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Träfflista för sökning "AMNE:(TVÄRVETENSKAPLIGA FORSKNINGSOMRÅDEN) AMNE:(Vårdvetenskap) AMNE:(Omvårdnad) "

Sökning: AMNE:(TVÄRVETENSKAPLIGA FORSKNINGSOMRÅDEN) AMNE:(Vårdvetenskap) AMNE:(Omvårdnad)

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31.
  • Blomqvist, Kerstin, 1953- (författare)
  • Prioriteringar i vårdflöden för äldre : en förstudie
  • 2007
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Denna rapport är resultatet av ett avgränsat projekt som syftade till att undersöka prioriteringar i vård av äldre där flera vårdgivare är involverade. De huvudsakliga frågeställningarna handlade om vilka vardagliga prioriteringar som görs samt vilka motiv eller överväganden som dessa baseras på. Vilka hälso- och sjukvårdsinsatser som skall ges till äldre personer grundas i organisationens eller samhällets motiv och värderingar men också i personalens egna uppfattningar. Innan relevansen av valda insatser kan bedömas krävs insikt i hur prioriteringar görs och på vilka värderingar de baseras - prioriteringsprocessen behöver med andra ord göras transparent. Denna förstudie är ett försök att i någon mån genomlysa prioriteringsprocessen och därmed fungera som ett avstamp inför fortsatta studier för att förstå hur vård till äldre personer kan ges - utifrån deras egna upplevelser och önskemål. Ett strategiskt urval av elva personer, anställda inom kommunal och landstingsdriven vård och omsorg intervjuades med hjälp av hypotetiska fallbeskrivningar. Studien visade att de prioriteringar som beskrevs sällan handlade om val mellan patientgrupper. I stället beskrevs val mellan olika vård- och omsorgsformer och val mellan olika rehabiliteringsinsatser. De val som oftast beskrevs var om patienten skulle erbjudas vård vid sjukhuset eller vård och omsorg i hemmet och om patienten skulle erbjudas rehabiliteringsinsatser i form av träning eller rehabiliteringsinsats främst i form av hjälpmedel. Analysen visade att beslutet baserades på överväganden relaterade till patienten, personalen och/eller organisationen. I normalfallet grundades beslutet på en kombination av dessa överväganden. Förstudien ger en komplex bild av de överväganden personal grundar sina prioriteringar på. Ett fynd är att beslut om vård/omsorgs- och rehabiliteringsinsatser inte enbart baserades på faktorer hos den individuella patienten utan även på faktorer relaterade till personalen och den organisation där beslutet fattats. Rapporten uppmanar till en allmän prioriteringsdiskussion bland personal som arbetar med äldre personer genom att problematisera människovärdesprincipens tillämpning när exempelvis äldres sociala nätverk vägs in som en prioriteringsgrund för om träning skall erbjudas eller ej. Rapporten uppmanar också till diskussion kring val av måttstock för utvärdering av effekt av olika behandlingar. Med ett kostnadseffektivitetsperspektiv kan prioriteringar av sjukvård och rehabilitering till äldre bli olika beroende på om minimerat funktionsbortfall eller återgång till friskt tillstånd är effektmått. Rapporten uppmanar också till en diskussion om rädslan hos personal att värderas som någon som ”skickar in i onödan” kan påverka prioriteringar av sjukvård till äldre. Slutligen är det viktigt att påpeka att studien inte kan ge något svar på frågan om hur patienten/brukaren uppfattar och värderar kvaliteten i vård eller rehabilitering på olika vårdnivåer. För att få svar på en sådan fråga krävs fördjupade studier som innefattar äldre patienter och deras närstående.
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35.
