| 1. |
- Widar, Marita, et al.
(författare)
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Caring and uncaring experiences as narrated by persons with long-term pain after a stroke
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - Oxford : Blackwell. - 0283-9318 .- 1471-6712. ; 21:1, s. 41-47
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe how persons with long-term pain after a stroke experience their care. The study is part of a larger research project concerning a group persons suffering from long-term pain after a stroke. Qualitative interviews were performed with 43 persons suffering from central poststroke pain, nociceptive pain or tension-type headache after their stroke incident. Content congruence emerged among the narratives (n = 43), and therefore the most information-rich ones (n = 23) were selected for deeper investigation by means of qualitative content analysis. The results reveal the patients’ need for being respected, understood and supported, also for being given adequate time and information. Accessibility and continuity in the professional contacts and with regard to medical and physical treatment was emphasized. The participants’ narratives highlight the importance of the professionals having knowledge of pain and pain management.
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| 2. |
- Anderzén-Carlsson, Agneta, et al.
(författare)
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Children's fear as experienced by the parents of children with cancer
- 2007
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Ingår i: Journal of Pediatric Nursing. - Amsterdam : Elsevier. - 0882-5963 .- 1532-8449. ; 22:3, s. 233-244
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Tidskriftsartikel (refereegranskat)abstract
- It is known that children with cancer experience and express fear, but little is found in the literature about how the parents experience their child's fear. This study aimed to highlight the parents' lived experience and understanding of their child's fear. Focus group interviews with 15 parents were performed. Data were analyzed through a phenomenological hermeneutic method. Fear in children with cancer is described by the parents as a multidimensional phenomenon, which is somehow difficult to identify. It appears in contrast to the absence of fear. The comprehensive understanding of the results reveals that the parents experience their children's fear as both a suffering and an ethical demand for the parents to answer.
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| 3. |
- Håkanson, Cecilia, et al.
(författare)
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Struggling with an unfamiliar and unreliable body : the experience of irritable bowel syndrome
- 2009
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - Oxford : Blackwell Publishing. - 1752-9816 .- 1752-9824. ; 1:1, s. 29-38
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To describe the phenomenon living with irritable bowel syndrome from a life-world perspective.Background. Ten to twenty per cent of the adult population in the world is known to live with irritable bowel syndrome. The life-world experience of people with irritable bowel syndrome has been paid little attention. A deeper understanding about the phenomenon living with irritable bowel syndrome is of interest for the future development of care.Design and methods. The study was performed using a phenomenological method. Data was collected by in-depth, open interviews performed in 2006, with nine persons between 25–55 years, diagnosed with irritable bowel syndrome. The interviews were analysed according to the method of Giorgi.Results. Six interrelated key constituents have been identified: Having an altered self-image, feeling ashamed, distrusting the body, feeling tired, blaming oneself, and finding solutions. A structure has been formulated, describing that living with irritable bowel syndrome means struggling with an unfamiliar and unreliable body. Tiredness, distrust, and feelings of shame towards the body bring about limitations in everyday life. At the same time, living with irritable bowel syndrome means having a strong will to exceed the limitations and become familiar with one self.Conclusion. This study suggests that living with irritable bowel syndrome means to struggle with an unfamiliar and unreliable body that brings about changes of self-image and limitations in every day life. Feelings of distrust, shame and embarrassment towards troublesome symptoms, are important contributions to the limitations experienced.Relevance to clinical practice. Nurses have a major role to play in the care for people with irritable bowel syndrome. A caring perspective, in which the life-world is central, is an important approach to care for these persons. Using the dialogue as a forum where patients can share their unique life-world experiences lets nurses gather knowledge that is essential in helping patients identify and acknowledge new and positive understandings of the lived body.
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| 4. |
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| 5. |
- Petersson, Pia, 1961-, et al.
