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Ageing with disability : a lifecourse perspective
- 2013
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Editorial collection (peer-reviewed)abstract
- This is the first book to address the issue of ageing after a long life with disability. It breaks new ground through its particular life course perspective, examining what it means to age with a physical or mental disability and what the implications are of 'becoming old' for people who have had extensive disabilities for many years. These people may have had to leave the labour market early, and the book looks at available care resources, both formal and informal. Ageing with disability challenges set ideas about successful ageing, as well as some of those about disabilities. The life course approach that is used unfolds important insights about the impact of multiple disabilities over time and on the phases of life. The book highlights the meaning of care in unexplored contexts, such as where ageing parents are caregivers or regarding mutual care in disabled couples. These are areas of knowledge which have, to date, been totally neglected.
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| 2. |
- Andreae, Christina, et al.
(author)
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Patients' Participation as It Appears in the Nursing Documentation, When Care Is Ruled by Standardized Care Plans
- 2011
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In: ISRN Nursing. - : Hindawi Limited. - 2090-5483 .- 2090-5491. ; 2011:Article ID 707601, s. 1-7
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Journal article (peer-reviewed)abstract
- This study aimed to describe inpatients with myocardial infarction and their participation in care as documented in the nursing records when standardized care plans are used in care. The use of standardized care plans not only has increased the quality of medical treatment but has also overlooked patients' opportunities to participate in their own care. There is a lack of knowledge about how standardized care plans influence patients' participation in nursing care. Data were collected from thirteen patients' records with diagnoses of myocardial infarction. Participation in the decision-making process and participation associated with “sharing with others” were searched for in the analysis. The analytical process was guided by content analysis. The findings were grouped into two categories: patients' intermediary participation and patients' active participation. The main results indicated that patients' intermediary participation depended on healthcare professionals' power to rule the nursing care situation.
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| 3. |
- Audulv, Åsa, 1980-, et al.
(author)
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The influence of illness perspectives on self-management of chronic disease
- 2011
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In: Journal of Nursing and Healthcare of Chronic Illness. - Singapore : Blackwell Publishing Ltd. - 1752-9816 .- 1752-9824. ; 3:2, s. 109-118
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Journal article (peer-reviewed)abstract
- Aim: To explore people’s illness perspectives and related self-management of chronic disease.Background: Individuals’ illness beliefs and perspectives have been suggested to influence their self-management behaviour. However, research that has examined the influence of illness perspectives on chronic disease self-management has been largely quantitative and has focused on selected elements of self-management. How individuals’ illness perspectives influence their whole of self-management has not been investigated in depth.Method: The phenomenographic research study entailed 26 narrative interviews with Swedish adults with a variety of chronic diseases. Data were collected mostly during 2006.Results: The participants described two illness perspectives; being life-oriented meant to focus upon how to live a good life with disease, whereas a diseaseoriented illness perspective emphasised the medical and physiological aspects of disease. The participants attested to one of the two illness perspectives as a main perspective, although they shifted between the perspectives depending of context and illness experience. The participants’ illness perspectives were reflected in their understandings of self-management. Participants with a dominant life-oriented illness perspective performed self-management in order to continue living a ‘normal’ life (e.g. facilitate activity and mental well-being). When holding a disease-oriented illness perspective, self-management was focused upon controlling disease (e.g. symptom management and avoiding disease related complications).Conclusions: People with chronic illness hold a dominant illness perspective that determines how they understand and enact self-management. These perspectives 2011 Blackwell Publishing Ltd 109 are not static; instead individuals tend to shift between the perspectives under specific circumstances.Relevance to clinical practice: Health-care providers shall acknowledge that individuals’ with chronic illness shift between a life-oriented and a disease-oriented illness perspective. The results of the current study can be used by health-care providers in order to launch a dialogue in order to support individuals’ self-management.
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| 4. |
- Audulv, Åsa, et al.
(author)
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The integration of chronic illness self-management
- 2012
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In: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 22:3, s. 332-345
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Journal article (peer-reviewed)abstract
- Self-management is crucial for people living with chronic diseases, but the actual process of integrating self-management has not been explored in depth. In this article, we investigate the integration of self-management into the lives of people with chronic illness. In this longitudinal study, we used an interpretive description approach. Twenty-one individuals were interviewed regularly during the first 3 years after they were diagnosed with a chronic condition. We found self-management integration to be an ongoing process that included four phases: seeking effective self-management strategies, considering costs and benefits, creating routines and plans of action, and negotiating self-management that fits one's life. The participants managed the phases according to their context, e.g., illness experience, life situation, personal beliefs, and social support. Health care providers should therefore facilitate self-management integration by providing support that is adjusted to the person's phase of self-management integration and life context.
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| 5. |
- Audulv, Åsa, et al.
