| 1. |
- Almborg, Ann-Helene, et al.
(författare)
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Discharged after stroke - important factors for health-related quality of life
- 2010
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Ingår i: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. ; 19:15-16, s. 2196-2206
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Tidskriftsartikel (refereegranskat)abstract
- Aims. This study examines different correlates to health-related quality (HRQoL) of life after discharge in patients with stroke. Background. HRQoL is an important aspect of life after suffering a stroke. Previous research has revealed several variables associated with poststroke quality of life, including age, gender, depression, fatigue, length of hospital stay, functional status and amount of social participation. However, the time span after stroke varies greatly in the different studies. Although the multiple factors that contribute to short-term postdischarge HRQoL have potential importance for discharge planning, to our knowledge, these factors have not been systematically investigated during the earlier days following discharge. Design. Cross-sectional study. Methods. The sample consisted of 188 consecutively included individuals (mean age 74 years, 56% men) from a stroke unit in southern Sweden. The interviews were performed two to three weeks after discharge and included use of the SF-36, the Center for Epidemiological Studies Depression Scale, the Barthel Index, the Frenchay Activities Index, performance of interests and survey of patients' perceived participation in discharge planning. Multiple linear regression analysis was conducted to identify variables associated with HRQoL. Results. Multiple regression analyses with the eight scales of SF-36 as dependent variables revealed eight models, one for each scale, which were statistically significant. Depressive symptoms were associated with lower HRQoL. Ability to perform personal and social activities, interests, younger age, education (elementary school) and shorter hospital stay were related to higher HRQoL. Patients' perceived participation in discharge planning was both positively and negatively associated with HRQoL. Conclusions. Several variables were related to good HRQoL two to three weeks post-discharge, particularly fewer depressive symptoms, participation in social activities such as outdoor activities and performance of interests. Relevance to clinical practice. These results can be used to design needs assessment forms of discharge planning to promote adaptation and recovery after stroke.
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| 2. |
- Orrung Wallin, Anneli, et al.
(författare)
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Psychometric properties concerning four instruments measuring job satisfaction, strain, and stress of conscience in a residential care context
- 2013
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 57:2, s. 162-171
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Tidskriftsartikel (refereegranskat)abstract
- There are many instruments assessing the wellbeing of staff, but far from all have been psychometrically investigated. When evaluating supportive interventions directed toward nurse assistants in residential care, valid and reliable instruments are needed in order to detect possible changes. The aim of the study was to investigate validity in terms of data quality, construct validity, convergent and divergent validity and reliability in terms of the internal consistency and stability of the Job Satisfaction Questionnaire, the Psychosocial Aspects of Job Satisfaction, the Strain in Dementia Care Scale (SDCS), and the Stress of Conscience Questionnaire (SCQ) in a residential care context. The psychometric properties of the instruments were investigated in terms of data quality, construct validity, convergent and divergent validity and reliability, including test-retest reliability, in a residential care context with a sample consisting of nurse assistants (n=114). The four instruments responded with different psychometric-related problems such as internal missing data, floor and ceiling effects, problems with construct validity and low test-retest reliability, especially when assessed on the item level. These problems were however reduced or disappeared completely when assessed for total and factor scores. From a psychometric perspective, the SDCS seemed to stand out as the best instrument. However, it should be modified in order to reduce floor effects on item level and thereby gain sensitivity. The Job Satisfaction Questionnaire seemed to have problems both with the construct validity and test-retest reliability. The final choice of instrument must, however, be made dependent on what one intends to measure.
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| 3. |
- Abdel Ghani, Rania Mahmoud, et al.
(författare)
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Parturient needs during labor : Egyptian women’s perspective toward childbirth experience, a step toward an excellence in clinical practice
- 2011
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Ingår i: Journal of Basic and Applied Scientific Research. - 2090-4304. ; 1:12, s. 2935-2943
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Tidskriftsartikel (refereegranskat)abstract
- Background: Every woman giving birth has expectations. Identifying women’s expectations, wishes, needs and fears enable the health care provider(s) to work toward a common goal of safe and positive childbirth experience. Aim: The aim was to determine women’s preferences and needs during labor. Design: Analytic- cross sectional study. Setting: El Kasr- Aini, - Cairo- University Maternity Hospitals. Sample: A random sample of 400 women were recruited in the present study with the following criteria; age ranged between 20-30 years old, can read and write, primigravida, nulliparous woman with singleton low risk pregnancies, in the third trimester, up to 37 weeks of gestational age, no previous abortion and free from any medical complains. Procedure: Data collection took place in the antenatal clinic, each interview administrated questionnaire took a time between 10-15 minutes. Mothers completed the questionnaire in the antenatal clinics during their waiting for medical examination. Results: Twenty two need requirements emerged from the women's perspective. The highest ranked needs for parturient women during labor are; maintaining privacy through all procedures of 86.5%, accessibility of nurses demonstrate empathy of 67.5%, availability to ventilate and expressing fear and anxiety of 57.5%, quick response to request of 67.5%, frequent monitoring of 52.8%, accessibility of caring medical staff of 47.2% and short delivery of 52.8%. Conclusion: Despite good general coverage of labor care among women, there were clear variations in the type of management given to them or needed by them. This study confirms that different factors predict the multidimensionality of childbirth satisfaction.
