| 1. |
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Att studera berättelser. Samhällsvetenskapliga och medicinska perspektiv
- 1997
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Att studera berättelser är en bok om narrativ teori och metod inom samhällsvetenskap och medicin. Boken är den första på svenska om berättelseforskning. Här medverkar bl.a. forskare som E.G. Mishler, C.K. Riessman och V. Adelswärd. Från olika utgångspunkter beskriver författarna hur människors berättelser kan analyseras och därmed bidra till att vidga och fördjupa kommunikationen mellan läkare och patient, mellan socialarbetare och klient.Berättelsen är en del av vårt kulturarv och en del av vår vardag. Boken ger stoff och kunskap åt alla som på ett eller annat sätt intresserar sig för människors tal och samtal. Författarna vänder sig till såväl yrkesverksammainom vård och omsorg som studerande och forskare inom samhälls- och vårdvetenskaperna.
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| 2. |
- Hydén, Margareta, 1948-, et al.
(författare)
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Samtal om den nya familjen och det eviga föräldraskapet
- 2002. - 1
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Hur undviker man att bråka om barnen även om man inte är sams efter skilsmässan? En skilsmässa föregås ofta av konflikter. Att då, i samband med separationen, hitta de bästa lösningarna för barnens vårdnad och umgänge ställer så stora krav på förhandlingsförmåga att de är övermäktiga för flertalet. För barnen är det av största betydelse att föräldrarna kommer överens. Över 50 000 barn och ungdomar i Sverige berörs varje år av en skilsmässa. Enligt svensk lag har barn rätt att behålla kontakten med bägge sina föräldrar, även om föräldrarna tycker illa om varandra eller befinner sig i någon form av konflikt. Sedan 1991 är kommunen skyldig att ställa upp med så kallade samarbetssamtal för dem som vill. Allt fler par, ungefär en fjärdedel av samtliga som separerar, tillvaratar den möjligheten. Det är alltså inte fråga om familjerådgivning, utan det uttalade målet är att hitta en överenskommelse mellan föräldrarna om barnens vårdnad och umgänge efter separationen. Vanligen är det socionomer inom familjerättsenheten som ansvarar för dessa samtal. Den första delen av boken är skriven utifrån ett familjesociologiskt perspektiv och diskuterar de förändrade familjeformerna i dagens samhälle. Den andra delen behandlar samarbetssamtal ur ett kommunikativt perspektiv, dvs hur man kan föra samarbetssamtal som leder fram till att parterna kan träffa en överenskommelse om barnens framtid. Boken tar upp frågor om hur man samtalar, hur man bryter mönster av anklagelser och försvar, hur man trots kanske låsta konflikter kan förhandla, vad man pratar om och vad man inte pratar om. Denna bok riktar sig till utbildningen i socialt arbete och för vidareutbildning av socionomer inom individ- och familjeomsorg, familjerätt och familjerådgivning. Den kan även läsas av par under separation som önskar hitta lösningar på vårdnad och umgänge för sina barns bästa.
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| 3. |
- Kiwi, Mahin, 1954-, et al.
(författare)
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Deciding upon Transition to Residential Care for Persons Living with Dementia : why Do Iranian Family Caregivers Living in Sweden Cease Caregiving at Home?
- 2018
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Ingår i: Journal of Cross-Cultural Gerontology. - : Springer-Verlag New York. - 0169-3816 .- 1573-0719. ; 33:1, s. 21-42
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Tidskriftsartikel (refereegranskat)abstract
- Previous research has shown how filial piety is strong among people of Iranian background and that traditional Iranian culture result in most families’ preferring to care for their elderly (and sick) family members at home. While acknowledging this, this article highlights what living in diaspora could mean in terms of cultural adaption and changing family values. By interviewing people with Iranian background living in Sweden (n = 20), whom all have been former primary caregivers to a relative living with dementia, we are able to show how the decision to cease caregiving at home is taken, and what underlying factors form the basis for such decision. Results indicate that although the existence of a Persian profiled dementia care facility is crucial in the making of the decision, it is the feeling of ‘sheer exhaustion’ that is the main factor for ceasing care at home. And, we argue, the ability to make such a decision based upon ‘being too tired’ must be understood in relation to transition processes and changes in lifestyle having an affect upon cultural values in relation to filial piety. Because, at the same time the changes on cultural values might not change accordingly among the elderly who are the ones moving into residential care, resulting in them quite often being left out of the actual decision.
