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Sökning: margareta rämgård

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  • Bolmsjö, Ingrid, et al. (författare)
  • Existential loneliness : An attempt at an analysis of the concept and the phenomen
  • 2018
  • Ingår i: Nursing Etichs. - SAGE. - 0969-7330. ; s. 1-16
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Background: According to ethical guidelines, healthcare professionals should be able to provide care that allows for the patients’ values, customs and beliefs, and the existential issues that are communicated through them. One widely discussed issue is existential loneliness. However, much of the debate dealing with existential loneliness concludes that both the phenomenon and the concept are quite vague. Aim: To clarify what constitutes existential loneliness, and to describe its lived experiences. A further aim was to provide a definition of existential loneliness that can function as a tool for identifying the phenomenon and for differentiating it from other kinds of loneliness. Method: A literature review including theoretical and empirical studies. Different search strategies were used to gather the articles included in the study. The analysis of the empirical studies had an interpretative approach. The articles were also analysed with the aim of providing a definition of existential loneliness. This was done by means of criteria such as language, uniqueness, theory and usefulness. This study is not empirical and does therefore not require an ethics review. Results: The analysis resulted in two main characteristics. The first one was perceiving oneself as inherently separated (disconnected) from others and from the universe. The second one brings out emotional aspects of EL, such as isolation, alienation, emptiness and a feeling of being abandoned. The empirical findings were divided into two categories: experiences of EL and circumstances in which EL arises. A definition of EL is also suggested, based on the two main characteristics identified. Conclusion: In order to meet patients’ needs, it is an ethical duty for healthcare staff to be able to recognise experiences of EL, that is, to communicate with the patients about these experiences in an appropriate manner. This in turn demands knowledge about existential issues and skills to deal with them.
  • Rämgård, Margareta, et al. (författare)
  • Det sociala sammanhanget : om Finsam MittSkånes arbete mot utanförskap
  • 2018
  • Bok (övrigt vetenskapligt)abstract
    • Finsam MittSkåne (där kommunerna Eslöv, Hörby och Höör ingår) har mellan åren 2012–2017 initierat och drivit ett flertal stora samverkansinsatser. I denna bok beskrivs tre av dessa insatser. Det som dessa tre insatser haft gemensamt är dels att de syftat till att öka graden av självförsörjning bland deltagarna, dels att de alla utgått från ett salutogent perspektiv. I detta perspektiv har det sociala sammanhanget och känslan av sammanhang haft särskilt stor betydelse. Malmö universitet har under flera år haft olika uppdrag för Finsam MittSkåne att studera, kartlägga och följa upp dessa insatser. Denna bok sammanfattar de erfarenheter som de olika rapporterna beskriver, men den ger även en djupare teoretisk bakgrund som inte beskrivits i rapporterna.
  • Sundström, Malin, et al. (författare)
  • Encountering existential loneliness among older people perspectives of health care professionals
  • 2018
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - 1748-2623. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Existential loneliness is part of being human that is little understood in health care, but, to provide good care to their older patients, professionals need to be able to meet their existential concerns. The aim of this study was to explore health care professionals' experiences of their encounters with older people they perceive to experience existential loneliness.METHOD: We conducted 11 focus groups with 61 health professionals working in home care, nursing home care, palliative care, primary care, hospital care, or pre-hospital care. Our deductive-inductive analytical approach used a theoretical framework based on the work of Emmy van Deurzen in the deductive phase and an interpretative approach in the inductive phase.RESULTS: The results show that professionals perceived existential loneliness to appear in various forms associated with barriers in their encounters, such as the older people's bodily limitations, demands and needs perceived as insatiable, personal shield of privacy, or fear and difficulty in encountering existential issues.CONCLUSION: Encountering existential loneliness affected the professionals and their feelings in various ways, but they generally found the experience both challenging and meaningful.
