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51.
  • Dahlqvist, Vera, et al. (författare)
  • Facing inadequacy and being good enough : psychiatric care providers' narratives about experiencing and coping with troubled conscience.
  • 2009
  • Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 16:3, s. 242-7
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study is to illuminate the meaning of encounters with a troubled conscience among psychiatric therapists. Psychiatric care involves ethical dilemmas which may affect conscience. Conscience relates to keeping or losing a sense of personal integrity when making judgments about one's actions. Ten psychiatric therapists were interviewed in June 2006. The interviews were tape-recorded, transcribed verbatim and interpreted using a phenomenological-hermeneutic method. Two themes 'Facing inadequacy' and 'Struggling to view oneself as being 'good enough'' are presented. In the therapists interviewed, awareness of their use of power, a sense of powerlessness and a sense of blame gave rise to feelings of betrayals and shameful inadequacy. By sharing their inadequacy with co-workers, they managed to endure the sense of their inadequacy which otherwise would have threatened to paralyse them. Finding consolation in sharing wearing feelings, becoming realistic and attesting their worthiness, they reached reconciliation and found confirmation of being good enough. The findings are interpreted in light of Lögstrup's ethics of trust, according to which conscience alerts us to silent but radical ethical demand and the risk of self-deception.
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52.
  • Englund, Ann-Charlotte, et al. (författare)
  • Being the parent of a child with asthma
  • 2001
  • Ingår i: Pediatric Nursing. - : Jannetti Publications, Inc.. - 0097-9805. ; 27:4, s. 365-373
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study is to describe what it means to be parents of a child with asthma. Unstructured interviews were carried out with 12 mothers and 12 fathers of children with asthma living in Sweden. The parents' accounts were analyzed using a phenomenological-hermeneutic approach. The results revealed that parents were living a strenuous life and their actions involved both protecting and liberating. Parents also reported feelings of sadness and acceptance. In most cases, mothers acted in a protecting manner and expressed feelings of sadness; fathers acted in a liberating manner and expressed feelings of acceptance. To gain a deeper understanding of the parents' actions and feelings, study results were interpreted through philosophical perspectives described by Ruddick (1989), Mayeroff (1965), and Hegel (1975). These interpretations show that the feelings and actions of these parents exist in a dialectical relation with one another. Results emphasize the importance of a good partnership between the parents and the nurse, where the nurse shows consideration for the parents' unique actions and feelings and understands and supports parents in the care of their child with asthma.
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53.
  • Ericson-Lidman, Eva, et al. (författare)
  • Healthcare personnel's experiences of situations in municipal elderly care that generate troubled conscience
  • 2013
  • Ingår i: Scandinavian Journal of Caring Sciences. - Hoboken, NJ, USA : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 27:2, s. 215-223
  • Tidskriftsartikel (refereegranskat)abstract
    • Healthcare personnel may perceive troubled conscience when feeling inadequate and powerless. It is important to further explore healthcare personnel's descriptions of situations in daily work, which generate troubled conscience to increase the awareness of such situations. This study aimed to describe health care personnel's experiences of situations in municipal elderly care that generate troubled conscience. In this qualitative study, interviews were conducted with Registered and Enrolled nurses and nursing assistants (n = 20) working in municipal elderly care. The interviews were tape-recorded, transcribed verbatim and analysed with content analysis. Situations that generated troubled conscience was (i) Being caught between different demands, comprising being forced to prioritize between different residents' needs, being torn between residents'-/relatives'-/and co-workers' needs and expectations' and between work and private life, (ii) Being torn away from residents to other 'must do's', comprising stealing time from residents' to do housekeeping chore' and to 'obey' rules and recommendations, (iii) Feeling unable to relieve suffering, comprising falling short when striving to help, lacking knowledge, advice and support and time to ease residents' suffering and finally, (iv) Being part of providing care that is or feels wrong, comprising providing poor care and/or witnessing co-workers providing poor care, and being forced to give care that feels wrong. These findings identify important factors that generate stress of conscience (stress caused by troubled conscience), including difficulties with balancing priorities and following rules and recommendations that seem contrary to best care, and the need for interdisciplinary teamwork. Findings point to that sharing what conscience tells in the work team opens up possibilities for healthcare personnel to constructively deal with troubled conscience. Intervention studies are needed to explore whether such measures contribute to relieve the burden of troubled conscience and increase possibilities to provide high quality care.