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| 4. |
- Andersson, Ann-Christine, et al.
(författare)
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Kvinnors upplevelse av att leva med diabetes typ 2
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Diabetes typ 2 är en kronisksjukdom som ökar på grund av förändrade kostvanor och minskad fysisk aktivitet. Det är en sjukdom som ställer stora krav på individen eftersom det är viktigt med välfungerande egenvård för att må bra. Att drabbas av en kronisk sjukdom upplevs oftast negativt samtidigt som det är viktigt att få ett namn på sjukdo- men. Det finns studier som tyder på att kvinnor verkar må psykiskt sämre och har sämre reglerad diabetes än män. För att kunna stödja kvinnorna i egenvården behövs kunskap om hur de upplever det att leva med diabetes. Syfte: Undersöka kvinnors upplevese av att leva med typ 2 diabetes. Metod: Litteraturstudie som bygger på nio kvalitativa artiklar. Resultat: Fyra teman hittades; besvikelse och svek, kluvenhet, skuld och skam samt oro för framtiden. Diskussion: Det är svårt att vara kvinna och leva med diabetes typ 2. Sjukdomen kräver daglig egenvård och kombinerat med andra roller som kvinnan har i sitt dagliga liv kan kraven upplevas som stressande för en del av kvinnorna. Många kvinnor med diabetes typ två upplevde att de var i behov av bättre stöd och information för att kunna leva med sin sjukdom. Slutsats: Vårdpersonal behöver mer utbildning och ha med ett genusperspektiv för att förstå kvinnornas behov. Diabetesutbildningen behöver utveckas till att omfatta hela familjen, men samtidigt måste den vara individanpassad.
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| 5. |
- Andersson, Emma, et al.
(författare)
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"Jag kan inte tänka på något annat" : en empirisk studie om rädsla ur ett livsvärldsperspektiv
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Vårdpersonal möter i arbetet patienter som upplever rädsla. Inom omvårdnad är förståelse för människors upplevelser och erfarenheter central. Genom att försöka förstå fenomen som påverkar människans livsvärld gynnas relationen mellan vårdtagare och sjuksköterska.Syfte: Syftet var att beskriva fenomenet rädsla ur ett livsvärldsperspektiv.Metod: Studien baserades på 74 berättelser om rädsla skrivna av sjuksköterskestudenter. Kvalitativ innehållsanalys användes.Resultat: Situationer av ovisshet, maktlöshet eller hot utlöste rädsla. Under rädsleupplevelsen gjorde den tysta kroppen sig påmind, kroppen upplevdes okontrollerbar, informanterna blev tillfälligt förvirrade och fick förändrad verklighetsuppfattning. Kamp- och flyktbeteende och upplevelser av att rädslan födde nya känslor beskrevs också. När rädslan släppte tystnade kroppen, situationen upplevdes overklig och ibland genant och händelsen lämnade spår.Diskussion: Eftersom människor riktar medvetandet olika är det individuellt vad människor blir rädda för. Rädslan finns i levd kropp och påverkar samt påverkas av levd tid. Att gå till sig själv och förstå sin egen rädsla underlättar för att känna igen och förstå upplevelsen av rädsla hos andra.Slutsats: Att förstå och kunna möta rädsla hos andra är centralt i omvårdnad liksom i alla människovårdande yrken. Då upplevelsen av rädsla är central är det viktigt att förhålla sig fördomsfri till vad som utlöser rädsla hos andra människor och undvika att värdera rädslan.
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| 6. |
- Bala, Sidona-Valentina, et al.
(författare)
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The experience of care at nurse-led rheumatology clinics
- 2012
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Ingår i: Musculoskeletal Care. - : Wiley. - 1478-2189 .- 1557-0681. ; 10:4, s. 202-211
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Tidskriftsartikel (refereegranskat)abstract
- Objective To describe how people with rheumatoid arthritis (RA) experience the care provided by Swedish nurse-led rheumatology outpatient clinics. Methods Eighteen adult people with a diagnosis of RA who had had at least three documented contact sessions with a nurse-led clinic were interviewed. The interviews were analysed with qualitative content analysis. Results Care was expressed in three categories: social environment, professional approach and value-adding measures. A social environment including a warm encounter, a familial atmosphere and pleasant premises was desired and contributed to a positive experience of care. The nurses' professional approach was experienced as empathy, knowledge and skill, as well as support. The care was described as person centred and competent, as it was based on the individual's unique experience of his/her disease and needs. The nurses' specialist knowledge of rheumatology and rheumatology care was highly valued. The offered care represented added value for the participants, instilling security, trust, hope and confidence. It was perceived as facilitating daily life and creating positive emotions. The nurse-led clinics were reported to be easily accessible and provided continuity of the care. These features were presented as fundamental guarantees for health care safety. Conclusion The experiences emphasized the need for a holistic approach to care. In this process, the organization of care and the role and skills of the nurse should be focused on the individual's needs and perspectives. The social environment, professional approach and value-adding measures are particularly relevant for optimal care at nurse-led rheumatology outpatient clinics.
