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Sökning: LAR1:gu > Tidskriftsartikel > Örebro universitet > Ekman Inger > Göteborgs universitet

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1.
  • Ehrenberg, Anna, et al. (författare)
  • Older patients with chronic heart failure within Swedish community health care: A record review of nursing assessments and interventions
  • 2004
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 13:1, s. 90
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Older patients with chronic heart failure constitute a large group within community home care that is at high risk for re-hospitalization. However, hospital readmission can be prevented if early signs of deterioration are recognized and proper interventions applied.AIMS AND OBJECTIVES: The aim of the study was to audit nursing care for older chronic heart failure patients within the Swedish community health care system.DESIGN: The study adopted a retrospective descriptive design.METHODS: In a Swedish urban municipality nursing documentation from 161 records on patients diagnosed with chronic heart failure was collected retrospectively from community nursing home care units. Patient records were reviewed for characteristics of nursing care and assessed for comprehensiveness in recording.RESULTS: The main results showed that medical care of patients with chronic heart failure was poorly recorded, making it possible only to follow fragments of the care process. The nursing notes showed poor adherence to current clinical guidelines. Only 12% of the records contained notes on patients' body weight and only 4% noted patients' knowledge about chronic heart failure. When interventions did occur, they largely consisted of drug administration.CONCLUSIONS: The findings revealed flaws in the recording of specific assessment and interventions as well as poor adherence to current international clinical guidelines.RELEVANCE TO CLINICAL PRACTICE: Supportive guidelines available at the point of care are needed to enhance proper community-based home health care for older patients with chronic heart failure.
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2.
  • Ekman, Inger, 1952-, et al. (författare)
  • Feasibility of a nurse-monitored outpatient-care programme for elderly patients with moderate-to-severe, chronic heart failure
  • 1998
  • Ingår i: European Heart Journal. - 0195-668X. ; 19:8, s. 1254-60
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To evaluate the feasibility of a nurse-monitored, outpatient-care program for elderly patients previously hospitalized with chronic heart failure.METHODS AND RESULTS: Patients with chronic heart failure hospitalized in the medical wards were screened to find those eligible for a randomized study to compare the effect of a nurse-monitored, outpatient-care programme aiming at symptom management, with conventional care. The inclusion criteria were patients classified in New York Heart Association classes III-IV, age 65 years, and eligibility for an outpatient follow-up programme. The total in-hospital population of patients discharged with a heart-failure diagnosis was surveyed. Eighty-nine per cent of all the hospitalized patients (n=1541) were 65 years old. Of these, 69% (n=1058) were treated in the medical wards which were screened. The study criteria were met by 158 patients (15%). No visits to the nurse occurred in 23 cases among the 79 patients randomized to the structured-care group (29%), mainly on account of death or fatigue. The numbers of hospitalizations and hospital days did not differ between the structured-care and the usual-care groups.CONCLUSIONS: Given the selection criteria and the outline of the interventions, the outpatient, nurse-monitored, symptom-management programme was not feasible for the majority of these elderly patients with moderate-to-severe, chronic heart failure, mainly because of the small proportion of eligible patients and the high drop-out rate. Management of these patients would have to be more adjusted to their home situation.
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3.
  • Ekman, Inger, 1952-, et al. (författare)
  • The meaning of living with severe chronic heart failure as narrated by elderly people
  • 2000
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 14, s. 130-36
  • Tidskriftsartikel (refereegranskat)abstract
    • The meaning of elderly patients' experiences of living with chronic heart failure was studied. Narrative interviews were analysed using a phenomenological hermeneutic approach. 'Feeling imprisoned in illness' and 'feeling free despite illness' constituted the themes. These themes were interpreted as describing variations in awareness of the relationship between the self and the body. In theme 'feeling imprisoned in illness' the body's illness and disability hindered the subjects from being themselves. In the theme 'feeling free despite illness' the disabled body was not experienced as limiting, but rather as a part of the self. The patients' understanding of the illness must be interpreted by the caregiver, who also needs to be aware of different modes of communicating feeling about the illness.
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4.
  • Eldh, A. C., et al. (författare)
  • A comparison of the concept of patient participation and patients' descriptions as related to healthcare definitions
  • 2010
  • Ingår i: International Journal of Nursing Terminologies and Classifications. - 1744-618X. ; 21:1, s. 21-32
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE. To depict what patients describe as patient participation and whether descriptions of patient participation are affected by gender, age, healthcare contact, and duration of disease. DATA SOURCES. Current patients (n= 362) responded to a questionnaire on participation. DATA SYNTHESIS. Patients' descriptions focused on having knowledge, rather than being informed, and on interacting with health professionals, rather than merely partaking in decision making. CONCLUSIONS. Patients' descriptions of participation correspond with the International Classification of Functioning, Disability and Health's definition, which includes "being involved in a life situation." Healthcare legislation and professionals employ a narrower concept of patient participation as defined by, e.g., Medical Subject Headings. PRACTICE IMPLICATIONS. Findings suggest that health professionals need to embrace what patients describe as participation.
