| 21. |
- Müllersdorf, Maria, et al.
(författare)
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Occupation as described by novice occupational therapy students in Sweden : the first step in a theory generative process grounded in empirical data
- 2008
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Ingår i: Scandinavian Journal of Occupational Therapy. - London : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 15:1, s. 34-42
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Tidskriftsartikel (refereegranskat)abstract
- A core assumption in occupational therapy is that occupation enhances health. This study is one of a series of planned studies carried out in Sweden, with the overall aim to develop a theory, based on empirical grounds, concerning the dimensions of occupation that may be useful in occupational therapy. The specific aim for this study is to examine the dimensions of occupation as generally understood among novice occupational therapy students. Grounded Theory was the chosen method. Data were collected among occupational therapy students. The students wrote down spontaneously what they considered to be included in activity. A preliminary core category ‘‘The what, why, and how of occupation’’ and five other categories emerged from the analysis: (1) The doing and context of occupation; (2) Motive for occupation; (3) Time and place for occupation; (4) Type of participation; and (5) Outcome of occupation. Relationships between the categories were established between the Motive for occupation and Outcome of occupation, which constitute a kind of prerequisite for occupation. The three remaining categories: The doing and context of occupation, Time and place for occupation, and Type of participation established a form for occupation. In conclusion, the study results illuminated the richness of the concept of occupation and support the core assumption in occupational therapy that occupation enhances health.
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| 22. |
- Pettersson, Ingvor, et al.
(författare)
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Lifeworld perspectives utilizing assistive devices : individuals, lived experience following a stroke
- 2007
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Ingår i: Canadian Journal of Occupational Therapy / Revue Canadienne d`Ergotèrapie. - Toronto : Canadian Association of Occupational Therapists. - 0008-4174. ; 74:1, s. 15-26
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In lifeworld research, the individual's experience of meaning is of primary importance.PURPOSE: This paper explores how individuals post stroke who have a disability, described their personal meaning and lived experiences associated with the use of assistive devices.METHODS: A hermeneutic-phenomenological research approach was used. A conversational interview was conducted with 22 post-stroke individuals regarding their daily experiences utilizing assistive devices.RESULTS: The results showed a dual experience regarding the use of assistive devices, which is often complex and contradictory. The devices were viewed as a prerequisite for well-being and independence but at the same time, the devices gave rise to negative feelings because of the restrictions implied by their use. These dual experiences were explored in relation to the lived body, space, relations to others, and time.PRACTICE IMPLICATIONS: The results of this study will facilitate occupational therapists understanding of an individual's experiences utilizing assistive devices and their need for support with this process.
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| 23. |
- Pettersson, Ingvor, et al.
(författare)
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The effect of an outdoor powered wheelchair on activity and participation in users with stroke
- 2006
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Ingår i: Disability and Rehabilitation: Assistive Technology. - Abingdon, Oxford, UK : Taylor & Francis. - 1748-3107 .- 1748-3115. ; 1:4, s. 235-243
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Tidskriftsartikel (refereegranskat)abstract
- Purpose.Persons with disabilities after stroke are often restricted in activity and participation in society because of mobility limitations. An outdoor powered wheelchair may be one among other interventions in a rehabilitation programme. The aim of this study was to describe and compare activity limitations and participation restrictions in persons with stroke from their own perspective, before and after using an outdoor powered wheelchair. Method. At baseline and follow-up two instruments were used: Individually Prioritized Problem Assessment (IPPA) and World Health Organization Disability Assessment Schedule II (WHODAS II). Results. The results indicated that the powered wheelchair has a great positive effect on activity and participation assessed with IPPA. The results also showed that most of the participants' problems could be categorised as belonging to the domain of 'Community, social and civic life' according to the International Classification of Functioning, Disability and Health (ICF), and the effect size in this domain was large (2.4) after the participants had used the wheelchair. Conclusion. An outdoor powered wheelchair is an essential device for persons with disability after stroke with regard to overcoming activity limitations and participation restrictions in everyday life.
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| 24. |
- Pettersson, Ingvor, et al.