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| 7. |
- Beck, Ingela, 1965-, et al.
(författare)
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Applying a palliative care approach in residential care : effects on nurse assistants' experiences of care provision and caring climate
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 28:4, s. 830-841
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA palliative care approach aims to integrate psychosocial and existential as well as relationship aspects in the care and is an approach that can be used in residential care. Nurse assistants are the ones who are closest to the residents but have limited prerequisites for working in accordance with the palliative care approach. We aimed to investigate the effects on nurse assistants' experiences of care provision and the caring climate of an intervention applying a palliative care approach in residential care.MethodsAn intervention involving nurse assistants (n = 75) and their leaders (n = 9), in comparison with controls (n = 110), was evaluated using a questionnaire at three points in time.ResultsIn the intervention group, positive effects were seen concerning the nurse assistants' reports of the care provision in that they focused more on the residents' stories about their lives and on communicating with the residents about what gave meaning to their lives. Also, negative effects were seen when the nurse assistants rated that the residents' needs for medical and nursing care had not been met at the facility directly after the intervention. No effects were seen concerning the caring climate or the prerequisites of providing more person-centred care.ConclusionThe intervention seemed to have encouraged the nurse assistants to focus on relationship aspects with the residents. So as not to jeopardise the NAs' well-being and to support NAs in keeping themselves involved in existential issues, their support most certainly needs to be continuous and ongoing. However, in spite of the leaders' involvement, the intervention was not sufficient for changing the organisational prerequisites for more person-centred care.
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| 8. |
- Beck, Ingela, 1965-
(författare)
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Att fokusera på "varandet" i en värld av görande : stöd till personalen i ett palliativt förhållningssätt vid vård- och omsorgsboende för äldre
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to study nurse assistants’ experience of palliative care and to investigate how an intervention with a focus on a palliative care approach in residential care facilities influenced the nurse assistants and their work situation. The thesis is based on two qualitative and two quantitative studies, focusing on nurse assistants working at residential care facilities for older people. The qualitative studies were based on focus-group interviews before the intervention (I) and individual interviews after the intervention (IV). The quantitative studies (II, III) were based on a questionnaire, including several measurements, that was answered pre-, and post- intervention. The intervention consisted of study circles with nurse assistants, and workshops together with their leaders, focusing on improvement work. A total of 75 nurse assistants participated in the intervention and answered the questionnaire at baseline and at two follow-ups, in comparison with 110 nurse assistants who served as controls. The results show that the nurse assistants experienced that it was difficult to focus on “being”, i.e. on relationship aspects in their work, since the main discourse in residential care focused on “doing”, i.e. on task oriented aspects. Palliative care was described as something that was only applied during a short and defined phase, namely the very last days of the residents’ life. The results also show that nurse assistants experienced difficulties facing emotional and existential issues with regards to both the residents and their relatives (I). The results of study I were, in turn, used as a basis for the development of the intervention. The evaluation of the intervention showed that the nurse assistants, after the intervention, had increased their focus on the residents’ situation and to a greater extent stated that they focused on the residents’ life stories and on aspects that brought meaning to their lives (III). The nurse assistants also stated that they experienced less criticism from their superiors as well as from the residents after the intervention (II). However, the evaluation also showed that the nurse assistants had a more negative view of the leadership (II), were more critical to the medical and the nursing care (III), and that their job satisfaction had decreased (II) after the intervention. Interviews after the intervention showed that they, as a result of the intervention, had not only gained increased insight into their own significance in their encounter with residents and their relatives, but also an increased awareness of the needs of the residents and their relatives. The intervention also contributed to an increased openness in the workgroup. However, the nurse assistants also expressed frustration over barriers, primarily in the form of a lack of resources and limited leadership (IV), standing in the way of the implementation of changes. The results indicate that the nurse assistants, through discussions and reflections over praxis in their ordinary work group, developed an increased awareness about, and focus on “being”, i.e. on relationship aspects. However, it would seem that essential prerequisites, such as support from the leaders and sufficient resources for working in line with a palliative care approach, were not provided. When implementing a palliative care approach in residential care facilities, more focus on support to the leaders is needed in order to maintain sustainable changes.
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