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| 2. |
- Carlsson, Eva, et al.
(författare)
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Multidisciplinary recording and continuity of care for stroke patients with eating difficulties
- 2010
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Ingår i: Journal of Interprofessional Care. - New York, USA : Informa Healthcare. - 1356-1820 .- 1469-9567. ; 24:3, s. 298-310
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Tidskriftsartikel (refereegranskat)abstract
- Eating difficulties after stroke are common and can, in addition to being a risk for serious medical complications, impair functional capability, social life and self-image. Stroke unit care entails systematic multidisciplinary teamwork and continuity of care. The purpose of this study was to describe (i) multidisciplinary stroke care as represented in patient records for patients with eating difficulties, and (ii) the written information that was transferred from hospital to elderly care. Data from 59 patient records were analysed with descriptive statistics and by categorization of phrases. Signs of multidisciplinary collaboration to manage eating problems were scarce in the records. While two notes from physiotherapists were found, nurses contributed with 78% of all notes (n = 358). Screening of swallowing and body weight was documented for most patients, whereas data on nutritional status and eating were largely lacking. The majority of notes represented patients' handling of food in the mouth, swallowing and lack of energy. Care plans were unstructured and few contained steps for managing eating. Discharge summaries held poor information on care related to eating difficulties. The language of all professionals was mostly unspecific. However, notes from speech-language therapists were comprehensive and entailed information on follow-up and patient participation
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| 3. |
- Ek, Kristina
(författare)
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Att leva med mycket svår kronisk obstruktiv lungsjukdom : ett liv i slowmotion
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to describe how people with very severe obstructive pulmonary disease (COPD) experienced their every day lives and created meaning, with focus on end-of-life. A second aim was to describe how death and dying can be viewed from the perspective of relatives to people with COPD. In study I, eight patients were interviewed about how COPD affected their everyday lives. A phenomenological method was used. In study II, four people with COPD who lived alone were interviewed over time, to illuminate how the illness influenced their everyday life and their existential thoughts about life and death. In study III, four couples of whom one partner in each couple had COPD were interviewed several times to illuminate the affect the illness had on the spousal relationship, their self-expressed needs, and their existential thoughts, from the perspective of two people living together. A phenomenological-hermeneutic method was used for the analyses in studies IIand III. Study IV aimed at studying patients’ last six months of life with focuson dying and death, and in this study content analysis was used.The studies (I-IV) revealed that suffering from very severe COPD can be a daily struggle to survive as well as to maintain the self-image. The studies also explicate experiences of a shrinking life space, and questions of meaning were being challenged (I). Study II showed that living alone provided feelings of independency. However the bodily losses reminded the patients’ about death and raised fears about death of being painful, as they did not want to face death alone. For the couples in study III living with COPD meant living in a changed pace with uncertainty, changed intimate relationship and finding new ways of living together. Study IV outlined the trajectory of illness to be irregular and characterized by periods of sudden deterioration, making it difficult to plan for the future. Death was experienced as an unexpected experience and was described by all as peaceful. The results in this thesis have outlined important insight into the existential challenges of living with COPD as experienced by the ill persons themselves and their next of relatives.