(författare)
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The value of an outdoor powered wheelchair with regard to the quality of life of persons with stroke : a follow-up study
- 2007
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Ingår i: Assistive technology. - New York, NY : Demos. - 1040-0435 .- 1949-3614. ; 19:3, s. 143-153
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Tidskriftsartikel (refereegranskat)abstract
- Evaluating the use of a powered wheelchair is of importance because of the increasing number of people with disabilities who are provided with one. The aim of this study is to describe characteristics of persons with stroke using an outdoor powered wheelchair and to evaluate the impact of the wheelchair on quality of life. A further aim is to compare the impact on quality of life in respect to age, gender, different disability characteristics, and living conditions. The 32 participants with stroke were recruited consecutively from three county council areas in Sweden. A follow-up design was applied including the EuroQol-5D questionnaires at baseline before the persons were prescribed an outdoor powered wheelchair, and after the participants had used the wheelchair for 3 to 5 months, data were collected by means of the EuroQol-5D and the Psychosocial Impact of Assistive Devices Scale (PIADS). The results indicated an improved quality of life with respect to the items competence, independence, capability, quality of life, well-being, happiness, and self-esteem on the PIADS. The usual activity dimension on the EuroQol-5D showed a significant improvement after wheelchair use. The group who drove the powered wheelchair at least once a day in the summer showed a more positive score on the total PIADS and its Competence subscale than persons who drove less. Furthermore, the group with higher rankings of the importance of the powered wheelchair scored higher on psychosocial impact than did the group with lower rankings. The conclusion is that the powered wheelchair mostly has a positive impact on the quality of life of users with stroke. Service providers should be alert, however, to the possible negative impact of a powered wheelchair on quality of life and support the user.
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| 25. |
- Andersson, Åsa, 1963-, et al.
(författare)
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Fear of falling in stroke patients : relationship with previous falls and functional characteristics
- 2008
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Ingår i: International Journal of Rehabilitation Research. - 0342-5282 .- 1473-5660. ; 31:3, s. 261-264
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to determine the relationship between fear of falling and functional characteristics of patients after stroke as well as to determine what characterizes fallers who score high fall-related self-efficacy, and nonfallers who score low fall-related self-efficacy. Patients (n=140) treated in a stroke unit during a 12-month period were included. On follow-up, fallers were identified and patients answered the questions in the Falls Efficacy Scale, Swedish version (FES-S). Assessments of motor capacity, functional mobility and balance were also made. In univariate analysis, low fall-related self-efficacy was significantly associated with increased age, female sex, earlier falls, visual and cognitive impairment, low mood and impaired physical function. In multivariate analysis, only earlier falls and physical function remained significant. Twenty percent of the patients scored low fall-related self-efficacy without having experienced a fall, and 11% who experienced a fall scored high fall-related self-efficacy. Impaired physical function was significantly associated with scoring low fall-related self-efficacy, for both fallers and nonfallers. Fear of falling is significantly associated with poor physical function and earlier falls. Falls Efficacy Scale, Swedish version could add useful information to a fall risk analysis. Patients scoring low fall-related self-efficacy should be offered fall prevention measures whether they have fallen or not.
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| 26. |
- Anderzén-Carlsson, Agneta, et al.
(författare)
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How physicians and nurses handle fear in children with cancer
- 2007
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Ingår i: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 22:1, s. 71-80
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Tidskriftsartikel (refereegranskat)abstract
- Previous research on fear in children with cancer has often focused on interventions to alleviate fear related to medical procedures and less on how to meet the challenges related to existential fear. This study aimed to describe how experienced nurses and physicians handle fear in children with cancer. Ten nurses and physicians with more than 10 years of experience in child oncology from a university hospital in Sweden were interviewed, and a qualitative content analysis was performed on the data. Nurses' and physicians' handling of fear encompasses commitment and closeness and yet also a distancing from fear and its expressions
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| 27. |
- Benbenishty, Julie, et al.
(författare)
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Nurse involvement in end-of-life decision making : the ETHICUS Study
- 2006
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Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 32:1, s. 129-132
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The purpose was to investigate physicians' perceptions of the role of European intensive care nurses in end-of-life decision making. DESIGN: This study was part of a larger study sponsored by the Ethics Section of the European Society of Intensive Care Medicine, the ETHICUS Study. Physicians described whether they thought nurses were involved in such decisions, whether nurses initiated such a discussion and whether there was agreement between physicians and nurses. The items were analyzed and comparisons were made between different regions within Europe. SETTING: The study took place in 37 intensive care units in 17 European countries. PATIENTS AND PARTICIPANTS: Physician investigators reported data related to patients from 37 centers in 17 European countries. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Physicians perceived nurses as involved in 2,412 (78.3%) of the 3,086 end-of-life decisions (EOLD) made. Nurses were thought to initiate the discussion in 66 cases (2.1%), while ICU physicians were cited in 2,438 cases (79.3%), the primary physician in 328 cases (10.7%), the consulting physician in 105 cases (3.4%), the family in 119 cases (3.9%) and the patient in 19 cases (0.6%). In only 20 responses (0.6%) did physicians report disagreement between physicians and nurses related to EOLD. A significant association was found between the region and responses to the items related to nursing. Physicians in more northern regions reported more nurse involvement. CONCLUSIONS: Physicians perceive nurses as involved to a large extent in EOLDs, but not as initiating the discussion. Once a decision is made, there is a sense of agreement. The level of perceived participation is different for different regions.
