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Sökning: LAR1:oru > (2000-2004) > Ersta Sköndal högskola

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1.
  • Andershed, Birgitta, et al. (författare)
  • Being a close relative of a dying person : development of the concepts "involvement in the light and in the dark"
  • 2000
  • Ingår i: Cancer Nursing. - 0162-220X. ; 23:2, s. 151-159
  • Tidskriftsartikel (refereegranskat)abstract
    • The current study is based on an earlier article in which relatives' involvement in care was described as involvement in the light or involvement in the dark. Involvement in the light was characterized as the relative being well informed and experiencing a meaningful involvement. The relatives involved in the dark felt uninformed, that they were groping around in the dark when they tried to support the patient. The present study analyzed further the meaning of involvement in the light and involvement in the dark, and investigated whether two different care cultures, the relationship with the staff, and a rapid course of illness influence the involvement of relatives. Relatives of 52 patients who died, 30 at a surgical department and 22 in a hospice ward, were interviewed after the patients' deaths. All the relatives of the patients in the hospice ward and 13 of those in the surgical department were judged to be involved in the light. Of the relatives judged to be involved in the dark, 12 either had a sick relative with a rapid course of illness or felt that the sick relative had died unexpectedly. A pattern was clearly observed: The relatives involved in the light described being met with respect, openness, sincerity, confirmation, and connection, whereas the opposite was experienced by those involved in the dark.
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2.
  • Andershed, Birgitta, et al. (författare)
  • Development of a theoretical framework describing relatives' involvement in palliative care
  • 2001
  • Ingår i: Journal of Advanced Nursing. - 0309-2402. ; 34:4, s. 554-562
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND:The present study is based on four earlier studies in which the authors classified the relative's involvement in palliative care into different categories and described the involvement as "involvement in the light" or "involvement in the dark".AIM:The aim of the study was to develop a theoretical framework concerning the involvement of relatives based on an in-depth analysis of the results of the four earlier studies.METHOD:Walker & Avant's (1995) strategies for theory construction were used for development of the framework. A number of different concepts, assumptions and statements about relatives' involvement were penetrated in an in-depth analysis.RESULTS:From the concepts two theoretical "blocks" of the relatives' involvement were developed and these constitute the foundation for the framework. One is based on concrete descriptions of the concepts "to know", "to be" and "to do". The other describes how the concepts of "involvement in the light" and "involvement in the dark" differ. Factors that promoted involvement in the light were professional care based on humanistic values, a stronger sense of coherence on the part of relatives, an appropriate illness trajectory, and other available resources. The opposite was the case for those who were involved in the dark. Five assumptions successively developed which together form the theoretical framework.CONCLUSIONS:An important conclusion that can be of importance in palliative care is that the manner in which the staff act toward the patient and relatives influence relatives' possibilities for involvement, patients' possibilities for an appropriate death, and the possibilities the staff have to give good care.
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3.
  • Andershed, Birgitta, et al. (författare)
  • Närståendes behov i palliativ vård
  • 2004
  • Ingår i: Närståendes behov : omvårdnad som akademiskt ämne III. - Stockholm : Svensk sjuksköterskeförening. - 91-85060-09-7 ; s. 103-115
  • Bokkapitel (populärvet., debatt m.m.)
4.
  • Ekwall, Ewa, et al. (författare)
  • Important aspects of health care for women with gynecologic cancer
  • 2003
  • Ingår i: Oncology Nursing Forum. - Pittsburg : Oncology Nursing Society. - 0190-535X. ; 30:2, s. 313-319
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose/Objectives: To describe what women diagnosed with primary gynecologic cancer reported to be important during their interacion with the healthcare system.Design: Qualitative.Setting: A specialized gynecologic cancer care unit in central Sweden.Sample: 14 women diagnosed with primary gynecologic cancer were recruited. The women had been referred to the specialized care unit for radiation or cytostatic therapy.Methods: Tape-recorded interviews were transcnbed, coded, categoized, and analyzed.Main Research Variables: Primary diagnosed women with cancer and their experience with quality of care during diagnosis and treatment.Findings: Three partly overlapping categories (i.e., optima! care,good communication, and self-image and sexuality) were found to be of central importance in quality of health care. Participants stated that health care should be based on their own perceptions of the need for information and dialogue and how the disease and treatment would affect their health, self-image, and sexuality. Everyday conversations also were very important.Conclusions: Central importance in health care for the women included both rational and human aspects. The primary need of participants was available, competent, and coordinated.Implications for Nursing: Women with gynecologic cancer should be given individualized information and care to satisfy their individual needs and reinforce their self-image. Nurses have an important role in strengthening women´s  feelings of hope and supporting them in maintaining as positive a self-image as possible. Information and everyday conversation are of great significance. Sexuality should be an integral part of holistic care; to this end, inclusion of each woman's sexual partner may be helpful when discussions concerning sexuality occur.