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| 4. |
- Fröding, Karin, 1974-
(författare)
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Public health, neighbourhood development and participation : research and practice in four Swedish partnership cities
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Det finns betydande skillnader i hälsa beroende på utbildning, socioekonomisk status, etnicitet, ålder och kön och det har konsekvenser för människors livslängd, livskvalitet och hälsa. Ojämlikheter i hälsa blir särskilt tydliga när man jämför olika geografiska områden, där vissa områden har hög koncentration av fattiga och socialt utslagna människor med dålig hälsa, arbetslöshet och låg utbildning. Att vidta åtgärder mot de utbredda hälsoskillnader som finns mellan människor med vitt skilda förutsättningar är en viktig utmaning för hälsofrämjande arbete. En strategi för att minska skillnader i hälsa mellan människor är att arbeta med områdesutveckling i prioriterade bostadsområden. Ett svenskt samarbete, Partnerskap för Hållbar Välfärdsutveckling, bildades 2003 mellan Helsingborg, Norrköping, Västerås och Örebro, kommunala bostadsbolag i dessa städer, flera nationella parter samt forskare vid Örebro universitet. Det centrala i partnerskapet var att genom erfarenhetsutbyte, metodutveckling och kunskapsspridning arbeta för en hållbar välfärdsutveckling i prioriterade bostadsområden (ett område från varje stad valdes ut). Integrerat i detta arbete var forskningsprogrammet ”Den hälsosamma staden - social integration, nätverkspolitik och hållbar välfärdsutveckling”, som följt partnerskapet vetenskapligt mellan åren 2003 och 2010. Det är av stor betydelse att integrera politik, praxis och forskning för att få kunskap om förutsättningar för en hälsosam utveckling i utsatta bostadsområden. Detta är en unik del av det nästan sjuåriga partnerskapsarbetet. Avhandlingens övergripande syfte har varit att inom ramen för Partnerskap för Hållbar Välfärdsutveckling studera folkhälsostrategier och lokalt utvecklingsarbete i kommuner och bostadsområden med särskild betoning på boendes deltagande för en hälsosam utveckling. Avhandlingens första studie syftar till att beskriva och analysera strategiskt folkhälsoarbete och lokalt områdesutvecklingsarbetet i fyra svenska kommuner samt den tidiga implementeringsfasen av Partnerskap för Hållbar Välfärdsutveckling. Datamaterialet består av dokumenterade intervjuer med folkhälsosamordnare och områdesutvecklare, deltagande observationer och skriftliga dokument. Resultatet visar att det redan i början av partnerskapsperioden fanns formella strukturer för folkhälsoarbetet i kommunen, till exempel ett folkhälsopolitiskt program, en utsedd samordnare, ett kontor och administrativa resurser samt politiker med särskilt ansvar för folkhälsofrågor. I uppbyggandet av de formella strukturerna var också de svenska nationella folkhälsomålen ett viktigt underlag. Vad gäller det lokala bostadsområdes arbete kan det ta sig olika uttryck även om målet är det samma. I partnerskapet fanns också tidigt höga förväntningar KARIN FRÖDING Public Health, Neighbourhood Development, and Participation I 83 att det skulle fungera som en sammanhållande kraft för ömsesidigt lärande och en positiv utveckling av prioriterade bostadsområden. Avhandlingens andra studie syftar till att analysera vad som karaktäriserar människor som deltar i områdesutveckling. Boende från tre av partnerskapskommunerna svarade på en enkät och resultatet visade på att människor som försökt påverka politiken i kommunen på olika sätt i större utsträckning deltar i områdesutveckling. Denna påverkan kan ske genom att kontakta en politiker eller lämna in ett medborgarförslag. Högt engagemang och aktivt deltagande var oberoende av individens sociodemografiska faktorer såsom utbildning eller inkomstnivå. Det var endast personer födda utanför Norden som i mindre utsträckning deltog i områdesutveckling. Avhandlingens tredje studie syftar till att undersöka en områdesbaserad interaktion mellan professionella (anställda), boende och forskare i en av partnerskapets utvalda stadsdelar. Baserat på deltagande observation under två år visar studien ett entydigt resultat: för att processen skall fungera krävdes att deltagarna öppet