| 1. |
- Broström, Anders, et al.
(författare)
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Communication during the initial visit to a CPAP clinic : Practitioners' experiences of facilitators and barriers when talking to patients with obstructive sleep apnea
- 2021
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 30:4
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Tidskriftsartikel (refereegranskat)abstract
- Adherence to continuous positive airway pressure treatment for obstructive sleep apnea tends to be poor. Communication influences adherence but has not previously been investigated from a practitioner perspective, although shared decision-making is known to be of great importance. The aim was to describe how practitioners experience communication with patients with obstructive sleep apnea during the initial visit at a continuous positive airway pressure treatment clinic, with focus on facilitators and barriers related to the 4 Habits Model, a communication model comprised of four types of interrelated skills to make encounters more patient-centred: investing in the beginning; exploring the patient perspective; showing empathy; and investing in the end. A descriptive design with qualitative content analysis was used. A deductive analysis was carried out based on interviews with 24 strategically selected practitioners from seven continuous positive airway pressure treatment clinics. The 4 Habits Model was used as a framework for identifying facilitators and barriers to communication. Investments in the beginning was described as creating contact, showing the agenda and being adaptive, while explore the patient perspective included showing awareness, being explorative and creating a participating climate. Show empathy consisted of showing openness, being confirmative and creating acceptance, while showing a structured follow-up plan, being open minded and invitational and creating motivation to build on were descriptions of invest in the end. Awareness of potential facilitators and barriers for patient-centred communication during the beginning, middle and end of a continuous positive airway pressure treatment consultation can be used to improve contextual conditions and personal communication competences among practitioners working with continuous positive airway pressure treatment initiation.
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| 2. |
- Craftman, Åsa, et al.
(författare)
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Home care assistants' attitudes and perceptions of caring for people at the end of life in their homes in Sweden
- 2022
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 30:5, s. e2648-e2656
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Tidskriftsartikel (refereegranskat)abstract
- The ageing population is increasing worldwide, with older people often having multimorbidity and a need for help with activities and personal care. Home Care Assistants (HCAs) are central to the provision of care in the home. They meet older people approaching the end of life and their relatives. Little is known about HCAs attitudes towards caring for a dying person and how aspects such as education, age, earlier care experiences, care education and experience of caring for dying older people affect their attitudes. The aim was to describe HCAs' attitudes towards the care of dying persons living in their ordinary homes. This cross-sectional study used the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) for data collection during December 2017 and January 2018, and descriptive statistics and regression analysis for data analysis. The participants were HCAs (n = 127, 96% of those eligible) in a municipality in central Sweden. An overall positive attitude was reported. About 32% lacked formal HCA education although 93% had experience of interacting with a dying person. Age, HCA education, internal palliative care education, number of years' experience and previous experience of caring for a dying person were independently associated with HCAs' attitudes. In the multivariate regression analysis, age and years of experience were the only significant predictors of HCAs' attitudes towards caring for dying care recipients. Young employees without HCA education and experience of a dying person might be vulnerable in situations involving caring for a dying person. Communicating about death and dying, forming a relationship with the care recipient and the family, and providing care when a person is dying can be challenging. Implications: Young employees without HCA education and experience of interacting with a dying person needs to be prepared for the situation. This needs to be considered by stakeholders and social and healthcare organisations.
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| 3. |
- Hedegaard, Joel, et al.
(författare)
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Gendered communicative construction of patients in consultation settings
- 2014
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Ingår i: Women & health. - : Informa UK Limited. - 0363-0242 .- 1541-0331. ; 54:6, s. 513-529
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to explore the communication in consultations between patients and health care staff from a gender perspective. We used 23 tape-recorded consultations between patients with Atrial Fibrillation and 5 nurses and 5 physicians at cardiac outpatient clinics at 6 different hospitals in southern Sweden during autumn 2009 to explore the verbal gendered constructions of patients. Through critical discourse analysis, we revealed that the male patients tended to describe their ailments with performance-oriented statements, whereas the female patients usually used emotional-oriented statements. The staff downplayed the male patients' questions and statements, while they acknowledged concern toward the female patients. Both the patients and the staff made conclusions according to a mutual construction. Male patients were constructed as competent, and female patients as fragile through gender-stereotypical communication. Open-ended statements and questions enabled consultations to be less limited by gender stereotypes.
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| 4. |
- Henoch, Ingela, 1956, et al.
(författare)
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Undergraduate nursing students' attitudes and preparedness toward caring for dying persons – A longitudinal study
- 2017
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Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 26, s. 12-20
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Tidskriftsartikel (refereegranskat)abstract
- Nursing education needs to prepare students for care of dying patients. The aim of this study was to describe the development of nursing students' attitudes toward caring for dying patients and their perceived preparedness to perform end-of-life care. A longitudinal study was performed with 117 nursing students at six universities in Sweden. The students completed the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) questionnaire at the beginning of first and second year, and at the end of third year of education. After education, the students completed questions about how prepared they felt by to perform end-of-life care. The total FATCOD increased from 126 to 132 during education. Five weeks' theoretical palliative care education significantly predicted positive changes in attitudes toward caring for dying patients. Students with five weeks' theoretical palliative care training felt more prepared and supported by the education to care for a dying patient than students with shorter education. A minority felt prepared to take care of a dead body or meet relatives. © 2017 Elsevier Ltd
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| 5. |
- Kidayi, Paulo L, et al.