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5.
  • Ivarsson, Ann-Britt, et al. (författare)
  • The meaning and form of occupational therapy as experienced by women with psychoses : A phenomenological study
  • 2002
  • Ingår i: Scandinavian Journal of Caring Sciences. - Oxford : Blackwell. - 0283-9318. ; 16:1, s. 103-110
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to illuminate the experiences of occupational therapy interventions in individuals with psychoses. Repeated tape-recorded narrative interviews were conducted with six women participating in occupational therapy immediately after an intervention. The subsequent analyses followed a phenomenological approach. Key constituents integrated in two structures, are the main ®ndings. The meaning of occupational therapy as expressed in the key constituents relief, selfknowledge, belief in the future, capability, resistance and satisfaction formed one structure. The form of occupational therapy as expressed in the key constituents time, environment, guidance, voluntariness and collaboration represented the other structure. These ®ndings con®rm and give empirical support to beliefs and assumptions expressed in occupational therapy literature. The results form a conceptual base for developing an evaluative assessment instrument for individuals with psychoses participating in occupational therapy.
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6.
  • Jackson, Karin, et al. (författare)
  • From alienation to familiarity : experiences of mothers and fathers of preterm infants
  • 2003
  • Ingår i: Journal of Advanced Nursing. - 0309-2402. ; 43:2, s. 120-129
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The birth of a preterm infant has a long-term impact on both parents. Mothers report more stress and poor adjustment compared with fathers. Influencing factors, such as family situation and health status of the child, can support or weaken the coping ability of the parents. Studies on experiences of fathers are sparse.AIM: The aim of this research was to study how mothers and fathers of preterm infants describe their experiences of parenthood during the infant's first 18 months of life.METHODS: Seven consecutively selected sets of parents of preterm infants born at </=34 weeks of gestation with no serious congenital defects were interviewed 1-2 weeks after the infant's birth and at 2, 6 and 18 months of age, and the findings were analysed using a phenomenological method.FINDINGS: Internalization of parenthood was described as a time-dependent process, with four syntheses of experiences - alienation, responsibility, confidence and familiarity. Within the syntheses, similarities in how mothers and fathers described their parental roles involved concern for the child, insecurity, adjustment and relationship with the child. Regarding differences, mothers experienced having more responsibility and control of the care and a need to be confirmed as a mother, while fathers described confidence in leaving the care to the staff and wanted to find a balance between work and family life. Important turning points in parenthood experiences often occurred when the infant could be removed from the incubator, discharged from the ward, and when the infant looked normal compared to full-term infants.CONCLUSIONS: The structure of the phenomenon of parenthood was formed by the integration of the syntheses of alienation, responsibility, confidence and familiarity. The structure seems to be based on the parents' expectations of the parental role, the infant's health condition and the health care environment. These interacting factors are influenced by cultural beliefs.
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7.
  • Larsson Kihlgren, Annica, et al. (författare)
  • Referrals from home care to emergency hospital care : basis for decisions
  • 2003
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 12:1, s. 28-36
  • Tidskriftsartikel (refereegranskat)abstract
    • The Swedish government implemented a reform, the Adel reform, in the care of older citizens in 1992, so that the communities where older people live became responsible for their care and housing. Nurses were appointed to make sure that older people were given accurate care and to act as supervisors for nurses' aides. In this study, 10 Registered Nurses from community home care services and four consultant head physicians in primary care were interviewed in order to illuminate what they thought influenced nurses' decisions to refer patients for emergency treatment and what support they requested to facilitate the decision. Content analysis showed the necessity of feeling secure in one's role as a community nurse. The categories that developed were: own competence, knowledge about the patient and a supportive working environment. The main theme was To feel safe in one's role – a basis for decision-making. High demands were put on the nurses' competence and their burden of responsibility became too great. This influenced decision-making negatively, if nurses felt that they were lacking in their own personal competence. Training in documentation for the nurses was required, as well as the need for organizations to provide staff with sufficient time for accurate documentation. A greater input of nursing and medical care was required to make it possible for patients to be cared for at home if they so wished. Respondents described considerable deficiencies in their working environment and in co-workers' competence, and nurses' professional roles within the community were not made clear. If these problems were remedied, this would improve working conditions, increase understanding, and reduce feelings of uncertainty among decision-makers.
