| 11. |
- Svantesson, Mia, et al.
(författare)
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Interprofessional ethics rounds concerning dialysis patients : staff's ethical reflections before and after rounds
- 2008
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Ingår i: Journal of Medical Ethics. - London : BMJ Publ. Group. - 0306-6800 .- 1473-4257. ; 34:5, s. 407-413
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether ethics rounds stimulated ethical reflection. METHODS: Philosopher-ethicist-led interprofessional team ethics rounds concerning dialysis patient care problems were applied at three Swedish hospitals. The philosophers were instructed to stimulate ethical reflection and promote mutual understanding between professions but not to offer solutions. Questionnaires directly before and after rounds were answered by 194 respondents. The analyses were primarily content analysis with Boyd's framework but were also statistical in nature. FINDINGS: Seventy-six per cent of the respondents reported a moderate to high rating regarding new insights on ethical problem identification, but the ethics rounds did not seem to stimulate the ethical reflection that the respondents had expected (p < 0.001). Dominant new insights did not seem to fit into traditional normative ethics but were instead interpreted as hermeneutic ethics. This was illustrated in the extended perspective on the patient and increased awareness of relations to other professions. Regarding insights into how to solve ethical problems, the request for further interprofessional dialogue dominated both before and after rounds. CONCLUSION: The findings show the need for interprofessional reflective ethical practice but a balance between ethical reflection and problem solving is suggested if known patients are discussed. Further research is needed to explore the most effective leadership for reflective ethical practice.
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| 12. |
- Tishelman, Carol, et al.
(författare)
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Using undergraduate nursing students as mediators in a knowledge transfer programme for care for patients with advanced cancer
- 2008
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Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 0961-5423 .- 1365-2354. ; 17:3, s. 253-260
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Tidskriftsartikel (refereegranskat)abstract
- Nursing today faces numerous challenges. Societal changes lead to reorganization of health care, changing workloads with sicker patients in hospital and home care, and limited economic resources. The increasing and changing nature of knowledge needed for expert care provision challenges nurses to continually update their competencies. These are issues demanding proactive and dynamic changes in the way nurses conceive their mandates and practice. The aim of the action-research project presented here was to foster improved quality of care for patients with advanced cancer through collaborative endeavours integrating cancer nursing clinical practice, research and education in a knowledge exchange programme. The programme was based on input about caregiving needs from multi-professional staff caring for patients with advanced cancer in a variety of healthcare settings. Undergraduate baccalaureate nursing students were then engaged in literature studies to help address these needs. Results of the studies were communicated back to the involved clinicians in a variety of ways. In this paper, we discuss what we have experienced as opportunities and obstacles in conducting the project, based on our reflections and external evaluations. This is linked to a broader discussion of ways of integrating cancer nursing research, education and practice.
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| 13. |
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| 14. |
- Wadensten, Barbro, et al.
(författare)
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Nursing staff's description of a good encounter in nursing homes
- 2009
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Ingår i: International Journal of Older People Nursing. - Oxford : Blackwell. - 1748-3735 .- 1748-3743. ; 4:3, s. 203-210
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Tidskriftsartikel (refereegranskat)abstract
- Background. It has been stated that there is too little research on what constitutes good communication and good encounters in nursing homes. Aim and objectives. The aim of the present study was to examine nursing staff members’ views on what is important in caring encounters with older people living in nursing homes. Design. A qualitative descriptive study using focus group interviews with staff in a nursing home in Sweden. Method. Focus group interviews, analysed using qualitative content analysis. Results. Three main themes emerged describing nursing staff members’ opinions about the content of good encounters: ‘Caring encounters from the perspective of equality’, ‘Caring encounters from the perspective of integrity’ and ‘Caring encounters from the perspective of promoting security’. Conclusions. The nursing staff had theoretical knowledge of what constitutes a good caring encounter, but they seemed to need more supervision and training to develop their ways of encountering older people as well as to become stronger in their professional role. When performing such training with staff, the methodology of appreciative inquiry could be a powerful tool. Relevance to clinical practice. It is important to help staff become empowered and to help them develop and improve their encounters with older care recipients.