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| 28. |
- Björklund, Margereth, 1950-, et al.
(författare)
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Health promoting contacts as encountered by individuals with head and neck cancer
- 2009
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - 1752-9816 .- 1752-9824. ; 1:3, s. 261-268
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To describe the characteristics of health promoting contacts with health professionals as encountered by individuals with head and neck cancer. Background. Head and neck cancer has a profound and chronic impact on the individual's everyday life, e.g. physical problems that hinder speaking, breathing, eating and drinking. Furthermore, fear and uncertainty can lead to long-term psychological and psychosocial problems. The National Institute of Public Health in Sweden advocates that all care contacts should improve the quality of the individual's health. Design. A qualitative descriptive and explorative design was used. Eight participants were interviewed in the year 2005 and a qualitative thematic content analysis of the data was performed. Findings. Health promoting contacts were defined as contacts where health care professionals contribute positively to the well-being of individual patients. Characteristics include being available, engaged, respectful and validating. Three themes were identified: being believed in one's illness story; having a working relationship with health professionals and receiving individualised, tailored care. Conclusions. Health promoting contacts were experienced mainly during the treatment phase, when patients had daily contact with specific, qualified health professionals. Although the interview questions focused on health promoting contacts, nearly half of the contacts were experienced as not health promoting. Feelings of abandonment were particularly manifested before and after treatment. The starting point for achieving health promoting contact lies in understanding the patient's lifeworld in relation to health, illness and suffering and focusing on the individual's personal strengths and health resources. Relevance to clinical practice. The findings highlighted the importance of ensuring that patient interests and concerns are core considerations in health care. The participants viewed continuing individualised, tailored care and access to ear, nose and throat healthcare professionals as highly important.
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| 29. |
- Blomberg, Karin, et al.
(författare)
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Closeness and distance : a way of handling difficult situations in daily care
- 2007
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:2, s. 244-254
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. The aim of this study was to describe how care team members caring for patients with advanced cancer describe how they handle difficult situations in daily care. In this paper 'difficult situations' refers to those situations team members themselves describe as difficult. Background. Serious illness and impending death involve great changes in a person's life. The care of patients with advanced cancer is complex and many different factors influence each care situation. This places demands on the way care team members handle problems and difficulties in daily care. Design. Qualitative descriptive study. Methods. The study is based on 16 focus group discussions with care team members who were caring for patients with advanced cancer at three different care units in two Swedish cities. The focus group discussions included 77 participants. The procedure for data analysis was inspired by the phenomenological method. Findings. The results show that care team members handled difficult situations by balancing between being close and distancing themselves. In most situations their choice of strategy seemed spontaneous rather than being a conscious decision, although it was sometimes described as a more conscious approach. Variations of closeness and distance that were identified were Identity, Meaning, Limit-setting and touching, Prioritization, the Team and the Organization. These could also be seen as tools that could facilitate or impede the use of closeness and distance. Conclusions. The results show that care team members have a need to reflect over daily care and to become aware of what governs different care actions. Relevance to clinical practice. If the experienced difficult situation is not handled in a way that is beneficial to the care team member, patient and relatives, it is assumed that this can result in stress, burnout and, above all, non-optimal care.
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| 30. |
- Blomqvist, Kerstin, 1953-
(författare)
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Närsjukvård : vad innebär det i Region Skåne?
- 2007
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Ingår i: FoU-tidningen. ; :6, s. 7-8
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- I forskningsplattformens uppdrag ingick att följa och dokumentera närsjukvårdsutvecklingen i regionen. Som ett första steg i detta arbete intervjuades 97 medborgare, medarbetare och beslutsfattare om vad de lade in i begreppet närsjukvård. Avsikten var att ta reda på hur olika grupper såg på vad närsjukvård var eller borde vara. Ett vanligt svar bland framför allt medborgare och medarbetare var att de hade hört talas om närsjukvård men att termen var tvetydig, oklar och kunde förstås på olika sätt. I avsaknad av en klar definition försökte de förstå genom att associera till orden nära och sjukvård.
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