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| 4. |
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| 5. |
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Beyond loss : dementia, identity, personhood
- 2014. - 1
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Focuses on what people with progressive dementias still have, largely because of their connections with others, is new and important.Collects interdisciplinary essays by internationally established scholarsProvides new ways of understanding and dealing with dementiaComing to terms with dementia is one of the great challenges of our time. This volume of new interdisciplinary essays by internationally established scholars offers new ways of understanding and dealing with it. It explores views of dementia that go beyond the idea of loss, and rather envisions it as multilayered transformation and change of personhood and identity, and as development that mostly is socially shared with others. The studies collected here identify new empirical, theoretical, and methodological areas that will be crucial to future research and clinical practice concerned with age-related dementia. Three general themes are singled out as of particular importance and interest: persons and personhood, identity and agency, and the social and the communal.Readership: Students and researchers in: nursing, medicine, psychology, social work, gerontology, bioethics, memory research; people engaged in dementia organizations, caregivers, social workers.
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| 6. |
- Björkman, Berit, et al.
(författare)
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Adult limb and breast amputees' experience and descriptions of phantom phenomena : a qualitative study
- 2010
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 1:1, s. 43-49
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Tidskriftsartikel (refereegranskat)abstract
- Background Phantom phenomena – pain or other sensations appearing to come from amputated body parts – are frequent consequences of amputation and can cause considerable suffering. Also, stump pain, located in the residual limb, is in the literature often related to the phantom phenomena. The condition is not specific to amputated limbs and has, to a lesser extent, been reported to be present after radical surgery in other body parts such as breast, rectum and teeth. Multi-causal theories are used when trying to understand these phenomena, which are recognized as the result of complex interaction among various parts of the central nervous system confirmed in studies using functional brain imaging techniques. Functional brain imaging has yielded important results, but without certainty being related to phantom pain as a subjective clinical experience. There is a wide range of treatment methods for the condition but no documented treatment of choice. Aims In this study a qualitative, explorative and prospective design was selected, in the aim to understand the patients’ personal experience of phantom phenomena. The research questions focused at how patients affected by phantom pain and or phantom sensations describe, understand, and live with these phenomena in their daily life. This study expanded ‘phantom phenomena’ to also encompass phantom breast phenomenon. Since the latter phenomenon is not as well investigated as the phantom limb, there is clinical concern that this is an underestimated problem for women who have had breasts removed. Methods The present study forms the first part of a larger, longitudinal study. Only results associated with data from the first interviews with patients, one month after an amputation, are presented here. At this occasion, 28 patients who had undergone limb amputation (20) or mastectomy (8) were interviewed. The focused, semi-structured interviews were recorded, transcribed, and then analyzed using discourse-narrative analysis. Results The interviewees had no conceptual problems in talking about the phenomena or distinguishing between various types of discomfort and discomfort episodes. Their experience originated from a vivid, functioning body that had lost one of its parts. Further, the interviewees reported the importance of rehabilitation and advances in prosthetic technology. Loss of mobility struck older amputees as loss of social functioning, which distressed them more than it did younger amputees. Phantom sensations, kinetic and kinesthetic perceptions, constituted a greater problem than phantom pain experienced from the amputated body parts. The descriptions by patients who had had mastectomies differed from those by patients who had lost limbs in that the phantom breast could be difficult to describe and position spatially. The clinical implication of this study is that when phantom phenomena are described as everyday experience, they become a psychosocial reality that supplements the definition of phantom phenomena in scientific literature and clinical documentation. Conclusions There is a need for clinical dialogues with patients, which besides, providing necessary information about the phenomena to the patients creates possibilities for health professionals to carefully listen to the patients’ own descriptions of which functional losses or life changes patients fear the most. There is a need for more qualitative studies in order to capture the extreme complexity of the pain–control system will be highlighted.
