense of self. Interviews and support group conversations involving 13 people with mild and moderate AD were analyzed using qualitative content analysis. Three themes were constructed: contributing to an important cause, gaining from participating, and experiencing risks and drawbacks. Participants described contributing to research as being in line with their lifelong values and lifestyles. They expressed contentment and pride about being research participants, emphasized their positive relationships with the researchers, and described participation as a meaningful activity. When research procedures threatened their sense of self, they were able to reason about risks and decline participation.
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| 4. |
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| 5. |
- Söderlund, Mona, 1957-, et al.
(author)
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Conversations between persons with dementia disease living in nursing homes and nurses : qualitative evaluation of an intervention with the validation method
- 2016
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 30:1, s. 37-47
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Journal article (peer-reviewed)abstract
- Living with dementia disease (DD) can include difficulties describing experiences of everyday lives, which can lead to withdrawal, social isolation or existential homelessness. Persons with DD living in nursing homes are mainly dependent on the nurses for establishing and maintaining relationships with those around them. It can be challenging for nurses to understand what a person with DD is trying to express and to make themselves understood in turn. The validation method is intended to facilitate communication with persons with DD, but to our knowledge, there have been no qualitative studies of how this influences persons' communication. This study aimed to illuminate the actions and reactions of persons with DD living in nursing homes in one-to-one conversations with nurses during 1 year of validation method training, as observed in videotapes. Four persons with DD were involved in videotaped conversations with four nurses who were participating in a validation method training programme. Videotapes with at least 5 months between the first and last recording were analysed and compared qualitatively. The findings are presented in four categories that were identified to various degrees in conversations at the beginning and at the end of the programme: being uninterested in or unable to answer questions, talking about more than one topic of conversation at the same time, trying to talk about what is on one's mind and speaking more freely about what is on one's mind. In the videotaped conversations at the end of the programme, the persons had the opportunity to use their remaining communication abilities. This may have been related to the development of the nurses' communication skills during the training programme, and so it is possible that persons with DD could benefit from communicating with nurses trained in the validation method.
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| 6. |
- Söderlund, Mona, et al.
(author)
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Implementation of the validation method : nurses’ descriptions of caring relationships with residents with dementia disease
- 2012
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In: Dementia. - London : Sage Publications. - 1471-3012 .- 1741-2684. ; 11:5, s. 569-587
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Journal article (peer-reviewed)abstract
- This study describes nurses’ experiences of relationships with residents with dementia disease (1) before and after validation method (VM) training and (2) after extensive experience using the VM. An intervention was performed in a nursing home, involving supervision plus one year of training in using the VM. Nurses were interviewed before and after the intervention. Nurses with extensive VM experience, working at another nursing home, were interviewed once. Qualitative content analysis of the transcribed interviews revealed four themes with sub-themes. Most nurses participating in the intervention described a changed approach afterwards, focusing more on residents and on their communications, which in turn seemed to lead to closer, more trusting relationships. A similar approach was described by the nurses with extensive VM experience. One conclusion is that supervised VM training facilitated nurses’ development of communication skills and abilities to establish close relationships with residents. Some nurses described the VM as demanding.
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| 7. |
- Söderlund, Mona, et al.
(author)
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Nurses’ movements within and between various paths when improving their communication skills : an evaluation of validation method training
- 2013
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In: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 3:2, s. 265-273
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Journal article (peer-reviewed)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.
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| 8. |
- Söderlund, Mona, et al.
(author)
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Validation method training : nurses' experiences and ratings of work climate
- 2014
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In: International Journal of Older People Nursing. - : Wiley-Blackwell. - 1748-3735 .- 1748-3743. ; 9:1, s. 79-89
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Journal article (peer-reviewed)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.
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