(author)
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Who's in charge? The role of responsibility attribution in self-management among people with chronic illness
- 2010
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In: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 81:1, s. 94-100
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To explore how responsibility attribution influences self-management regimens among people with chronic illness.METHODS: This qualitative content analysis included 26 interviews with people living with chronic illness.RESULTS: The participants attributed responsibility to internal, external or a combination of these factors, meaning that they either assumed responsibility for self-management or considered other people or factors responsible. Internal responsibility was associated with a multifaceted self-management regimen, whereas external responsibility was related to "conventional" self-management such as taking medication, managing symptoms and lifestyle changes.CONCLUSION: How responsibility is attributed is vital for the way in which individuals perform self-management. In this study, those who attributed responsibility to external factors mainly performed recommended behaviours to control their illness. In contrast, to take charge of their illness and be an active participant in the care, individuals must take responsibility for themselves, i.e. internal responsibility.PRACTICE IMPLICATIONS: Health-care providers should acknowledge and support individuals' wishes about various levels of responsibility as well as different kinds of patient-provider relationships.
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| 6. |
- Axelsson, Lena, et al.
(author)
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Thoughts on death and dying when living with haemodialysis approaching end of life
- 2012
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 21:15-16, s. 2149-59
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Journal article (peer-reviewed)abstract
- AIMS AND OBJECTIVES: To describe inner thoughts and feelings relating to death and dying when living with haemodialysis approaching end of life.BACKGROUND: Patients who undergo maintenance haemodialysis suffer a significant symptom burden and an impaired quality of life. The high mortality rate in these patients indicates that about one-fourth of them are in their last year of life, suggesting the presence of death and dying in the haemodialysis unit.DESIGN: A qualitative descriptive design was used. Methods. A total of 31 qualitative interviews were conducted with eight patients (aged 66-87) over a period of 12 months. Qualitative content analysis was used to analyse data.RESULTS: The analysis revealed 10 subthemes that were sorted into three main themes. Being aware that death may be near comprises being reminded of death and dying by the deteriorating body, by the worsening conditions and deaths of fellow patients, and by knowing haemodialysis treatment as a border to death. Adapting to approaching death comprises looking upon death as natural, preparing to face death, hoping for a quick death and repressing thoughts of death and dying. Being alone with existential thoughts comprises a wish to avoid burdening family, lack of communication with healthcare professionals and reflections on haemodialysis withdrawal as an hypothetic option.CONCLUSIONS: Living with haemodialysis approaching, the end of life involves significant and complex existential issues and suffering, and patients are often alone with their existential thoughts.RELEVANCE TO CLINICAL PRACTICE: Nurses and other healthcare professionals in haemodialysis settings need to combine technical and medical abilities with committed listening and communication skills and be open to talking about death and dying, with sensitivity to individual and changeable needs.
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| 7. |
- Berg, Katarina, et al.
(author)
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Postoperative recovery from the perspective of day surgery patients : A phenomenographic study
- 2013
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In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 50:12, s. 1630-1638
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Journal article (peer-reviewed)abstract
- Background: Today, many patients undergo surgical procedures in a day surgery setting. The shift from inpatient care to care at the patient’s own home following discharge places various demands on patients and their families during the recovery process. There is a need for knowledge of how the postoperative recovery process is perceived, as research indicates a lack of support for patients managing recovery at home.Objectives: To explore day surgery patients’ perceptions of postoperative recovery.Design: A qualitative design with a phenomenographic approach was used.Methods and settings: Semi-structured interviews with 31 patients undergoing an orthopaedic, general or urologic day surgical procedure were carried out face-to-face at the patients’ homes, 11-37 days post-discharge. Patients were recruited from two day surgery settings: one private unit and one unit associated with a local county hospital.Results: The patients perceived postoperative recovery as comprising internal and external prerequisites and implied changes in ordinary life with varying levels of support. The organization at the day surgery unit, with its advantages and disadvantages, was perceived as having an impact on the subsequent recovery trajectory. The results are demonstrated in three descriptive categories: ‘Conditions for recovery at home’, The rollback to ordinary life’ and ‘Being a cog in a flow of care’.Conclusions: Postoperative recovery following day surgery implies, from the patients’ perspective, a migration from being a recipient of care at the day surgery unit to playing an active role, with extensive responsibility at home. To manage self-care confidently, postdischarge patients require knowledge and understanding of what constitutes the normal range in recovery following their specific surgical procedure.
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| 8. |
- Bergdahl, Elisabeth, et al.
(author)
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Co-creating possibilities for patients in palliative care to reach vital goals - a multiple case study of home-care nursing encounters
- 2013
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In: Nursing Inquiry. - : Wiley-Blackwell. - 1320-7881 .- 1440-1800. ; 20:4, s. 341-351
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Journal article (peer-reviewed)abstract
- The patients home is a common setting for palliative care. This means that we need to understand current palliative care philosophy and how its goals can be realized in home-care nursing encounters (HCNEs) between the nurse, patient and patients relatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been a reliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliative care. The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation building phase. The results show that planned palliative HCNEs can be described as a process of co-creating possibilities for the patient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However, in some HCNEs, co-creation did not occur: Wishes and needs were discouraged or made impossible and vital goals were not reached for the patients or their relatives. Further research is needed to understand why. The co-creative process presented in this article can be seen as a concretization of the palliative care ideal of working with a person-centered approach.
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