  • Carlsson, Eva, et al. (författare)
  • Methodological Issues in Interviews Involving people with Communication Impairments After acquired Brain Damage
  • 2007
  • Ingår i: Qualitative Health Research. - Newbury Park, Calif. : Sage Publications. - 1049-7323 .- 1552-7557. ; 17:10, s. 1361-1371
  • Tidskriftsartikel (refereegranskat)abstract
    • Qualitative research has made a significant contribution to the body of knowledge related to how people experience living with various chronic diseases and disabilities, however, the voices of certain vulnerable populations, particularly those with impairments that affect their ability to communicate, are commonly absent. In recent years, a few researchers have attempted to explore the most effective ways to ensure that the voices of people with communication impairments from acquired brain damages can be captured in qualitative research interviews, yet several methodological issues related to including this population in qualitative research remained unexamined. In this article, the authors draw on insights derived from their research on the experiences of adult survivors of stroke and traumatic brain injury to describe methodological issues related to sampling, informed consent, and fatigue in participant and researcher while also making some recommendations for conducting qualitative interviews with these populations.
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36.
  • Carlsson, Eva, et al. (författare)
  • Multidisciplinary recording and continuity of care for stroke patients with eating difficulties
  • 2010
  • Ingår i: Journal of Interprofessional Care. - New York, USA : Informa Healthcare. - 1356-1820 .- 1469-9567. ; 24:3, s. 298-310
  • 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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37.
  • Carlsson, Eva (författare)
  • Understanding Persons with Eating Difficulties and Communication Impairment after Stroke : Patients Experiences and Methodological Issues in Qualitative Interviews
  • 2006
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Difficulties with eating are common after stroke and are often associated with communication problems. Although numerous aspects of dysfunction have been identified, little is known about the experiences of living with eating difficulties after stroke. A few researchers have attempted to explore how best to ensure that the voices of people with communication impairment can be captured in qualitative research interviews, but several methodological issues related to including this population in qualitative research have remained unexamined. The purpose of the thesis was to illuminate the phenomenon of eating difficulties after stroke and to discuss methodological issues involved in interviewing persons with communication impairment. Study I had a qualitative, descriptive design involving repeated interviews and participant observations with three persons 1½ years post-stroke. Eating difficulties after stroke were experienced as Striving to live a normal life with the sub-themes Abandoned to learn on one’s own, Experiences of losses, and Feeling dependent. The findings showed that “eating difficulties after stroke” is a complex phenomenon, and that, based on the experiences of stroke survivors, there is a need for health care professionals to develop and use methods for eating training and other forms of support during the continuum of care. The combination of repeated interviews and participant observations seemed to be an approach that should be tested in larger studies. Study II was a methodological exploration based on the experiences gained in Study I and in a qualitative study involving persons with traumatic brain injury. Methodological issues related to sampling, obtaining informed consent, and fatigue in participant and researcher were discussed, and strategies for conducting qualitative interviews with these populations were suggested.
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39.
  • Edvardsson, Tanja I., et al. (författare)
  • Subjective quality of life in persons with low-grade glioma and their next of kin
  • 2009
  • Ingår i: International Journal of Rehabilitation Research. - Baltimore, Md. : Lippincott Williams & Wilkins. - 0342-5282 .- 1473-5660. ; 32:1, s. 64-70
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with low-grade glioma have a longer survival than patients with highly malignant glioma, and for this reason questions of quality of life (QoL) are of particular importance to such patients as well as to their next of kin. No studies have been found in which both adult patients with low-grade glioma and their next of kin have estimated their own QoL. This study was therefore designed to investigate the subjective QoL of these two groups. Thirty-nine patients with low-grade glioma selected from a well-defined county population and 27 next of kin participated in the study. The questionnaire used in the study was the subjective estimation of QoL. The main results and conclusions are as follows: the variable absence of work/meaningful occupation showed statistically significant lower ratings among patients than among next of kin. The results show significant influence mainly on the patients' and their next of kin's internal psychological condition; related to background variables but the pattern in the results was inconsistent. There is a need for recurrent rehabilitation during this long-term disease, and a need to give vocational rehabilitation to support the patient's desire to have a meaningful occupation. It is also of importance to include the patient's next of kin when offering rehabilitation.
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40.
  • Ek, Kristina (författare)
  • Att leva med mycket svår kronisk obstruktiv lungsjukdom : ett liv i slowmotion
  • 2010
  • 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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