| 1. |
- 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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| 2. |
- Asplund, Kenneth, et al.
(författare)
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Facial expressions in severely demented patients : a stimulus-response study of four patients with dementia of the Alzheimer type
- 1991
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 6:8, s. 599-606
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Tidskriftsartikel (refereegranskat)abstract
- The ability to exhibit facial expressions was studied in four patients with severe dementia of the Alzheimer type (SDAT), by means of the Facial Action Coding System (FACS) and physiological responses (heart rate, respiration, skin temperature) under pleasant and unpleasant stimulus conditions. Complex facial expressions that could be interpreted as expressions of emotions were not seen. An increase in the number of facial movements and changes in the physiological responses were seen most markedly under the unpleasant stimulus condition. The patients' reactions during the assumed pleasant stimulus conditions indicated comfort. Different reactions were obtained among the patients. The importance of developing further methods to identify and interpret facial movements in nurse-patient relationships is emphasized.
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| 3. |
- Rahm Hallberg, Ingalill, et al.
(författare)
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Nurses´ experiences of strain and their reactions in the care of severely demented patients.
- 1995
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 10:9, s. 757-766
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Tidskriftsartikel (refereegranskat)abstract
- All nurses (N = 132) on the wards specializing in the care of the demented within a municipality were given two scales to assess their view of common patient actions and how easy they thought those actions were to deal with in the care situation, and to assess their emotional reactions during the provision of care. Also the Maslach burnout Inventory (MBI) and the Work Related Strain Inventory (WRSI) were used to test concurrent validity. Based on principal component analysis, the nurses' view of patient actions resulted in being agitated, unruly, living empty lives, being peaceful, dependent, non-responsive and cooperative, and the nurses' view of difficulties in dealing with patient actions revealed ability to manage deprivation, agitation, desertedness, wilfulness, peacefulness and cooperation. A three-factor solution was chosen for the emotional reactions: feelings of devotion - rejection, association - dissociation and usefulness - uselessness. Agitated and dependent patient actions were found to be most common while agitation and desertedness were regarded as most difficult. Patient seen as agitated and living empty lives related to the provision of care being difficult while dependence related to care as being easy to provide. Thus the findings gave further support to the belief that viewing the patient's life as meaningful as well as being able to develop a cooperative nurse-patient relationship is crucial for nurses' experience of strain. Thus support should be directed towards achieving this kind of relationship.
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