  • Sundström, Malin, 1968-, et al. (författare)
  • Health and social care planning in collaboration in olderpersons’ homes the perspectives of older persons, familymembers and professionals
  • 2018
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 32:1, s. 147-156
  • Tidskriftsartikel (refereegranskat)abstract
    • Providing health and social care to older persons is challenging, since older persons often have multiple diseases and a complex health situation. Hence many professions and organisations are involved. Lack of interprofessional and interorganisational collaboration leads to fragmented care. Care planning meetings before hospital discharge have long been used to overcome this fragmentation, but meetings conducted at the hospital have limitations in identifying long-term needs at home. A new model for health and social care planning in collaboration (HSCPC) in older persons' homes was introduced in two Swedish municipalities. The aim of this study was to gain a deeper understanding of the HSCPC-meeting from the perspectives of older persons, family members, and professionals. Ten care planning meetings from two municipalities were consecutively included. Interviews in retrospect with ten older persons, eight family members, and ten groups of professionals who had attended the HSCPC-meeting at home were analysed with a hermeneutic approach. Four themes emerged: unspoken agendas and unpreparedness, security and enhanced understanding, asymmetric relationships, and ambiguity about the mission and need for follow-up. The comprehensive interpretation is that the professionals handled the HSCPC-meeting mainly as a routine task, while the older persons and family members viewed it as part of their life course. Older persons are in an inferior institutional, cognitive and existential position. However, meeting together in the home partly reduced their inferior position. Findings from this study provide some general suggestions for how HSCPC-meetings should be designed and developed: attention of power relations, the importance of meeting skills and follow-up.
  • Årestedt, Liselott, et al. (författare)
  • Experiences of encounters with healthcare professionals
  • 2018
  • Ingår i: Journal of Clinical Nursing. - Wiley. - 1365-2702. ; 27:3-4, s. 836-847
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives: To describe and explore the experience of healthcare encounters in families living with chronic illness. Background: Living with chronic illness is a family concern and often includes frequent encounters with healthcare professionals. These encounters affect how persons with illness and family members handle everyday life. Disease-related explanations are perceived by healthcare professionals as being of higher importance than the actual experience of illness, even though patients are concerned with issues involving their everyday life. Design: A descriptive design with a qualitative approach. Methods: Narrative family interviews were conducted with twelve families, using a qualitative content analysis. Results: One main category was indicated following analysis, specifically “The impact of an accompanying family member.” Additionally, three subcategories were revealed; “The importance of collaboration,” “Mutual understanding,” “A desire to be confirmed in one’s illness”. Conclusions and relevance to clinical practice: Having a participating family member increased the sense of power in families during encounters with healthcare professionals. This participation constitutes a level of support, making it easier for families to handle everyday life due to illness. Family members are, in most cases, included in discussions and decisions, both before and after encounters, and it should be a natural for healthcare professionals to invite them to the encounter too. This is an offer that may not fit every family, but the person with illness or the family should at least have the opportunity to choose.
  • Abma, Tineke, et al. (författare)
  • Social impact of participatory health research : collaborative none- linear processes of knowledge mobilization
  • 2017
  • Ingår i: Educational Action Research. - Routledge. - 1747-5074. ; 25:4, s. 489-505
  • Tidskriftsartikel (refereegranskat)abstract
    • Social impact, defined as an effect on society, culture, quality of life, community services, or public policy beyond academia, is widely considered as a relevant requirement for scientific research, especially in the field of health care. Traditionally, in health research, the process of knowledge transfer is rather linear and one-sided and has not recognized and integrated the expertise of practitioners and those who use services. This can lead to discrimination or disqualification of knowledge and epistemic injustice. Epidemic injustice is a situation wherein certain kinds of knowers and knowledge are not taken seriously into account to define a situation. The purpose of our article is to explore how health researchers can achieve social impact for a wide audience, involving them in a non-linear process of joint learning on urgent problems recognized by the various stakeholders in public health. In participatory health research impact is not preordained by one group of stakeholders, but the result of a process of reflection and dialog with multiple stakeholders on what counts as valuable outcomes. This knowledge mobilization and winding pathway embarked upon during such research have the potential for impact along the way as opposed to the expectation that impact will occur merely at the end of a research project. We will discuss and illustrate the merits of taking a negotiated, discursive and flexible pathway in the area of community-based health promotion.
