| 51. |
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| 52. |
- Orban, Kristina, et al.
(författare)
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Using a time-geographical diary method in order to facilitate reflections on changes in patterns of daily occupations
- 2012
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Ingår i: Scandinavian Journal of Occupational Therapy. - London : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 19:3, s. 249-259
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Tidskriftsartikel (refereegranskat)abstract
- Objective and methods: Time-use methodologies have been proposed to be established research techniques when exploring aspects of daily occupations. In this study, two graphs illustrating the time arrangement of occupations as they appear in a continuous sequence were used in order to encourage individuals to reflect on their everyday life. The aim was to investigate the usefulness of a time-geographical diary method (using illustrative graphs) in combination with stimulated-recall interviews, to facilitate reflections on how patterns of daily occupations change over time and the causes that lie behind these changes. The study had a qualitative design. The participants were two working, married mothers, i.e. individuals considered to have highly complex patterns of daily occupations. The data analysis was performed by using thematic content analysis. Results: The results showed that the stimulated-recall interviews, based on the graphs, facilitated new insights that came to light concerning the scope of the participants' daily life. The method enabled the participants to reflect on their patterns of daily occupations and become aware of changes relevant to explain the causes for engaging in occupations the way they did. Conclusions: The method thus seems useful in research and practice for occupational therapists working with individuals with a need to change lifestyle. © 2012 Informa Healthcare.
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| 53. |
- Sundström, Malin
(författare)
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Existentiell ensamhet hos sköra äldre personer : vårdpersonals och volontärers erfarenheter och behov av stöd
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the thesis was to explore healthcare professionals’ and volunteers’ experiences of encountering older persons’ existential loneliness, the significance of the care context, and first-line managers’ view of support. Three of the studies were qualitative with a descriptive design (studies I–III) and the fourth was quantitative with a cross-sectional design (Study IV). The data collection for studies I and II was based on focus group interviews with healthcare professionals (i.e., nurse assistant, registered nurse, physician, occupational therapist, physiotherapist, social counsellor, and social worker) in home care, residential care, hospital care, palliative care, primary care, and pre-hospital care. The data collection for Study III was based on focus group interviews and individual interviews with volunteers from various organisations. Study IV was based on a questionnaire sent to first-line managers in municipal care, examining their views of support for staff and volunteers encountering existential issues among older persons. The findings of Study I indicated that, during the everyday care of older people, healthcare professionals experienced existential loneliness in various ways and situations related to ageing, illness, and end of life. The professionals’ stories about encountering older persons’ existential loneliness revealed that they often felt insecure about how to talk about existential issues. They also felt inadequate and frustrated when encountering barriers such as the older person’s bodily limitations, demands and needs (perceived as insatiable), personal privacy, or fear and difficulty in encountering existential issues. Study II was a multiple case study of the care contexts of home care, residential care, hospital care, and palliative care. The findings indicated that the care context matters regarding professionals’ views and interpretations of the origin of existential loneliness. In home care and residential care, these views and interpretations concerned life, the present, and the past. In hospital and palliative care, existential loneliness mainly concerned the older person’s forthcoming death. Professionals considered creating relationships an important part of their role in all care contexts, although the meanings, purposes, and conditions of these relationships differed (Study II). Study III showed that being a volunteer meant being a fellow human being, alleviating others’ and one’s own loneliness. Becoming a volunteer was 11 12 a way of finding meaning, and volunteering made the volunteers feel rewarded and simultaneously emotionally challenged. Encountering loneliness, including existential loneliness, required sensitivity to others’ needs for both closeness and distance. The findings of Study IV, based on a questionnaire, indicated that 88% of the first-line managers found that older persons sometimes or often expressed existential loneliness. They also reported that staff insecurity was the major obstacle to talking about existential issues with the older persons. Support was provided in the form of structured reflection, but provision of systematic supervision was reported by only 6% of first-line managers. The managers reported that most support was provided by themselves or by registered nurses. Almost half of the managers (44%) reported that, at their units, volunteers were engaged in activities such as everyday conversations and/or music/entertainment. In addition, they also reported a desire for volunteers to be more involved in both everyday and existential conversations. In conclusion, one of the most important findings of this thesis was the insecurity of the professionals, manifested in a fear of discussing existential issues. This was revealed in the interviews with the professionals and confirmed by the first-line managers. According to both professionals and volunteers, the relationship with the older person was important when encountering existential issues. The thesis demonstrates the importance of helping professionals focus on existential issues about life and death and of the potential of volunteers as an important complement in the care of older people.
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| 54. |
- Andersson, Edith, et al.
(författare)
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Nurses' experiences of the encounter with elderly patients in acute confusional state in orthopaedic care.
