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  • Håkanson, Cecilia, et al. (författare)
  • Struggling with an unfamiliar and unreliable body : the experience of irritable bowel syndrome
  • 2009
  • Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - Oxford : Blackwell Publishing. - 1752-9824. ; 1:1, s. 29-38
  • 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.
  • Benzein, Eva, et al. (författare)
  • Families' importance in nursing care : nurses' attitudes--an instrument development
  • 2008
  • Ingår i: Journal of Family Nursing. - 1074-8407. ; 14:1, s. 97-117
  • Tidskriftsartikel (refereegranskat)abstract
    • This article describes the development and testing of a research instrument, Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA), designed to measure nurses' attitudes about the importance of involving families in nursing care. The instrument was inductively developed from a literature review and tested with a sample of Swedish nurses. An item-total correlation and a first principal component analysis were used to validate the final instrument, including a second principal component analysis to analyze dimensionality, and Cronbach's alpha was used to estimate internal consistency. The instrument consists of 26 items and reveals four factors: families as a resource in nursing care, family as a conversational partner, family as a burden, and family as its own resource. Cronbach's alpha was 0.88 for the total instrument and 0.69 to 0.80 for the subscales. The instrument requires further testing with other nurse populations.
  • Edvardsson, Tanja, et al. (författare)
  • Subjective quality of life in persons with low-grade glioma and their next of kin
  • 2009
  • Ingår i: International Journal of Rehabilitation Research. - Baltimore, Md. : Lippincott Williams & Wilkins. - 0342-5282. ; 32:1, s. 64-70
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with low-grade glioma have a longer survival than patients with highly malignant glioma, and for this reason questions of quality of life (QoL) are of particular importance to such patients as well as to their next of kin. No studies have been found in which both adult patients with low-grade glioma and their next of kin have estimated their own QoL. This study was therefore designed to investigate the subjective QoL of these two groups. Thirty-nine patients with low-grade glioma selected from a well-defined county population and 27 next of kin participated in the study. The questionnaire used in the study was the subjective estimation of QoL. The main results and conclusions are as follows: the variable absence of work/meaningful occupation showed statistically significant lower ratings among patients than among next of kin. The results show significant influence mainly on the patients' and their next of kin's internal psychological condition; related to background variables but the pattern in the results was inconsistent. There is a need for recurrent rehabilitation during this long-term disease, and a need to give vocational rehabilitation to support the patient's desire to have a meaningful occupation. It is also of importance to include the patient's next of kin when offering rehabilitation.
  • Boström, Katrin, et al. (författare)
  • Being the next of kin of an adult person with muscular dystrophy
  • 2006
  • Ingår i: Clinical Nursing Research. - 1054-7738. ; 15:2, s. 86-104
  • Tidskriftsartikel (refereegranskat)abstract
    • A chronic disorder affects all members of the family in various ways. The aim of this study is to elucidate the next of kin's (N= 36) experiences when an adult family member has muscular dystrophy. The relationships were partner (36%, n= 14), parent (18%, n= 7), child (21%, n= 8), sibling (15%, n= 6), and other relative (3%, n= 1). Latent content analysis is employed and involves an interpretation of the interviewtext. The results showthe meaning of being close to a person with muscular dystrophy through the themes that emerged: exposure of the family; the span between obligation and love; being vigilant, protective, and supportive; and striving for an ordinary life. This study reveals a need for healthcare staff to understand the next of kin's narrated meaning of changes when a family member has a progressive disease.
  • Pettersson, Ingvor, et al. (författare)
  • Lifeworld perspectives on assistive devices : lived experiences of spouses of persons with stroke
  • 2005
  • Ingår i: Scandinavian Journal of Occupational Therapy. - London : Taylor & Francis. - 1103-8128. ; 12:4, s. 159-169
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this study was to explore how spouses of persons with a disability following stroke describe their lived experiences regarding assistive devices in everyday life. A phenomenological lifeworld approach was used and conversational interviews were conducted with 12 spouses. Their lived experiences of assistive devices were explored in relation to four lifeworld existentials intertwined in everyday life. The results showed that lived body concerns aspects of feelings, habits, and incorporation of the devices with one's own body. The devices are, from the spouses' perspective, a prerequisite for their partner with stroke living at home. Successively the devices are incorporated into the couples' homes, and they provide a new view of the environment, aspects related to lived space. The devices bring about a changed relation to lived time, related to past, present, and future. Further, lived human relation concerns changed relationships to husbands/wives with stroke, including a great responsibility due to the devices and their usage. The results also included stigmatizing aspects and a twofold relationship to health professionals regarding participation in decisions about prescribing assistive devices. Understanding the unique meaning of assistive devices from the spouses' perspective is vital for occupational therapists prescribing such devices.
  • Pettersson, Ingvor, et al. (författare)
  • The value of an outdoor powered wheelchair with regard to the quality of life of persons with stroke : a follow-up study
  • 2007
  • Ingår i: Assistive technology. - New York, NY : Demos. - 1040-0435. ; 19:3, s. 143-153
  • 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.
  • Svantesson, Mia, et al. (författare)
  • Nurses’ and physicians’ opinions on aggressiveness of treatment for general ward patients
  • 2006
  • Ingår i: Nursing Ethics. - 0969-7330. ; 13:2, s. 147-162
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to evaluate agreement between nurses’ and physicians’ opinions regarding aggressiveness of treatment and to investigate and compare the rationales on which their opinions were based. Structured interviews regarding 714 patients were performed on seven general wards of a university hospital. The data gathered were then subjected to qualitative and quantitative analyses. There was 86% agreement between nurses’ and physicians’ opinions regarding full or limited treatment when the answers given as ‘uncertain’ were excluded. Agreement was less (77%) for patients with a life expectancy of less than one year. Disagreements were not associated with professional status because the physicians considered limiting life-sustaining treatment as often as the nurses. A broad spectrum of rationales was given but the results focus mostly on those for full treatment. The nurses and the physicians had similar bases for their opinions. For the majority of the patients, medical rationales were used, but age and quality of life were also expressed as important determinants. When considering full treatment, nurses used quality-of-life rationales for significantly more patients than the physicians. Respect for patients’ wishes had a minor influence.
  • Tishelman, Carol, et al. (författare)
  • Using undergraduate nursing students as mediators in a knowledge transfer programme for care for patients with advanced cancer
  • 2008
  • Ingår i: European Journal of Cancer Care. - 0961-5423. ; 17:3, s. 253-260
  • 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.
  • Widar, Marita, et al. (författare)
  • Living with long-term pain after stroke
  • 2007
  • Konferensbidrag (övrigt vetenskapligt)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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