(författare)
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Telling stories from everyday practice, an opportunity to see a bigger picture : a participatory action research project about developing discharge planning
- 2009
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Ingår i: Health and Social Care in Community. - Oxford : Blackwell Science. - 1365-2524 .- 0966-0410. ; 17:6, s. 548-556
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Tidskriftsartikel (refereegranskat)abstract
- In spite of laws, rules and routines, findings from Swedish as well as international research show that discharge planning is not a simple matter. There is considerable knowledge about discharge planning but the quality of the actual process in practice remains poor. With this in mind, a research and developmental (R & D) health and social care network decided to use Participation Action Research (PAR) to explore the discharge planning situation in order to generate new ideas for development. This paper reports on the research process and the findings about our enhanced understanding about the discharge planning situation. Story Dialogue Method was used as a method. The method is based on stories from everyday practice. The stories are used as ‘triggers’ to ask probing questions in a dialogical and structured form. Local theory is developed to help the participants to find solutions for action in the practice. Our findings were that the discharge planning situation could be seen as a system including three interconnected areas: patient participation, practitioners’ competence and organisational support. To reach good quality in discharge planning all this three issues need to be developed, but not only as routines and forms. Rather, when developing a discharge planning situation a system where relational aspects such as confidence and continuity are essential and thus needs to be considered. To achieve a change the core problem needs to be clarified. When the issue is complex the solution needs to consider the bigger picture and not just the parts. Telling stories from everyday practice and to systematically reflect and analyse those in inter-professional groups can create opportunities for enhanced understanding as well as be a vehicle for future change of practice.
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| 6. |
- Skovdahl, Kirsti, 1964-, et al.
(författare)
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Tactile stimulation associated with nursing care to individuals with dementia showing aggressive or restless tendencies : an intervention study in dementia care
- 2007
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Ingår i: International Journal of Older People Nursing. - Oxford : Blackwell Publishing. - 1748-3735 .- 1748-3743. ; 2, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This study aimed to describe from documentation both the caregivers' experiences of giving tactile stimulation to five people with moderate-to-severe dementia and who showed aggressive or restless tendencies, and the changes seen in them. Background. Clinical experiences indicate that tactile stimulation can contribute to a feeling of trust and confirmation as well as to improving communication, promoting relaxation and easing pain. There is, however, very little scientific documentation of the effects of touch massage for people with dementia. Design. From caregivers' documentation (28 weeks) of experiences, the giving of tactile stimulation to five randomly selected people with dementia showing aggressive or restless tendencies and the subsequent changes noticed. Method. The documentation was analysed by using qualitative content analysis. Results. All residents displayed signs of positive feelings and relaxation. The caregivers stated that they felt able to interact with the residents in a more positive way and that they felt they had a warmer relationship with them. Conclusion. Tactile stimulation can be seen as a valuable way to communicating non-verbally, of giving feedback, confirmation, consolation or a feeling of being valuable and taken care of. Relevance to clinical practice. Tactile stimulation has to be administered with respect and care, and given from a relational ethics perspective. Otherwise, there is a risk that tactile stimulation will be used merely as a technique instead of as a part of an effort to achieve optimal good, warm nursing care.
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| 7. |
- Svantesson, Mia, et al.
(författare)
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Interprofessional ethics rounds concerning dialysis patients : staff's ethical reflections before and after rounds
- 2008
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Ingår i: Journal of Medical Ethics. - London : BMJ Publ. Group. - 0306-6800 .- 1473-4257. ; 34:5, s. 407-413
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether ethics rounds stimulated ethical reflection. METHODS: Philosopher-ethicist-led interprofessional team ethics rounds concerning dialysis patient care problems were applied at three Swedish hospitals. The philosophers were instructed to stimulate ethical reflection and promote mutual understanding between professions but not to offer solutions. Questionnaires directly before and after rounds were answered by 194 respondents. The analyses were primarily content analysis with Boyd's framework but were also statistical in nature. FINDINGS: Seventy-six per cent of the respondents reported a moderate to high rating regarding new insights on ethical problem identification, but the ethics rounds did not seem to stimulate the ethical reflection that the respondents had expected (p < 0.001). Dominant new insights did not seem to fit into traditional normative ethics but were instead interpreted as hermeneutic ethics. This was illustrated in the extended perspective on the patient and increased awareness of relations to other professions. Regarding insights into how to solve ethical problems, the request for further interprofessional dialogue dominated both before and after rounds. CONCLUSION: The findings show the need for interprofessional reflective ethical practice but a balance between ethical reflection and problem solving is suggested if known patients are discussed. Further research is needed to explore the most effective leadership for reflective ethical practice.
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| 8. |
- Tishelman, Carol, et al.