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54.
  • Ericson-Lidman, Eva, et al. (författare)
  • Meanings of being a female co-worker to a person developing burnout
  • 2007
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell Publishing Inc.. - 0283-9318 .- 1471-6712. ; 21:2, s. 155-162
  • Tidskriftsartikel (refereegranskat)abstract
    • Burnout is dramatically increasing in many industrialised countries. Burnout is mainly studied from the perspective of the burnout person although it has been confirmed to affect co-workers as well. This study aimed to illuminate meanings of being a female co-worker to a person developing burnout. Fifteen interviews with nursing and medical staff were performed, tape-recorded and transcribed verbatim and a phenomenological-hermeneutic method was used to interpret the text. One meaning of being a female co-worker is struggling, on the one hand to understand and help the person developing burnout and on the other hand to manage their work and survive oneself. This means to be torn between helping the workmate and managing their work. Co-workers are filled with contradictory feelings, from deep concern to aversion and when the workmate finally goes on sick leave, co-workers' feelings of shortcomings and failure emerge, along with troubled conscience. This study reveals a picture of the difficulties of being a female co-worker to a person developing burnout that it is crucial to be aware of.
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55.
  • Fischer, Regina Santamäki, et al. (författare)
  • Embracing opposites : meanings of growing old as narrated by people aged 85
  • 2008
  • Ingår i: The International Journal of Aging & Human Development. - Farmingdale, N.Y. : Baywood. - 0091-4150 .- 1541-3535. ; 67:3, s. 259-71
  • Tidskriftsartikel (refereegranskat)abstract
    • Many old people suffer from prolonged and multiple bodily ailments, new diseases, and increased risk for disadvantages and losses in life. Aging also means becoming mature and wise. This study illuminates the meaning of the lived experience with respect to changes in late life. Using a phenomenological hermeneutic method, this study analyzes transcribed interviews of 15 85-year-old people. Four themes were formulated: embracing weakness and strength, embracing slowness and swiftness of time, embracing reconciliation and regret, and embracing connectedness and loneliness. From these analyses, growing old was described as--maintaining one's identity in spite of the changes that come with aging and, embracing opposites--being changed and feeling being the same.
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56.
  • Fjelltun, Aud-Mari, et al. (författare)
  • Functional levels and nurse workload of elderly awaiting nursing home placement and nursing home residents : a comparative study.
  • 2009
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 23:4, s. 736-747
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was twofold: to compare the functional levels of elderly awaiting nursing home placement and nursing home residents, and to compare their nurses' physical and psychological workloads. In Norway, the demand for nursing home placement has increased greatly. Elderly awaiting placement can receive care from home health care services and/or from their families. Documenting elderly's functional levels may illuminate the extent of the carers' workloads and the need for support during the waiting period. The study was conducted in 2005 on two groups in northern Norway. Using the Multi-Dimensional Dementia Assessment Scale to assess functional levels, one group of nurses assessed elderly awaiting nursing home placement (n = 36) and another group of nurses assessed nursing home residents (n = 47). The nurses also reported physical and psychological workloads in caring for these elderly. A comparison of the functional levels between elderly awaiting nursing home placement and nursing home residents showed few statistically significant differences. Nursing home residents had two lower motor functions, needed more assistance with activities of daily living, more regular administration of enemas, were more often unable to speak, and showed lower orientation levels. Clinically significant similarities were found in five motor functions, including rising from lying to sitting, rising out of bed and walking, and in behavioural and psychiatric symptoms. Both groups of elderly had a high prevalence of sadness and fearfulness. The results of this study indicate that elderly awaiting nursing home placement can be as frail as nursing home residents. These results highlight the elderly's need for assistance and reveal the need for more nursing home beds. Nurses in home health care and nursing homes rated physical and psychological workloads similarly. As many carers provide care 24 hours a day, these results also illuminate the need to support carers during the waiting period.
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57.