diskuterade enskilda situationer, personliga åtaganden och ömsesidiga förväntningar. Vidare var det viktigt att demaskera makt och auktoritet bland dem som deltar i processen för att inte några skulle ha mer inflytande på arbetet än de andra. Tiden visade sig vara viktig, att processen fick ta den tid det tog med konsensus som ett ledord. Slutligen var det viktigt att acceptera olika nivåer av deltagande. Allt detta bidrar till att skapa en gemensam känsla av engagemang och demokratisk dialog som är så viktigt i ett interaktivt samarbete. I avhandlingens fjärde studie är syftet att studera utvecklingsprocesser för att nå hållbara strukturer för lokalt områdesutvecklingsarbete i de fyra partnerskapsstäderna. Arbetet i Partnerskap för Hållbar Välfärdsutveckling har liksom kommunerna och det lokal områdesarbetet följts mellan åren 2003-2009. Genom en serie studier inom forskningsprogrammet med intervjuer, enkäter, deltagande observation och dokumentanalys har det utformats en databas för fallstudier. Resultatet visar att det under partnerskapsperioden fanns byggstenar i form av politiskt stöd, lokala partnerskap och boendes deltagande i områdesarbetet. När Partnerskap för Hållbar Välfärdsutveckling upphörde fanns dock få hållbara strukturer för områdesutveckling kvar. Det politiska stödet för områdesutveckling var under partnerskapstiden konstant högt men cykliskt, vilket innebar att prioriteringar ändrades. I samtliga fyra studerade stadsdelar hade områdesarbetet delvis avstannat och politiskt stöd och resurser lagts på andra områden i respektive kommun. I ett lokalt partnerskapssamarbete mellan kommun och kommunalt bostadsbolag finns dock möjlighet att bilda hållbara strukturer när såväl det strategiska som det lokala involveras i den praktiska delen av områdesutveckling. Medborgarnas deltagande verkar också utgöra en viss hållbar struktur för områdesutveckling, trots minskat politiskt stöd och resurser. Sammanfattningsvis visar denna avhandling att ett partnerskap för lokalt folkhälsoarbete kan fungera som en sammanhållande länk för lärande och utveckling bland alla inblandade aktörer. För ett fungerande områdesutvecklingsarbete är den lokala kontexten av största vikt liksom formella strukturer och ett nationellt stöd. Det är dessutom nödvändigt att beakta alla boende som potentiella deltagare i områdesutveckling oberoende av utbildning, kön eller inkomstnivå. När ett projektbaserat partnerskap avslutas måste det dessutom finnas strukturer som kan ta vid efter projekttidens slut. Avslutningsvis visar avhandlingen att ett områdesbaserat samspel med deltagande av professionella, boende och forskare ställer krav på en öppen, jämbördig dialog med ett accepterande förhållningssätt till olika nivåer av deltagande samt stort tidsutrymme.
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| 5. |
- Håkanson, Cecilia, et al.
(författare)
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Being in the Patient Position : Experiences of Health Care Among People With Irritable Bowel Syndrome
- 2010
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Ingår i: Qualitative Health Research. - Thousand Oaks, USA : Sage Publications. - 1049-7323 .- 1552-7557. ; 20:8, s. 1116-1127
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to gain in-depth understanding of what it is like for a person with irritable bowel syndrome to be in the patient position in encounters with health care providers. We conducted qualitative interviews with nine individuals. Our analysis, guided by interpretive description, revealed experiences of unsupportive and supportive encounters. Unsupportive encounters were shaped by humiliation, insignificance, and abandonment. Not feeling believed and acknowledged as persons made the participants lose trust in their own experience, which enhanced their unfamiliar mood of being in the world. Supportive encounters were less prominent. These were characterized by openness and acknowledgment of the patient’s lifeworld. Feeling significant and being listened to promoted feelings of being in a partnered, cocreating relationship. It is reasonable to assume that care originating in the patient’s lifeworld would support the patients to use their strength to manage illness and regain familiarity in everyday life.