(författare)
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Cross-Cultural Adaptation and Psychometric Properties of the Swahili Version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR45 among Breast Cancer Patients in Tanzania
- 2023
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Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 11:18
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer is the most frequent cancer in women in Africa and contributes to premature death and poor quality of life. This study aimed to determine the validity, reliability, and psychometric properties of the Swahili version of EORTC QLQ-BR45 among women with breast cancer in Tanzania. A cross-sectional study design with non-probability convenience sampling was employed. Data were collected in two tertiary hospitals and one national cancer institute; 414 participants completed the EORTC-QLQ-C-30 and EORTC-QLQ-BR45. The reliability of QLQ-BR45 was measured using Cronbach's alpha and McDonald's Omega coefficients. The factor structure of EORTC QLQ-BR45 was assessed using confirmatory factor analysis. The internal consistencies for the five dimensions were all above 0.7 indicating satisfaction, except for systemic therapy side effects with a marginal value of 0.594 and significant correlations between the dimensions of QLQ-C30 and BR45. The final model fit well to the data, with the comparative fit index = 0.953, Tucker-Lewis index = 0.947, root mean square error of approximation = 0.041 (90% CI: 0.035, 0.046), and standardized root mean square residual = 0.072. In conclusion, the QLQ BR45 Swahili version displayed good reliability, validity, and psychometric properties and can be used in Swahili-speaking Sub-Saharan countries.
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| 6. |
- Kidayi, Paulo L, et al.
(författare)
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Quality of cancer care in Tanzania as experienced by patients : A qualitative study
- 2023
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Ingår i: Sage Open Nursing. - : SAGE Publications. - 2377-9608. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Cancer is a disease of public importance in Tanzania. Considering a limited health care system with few cancer centers and low health literacy in general, people are diagnosed at late stage and face difficulties in accessing care for their cancer. All these challenges affect the caring situation for the nurses who meet the patients at the cancer care centers.OBJECTIVE: This study aimed to explore the journey of cancer care experienced by patients with cancer.Research questions:How do patients experience the quality of care at the cancer care centers?How do patients experience the family's and the community's role?METHODS: Semi-structured qualitative interviews were carried out with 15 patients treated for colorectal-, breast-, or prostate cancer in three cancer care centers in Tanzania. A purposive sampling was used. Qualitative content analysis according to Graneheim and Lundman was employed.RESULTS: Three main themes and six sub-themes emerged. The main themes were e xperiences of cancer care services, the role of the family, community challenges and cancer care. The sub-themes were communication, resource allocation at the cancer care centers, fmily's denial, family challenges, limitations of primary care and misconceptions, and accessibility of cancer service and the health care system. The findings show that patients experienced incapacitated health care facilities for cancer care, misconceptions in the community and challenges for the families.CONCLUSIONS: The quality of cancer care in Tanzania needs to be improved, patients face challenges in all levels of health care facilities, including families, and the community at large. The distance to oncology care, economic hardship, and lack of knowledge in the community including families, lead to late diagnosis and suffering for the patients. There is a great need for education regarding cancer within healthcare, as well as in the community, to change the situation for patients with cancer.
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| 7. |
- Lundh Hagelin, Carina, et al.
(författare)
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Factors influencing attitude toward care of dying patients in first-year nursing students.
- 2016
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Ingår i: International journal of palliative nursing. - : Mark Allen Group. - 1357-6321 .- 2052-286X. ; 22:1, s. 28-36
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Tidskriftsartikel (refereegranskat)abstract
- To describe Swedish first-year undergraduate nursing students' attitudes toward care of dying patients. Possible influences such as age, earlier care experiences, care education, experiences of meeting dying patients and place of birth were investigated.
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| 8. |
- Siouta, Eleni, et al.
(författare)
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Content and distribution of discursive space in consultations between patients with atrial fibrillation and healthcare professionals.
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:1, s. 47-55
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe (i) the topics participants talk about, (ii) the use of discursive space in consultations between patients with atrial fibrillation (AF) and their nurses and physicians, and (iii) the frequencies of the ways the patients, nurses and physicians introduce the topics.METHODS: Data were collected from 23 videotaped consultations concerning patients with AF as well as physicians and nurses, respectively. To obtain a description of topics discussed, the transcripts were analysed using content analysis. The patterns of dominance for the respective topic and participant were explored from the framework of analysis that treats dominance.RESULTS: Four topics were used by both nurses and physicians in the consultations. These were 'pathophysiology', 'diagnostic procedures', 'treatment' and 'activity'. In the nurse-patient consultation an additional topic, 'routines related to the physician's responsibilities', emerged. With respect to the number of words and turns, the distribution of the discourse space was almost equal between the nurses and patients and unequal between the physicians and patients. The healthcare professionals initiated the topics more frequently compared to the patients, whereby the medical approach recommended in the guidelines for AF could be recognized. The patients were the dominating initiators in the topic 'activity', which refers to the adaptation of activities in daily life in relation to the AF.CONCLUSIONS: The medical-driven agenda dominates over the patient-driven agenda in consultations between healthcare professional and patients with AF. The patients initiated the conversations when discussing living with AF and were more talkative during conversations in nurse consultations.
