| 1. |
- Browall, Maria, et al.
(författare)
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Existential encounters: Nurses' descriptions of critical incidents in end-of-life cancer care
- 2014
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 18:6, s. 636-644
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Tidskriftsartikel (refereegranskat)abstract
- Nurses working with cancer patients in end of life care need to be prepared to encounter patients' psychosocial and spiritual distress. Aim: The aim of this study was to describe nurses' experiences of existential situations when caring for patients severely affected by cancer. Methods and sample: Nurses (registered and enrolled) from three urban in-patient hospices, an oncology clinic and a surgery clinic and a palliative homecare team were, prior to the start of a training program, invited to write down their experiences of a critical incident (CI), in which existential issues were featured. Results: Eighty-eight CIs were written by 83 nurses. The CIs were analyzed with qualitative content analysis. Two main themes were found: Encounters with existential pain experiences, which concerned facing death and facing losses; and Encountering experiences of hope, which concerned balancing honesty, and desire to live. Conclusions: This study points out that health care professionals need to be aware of patients' feelings of abandonment in exposed situations such as patients' feelings of existential loneliness. That there are some patients that express a desire to die and this makes the nurses feel uncomfortable and difficult to confront these occurrences and its therefore important to listen to patients' stories, regardless of care organization, in order to gain access to patients' inner existential needs.
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| 2. |
- Browall, Maria, 1963, et al.
(författare)
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Health care staff's opinions about existential issues among patients with cancer.
- 2010
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Ingår i: Palliative & supportive care. - : Cambridge University Press. - 1478-9523 .- 1478-9515. ; 8:1, s. 59-68
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective of this study was to explore health care staff's opinions about what existential issues are important to patients with cancer and staff's responsibility when existential issues are raised by patients. METHOD: Four focus group interviews were conducted with health care staff (N = 23) at an in-patient hospice, on an oncology ward, on a surgical ward, and with a palliative home health care team. The focus group interviews focused on two questions, first, about health care staff's opinions about patients' important existential questions and, second, about health care staff's responsibility when existential issues are raised by the patient. The interviews were tape-recorded, transcribed verbatim, and analyzed by qualitative content analysis into subcategories and categories. RESULTS: Four categories and 11 subcategories emerged from the first question. The first category, "life and death," was based on joy of living and thoughts of dying. The second category "meaning," consisted of acceptance, reevaluation, hope, and faith. The third category, "freedom of choice," consisted of responsibility and integrity, and the fourth and last category, "relationships and solitude," consisted of alleviation, dependency, and loss. One category emerged from the second question about the health care staff's responsibility, "to achieve an encounter," which was based on the subcategories time and space, attitudes, and invitation and confirmation. SIGNIFICANCE OF RESULTS: The strength of this study was that the findings were fairly congruent in different settings and in different geographical areas. Health care staff were aware of the importance of existential issues to patients. The existential issues, mentioned by health care staff, are similar to findings from studies conducted among patients, which is another strength of the present study. Health care staff are also confident about how to act when these issues are raised by the patients. The challenge for the future is to implement the findings from this study among health care staff in different settings.
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| 3. |
- Dalal, Koustuv, et al.
(författare)
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Contraception use and associations with intimate partner violence among women in Bangladesh
- 2012
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Ingår i: Journal of Biosocial Science. - New York, USA : Cambridge University Press. - 0021-9320 .- 1469-7599. ; 44:1, s. 83-94
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Tidskriftsartikel (refereegranskat)abstract
- This study examines the association between contraception use and intimate partner violence (IPV) among women of reproductive age in Bangladesh. The observational study of 10,996 women used the chi-squared test and logistic regressions to assess the associations. Almost 80% of all respondents had used contraceptives at some point in their lives. About half of the respondents (48%) were victims of physical violence, while 11% experienced sexual abuse from their husbands. Urban residents, higher educated women and women aged 20-44 were more likely to use contraceptives than their peers in rural areas, those with lower education and those in their late forties (45-49 years). Women exposed to physical violence were almost two times (OR 1.93, CI 1.55-2.41) more likely to use contraceptives compared with their non-abused peers. Sexual abuse had no significant association with contraceptive use. Physical violence is a predictor for higher levels of contraceptive use among women in Bangladesh. The findings emphasize the importance of screening for IPV at health care centres. The differences in urban and rural contraceptive use and IPV exposure identified by the study have policy implications for service delivery and planning.
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| 4. |
- Dalal, Koustuv, et al.