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| 15. |
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| 16. |
- Widar, Marita, et al.
(författare)
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Living with long-term pain after stroke
- 2007
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- ObjectivesThe general aim of this thesis was to classify and describe long-term pain two years after a stroke and to describe the experiences of pain, and the consequences it has on the persons’ lives.Material and methodsThe studies comprised 43 persons, 13 women and 30 men, aged 33-82 years, with pain after stroke and no other major pain conditions and able to participate in an interview and independently answer questionnaires.The studies were conducted from a multidimensional perspective on pain, combining quantitative and qualitative methods. Clinical examinations were somatic, neurological and Quantitative Sensory Testing (QST). The Pain-O-Meter, ADL staircase, Self-reported impairment, SF-36 and Hospital Anxiety and Depression Scale were used. Qualitative interviews were performed and analyzed with content analysis.ResultsThree types of pain were classified: Neuropathic (central post-stroke pain) (n=15), nociceptive/mainly shoulder pain (n=18) and tension-type headache (n=10). Pain onset, within one to six months in most of the cases was after discharge from the hospital. Continuous pain or pain almost every day was reported by nearly two-thirds. The pain was mostly described as troublesome, annoying and tiring in all groups. The rating of pain intensity revealed individual differences among the participants within the pain groups. In addition to long-term pain, the participants suffered several impairments and nearly half of them were dependent on others, and two-thirds on assistive devices. Several coping strategies were described, most often problem-focused. Their health-related quality of life was decreased, mostly related to their long-term pain and physical impairments. Their experiences of caring revealed the need of improvements in knowledge about long-term pain, attention and understanding among the professionals, and continuity in the contacts.ConclusionAll professionals need knowledge about pain conditions after stroke. Pain assessment and classification, regular follow-up and documentation are required in order to prevent unnecessary suffering. Patients need attention, understanding and continuity in contacts with professionals. Further, information and education about pain and treatment/caring interventions are required in the case of both the sufferer and next of kin.
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| 17. |
- da Silva, Zacarias J., et al.
(författare)
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Changes in prevalence and incidence of HIV-1, HIV-2 and dual infections in urban areas of Bissau, Guinea-Bissau : is HIV-2 disappearing?
- 2008
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Ingår i: AIDS. - London : Gower Academic Journals. - 0269-9370 .- 1473-5571. ; 22:10, s. 1195-1202
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To assess the changes in HIV prevalence and incidence between 1996 and 2006 in urban areas of Bissau.Design: A cross-sectional survey of 384 randomly selected houses within a community-based follow-up study of HIV-1 and HIV-2.Methods: A total of 3242 individuals aged at least 15 years were eligible for inclusion. Participants were interviewed about behavioral and socio-economic factors and had a blood sample drawn. A total of 2548 individuals were tested for antibodies to HIV-1 and HIV-2, of whom 649 had taken part in a similar survey in 1996.Results: With 0.5% HIV dual reactions included, the overall HIV-1 prevalence was 4.6% (118 out of 2548) and the HIV-2 prevalence was 4.4% (112 out of 2548). The prevalence of HIV-1 increased more for women than men especially in the 25-34-year age group. HIV-2 prevalence decreased below 45 years of age but not for individuals more than 45 years old. The incidence rate between 1996 and 2006 was 0.5 per 100 person-years for HIV-1 and 0.24 per 100 person-years for HIV-2. Compared with a previous period from 1987 to 1996, the incidence of HIV-2 is declining whereas no significant increase in the incidence of HIV-1 was observed.Conclusions: The present study shows an increasing prevalence of HIV-1 and a decreasing prevalence of HIV-2 in Guinea-Bissau. HIV is generally a bigger problem for women. Despite the general decline in prevalence, HIV-2 may continue as an infection in older people, especially women.