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5.
  • Eldh, Ann Catrine, et al. (författare)
  • Conditions for patient participation and non-participation in health care
  • 2006
  • Ingår i: Nursing Ethics. - 0969-7330. ; 13:5, s. 503-514
  • Tidskriftsartikel (refereegranskat)abstract
    • This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making.
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6.
  • Eldh, Ann Catrine, et al. (författare)
  • Considering patient non-participation in health care
  • 2008
  • Ingår i: Health Expectations. - 1369-7625. ; 11:3, s. 263-71
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: The aim of this study was to depict patient non-participation as described by a diverse group with recent experiences of being patients. BACKGROUND: Patient participation is regarded as a primary condition for optimal quality of care, suggesting that non-participation should be avoided. A common understanding of the concept of patient non-participation is needed. A discrepancy in definitions of patient non-participation has been found in health-care interactions, health-care classifications and health-care research, and little is known of what patient non-participation represents to patients. STUDY DESIGN: A survey consisting of closed-ended and open-ended questions was administered to persons that had recently been patients to gather respondents' descriptions of what they considered as patient non-participation. Qualitative content analysis was used to analyse free-text descriptions, and descriptive statistics were used for the close-ended alternatives. FINDINGS: Lacking information (e.g. not being provided with appropriate information) and lacking recognition (e.g. not being listened to and/or lacking recognition as an individual with individual needs and concerns) were significant aspects of patient non-participation. Furthermore, non-participation encompassed facing organization-centred, as opposed to patient-centred, health care as well as feeling insecure in health care interactions. CONCLUSION: The findings provide input for a better understanding of what patients experience as non-participation. Organising for the caregivers to be able to thoroughly listen to the patients' illness narratives would easily reduce the risk of patient's experiencing what is described as non-participation and would provide a sound base for patient learning needs.
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7.
  • Eldh, Ann Catrine, et al. (författare)
  • The meaning of patient participation for patients and nurses at a nurse-led clinic for chronic heart failure
  • 2006
  • Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151. ; 5:1, s. 45-53
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundThe legislation of many Western countries emphasizes active patient participation. Patients with chronic heart failure (CHF), however, have experienced participation differently from the general interpretation of legal definitions. Education improves uptake of self-management strategies yet knowledge is lacking about support of patients' own resources in CHF.AimTo explore the phenomena of patient participation and non-participation as shown in patient visits to a nurse-led clinic for CHF and as experienced by the patients and nurses.MethodsData triangulation of field notes from participatory observations and texts from narrative interviews with the patients and assigned nurse specialists. Data were analyzed according to the phenomenological hermeneutic tradition.FindingsPatients' experience of participation and non-participation was interpreted as “Being responsible and accepting responsibility” and “Lacking an equal relationship while being controlled”, respectively. Nurses experienced patient participation as “Getting information and security to act” and patient non-participation as “Not accepting”.ConclusionConflicting values of patients and nurses, which were interpreted with respect to participation and non-participation, presumably might influence patient information and education negatively. The issue of participation should be raised as a means of attaining concordance and to facilitate patient participation with education specifically tailored to the individual patient's needs.
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8.
  • Eldh, Ann Catrine, et al. (författare)
  • The phenomena of participation and non-participation in health care : experiences of patients attending a nurse-led clinic for chronic heart failure
  • 2004
  • Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151. ; 3:3, s. 239-246
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Patient participation is stressed in the health care acts of many western countries yet a common definition of the concept is lacking. The understanding of experiences of patients with chronic heart failure (CHF) who attend nurse-led specialist clinics, a form of care suggested as beneficiary to this group, may promote a better understanding of participation. Aim: To investigate the meanings of participation and non-participation as experienced by patients living with CHF. Methods: Narrative interviews analysed in the phenomenological hermeneutic tradition inspired by Ricoeur where the interpretation is made in the hermeneutic circle, explaining and understanding the experienced phenomena. Findings: Participation was experienced as to “be confident”, “comprehend” and “seek and maintain a sense of control”. Non-participation was experienced as to “not understand”, “not be in control”, “lack a relationship” and “not be accountable”. The findings indicate that the experiences of participation and non-participation can change over time and phases of the disease and treatment. Conclusion: The study suggests an extended view on the concept of participation. Patients' experiences of participation in health care can vary and should therefore be an issue for dialogue between nurses and patients with CHF in nurse-led specialist clinics.
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