(författare)
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Economic Costs of Domestic Violence : A Community Study in South Africa
- 2011
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Ingår i: HealthMed. - Sarajevo, Bosnia-Herzegovina : DRUNPP. - 1840-2291 .- 1986-8103. ; 5:6/Suppl 1, s. 1931-1940
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Tidskriftsartikel (refereegranskat)abstract
- The present study estimated economic costs of domestic violence against women who sought help from a community care centre in South Africa. It aimed to relate the victims' income and victims' family income to violence related injuries and related costs. This was a cross sectional study with face-to-face interviews in a community care center in which victims of domestic violence sought various kinds of assistance. In total, 261 women were interviewed. The average economic cost of each domestic violence incidence was 691 USD while average cost for medical expenditure was 29 USD and average loss of income due to domestic violence was 2092 USD. Larger families and higher individual and family incomes were protective factors for severity of violence related injuries. Pain and discomfort due to domestic violence emerged as expensive for both medical costs and productivity losses. Considering the average monthly income of 482 USD, domestic violence averaged a cost per incident of 691 USD during the previous month, indicating a deficit in household budget. We found that domestic violence against women resulted with expensive injuries, pain and discomforts.
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| 5. |
- Dalal, Koustuv, et al.
(författare)
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Economic empowerment of women and utilization of maternal delivery care in Bangladesh
- 2012
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Ingår i: International Journal of Preventive Medicine. - : Isfahan University of Medical Sciences (IUMS). - 2008-7802 .- 2008-8213. ; 3:9, s. 628-636
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Maternal mortality is a major public health problem in low-income countries, such as Bangladesh. Women's empowerment in relation to enhanced utilization of delivery care is underexplored. This study investigates the associations between women's economic empowerment and their utilization of maternal health care services in Bangladesh. Methods: In total, 4925 women (15-49 years of age) with at least one child from whole Bangladesh constituted the study sample. Home delivery without skilled birth attendant and use of institutional delivery services were the main outcome variables used for the analyses. Economic empowerment, neighborhood socioeconomic status, household economic status, and demographic factors were considered as explanatory variables. The chi square test and unadjusted and adjusted logistic regression analyses were applied at the collected data. Results: In the adjusted model, respondent's and husband's education, household economic status, and residency emerged as important predictors for utilization of delivery care services. In the unadjusted model, economically empowered working and microfinanced women displayed more home delivery. Conclusion: The current study shows that use of delivery care services is associated with socioeconomic development and can be enhanced by societies that focus on general issues such as schooling, economic wellbeing, and gender-based discrimination.
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| 6. |
- Dalal, Koustuv, et al.
(författare)
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Intimate Partner Violence against Women in Nepal : An Analysis through Individual, Empowerment, Family and Societal Level Factors
- 2014
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Ingår i: Journal of Research in Health Sciences. - Hamadan, Iran : Hamadan University of Medical Sciences. - 1682-2765 .- 2228-7795 .- 2228-7809. ; 14:4, s. 251-257
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The current study estimated the national prevalence rate of intimate partner violence against women (IPVAW) in Nepal. Besides, the individual level, empowerment level, family and societal level factors were assessed to relate with the victims of IPAVW in Nepal.METHODS: Nationally representative sample of 4210 women of reproductive age (15-49 yr) were included in the study. Household surveys using two stage sampling procedures, face to face interview with pre-tested questionnaires were performed. Emotional, physical and sexual violence were target variables. A violence variable was constructed from these three types of violence. Individual level factors were measured by age, residency, education, religion and husband's education. Empowerment factors included employment status and various decision making elements. Family and societal factors included economic status, neighborhood socioeconomic disadvantage index, history of family violence, husband's controlling behavior and other issues. Cross tabulation with chi-square tests and multivariate logistic regression were employed.RESULTS: Prevalence of emotional IPVAW was 17.5%, physical IPAVW 23.4% and sexual IPAVW 14.7%. Overall the prevalence of IPVAW in Nepal was 32.4%. Joint decision making for contraception, husband's non-controlling behavior to wives and friendly feelings were emerged as less likely to be IPVAW perpetration.CONCLUSIONS: The findings have immense policy importance as a nationally representative study and indicating necessity of more gender equality.
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| 7. |
- Dalal, Koustuv, 1969-, et al.