- 2003
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Ingår i: International Journal of Nursing Studies. - 1873-491X. ; 40:4, s. 437-448
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate nurses’ experiences of the encounter with elderly patients who developed acute confusional state (ACS) in orthopaedic care. Forty-eight nurses with professional background as registered (n=26) or licensed practical nurses (n=22) who took part in the nursing care of acute confused patients were involved. Open-ended unstructured interviews were conducted with regard to the course of events, experiences and interpretation of what had happened during the ACS as well as the nurses’ actions and encounter with the confused patient. The texts were analysed using manifest and latent content analysis, revealing that the nurses had difficulties in reaching the patients and their reality, and thus in understanding their experiences. Interpretation of the nurses’ experiences showed that the nurses found it difficult to reach the patients’ reality because the patients were in a divided and/or different world. They interpreted the patients as seeking solitude or company, keeping a distance or being suspicious of the nurses. The findings indicated that the interaction in the encounter between the acutely confused patients and the nurses indicated insufficient and/or broken reciprocity. The nurses used various strategies to meet the patients, being a companion and/or being a surrogate. They acted in the encounter based on their view of the patient and their ability to enter into and understand the patients’ situation. The strategies were more or less successful, sometimes resulting in contact and calming the patients and in other cases increasing the patients’ irritation and anger. The results were more successful when the strategies were derived from the nurses’ interpretation of the patients’ situation and the nurses paid attention to the patients and confirmed them.
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| 55. |
- Andersson, Edith, et al.
(författare)
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The meaning of acute confusional state from the perspective of elderly patients.
- 2002
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 17:7, s. 652-663
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this study was to illuminate lived experience of having been in an acute confusional state (ACS) as narrated by elderly patients in orthopaedic care. METHOD: Qualitative study with phenomenological hermeneutic method for analysing the data based on narrative interviews. Fifty patients (67-96 years of age) who developed ACS during hospitalisation and in all cases the ACS ceased during their stay on the ward were interviewed once lucid again regarding the course of the event, their experiences, memories and interpretation of what had happened during the ACS. RESULTS: The meaning of the patients' lived experiences of being and having been confused was interpreted as 'Being trapped in incomprehensible experiences and a turmoil of past and present and here and there', comprising the themes trying to get a grip on the experience of the confusion, encountering past, present and the realm of the imagination as reality during the period of confusion and confronting the idea of having been confused. Contradictory to earlier research the patients remembered and could tell in great detail about their ACS. While confused, the confusional state means that impressions of all kinds invade the mind of the person and are experienced as reality, making him/her a victim of these impressions rather than the one who controls what comes into his/her mind. While in the middle of these experiences the person simultaneously senses that the impressions are unreal, thus indicating that he/she is in some sort of borderland between understanding and not understanding. The things that come into the mind of the person can either be frightening or neutral or enjoyable scenarios that seem to be mainly familiar but can also be unknown. These scenarios seem to be a mixture of past and present, of events and people while they seem to float from location to location. CONCLUSIONS: The findings indicates that what takes place during the ACS is not nonsense but probably a mix of the patient's life history, their present situation and above all a form of communication concerning their emotional state and inner experiences in this new situation. The findings also indicated that one possible approach to the patients is to confirm and support the patients in narrating their experiences both during the confusion and also after the ACS had ceased.
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| 56. |
- Andersson, Magdalena, et al.
(författare)
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Health care consumption and place of death among old people with public home care or in special accommodation in their last year of life
- 2007
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 19:3, s. 228-239
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS:Developing care for older people in the last phase of life requires knowledge about the type and extent of care and factors associated with the place of death. The aim of this study was to examine age, living conditions, dependency, care and service among old people during their last year of life, but also their place of death and factors predicting it.METHODS:The sample (n=1198) was drawn from the care and services part of the Swedish National Study on Ageing and Care (SNAC). Criteria for inclusion were being 75+ years, dying in 2001-2004, and having public care and services at home or in special accommodation.RESULTS:In the last year of life, 82% of persons living at home and 51% living in special accommodation were hospitalized; median stays were 10 and 6.7 days respectively. Those living at home were younger and less dependent in ADL than those living in special accommodation. Those living at home and those having several hospital stays more often died in hospital. In the total sample, more visits to physicians in outpatient care predicted dying in hospital, whereas living in special accommodation and PADL dependency predicted dying outside hospital.CONCLUSIONS: Old people in their last year of life consumed a considerable amount of both municipal care and outpatient and in-hospital medical care, especially those living at home, which in several cases ended with death in hospital.
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| 57. |
- Andersson, Magdalena, et al.
