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| 62. |
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| 63. |
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| 64. |
- Bjuresäter, Kaisa, 1970-
(författare)
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Home enteral tube feeding - from patients’, relatives’ and nurses’ perspectives
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Changes in the health-care system during the past decades have led to an increased transfer of health care to the home environment which also concerns patients treated with home enteral tube feeding (HETF). Research is scarce about how HETF care is functioning. Therefore, the overall aim with this thesis was to describe and explore HETF care and treatment from patients', relatives' and nurses' perspectives. Three qualitative and one quantitative study were used. The findings showed that the HETF treatment and care had a great impact on daily life for both patients and their relatives and implied many practical, emotional and social problems in their daily life, which they strived to manage. Side effects were common and the patients' reported low HRQL and general health. The amount and quality of received guidance and support from the health care, not least before discharge, turned out to have impact on the patients' and the relatives' daily life and how they could manage their situation. Lack of guidance and support meant insecurity, worries and distress. Cooperation in the care trajectory was found to be decisive for how well the care was running. Nurses' knowledge about tube feeding and discharge planning procedures, their commitment to the patients' care, as well as clarity regarding responsibility of HETF care were factors of crucial importance on how the cooperation worked, and the quality of the HETF care. This thesis shows the need of improvements regarding the care of HETF patients and their relatives.
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| 65. |
- Bjuresäter, Kaisa, 1970-, et al.
(författare)
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Patients’ experiences of home enteral tube feeding (HETF) : a qualitative study
- 2015
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Ingår i: Journal of research in nursing. - : Sage Publications. - 1744-9871 .- 1744-988X. ; 20:7, s. 552-565
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Tidskriftsartikel (refereegranskat)abstract
- Use of home enteral tube feeding (HETF) has increased in Western countries but research is scarce, especially about patients’ experiences of daily life when being treated with HETF. This study aimed to explore what it means to live with HETF and how the situation can be managed. A qualitative method was carried out according to Grounded Theory. In total, 22 interviews were performed with 11 patients treated with HETF for between 8 weeks and 2 years, using open-ended questions. Sampling, data collection and data analysis were carried out simultaneously. To be treated with HETF was experienced as positive as it meant survival, but the most prominent finding told about experiences of restrictions, practical problems and distress in the patients’ daily lives. How daily life turned out seemed to depend on the patient’s ability to manage problems, but was also strongly related to the amount and quality of information and support they received from health professionals. Lacking preparation before discharge as well as lacking support at home meant insecurity and uncertainty. The findings stress the need for comprehensive preparation and support from health professionals, and improvements are needed to facilitate HETF patients’ daily life.
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| 66. |
- Bjuresäter, Kaisa, 1970-, et al.
(författare)
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Patients Living with Home Enteral Tube Feeding : Side effects, health-related quality of life and nutritional care
- 2014
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Ingår i: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 2:3, s. 64-75
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to examine patients’ perceptions of side effects, health-related quality of life (HRQL), generalhealth, and nutritional care among patients receiving home enteral tube feeding (HETF) at two occasions after dischargefrom hospital. Three questionnaires, one study-specific, the Short Form 12 (SF-12) and the Health Index (HI), were sent topatients with HETF (n=62) twice, two weeks after discharge from hospital and two months later. Forty patients respondedtwo weeks after discharge and out of these 29 patients also responded after two months. Data were collected in centralSweden from March 2006 to January 2010. Side effects were common at both points of data collection (70% of thepatients after two weeks and 72% after two month). Patients using bolus feeding reported significantly fewer side effectsthan patients using intermittent feeding. HRQL and HI scores for the total group were low at both points of data collection.The bolus feeding group reported significantly higher physical HRQL and emotional HI than the intermittent feedinggroup did. Most patients were satisfied with the information and support they received from the health care team. Thisstudy has revealed that patients treated with HETF experienced side effects limiting their daily life to a great extent.Differences in HRQL related to feeding methods were found. Individualized support and regular controls are needed inorder to meet patient needs. Bolus feeding may be a suitable feeding method to improve well-being.
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| 67. |
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| 68. |
- Bjuresäter, Kaisa, 1970-, et al.
(författare)
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Struggling in an inescapable life situation : being a close relative of a person dependent on home enteral tube feeding
- 2012
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 21:7-8, s. 1051-1059
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore what it means to be a close relative of a person dependent on home enteral tube feeding (HETF) and how they can manage this situation. Background. Previous studies have shown that the situation of close relatives in home care in general can be burdensome and difficult. Research is scarce about experiences of close relatives when patients are treated with HETF. Design. A qualitative design was used, in accordance with grounded theory ( GT). Methods. Twelve close relatives were interviewed twice, using open- ended questions. Five were relatives of patients supported by home care services or advanced home care teams. Using the GT method, sampling, data collection and data analysis were carried out simultaneously. Results. One core category, ` Struggling in an inescapable life situation' and eight categories were found. The situation led to involuntary changes in the lives of the close relatives, something they could do little about. Their lives had become completely upturned and restricted by the HETF. Togetherness and pleasure was lost and they felt lonely. The relatives faced a new role of being informal caregivers and they had to adjust their daily life accordingly. They felt forced to take on a heavy responsibility for which they lacked support. The close relatives struggled to manage and to make the best of their new situation. Conclusions. This study highlighted the demands and vulnerability which is embedded in the role of being a close relative of a patient with HETF. It also pointed out their need for comprehensive support from the health care system.