(författare)
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Using undergraduate nursing students as mediators in a knowledge transfer programme for care for patients with advanced cancer
- 2008
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Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 0961-5423 .- 1365-2354. ; 17:3, s. 253-260
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Tidskriftsartikel (refereegranskat)abstract
- Nursing today faces numerous challenges. Societal changes lead to reorganization of health care, changing workloads with sicker patients in hospital and home care, and limited economic resources. The increasing and changing nature of knowledge needed for expert care provision challenges nurses to continually update their competencies. These are issues demanding proactive and dynamic changes in the way nurses conceive their mandates and practice. The aim of the action-research project presented here was to foster improved quality of care for patients with advanced cancer through collaborative endeavours integrating cancer nursing clinical practice, research and education in a knowledge exchange programme. The programme was based on input about caregiving needs from multi-professional staff caring for patients with advanced cancer in a variety of healthcare settings. Undergraduate baccalaureate nursing students were then engaged in literature studies to help address these needs. Results of the studies were communicated back to the involved clinicians in a variety of ways. In this paper, we discuss what we have experienced as opportunities and obstacles in conducting the project, based on our reflections and external evaluations. This is linked to a broader discussion of ways of integrating cancer nursing research, education and practice.
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| 9. |
- Wadensten, Barbro, et al.
(författare)
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Nursing staff's description of a good encounter in nursing homes
- 2009
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Ingår i: International Journal of Older People Nursing. - Oxford : Blackwell. - 1748-3735 .- 1748-3743. ; 4:3, s. 203-210
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Tidskriftsartikel (refereegranskat)abstract
- Background. It has been stated that there is too little research on what constitutes good communication and good encounters in nursing homes. Aim and objectives. The aim of the present study was to examine nursing staff members’ views on what is important in caring encounters with older people living in nursing homes. Design. A qualitative descriptive study using focus group interviews with staff in a nursing home in Sweden. Method. Focus group interviews, analysed using qualitative content analysis. Results. Three main themes emerged describing nursing staff members’ opinions about the content of good encounters: ‘Caring encounters from the perspective of equality’, ‘Caring encounters from the perspective of integrity’ and ‘Caring encounters from the perspective of promoting security’. Conclusions. The nursing staff had theoretical knowledge of what constitutes a good caring encounter, but they seemed to need more supervision and training to develop their ways of encountering older people as well as to become stronger in their professional role. When performing such training with staff, the methodology of appreciative inquiry could be a powerful tool. Relevance to clinical practice. It is important to help staff become empowered and to help them develop and improve their encounters with older care recipients.
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| 10. |
- Widar, Marita, et al.
(författare)
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Living with long-term pain after stroke
- 2007
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- ObjectivesThe general aim of this thesis was to classify and describe long-term pain two years after a stroke and to describe the experiences of pain, and the consequences it has on the persons’ lives.Material and methodsThe studies comprised 43 persons, 13 women and 30 men, aged 33-82 years, with pain after stroke and no other major pain conditions and able to participate in an interview and independently answer questionnaires.The studies were conducted from a multidimensional perspective on pain, combining quantitative and qualitative methods. Clinical examinations were somatic, neurological and Quantitative Sensory Testing (QST). The Pain-O-Meter, ADL staircase, Self-reported impairment, SF-36 and Hospital Anxiety and Depression Scale were used. Qualitative interviews were performed and analyzed with content analysis.ResultsThree types of pain were classified: Neuropathic (central post-stroke pain) (n=15), nociceptive/mainly shoulder pain (n=18) and tension-type headache (n=10). Pain onset, within one to six months in most of the cases was after discharge from the hospital. Continuous pain or pain almost every day was reported by nearly two-thirds. The pain was mostly described as troublesome, annoying and tiring in all groups. The rating of pain intensity revealed individual differences among the participants within the pain groups. In addition to long-term pain, the participants suffered several impairments and nearly half of them were dependent on others, and two-thirds on assistive devices. Several coping strategies were described, most often problem-focused. Their health-related quality of life was decreased, mostly related to their long-term pain and physical impairments. Their experiences of caring revealed the need of improvements in knowledge about long-term pain, attention and understanding among the professionals, and continuity in the contacts.ConclusionAll professionals need knowledge about pain conditions after stroke. Pain assessment and classification, regular follow-up and documentation are required in order to prevent unnecessary suffering. Patients need attention, understanding and continuity in contacts with professionals. Further, information and education about pain and treatment/caring interventions are required in the case of both the sufferer and next of kin.
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