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| 7. |
- Björkman, Berit, 1944-, et al.
(författare)
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Phantom phenomena – Their perceived qualities and consequences from the patient’s perspective
- 2012
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Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8860 .- 1877-8879. ; 3:3, s. 134-140
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: The curious phenomenon phantom limbs early became the object of research, and its underlying mechanisms have been discussed over the years. The complex nature of phantom phenom- ena makes interpretation of the results ambiguous, regarding both prevalence and the accompanying suffering. There is a lack of knowledge about how amputees experience the meaning and consequences of phantom phenomena. The present aim, therefore, was to investigate how individuals, in an interview situation, described the qualities of possible perceived phantom phenomena, and how their experience affected their lives one month after the amputation/mastectomy.Methods: Twenty-eight women and men who had undergone a limb amputation or mastectomy were interviewed. The focused, narrative-oriented interviews were transcribed verbatim and the scripts were analysed with content analysis.Results: One month after the amputation the informants described and related their phantom pain and phantom sensations in sensory-discriminative, motivational-affective and cognitive-evaluative dimen- sions. The phantom sensations were experienced mainly as more agonizing than the phantom pain.Despite both the high intensity of and the high annoyance at the phantom pain and phantom sensations, a majority felt that the phantom phenomena were not a hindrance in their attempts to recapture ordinary life. But when the hindrance was evaluated as high, the annoyance was evaluated as the highest possible for both phenomena or for the phantom sensations alone, never for phantom pain alone. The interviewees’ reported attitudes of hindrance were also described and estimated in the light of their sociocultural circumstances. Thus, other preceding and/or co-existent pain conditions as well as factors such as pre- operative information, the respondents’ views on pain treatment, and their knowledge and understanding of phantom phenomena were mentioned and related to the pain-producing situation.Two-thirds of the interviewees had received post-surgical information and for some, the phenomena were well-known from earlier experience. A majority applied some version of the medical explanation model, irrespective of age or level of education. However neither information nor medical explanation, or both, sufficed for them to understand their own phantom phenomena. Thus, differences between the concepts explanation and understanding seemed significant for the annoyance related to the phantom phenomena.Regarding background data: (i) the majority of the interviewees had had pre-amputation pain prob- lems; (ii) the breast-cancer phantoms differed in several ways; (iii) there were some age and gender differences in the descriptions of hindrance.Conclusions and implications: These findings highlight the importance of observing the individual approach to the phenomena as a process of evaluation and selection. In addition, experience and under- standing of the phantoms also have sociocultural aspects. There follows the need for individualized communication and information from the clinician, and for incorporating a socioscientific and meaning- centred approach in future studies. The present insights could also be of value in other iatrogenic pain conditions.
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| 8. |
- Björkman, Berit, et al.