  • Larsson, Helena, et al. (författare)
  • Older persons’ existential loneliness, as interpreted by their significant others - an interview study study
  • 2017
  • Ingår i: BMC Geriatrics. - BioMed Central. - 1471-2318. ; 17:138
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In order to better understand people in demanding medical situations, an awareness of existential concerns is important. Studies performed over the last twenty years conclude that when dying and death come closer, as in the case with older people who are stricken by infirmity and diseases, existential concerns will come to the fore. However, studies concerning experiences of existential loneliness (EL) are sparse and, in addition, there is no clear definition of EL. EL is described as a complex phenomenon and referred to as a condition of life, an experience, and a process of inner growth. Listening to someone who knows the older person well, as significant others often do, may be one way of learning more about EL. Methods: This study is part of a larger research project on EL, the LONE study, where EL is explored through interviews with frail older people, their significant others and health care professionals. The aim of this study was to explore frail older (>75) persons’ EL, as interpreted by their significant others. The study is qualitative and based on eighteen narrative interviews with nineteen significant others of older persons. The data was analysed using Hsieh and Shannon’s conventional content analysis. Results: According to the interpretation of significant others, the older persons experience EL (1) when they are increasingly limited in body and space, (2) when they are in a process of disconnecting, and (3) when they are disconnected from the outside world. Conclusion: The result can be understood as if the frail older person is in a process of letting go of life. This process involves the body, in that the older person is increasingly limited in his/her physical abilities. The older person’s long-term relationships are gradually lost, and finally the process entails the older person’s increasingly withdrawing into him- or herself and turning off the outside world. The result of this study is consistent with previous research that has shown that EL is a complex phenomenon, but the implications of this research include a deepened understanding of EL. In addition, the study highlights the interpretations of significant others.
  • Rämgård, Margareta, et al. (författare)
  • PHR in Health and Social Care for older people – Regional development through learning within and across organisations
  • 2017
  • Ingår i: Educational Action Research. - Taylor & Francis. - 0965-0792. ; 25:4, s. 506-524
  • Tidskriftsartikel (refereegranskat)abstract
    • The study draws on findings from a series of seven participatory action research projects in community care for older people carried out over a period of eight years in 20 municipalities in southern Sweden. The analysis here looks at social impact across administrative levels and geographical scales. Different professional groups and care workers in community care participated, crossing divides between social work and health care. The participatory methods all involved a phase of individual reflection, a phase of reflection in practice with colleagues and mixed groups at the regional level, including unit managers and directors in some stages. Impacts concerned interprofessional learning and improved conditions for collaboration in care for older people across institutional boundaries as well as organisational learning across the municipalities. The action research approach was characterised by intensive work with values, empowering low-status professional groups. Social impacts were achieved beyond each project by benefitting from the multi-stakeholder design, using the structure of the organisations and the regional R&D department of the Association of Local Authorities. Over time, the different projects thus contributed to regional development ‘from below’. Nevertheless, employer perspectives tended to determine which conclusions from the projects were eventually implemented and prioritised. Continued reflective dialogue meetings between professional groups are therefore, needed as part of regular work processes. Local and regional structures need forms of autonomy that allow them to implement recommendations from participatory projects. Finally, employee perspectives need to be reflected in decision-making at all levels, particularly including low-status groups of care staff.
  • Rämgård, Margareta, et al. (författare)
  • Platsens betydelse för vården
  • 2017
  • Ingår i: Omvårdnad & Äldre. - Studentlitteratur. - 9789144102795 ; s. 567-580
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