| 1. |
- alharbi, tariq, 1979-, et al.
(författare)
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Organizational culture and the implementation of person-centered care: Results from a change process in Swedish hospital care.
- 2012
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Ingår i: Health Policy. - 0168-8510. ; 108:2-3, s. 294-301
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding.
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| 2. |
- Andersson, Susanne, 1957-, et al.
(författare)
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It's up to me! Experiences of living with pre-diabetes and the increased risk of developing type 2 diabetes mellitus
- 2008
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Ingår i: Primary Care Diabetes. - 1751-9918. ; 2:4, s. 187-93
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To explore experiences of pre-diabetes and the associated increased risk of type 2 diabetes mellitus. METHODS: Eight participants with pre-diabetes were interviewed for a 45-60 min period. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological hermeneutic approach. RESULTS: Living with pre-diabetes means existing on the borderline of being healthy and suffering from T2DM. Three themes were formulated; "seeing possibilities in an uncertain future", "facing obstacles and loss of liberty" and "balancing between possibilities and obstacles" Being on the borderline and balancing between possibilities and obstacles were interpreted as a distressing feeling of being at increased risk of developing T2DM, although this feeling can change to one of either facing possibilities or facing obstacles. CONCLUSIONS: Special focus must be directed towards persons with pre-diabetes, as they are caught between possibilities and obstacles. Advanced care in the form of health dialogues can convince these people of their own abilities to influence the outcome of pre-diabetes. The result of this study can guide health care practitioners in comprehending each participant's understanding of the situation, thus helping them to create pedagogical dialogues in which patients' experiences, conceptions, explanations as well as explicit and implicit questions are identified.
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| 3. |
- Andersson, Susanne, 1957-, et al.
(författare)
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Perceived symptoms in people living with impaired glucose tolerance.
- 2011
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Ingår i: Nursing Research and Practice. - 2090-1429. ; 2011:Article ID 937038
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to identify symptoms in people with impaired glucose tolerance (IGT) and describe their experiences of living with the symptoms which they related to their condition. Twenty-one participants, from a cross-sectional population-based study, diagnosed as having IGT, were invited for an interview. The interviews were analyzed in two phases by means of a manifest and latent content analysis. The narratives included seven categories of symptoms (and more than 25 different symptoms) presented by the respondents. This study shows that symptoms such as the patient's own interpretation of different perceptions in the body must be considered, as well as signs and/or objective observations. Symptoms ought to be seen as complementary components in the health encounter and health conversation. The results of this study indicate that health professionals should increase their awareness of the balance between the implicit and the explicit bodily sensations that individuals communicate. Further studies are needed.
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| 4. |
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| 5. |
- Berghammer, Malin, 1970-, et al.
(författare)
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Self-reported health status (EQ-5D) in adults with congenital heart disease
- 2011
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Ingår i: International journal of cardiology. - 1874-1754. ; In Press
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Today, more patients with congenital heart disease (CHD) reach adulthood. There are conflicting findings concerning the relationship between quality of life (QoL) or health state for adults with CHD and the complexity of their CHD. The aim of the study was, firstly, to compare the reported health status and health perception of adult patients with CHD and, secondly, to investigate what variables influenced the patients' health status and health perception. METHODS: Data from 1435 patients completing the EQ-5D questionnaire, which includes reported health status and health perception, were analyzed. RESULTS: Valid EQ-5D data were reported by 1274 patients, showing overall results indicating a good health status. Problems were most frequently reported in the dimension "pain/discomfort" (31.9%) and "anxiety/depression" (29.8%). Higher occurrence of problems were reported by patients with complex disease i.e. single ventricle (p<0.001) and by female patients (p<0.0001). Symptomatic patients reported a lower health status (p<0.0001) and a lower perceived health on EQ-VAS (p<0.0001). Of the asymptomatic patients, 20.5% nevertheless reported problems in "pain/discomfort" and 22.2% in the "anxiety/depression" dimension. CONCLUSION: The health status of adults with CHD is influenced by symptoms, NYHA-classification, age and gender. Adults with CHD report a lower occurrence of problems in comparison to previously published results from a general population, but the importance of actively asking about the patient's experience is demonstrated by the high degree of asymptomatic patients reporting problems on EQ-5D.
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| 6. |
- Berghammer, Malin, 1970-, et al.
(författare)
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Young adults experiences of living with congenitala heart disease
- 2006
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Ingår i: International Journal of Cardiology. - 0167-5273. ; 110:3, s. 340-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Advances in care have improved the longevity and quality of life for children with congenital heart disease; however, many of them need lifelong highly qualified specialist care. The cardiac lesion involved may not always be the patient's main problem; issues related to quality of life may dominate. AIM: To explore and gain a deeper understanding of young adults experiences of living with congenital heart disease in order to enhance the quality of care provided by the health care system. METHOD: Transcribed in-depth interviews were analysed using a phenomenological-hermeneutic method. Six adults with congenital heart disease, aged 22-39 years old, were included in the study. RESULTS: Analyses yielded two themes, having the disease and living with illness, both originating from the main theme of ambivalence. The interviewees were ambivalent in how they viewed themselves, how they faced their daily life and how they dealt with their encounters with the health care system. They had to strike a balance between being different and not being different; being sick and being healthy; revealing their congenital heart disease or hiding it and living with a hidden handicap. They also had to cope with the disease and with the health care system. CONCLUSION: Young adults with congenital heart disease are ambivalent. They have a strong wish to be healthy and they might hide their symptoms from the healthcare personnel and sometimes even from themselves. A psychosocial preparedness when meeting these patients is necessary.