(författare)
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Health care consumption and place of death among old people with public home care or in special accommodation in their last year of life.
- 2007
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Ingår i: Aging clinical and experimental research. - 1720-8319. ; 19:3, s. 228-239
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Developing care for older people in the last phase of life requires knowledge about the type and extent of care and factors associated with the place of death. The aim of this study was to examine age, living conditions, dependency, care and service among old people during their last year of life, but also their place of death and factors predicting it. METHODS: The sample (n=1198) was drawn from the care and services part of the Swedish National Study on Ageing and Care (SNAC). Criteria for inclusion were being 75+ years, dying in 2001-2004, and having public care and services at home or in special accommodation. RESULTS: In the last year of life, 82% of persons living at home and 51% living in special accommodation were hospitalized; median stays were 10 and 6.7 days respectively. Those living at home were younger and less dependent in ADL than those living in special accommodation. Those living at home and those having several hospital stays more often died in hospital. In the total sample, more visits to physicians in outpatient care predicted dying in hospital, whereas living in special accommodation and PADL dependency predicted dying outside hospital. CONCLUSIONS: Old people in their last year of life consumed a considerable amount of both municipal care and outpatient and in-hospital medical care, especially those living at home, which in several cases ended with death in hospital. (Aging Clin Exp Res 2007; 19: 228-239) ©2007, Editrice Kurtis
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| 58. |
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| 59. |
- Andersson, Magdalena, et al.
(författare)
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Old people receiving municipal care, their experiences of what constitutes a good life in the last phase of life : a qualitative study
- 2008
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 45:6, s. 818-828
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundOld people's life situation when receiving municipal help and care in their last period of life is sparsely investigated from their own perspective.ObjectiveThe aim of this study was to investigate the experiences of aspects that bring about a good life in the last phase of life among people (75+ years) receiving municipal care.ParticipantsOlder people living in a municipality in Southern Sweden being 75 years or older, receiving help and/or care from the municipality, and having a life-threatening disease and/or receiving palliative care were asked to participate. In all 17 people, 10 women and 7 men, aged 78–100 years were included.MethodsQualitative interviews, with the emphasis on their present life situation especially what brought about a good life, were performed. The interviews were analysed using qualitative content analysis.ResultsThe experience was interpreted to be Turning inwards to come to peace with the past, the present and approaching death while being trapped by health complaints. Six categories embraced the experience of aspects that constitute a good life in the last phase of life: Maintaining dignity, Enjoying small things, Feelings of “being at home”, Being in the hands of others, trying to adjust, Still being important for other people and Completing life while facing death.ConclusionThis study confirm theories suggesting that the last phase of life in old age meant focusing inwards, reflecting on the entire life as a way of completing it as well as enjoying small things and also viewing oneself in the perspective of contributing to the future. It also indicated that this phase of life meant being trapped by health complaints and functional limitations. The struggle to maintaining dignity as opposed to being in the hands of others implies that the concept of palliative care may be useful as a framework for providing nursing care to very old people, especially at the end of life.
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| 60. |
- Andersson, Magdalena, et al.
(författare)
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Old people receiving municipal care, their experiences of what constitutes a good life in the last phase of life.
- 2008
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 1873-491X .- 0020-7489. ; 45:6, s. 818-828
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Old people's life situation when receiving municipal help and care in their last period of life is sparsely investigated from their own perspective. Objective: The aim of this study was to investigate the experiences of aspects that bring about a good life in the last phase of life among people (75 + years) receiving municipal care. Participants: Older people living in a municipality in Southern Sweden being 75 years or older, receiving help and/or care from the municipality, and having a life-threatening disease and/or receiving palliative care were asked to participate. In all 17 people, 10 women and 7 men, aged 78-100 years were included. Methods: Qualitative interviews, with the emphasis on their present life situation especially what brought about a good life, were performed. The interviews were analysed using qualitative content analysis. Results: The experience was interpreted to be Turning inwards to come to peace with the past, the present and approaching death while being trapped by health complaints. Six categories embraced the experience of aspects that constitute a good life in the last phase of life: Maintaining dignity, Enjoying small things, Feelings of "being at home", Being in the hands of others, trying to adjust, Still being important for other people and Completing life while facing death. Conclusion: This study confirm theories suggesting that the last phase of life in old age meant focusing inwards, reflecting on the entire life as a way of completing it as well as enjoying small things and also viewing oneself in the perspective of contributing to the future. It also indicated that this phase of life meant being trapped by health complaints and functional limitations. The struggle to maintaining dignity as opposed to being in the hands of others implies that the concept of palliative care may be useful as a framework for providing nursing care to very old people, especially at the end of life.
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