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- Nordgren, Lena, et al.
(författare)
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An exploration of formal care from the perspective of middle-aged heart failure patients
- 2007
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953.
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Konferensbidrag (refereegranskat)abstract
- PurposeTo explore and describe the phenomenon: Formal care from the perspective of middle-aged persons living with HF.MethodsData was collected in seven unstructured interviews with middle-aged people (four men, three women) living with moderate-severe HF. It was analysed using a phenomenological approach.ResultsPeople with HF are dependent on care and treatment. Formal care, in the form of medication or other treatments, balances the life situation and gives hope for relief and access to a rich and meaningful life again. Care, thus, means hope for a change or improvement and makes life possible to live.Within the context of formal care patients are able to surrender to a secure retreat. When they surrender to care they should be the ones to whom care is given, but instead they turn into objects to be examined and treated, almost as if they were not there. As carers reduce patients to objects, to someone or something which is categorised, treated or informed on basis of standard guidelines, they feel powerless and that they have no value in the carer's eyes. The patients feel betrayed and they do not trust or rely on carers or on the care that they receive and need.Formal care is performed within an organisation with a structure which patients perceive as unclear. It is an organisation in which individuals are not seen or the individual's needs are not provided for. The organisation is to a great extent governed by routines, financial values and bureaucracy. The hospital environment and its routines depersonalise patients, which increases their feelings of uncertainty towards carers and to the caregiving organisation. Patients experience that carers expect them to be active in their health process and to participate in decision-making, but nobody clearly explain to them what they are up against, what they have do deal with. Instead of an opportunity to gain increased access to life, which in spite of illness and limits can be a bearable and meaningful life, patients are left with confusion and existential uncertainty.ConclusionDemands on high quality medical care signify that routines and recommendations must be followed. However, there is a danger, if care is performed solely on basis of routines and recommendations, that carers disregard the uniqueness in each patient's life situation. Carers need to find approaches to formal care that acknowledges individuals and at the same time ensures good quality medical care for patients.
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| 2. |
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| 3. |
- Nordgren, Lena, et al.
(författare)
-
An exploration of the phenomenon of formal care from the perspective of middle-aged heart failure patients
- 2007
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 6:2, s. 121-129
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite a considerable amount of research into heart failure there remains a divergence between the care available and patient's needs. The predominant biomedical perspective is more focused on the disease rather than the patient. In order to deliver formal care appropriate to the needs of middle-aged patients with moderate-severe HF it is imperative to gain the perspective of the individual patient. AIMS: The aim of the current study was to explore and understand the phenomenon: Formal care as experienced from the perspective of middle-aged patients living with HF. METHODS: The study was performed using a lifeworld perspective. Data was collected in seven unstructured interviews with middle-aged people living with moderate-severe HF. Data was analysed using a phenomenological approach. RESULTS: Formal care, as experienced by middle-aged patients living with moderate to severe HF, means hope to once again be able to have access to life. However, the meaning of formal care is ambiguous, which signifies that care means both health and suffering at the same time. The essence's meaning constituents are: dependency of care, surrender to care and unclear participation. CONCLUSION: The experience of formal care means both well-being and suffering at the same time. Patients' suffering in relation to formal care can be reduced if formal carers act from an ethical patient perspective point of view and if carers regard patients' lived experiences.
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| 4. |
- Nordgren, Lena, et al.
(författare)
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Being on sick leave due to heart failure : Encounters with social insurance officers and associations with sociodemographic factors and self-estimated ability to return to work.
- 2016
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 15:3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Little is known about sick leave and the ability to return to work (RTW) for people with heart failure (HF). Previous research findings raise questions about the significance of encounters with social insurance officers (SIOs) and sociodemographics in people sick-listed due to HF.AIMS: To investigate how people on sick leave due to HF experience encounters with SIOs and associations between sociodemographic factors, experiences of positive/negative encounters with SIOs, and self-estimated ability to RTW.METHODS: This was a population-based study with a cross-sectional design. The sample consisted of 590 sick-listed people with HF in Sweden. A register-based investigation supplemented with a postal survey questionnaire was conducted. Bivariate correlations and logistic regression analysis was used to test associations between sociodemographic factors, positive and negative encounters, and self-estimated ability to RTW.RESULTS: People with low income were more likely to receive sickness compensation. A majority of the responders experienced encounters with SIOs as positive. Being married was significantly associated with positive encounters. Having a low income was related to negative encounters. More than a third of the responders agreed that positive encounters with SIOs facilitated self-estimated ability to RTW. High income was strongly associated with the impact of positive encounters on self-estimated ability to RTW.CONCLUSION: Encounters between SIOs and people on sick leave due to HF need to be characterized by a person-centred approach including confidence and trust. People with low income need special attention.
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| 7. |
- Nordgren, Lena, et al.
(författare)
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Symptoms experienced in the last six months of life in patients with end-stage heart failure
- 2003
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Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151 .- 1873-1953. ; 2:3, s. 213-217
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: Despite today's modern therapy, the advancement of chronic heart failure (CHF) has not been curbed (Dying from heart failure: lessons from palliative care, BMJ, 317, 1998, 961-962, Editorial). Consequently, the suffering in patients with end-stage CHF is still present. The knowledge on the frequency of symptoms in these patients is scarce. AIMS: The aim of this study was to achieve a deeper understanding of patients with end-stage CHF and to describe symptoms in these patients during the last 6 months of life by examining documentation in medical records. METHODS: The study adopted a descriptive, retrospective design using record reviews to collect data, in which 80 medical records of patients hospitalised for CHF in 1995 were reviewed. Descriptive statistics and Student's t-tests were performed. RESULTS: Breathlessness was the most common symptom (men 90%, women 86%). The largest gender difference was on limitation in physical activity (men=77%, women=37%, total=49%, P=0.001). CONCLUSION: (1) Twenty-one symptoms were observed, implicating that, patients with CHF in later stages of the disease experience a wide range of symptoms. (2) Despite the fact that several symptoms were documented by both nurses and physicians, it is quite remarkable that symptom-controlling measures were only provided sparingly. (3) A palliative care approach may benefit patients suffering from end-stage CHF.
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