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| 7. |
- Berndtsson, Ina, 1953-, et al.
(författare)
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Thirty years of experience living with a continent ileostomy
- 2005
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Ingår i: Journal of Wound, Ostomy, and Continence Nursing. - 1071-5754. ; 32:5, s. 321
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study describes long-term adjustment of people with a continent ileostomy. SUBJECTS AND METHODS: Subjects were 68 people (25 males and 43 females) who underwent an operation for ulcerative colitis with a continent ileostomy (Kock pouch). The median number of years subjects had lived with a continent reservoir was 31 (range 29-36) at follow-up and the median subject age was 60 (40-89). Subjects completed a 36-item questionnaire designed to assess adjustment to ostomy surgery. Subjects ranked the questionnaire using a 6-point Likert scale; a response alternative "not relevant" was available. Content analysis was conducted on subjects' responses to an open-ended question covering aspects of their quality of life. RESULTS: High median adjustment ratings were found for all 36 statements; the maximum median rating of 6 appeared on 28 items. Eight items with the lowest median ratings were in the following domains: embarrassing situations, activity, body image, sexuality, and good care. Five items on medical care and 3 items on sexuality were most frequently considered "not relevant" by respondents. The most frequently mentioned quality-of-life domains were family, health, friends, and employment. Content analysis indicated that respondents were self-reliant, although they indicated that they experienced considerable impediments to bowel evacuation outside of the home. CONCLUSIONS: In the long-term, people with a continent ileostomy have good self-care. The quality and availability of public restrooms, however, reduces their daily activities away from home.
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| 8. |
- Bosworth, H. B., et al.
(författare)
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Medication adherence: a call for action
- 2011
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Ingår i: American heart journal. - 1097-6744. ; 162:3, s. 412
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Tidskriftsartikel (refereegranskat)abstract
- Poor adherence to efficacious cardiovascular-related medications has led to considerable morbidity, mortality, and avoidable health care costs. This article provides results of a recent think-tank meeting in which various stakeholder groups representing key experts from consumers, community health providers, the academic community, decision-making government officials (Food and Drug Administration, National Institutes of Health, etc), and industry scientists met to evaluate the current status of medication adherence and provide recommendations for improving outcomes. Below, we review the magnitude of the problem of medication adherence, prevalence, impact, and cost. We then summarize proven effective approaches and conclude with a discussion of recommendations to address this growing and significant public health issue of medication nonadherence.
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| 9. |
- Brännström, Margareta, et al.
(författare)
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Being a close relative of a person with severe, chronic heart failure in palliative advanced home care - a comfort but also a strain.
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 21:3, s. 338-344
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Tidskriftsartikel (refereegranskat)abstract
- Within previous research on family care of terminally ill people, studies have only rarely been carried out concerning heart failure care. This study aims to illuminate meanings of being a close relative of a person with severe, chronic heart failure (CHF) in palliative advanced home care (PAHC). Narrative interviews were conducted with three close relatives, tape-recorded, transcribed verbatim and a phenomenological-hermeneutic method was used to interpret the text. Meanings of being a close relative is to follow the life-threatening ups and downs, the person with CHF is going through. This means being on primary call, always on standby to mediate security and pleasure. In the deepest downs it is also to call for the back-up call i.e. the PAHC team, trusting their ability to show up on time to alleviate in the worst downs i.e. ease suffering. This study reveals that to be the close relative that the ill person is dependent on 24 hours a day is both a comfort and a strain.
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| 10. |
- Brännström, Margareta, et al.
(författare)
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Living with severe chronic heart failure in palliative advanced home care.
- 2006
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Ingår i: European Journal of Cardiovascular Nursing. - 1474-5151. ; 5:4, s. 295-302
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Living with severe chronic heart failure (CHF) in palliative care has been little studied. AIM: The aim of this study is to illuminate meaning of living with severe CHF in palliative advanced home care through patients' narratives. METHODS: Narrative interviews were conducted with 4 patients, tape-recorded and transcribed verbatim. A phenomenological-hermeneutic method was used to interpret the text. RESULTS: Meaning of living with severe CHF in palliative advanced home care emerged as 'knocking on death's door' although surviving. The course of the illness forces one to live a 'roller coaster life,' with an ongoing oscillation between ups and downs. Making it through the downs breeds a kind of confidence in one's ability to survive and the will to live is strong. Being offered a safety belt in the 'roller coaster' by the palliative advanced home care team evokes feelings of security. CONCLUSIONS: Meaning of living with severe CHF in palliative advanced home care is on one hand, being aware of one's imminent death, on the other hand, making it through the downs i.e. surviving life-threatening conditions, breed confidence in also surviving the current down. Being constructively dependent on palliative advanced home care facilitates everyday life at home.
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