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| 69. |
- Björkström, Monica, et al.
(författare)
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An attempt to improve nurses' interest in and use of research in clinical practice by means of network support to facilitator nurses
- 2014
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Ingår i: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 4:3, s. 58-68
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Tidskriftsartikel (refereegranskat)abstract
- Background: Scientific knowledge is expected to be used in clinical practice to ensure that patients are given evidence-based nursing care. Therefore, in order to improve nurses’ research utilisation in clinical practice a network had been provided for nurses especially interested in nursing development in eleven wards. These nurses were expected to take on the role of key person (facilitator) for nursing development in clinical practice.Aim: The study was aimed at describing nurses’ interest in nursing research, how network support to ‘facilitator nurses’ could improve development in patient care based on evidence, and what hindering factors for such development could be.Methods: One and a half years after onset of the project a follow-up study was conducted with a questionnaire answered by 75 (64%) nurses, and group interviews with nine facilitators and eleven head nurses.Findings: The nurses’ interest in research utilisation was in general high and in eight wards development work had started. The facilitator nurses had mostly worked without involving their colleagues. Hindering factors for nursing development were related to time, EBP knowledge, involvement and the interest of head nurses and colleagues. Education, work place, previous participation in research projects, and participation in the network impacted positively on nurses’ attitudes to and interest in research.Conclusion and implication for clinical practice: Providing networks to ‘facilitator nurses’ in the ward could be useful for developing nursing care based on research findings. However, support from nurse leaders, involvement of the whole nursing staff, and training in research utilisation are important factors for success.
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| 70. |
- Björkström, Monica, 1953-
(författare)
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Den professionella sjuksköterskan : i relation till den akademiska sjuksköterskeutbildningen
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Professional Nurse in Relation to Academic Nursing EducationThe increasing demands on the nurse’s competence in the society are reflected in laws and ordinances as well as in the transition of the nursing education to universities. The overall aim of this thesis was to illuminate, describe and understand nurses’ professional awareness in relation to academic nursing education.The longitudinal studies I and II of the thesis included novice nursing students (n= 164/163), senior students (n=123/124), and nurses three to five years after graduating (n=83/82). Study III of the thesis covered a nationally random selection of nurses graduated during four different years before and after the implementation of the academic education (n=289). Study IV focused on senior students (n=155). The data were collected by means of three questionnaires: open questions where the respondents were asked to describe their views of a good nurse and a bad nurse (I); a scale for assessing the professional self in relation to others (modified Nurse Self Description Form) (II); and finally, a questionnaire designed to asses the nurses’ (III) and the students’ (IV) attitudes to and awareness of research within nursing (as developed in study III). The data were analysed by means of content analysis (I) and parametric and non-parametric statistical methods (II, III, IV), and factor analysis (III).The result was that the characteristic of a good nurse ”to do good for others” emerged strongly and retained its dominant position throughout the education and beyond. ”To be competent and skilled” was also highly favoured and gained ground during and after the training. ”To have professional courage and pride” and ”to seek professional development” were considerably less prominent but increased slightly in importance over time (I). The professional self in relation to others in similar situations were generally rated as both strong among students and experienced nurses (II). Also in this respect there was an emphasis on the aspect of doing good for others. The professional self grew stronger over time in the areas of drive, objectivity, flexibility, ability to teach, ability to communicate and sociability, whereas the desire to contribute through research and knowledge mastery decreased over time (II). The process of developing into an experienced nurse, however, entailed increased awareness of the complexity of the nursing profession. The instruments for measuring attitudes to nursing research were validated through factor analysis, which generated seven factors termed ”research language,” ”need of research knowledge,” ”participation,” ”the profession,” ”meaningfulness,” ”study literature,” and ”developing–resources” (III). Nurses (III) as well as students (IV) expressed a positive attitude to nursing research and its application to the nursing profession. However, the nurses in particular stated that they seldom read scientific journals and seldom applied nursing research in their daily work.To sum up, the research in this thesis shows that students and nurses only to a moderate extent displayed the professional awareness that the academic nursing education aims for. The traditional image of a good nurse was the most clearly manifested form of awareness, whereas insufficient awareness was registered in areas related to own responsibility for research-based practice. The result indicates a need for further collaboration between the nursing education and the health care sector, as well as for academically highly qualified nurses as resource persons in nursing practice, to support quality development in nursing, and serve as role models for students.
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