  • Fjelltun, Aud-Mari Sohini, et al. (författare)
  • Carers' experiences with overnight respitecare : a qualitative study
  • 2009
  • Ingår i: Vård i Norden. - 0107-4083 .- 1890-4238. ; 29:3, s. 23-27
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim The aim of this study was to explore experiences with overnight respite care (ORC) of Norwegian carers who provided care to frail elderly awaiting nursing home placement. Background In many Western countries respite care has become part of health care service provision, and various types of respite care are available. The intent with respite care can be twofold; caring for the care receiver and supporting the carer. Methods This was a descriptive qualitative study. Interviews were conducted with 15 carers, transcribed and analysed by qualitative content analysis. Findings The carers described various experiences with ORC. If ORC supported the family unit, it was welcomed by carers and experienced as supportive. If ORC did not support the family unit, many carers rejected ORC, and it was experienced as non-supportive. Two categories were constructed: 'experiencing ORC as supportive for the family as a unit' and 'not experiencing ORC as supportive for the family as a unit'. Conclusion To support more carers, nurses have to listen to carers’ experiences about ORC. Nurses need to take responsibility for the family as a unit and provide more flexible ORC services based on both carers’ and elderly’s needs.
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58.
  • Fjelltun, Aud-Mari Sohini, et al. (författare)
  • Nurses' and carers' appraisals of workload in care of frail elderly awaiting nursing home placement.
  • 2009
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 23:1, s. 57-66
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The aim of this study is to describe carers' and nurses' appraisals of workload in care of frail elderly awaiting nursing home (NH) placement. BACKGROUND: Carers' workload of care for frail elderly awaiting NH placement has been studied separately from that of nurses' workload. The literature neither addressed a comparison of carers' and nurses' appraisals of psychological and physical workloads nor the most strenuous factors common to the workloads of both nurses and carers in care of the same elderly person. The terms 'carers' and 'nurses' in this paper refer to informal caregivers and to both enrolled nurses and Registered Nurses respectively, when no particular one is stated. METHOD: The sample comprised 11 nurses and 11 carers paired based on care provided to the same elderly person awaiting NH placement in Norway. Data collected by a workload-scale was analyzed by descriptive statistics. Data collected by individual interviews were analyzed by qualitative content analysis. Carers' and nurses' appraisals of workload were compared and contrasted and most strenuous factors described. FINDINGS: The findings show that both carers and nurses rated workload levels maximum. Carers' highest ratings concerned psychological workload, while nurses' highest ratings concerned physical workload. The workload ratings concerning elderly with advanced dementia disease were most similarly aligned. Qualitative content analysis showed three categories that describe the most strenuous factors common to the workloads of both carers and nurses. These were feeling responsible, burdened and ambivalent. CONCLUSION: This study reports carers' and nurses' appraisals of workload in care of frail elderly awaiting NH placement. The results show many similarities and some differences. These results may help guide policy development to address resource allocations to elderly care. Further research is needed to address workloads of care for elderly awaiting NH placement.
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59.
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60.
  • Glasberg, Ann-Louise, et al. (författare)
  • Burnout and 'stress of conscience' among healthcare personnel
  • 2007
  • Ingår i: Journal of Advanced Nursing. - : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 57:4, s. 392-403
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. This paper reports a study examining factors that may contribute to burnout among healthcare personnel.Background: The impact on burnout of factors such as workload and interpersonal conflicts is well‐documented. However, although health care is a moral endeavour, little is known about the impact of moral strain. Interviews reveal that healthcare personnel experience a troubled conscience when they feel that they cannot provide the good care that they wish – and believe it is their duty – to give.Methods: In this cross‐sectional study, conducted in 2003, a sample of 423 healthcare personnel in Sweden completed a battery of questionnaires comprising the Maslach Burnout Inventory, Perception of Conscience Questionnaire, Stress of Conscience Questionnaire, Social Interactions Scale, Resilience Scale and a personal/work demographic form.Results: Regression analysis resulted in a model that explained approximately 59% of the total variation in emotional exhaustion. Factors associated with emotional exhaustion were ‘having to deaden one's conscience’, and ‘stress of conscience’ from lacking the time to provide the care needed, work being so demanding that it influences one's home life, and not being able to live up to others’ expectations. Several additional variables were associated with emotional exhaustion. Factors contributing to depersonalization were ‘having to deaden one's conscience’, ‘stress of conscience’ from not being able to live up to others’ expectations and from having to lower one's aspirations to provide good care, deficient social support from co‐workers, and being a physician; however, the percentage of variation explained was smaller (30%).Conclusion: Being attentive to our own and others’ feelings of troubled conscience is important in preventing burnout in health care, and staff need opportunities to reflect on their troubled conscience. Further research is needed into how a troubled conscience can be eased, particularly focusing on the working environment.
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