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8.
  • Shields, Linda, et al. (författare)
  • Nursing and health care in Sweden
  • 2002
  • Ingår i: The Australian journal of advanced nursing. - 0813-0531. ; 20:1, s. 20-26
  • Tidskriftsartikel (refereegranskat)abstract
    • Sweden, one of the Nordic countries, has a long history of social justice and equality of access to health care. Nursing plays an important role in this and nursing education is of a high standard. The aim of this paper is to describe Sweden's health system and nursing within it, thereby giving Australian nurses information which may generate an interest in, and provide background for, collaborative work. It is part of a series initiated by the first author who visited Sweden, Iceland and England in 2000 under the auspices of a Churchill Fellowship, and who has returned to Sweden and England to continue work begun during the Fellowship. Sweden's health service is characterised by an ethic of egalitarianism and high standards; primary health care plays a large role and tertiary health care is easily accessible. Nursing in Sweden is of a high standard, with devolvement of responsibility and decision-making to those working in the wards and units. Nursing education has been influenced by the historical development of nursing in Europe and today, Swedish nurses enjoy a high standard of university education with government support readily available to make specialist education accessible. Because of the similarities in both the cultures, and nursing, in Australia and Sweden, Australian nurses would find Sweden a wonderful country in which to implement cross-cultural, collaborative work.
9.
  • Ternestedt, Britt-Marie, et al. (författare)
  • A good death - Development of a nursing model of care
  • 2002
  • Ingår i: Journal of Hospice and Palliative Nursing. - 1522-2179. ; 4:3, s. 153-160
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to describe the ongoing process at a Swedish hospice to further develop a model for care planning, documentation, and evaluation of the quality of death. The model was adapted to a nursing context by means of concept derivation. The core of the model is the patient as a person, in which that person’s experiences and need for control in his or her life are acknowledged. Six key words have been used as guidelines in this process: symptom control, self-determination, social relations, self-image, synthesis, and surrender. In a retrospective analysis of patient deaths it was found that of 35 patients, 15 had a very good death, 17 a good death, and 3 a bad death. Use of the 6 S key words provided the staff with continual opportunities for reflection, which was described as increasing their awareness concerning the needs of individual patients and concerning individualized nursing care.
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10.
  • Tishelman, Carol, et al. (författare)
  • Complexity in caring for patients with advanced cancer
  • 2004
  • Ingår i: Journal of Advanced Nursing. - 0309-2402. ; 45:4, s. 420-429
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. The gap between nursing research and practice is readily acknowledged in literature, with a variety of strategies suggested for reducing this gap. It is necessary not only to address problems of research implementation in practice, but also to find strategies that strengthen the influence of practitioners on research agendas through more collaborative relationships in order to have an impact on care of patients. A multi-centre research project was therefore initiated by two universities and three health care facilities, aiming to improve quality of care for patients with advanced cancer through a knowledge-exchange programme between nurse researchers, practitioners and students. Aim. The aim of this article is to explore how clinical staff reason about care provision for patients with advanced cancer, through analysis of 20 focus group discussions conducted with staff in three different health care facilities in two Swedish cities. An initial analysis based on grounded theory was complemented with consideration of the interactive process in the focus group discussions, and carried out by a team consisting of senior nurse researchers, clinical experts and nursing instructors. Findings. The findings of the focus group discussions emphasize the complexity of caregiving for patients with advanced cancer. The tension between caregiving ideals and limits imposed by the realities of caregiving in today's health system were striking. Practitioners discussed the organization of care, different constellations of relationships between patients, family members and professionals, and theoretical and experiential knowledge as equally important aspects in dealing with all concrete situations in daily practice. The importance of reflective practice, use of self and ethical reasoning also permeated the focus group discussions. Conclusions. These findings highlight an integrated need both to influence organizational structures and working relationships, along with increasing knowledge, if sustainable change is to be effected.
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