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| 9. |
- Siouta, Eleni, et al.
(författare)
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Interactional resistance between patients with atrial fibrillation and cardiologists in consultation on treatment with warfarin: the value of shared decision-making
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - 2043-7730 .- 2043-7749. ; 2:3, s. 427-436
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Rationale: Atrial fibrillation (AF) increases the risk of stroke and it can be reduced by treatment with warfarin. Some patients consider that warfarin is a stressful treatment with undesired effects and the perceived barriers include unwillingness to take it. Knowledge of patients resisting warfarin treatment may be useful for the potential threat to maintaining shared decision-making in the consultation as a central tenet of person-centered medicine. Aims and objectives: To identify how patients resist treatment with warfarin and how cardiologists respond to patients’ resistance. The co-constructive perspective of this work analyses the consultations by emphasizing the clinical communication strategies of both patients and cardiologists. Method: Eleven videotaped consultations, in 4 different hospitals, were selected for analysis. Treatment interactions regarding warfarin between patients with AF and cardiologists were analysed, according to the methodology of conversation analysis. Results: There were 4 types of resistance from patients for accepting treatment with warfarin. These included “Giving reasons for their resistance”, “Suggestion of another treatment option by the patient”, “Stating a treatment preference” and “Questioning or challenging the cardiologist’s treatment recommendation”. The cardiologists’ responses to the patients’ resistance included “Repeating the treatment recommendation”, “Negotiation with the patient”, “Providing additional information on the recommended treatment” and “Extending the explanation for the purpose of taking the treatment”. Conclusions: By showing resistance, patients are thought to want to participate in their treatment decisions and an awareness of patients’ resistance to treatment enables cardiologists to address the patients’ experience-based views on their treatment and individual concerns as part of clinical strategies to increase the person-centeredness of medical intervention.
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| 10. |
- Unbeck, Maria, et al.
(författare)
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Design, application and impact of quality improvement theme months in orthopaedic nursing: A mixed method case study on pressure ulcer prevention
- 2013
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 50:4, s. 527-535
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Tidskriftsartikel (refereegranskat)abstract
- Background: While there is growing awareness of quality problems in healthcare systems, it remains uncertain how best to accomplish and sustain improvement over time. less thanbrgreater than less thanbrgreater thanObjective: To report on the design and application of quality improvement theme months in orthopaedic nursing, and evaluate the impact on pressure ulcer as an example. less thanbrgreater than less thanbrgreater thanDesign: Retrospective mixed method case study with time series diagrams. less thanbrgreater than less thanbrgreater thanSetting: An orthopaedic department at a Swedish university hospital. less thanbrgreater than less thanbrgreater thanMethod: The interventions were led by nursing teams and focused on one improvement theme at a time in two-month cycles, hence the term improvement theme months. These included defined objectives, easy-to-use follow-up measurement, education, changes to daily routines, "reminder months" and data feedback. The study draws on retrospective record data regarding one of the theme topics, pressure ulcer risk assessment and prevalence, in 2281 orthopaedic admissions during January 2007-October 2010 through point prevalence measurement one-day per month. Data were analysed in time series diagrams and through comparison to annual point prevalence data from mandatory county council-wide measurements prior to, during and after interventions from 2003 to 2010. By using document analysis we reviewed concurrent initiatives at different levels in the healthcare organisation and related them to the improvement theme months and their impact. less thanbrgreater than less thanbrgreater thanResults: The 46 monthly point prevalence samples ranged from 28 to 66 admissions. Substantial improvements were found in risk assessment rates for pressure ulcers both in the longitudinal follow-up (p andlt; 0.001) and in the annual county council-wide measurements. A reduction in pressure ulcer rate was observed in the annual county council-wide measurements. In the longitudinal data, wider variation in the pressure ulcer rate was seen (p andlt; 0.067); however, there was a significant decrease in pressure ulcer rates during the final ten-month period in 2010, compared to the baseline period in 2007 (p = 0.004). Improvements were moderate the first years and needed reinforcement to be maintained. less thanbrgreater than less thanbrgreater thanConclusions: The theme month design and the way it was applied in this case showed potential, contributing to reduced pressure ulcer prevalence, as a way to conduct quality improvement initiatives in nursing. For sustainable improvement, multi component interventions are needed with regular monitoring and reminder efforts.
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