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| 6. |
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| 7. |
- Lindskov, Cecilia
(författare)
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Family centre practice and modernity : a qualitative study from Sweden
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Family centres have become a common institution to promote health and wellbeingamong young children (0-6 years of age) and their parents in Sweden. Thecore of the work is usually based on both maternal and child health care, a preschooland social services, all located under the same roof in the local community.The family centre in this study, known as the "Family House", was the firstof its type to be built in the city of Kristianstad, Sweden.The overall aim of the thesis was to understand family centre practice throughprofessionals' and parents' perceptions of the Family House and its relationship to modernity.The study employed a qualitative design using phenomenography as method tocapture people's perceptions of the practice. The research also drew on the approachof action research, where participants and researchers co-generateknowledge through collaborative communicative processes. Data was generatedfrom semi-structured interviews conducted with nineteen professionals andsixteen individual parents. Dialogue sessions with the professionals of the studyhave been held in order that they and the researcher could enter into a dialoguebased on the findings of the interviews. Data was consequently also generatedfrom these meetings.The way the professionals perceived the practice of the Family House fell intothree categories, namely, as a professional service, the provision of an informalmeeting place for professionals and families with young children or as a broadcommunity-based centre. Parents' perceptions fell into four categories; as aprofessional reception to obtain expert guidance and support, a study circle andliving room to informally share experiences and socialising, and a playgroundfor children where children could interact and learn social skills.One core finding of this thesis is that family centre practice for those involvedcontained a balancing act between simple modern expertise to control the futureand late modern opportunities for self-realisation and reflexivity.Parents and professionals shared the responsibility for children's well-being andthe distinction between private and public was blurred since parents used theHouse as a social arena for developing personal relations. It was also an arenafor integration between Swedes and immigrants based on engagement for bothcultural diversity and similarity.
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| 8. |
- Rydlo, Cecilia
(författare)
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Fighting for the otherness : student nurses' lived experiences of growing in caring
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In Swedish nursing education, student nurses should gain a bachelor degreein the main field of study. However, five designations of the main field ofstudy exist among the higher education institutions and the present thesisfocuses on the main field of study caring science. Former studies show thatthe acquisition of knowledge in caring by student nurses is characterized bytroubles, uncertainty and confusion. The aim was to describe how growingin caring is experienced by student nurses during education.The theoretical perspective was caring science with focus on caringscience didactics, while the epistemological frame constituted of a phenomenological lifeworld approach. Data was gathered with interviews andwritten narratives at different occasions during the education in order tograsp the general structure of growing in caring.The findings illuminated that growing in caring means a struggle forone’s own caring beliefs to exist and survive in a world filled with diverseexpectations of caring. Through recognizing expectations of caring, studentnurses discover the complexity of caring. In this complexity, they understand themselves as being different and the otherness appears. The otherness consists of unique beliefs about caring based on former experiences. Inorder to give evidence for the otherness, concepts from caring theories thatagree with one’s own caring beliefs are found, which transform the concepts from being meaningless to being essential in caring. The conceptsstrengthen the student nurses’ growth in caring and constitute a support intheir discussions about caring. In this struggle for gaining access with theirotherness, they become convinced that they can make changes for the patient and strength arises to fight for their otherness.The study showed that the otherness appears as the hub in the studentnurse’s world, which gains nourishment to discover paths to think, feel andact in a caring manner. This gives an incentive that innovative learningstrategies that both grasp the student nurses’ lifeworld as well as bringknowledge in caring into awareness for them are needed to be developed.
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| 9. |
- Thoroddsen, Asta, et al.
(författare)
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Nursing specialty knowledge as expressed by standardized nursing languages
- 2010
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Ingår i: International Journal of Nursing Terminologies and Classifications. - Malden, USA : Wiley-Blackwell. - 1541-5147 .- 2047-3087 .- 2047-3095. ; 21:2, s. 69-79
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe how nursing specialty knowledge is demonstrated in nursing records by use of standardized nursing languages.Methods: A cross-sectional review of nursing records (N = 265) in four specialties.Findings: The most common nursing diagnoses represented basic human needs of patients across specialties. The nursing diagnoses and related interventions represented specific knowledge in each specialty. Sixty-three nursing diagnoses (nine appeared in four specialties) and 168 nursing interventions were used (24 appeared in four specialties).Conclusions: Findings suggest that standardized nursing languages are capable of distinguishing between specialties. Further studies with large data sets are needed to explore the relationships between nursing diagnoses and nursing interventions in order to make explicit the knowledge that nurses use in their nursing practice.Practice implications: Nursing data in clinical practice must be stored and retrievable to support clinical decision making, advance nursing knowledge, and the unique perspective of nursing.
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| 10. |
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