(författare)
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The meaning and consequences of amputation and mastectomy from the perspective of pain and suffering
- 2017
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Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8860 .- 1877-8879. ; 14:1, s. 100-107
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe concepts ‘pain’ and ‘suffering’ are frequently treated as synonymous. However, they are clearly distinct phenomena. Phantom phenomena including pain and sensory disturbances are still recognized as long-lasting problems after limb amputation and after mastectomy. The complex nature of phantom phenomena makes the interpretation of its results ambiguous, regarding the prevalence of pain, sensory disturbances and the accompanying suffering. There is clinical experience that suffering is a great burden for the individual but there is a lack of systematic studies of patients’ own evaluations of the suffering caused by their phantom phenomena.ObjectivesThe overall aim of this study was to identify and describe patients’ suffering related to, and as a part, of their post-amputation situation.MethodsThe present study constitutes a part of a prospective, two-year follow up project investigating interviews of 28 men and women in different ages and who have undergone a limb amputation or mastectomy. The reason for amputation or mastectomy varied among the patients and included vascular diseases, cancer (sarcoma and breast-cancer) and trauma. Our ambition was to extract as much variations as possible in different, individualized aspects of the actual pain and suffering producing situation. The participants were, here, invited to open-ended, narrative-oriented interviews one month after the surgery. The interviews were transcribed verbatim and analyzed within qualitative methodology: thematic content analysis.ResultsTwenty-two of 28 interviewees experienced phantom pain and phantom sensations. The two surgical processes amputation and mastectomy meant for a majority of the interviewees a critical event with threatening consequences for everyday life such as loss of function and personal integrity. Nine interviewees felt even stigmatized as a result of their lost body part. Numerous inter-related factors following the amputation/mastectomy, which can inflict severe suffering on the amputee, were uncovered. The context in which the interviewees were informed about the decision to amputate proved to be one such critical and important factor.ConclusionTo understand potential suffering in relation to phantom phenomena, it will never be enough merely to have knowledge of the underlying physiological or neurological mechanisms and/or the intensity of phantom pain and phantom sensations. Rather, it is necessary to find out how the loss of the body part and its everyday consequences are experienced by patients.ImplicationsIt is important to create time for real dialogue with the patients both during pre-operative preparation and post-operative rehabilitation in order to clarify and verbalize elements that constitute the patients individual suffering. Hopefully this strategy can alleviate future chronic pain problems, severe psycho-social distress and suffering. Such an approach ought to have impact also for perceived suffering after other types of surgery or different invasive treatments.
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| 9. |
- Bülow, Pia, et al.
(författare)
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In dialogue with time : identity and illness in narratives about chronic fatigue
- 2003
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Ingår i: Narrative Inquiry. - : John Benjamins Publishing Company. - 1387-6740 .- 1569-9935. ; 13:1, s. 71-97
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Tidskriftsartikel (refereegranskat)abstract
- When we are stricken with an illness or some other affliction, the temporal frameworks that we take for granted in our everyday lives are overturned. Thus suffering and illnesses raise questions associated with temporality: were the past events necessary and unavoidable, could anything else have happened, and what will happen next? In this article we will discuss two intertwined problems that have to do with the organization of time in narratives about illness: the interviewee’s attempt to create an interview narrative and the researcher’s need to create a temporal order and coherence in the interview material properly founded in research. With a foothold in the literary scholars Morson’s and Bernstein’s theories about shadows of time we base our argument on an analysis of narratives given in interviews by people affected by Chronic Fatigue Syndrome (CFS). The analysis shows various ways time can be used as a discursive tool to temporalize illness and suffering including temporalities that frequently go outside linear time perceptions by the use of “sideshadowings”. These various ways of temporalizing illness influence, for instance, factors like issues of responsibility and freedom of action. Findings like these indicate the importance of including the interviewees’ own temporalizations in the analysis of illness narratives in social science.
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| 10. |
- Bülow, Pia, et al.
(författare)
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Patient school as a Way of Creating Meaning in a Contested Illness : The Case of CFS
- 2003
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Ingår i: Health. - : SAGE Publications. - 1363-4593 .- 1461-7196. ; 7:2, s. 227-249
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Tidskriftsartikel (refereegranskat)abstract
- Creating meaning in a situation of contested illness like Chronic Fatigue Syndrome (CFS) is an interactive process. As an example of how meaning is created, a CFS patient school organized by a hospital clinic in Sweden is discussed. This school can be seen as both a school and a medically oriented activity. The presence of different frameworks provides an opportunity to use different perspectives to understand CFS. It makes it possible for the participating men and women to regard the illness both from the outside as a social object, from the inside through personal experiences and to put the diagnosis and suffering in a larger ‘sickness’ perspective. Consequently, a number of different interpretations are brought up and used to create meaning in a situation of illness. The patients/students are thus learning discursively to manage the illness at the same time as they examine different ways to interpret their experiences through this discursive activity.
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