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| 18. |
- Frisk, Margot, et al.
(författare)
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An investigation of the housing environment for persons with asthma and persons without asthma
- 2006
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 13:1, s. 4-12
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Tidskriftsartikel (refereegranskat)abstract
- Asthma is a chronic disease affected by environmental factors that may increase symptoms that impact on a persons' well-being. An important issue in occupational therapy is to improve the relationship between a person's functional capacity and the physical environment. The aim of the study was to compare the housing environment of persons with asthma (cases, n=49) and persons without asthma (controls, n=48), with regard to building construction and condition, physical, chemical and biological factors, and cleaning routines. A secondary aim was to compare different types of accommodation within cases and controls. A specialist team, including a construction engineer, a biological scientist, and an occupational therapist, conducted the study. Data were collected using protocols, as well as a number of established technical methods from the field of occupational and environmentsl medicine. The primary results showed no major differences in the housing environment between the two groups. However, in individual homes environmental factors at levels that could increase symptoms were identified. When single-familyhouses were compared with multi-family houses, significant differences were found indicating that preventive interventions may be needed in some single-family houses. Further studies are needed to clarify the person-environment relationship for persons with asthma, focusing on their ability to perform daily activities.
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| 19. |
- Frisk, Margot L. A., 1945-, et al.
(författare)
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Can a housing environmental index establish associations between indoor risk indicators and clinical tests in persons with asthma?
- 2009
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Ingår i: International Journal of Environmental Health Research. - London : Taylor & Francis. - 0960-3123 .- 1369-1619. ; 19:6, s. 389-404
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the associations between indoor risk indicators, identified by a Housing Environmental index (HE-index), and clinical tests of lung function, allergy and bronchial hyper-responsiveness (BHR). Forty-nine eligible subjects participated in the investigation. The HE-index was based on national and international guidelines and related to measurements of humidity, temperature, carbon dioxide, formaldehyde, nitrogen dioxide, allergens and occurrence of tobacco smoke and pets. Only 18% of the investigated homes did not have any of the risk indicators. Statistically significant associations were found between exposure to mites and lung function, and to a lesser degree in BHR for subjects living in homes with pets. The cut-off levels in the HE-index were not specifically related to health effects and may therefore have been too high for sensitive persons. Further studies are needed to establish relevant guidelines for the identification of risk indicators in the housing environment for persons with asthma.
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| 20. |
- Kjellin, Lars, et al.
(författare)
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Activity-based assessment (BIA)-inter-rater reliability and staff experiences
- 2008
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Ingår i: Scandinavian Journal of Occupational Therapy. - London : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 15:2, s. 75-81
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Tidskriftsartikel (refereegranskat)abstract
- The BIA method, based on assessment of patients in activities, was developed to enable reliable assessment of clients' occupational functioning. The method evaluates the patient's ego functions and capacity for activity and participation. The aims of this study were to examine inter-rater reliability for the BIA method and to compare the experiences of staff working with the BIA with those of staff using standard assessment (SA). In SA, the patient's activity problems and capacities were assessed without using any structured protocol. Four staff members worked according to the BIA method and eight according to SA. The estimation of reliability was based on data from 14 patients who went trough the BIA and were assessed by five staff members. These assessments resulted in all in about 400 statements, which were classified and compared for agreement between raters. In order to address the aim concerning staff experiences, a questionnaire was filled out anonymously by the staff. The inter-rater reliability of the nine ego functions varied from 0.76 to 1.00. The scale was deemed appropriate by the BIA staff and they had significantly higher median ratings on work satisfaction and appropriateness than the SA staff. In conclusion, the inter-rater reliability of the BIA was found to be good. The BIA method also seems to have a high degree of appropriateness, constituting a promising assessment tool when occupational functioning is addressed.
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