(författare)
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Knowledge and attitudes towards childhood injury prevention : a study of parents in Shanghai, China
- 2012
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Ingår i: HealthMed. - Sarajevo, Bosnia & Herzegovina : DRUNPP. - 1840-2291 .- 1986-8103. ; 6:11, s. 3783-3789
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Tidskriftsartikel (refereegranskat)abstract
- Childhood injuries are a major problem worldwide. The study explored the parents' knowledge and attitudes towards childhood injury prevention in relation to theirsocioeconomic status. The study also tried to compare parents' perceptions of cause and place of child injury with actual cause and place of injury. This was a cross sectional study of 986 randomly selected parents whose children (3-6 years old) were enrolled at selected kindergartens in a 'Safe Community' in Shanghai, China. Chi-square tests and bar diagrams were used. Almost all parents (97%) thought that injury was a serious problem for their children. Around half of the parents thought that child injuries could be prevented while almost one-third (29%) of parents indicated that there were risk factors in the living environment of their children. Parental perceptions of cause of injuries and place of injuries significantly differed from that of the reality. Parents identified the most common barriers of childhood injury prevention: lack of parental attention (41.6%), environment (35.6%) and children's risky behavior (22.7%). The difference between parental opinions and reality illustrated that parents had incorrect knowledge of childhood injuries, which might lead to incorrect foci of prevention programs.Before tackling environmental modifications to prevent child injuries, policy makers should focus on rectifying parents' incorrect perceptions and on modifying their attitudes as key players. It is important to first raise awareness about childhood injury prevention among the parents for appropriate intervention strategies.
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| 8. |
- Dalal, Koustuv, et al.
(författare)
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Male adolescents' attitudes toward wife beating : a multi-country study in South Asia
- 2012
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Ingår i: Journal of Adolescent Health. - New York, USA : Elsevier. - 1054-139X .- 1879-1972. ; 50:5, s. 437-442
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study has aimed to address the gaps in knowledge about male adolescents and their attitudes toward wife beating in multi-country study in Bangladesh, India, and Nepal.Methods: The study used secondary data generated from nationally representative samples of male adolescents (aged 15-19 years) in the demographic and health surveys data in Bangladesh, India, and Nepal. These were household surveys using structured questionnaires, with 275 boys in Bangladesh, 13,078 boys in India, and 939 boys in Nepal. Chi-square tests and logistic regressions were used to assess the associations.Results: In Bangladesh, 42% of 275 respondents had justified wife beating; in India, 51% of 13,078 male adolescents had supported wife beating; and in Nepal, 28% of 939 respondents had supported wife abuse. Individual-level factors, such as rural residency, low educational attainment, low economic status, being unemployed, and having a history of family violence, were positively associated with the justification of wife abuse.Conclusions: This multi-country study indicates a general trend of male adolescents' strong supportive attitude toward wife beating, and hence may suggest that policy makers can specifically target young groups of the population for various interventions for reducing violence against women.
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| 9. |
- Henoch, Ingela, 1956, et al.
(författare)
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Patients’, family members’ and healthcare staffs’ opinions about existential issues as a base for an educational intervention
- 2011
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Ingår i: BMJ Supportive & Palliative Care. - : BMJ. - 2045-4368 .- 2045-435X. ; 1:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective To explore patients', family members' and healthcare staff's opinions about existential issues important to patients with cancer and their relatives. Methods Two integrative literature reviews were conducted about existential issues among cancer patients and relatives, and interventions to meet these issues. Four focus groups were conducted with healthcare staff working with cancer patients at different stages about patients' existential issues, and staff's responsibility when existential issues are raised. Results In the patient review, existential issues were divided into two themes: struggle to maintain self-identity and threats to self-identity. Relatives' existential issues concerned living both in and beyond the presence of death, with reminders of death, compelling them to respond to life close to death and seek support. Few interventions directed to patients or relatives applicable to everyday healthcare practice were found. Focus groups with staff revealed four categories of patients' existential issues, life and death, meaning, freedom of choice, relationships and solitude. According to staff, their responsibility concerned achieving an encounter with the patient. Conclusion Results from three studies are congruent in that, patients, relatives and staff agree, although in different ways, about the importance of existential issues to patients and relatives. Healthcare staff was aware of the importance of existential issues and are to some extent confident about how to act when these issues are raised by the patients. Ongoing studies The project group now continues implementing findings from these studies in an educational intervention to healthcare staff in different settings, and planning interventions to patients and relatives.
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| 10. |
- Henoch, Ingela, 1956, et al.
(författare)
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The Swedish Version of the Frommelt Attitude Toward Care of the Dying Scale : Aspects of Validity and Factors Influencing Nurses' and Nursing Students' Attitudes.
- 2014
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Ingår i: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 37:1, s. E1-E11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language. OBJECTIVES:: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients. METHODS:: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used. RESULTS:: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients. CONCLUSIONS:: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients. IMPLICATION FOR PRACTICE:: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.
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