| 1. |
- Andersson, Ewa K., et al.
(författare)
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Standing alone when life takes an unexpected turn : Being a midlife next of kin of a relative who has suffered a myocardial infarction
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 27:4, s. 864-871
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Tidskriftsartikel (refereegranskat)abstract
- Background: Suffering a myocardial infarction (MI) is a life-threatening event that impacts not only on the individual concerned but also on the next of kin. However, there seems to be a paucity of naturalistic inquiries that focus specifically on midlife next of kin and their experience of being close to a relative who has suffered an MI. This study aims to elucidate the experience of being a midlife next of kin of a relative who has suffered a myocardial infarction. Method: Nine women and four men in midlife participated in the focused interviews, which were conducted and analysed during 2010/2011 using Lindseths and Norbergs' description of the phenomenological hermeneutical method. Findings: Four themes - Solely responsible, Lurking unease, Left out of the picture and Life on hold - formed the basis of the core theme Standing alone when life takes an unexpected turn. The core theme was interpreted as a central phenomenon encompassing the experience of being solely responsible for the well-being of their relative and the family, thus putting their own life on hold. The core theme also reflected the next of kin's experience of being left out of the picture when it came to the relative's care before and after the MI. Conclusion: The next of kin's negative feelings of standing alone were further intensified by their experience of being left out of the picture by the healthcare professionals concerning their relative's care. As a cardiac nurse, it would seem essential to have knowledge about the experiences of next of kin in connection with a relative's MI event. Such knowledge can facilitate the planning and organisation of nursing care and at the same time address the next of kin's role in the recovery and rehabilitation process.
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| 2. |
- Andersson, Ewa K., et al.
(författare)
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The Experience of Younger Adults Following Myocardial Infarction
- 2013
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Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 23:6, s. 762-772
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Tidskriftsartikel (refereegranskat)abstract
- Syftet med denna studie var att belysa meningsupplevelser för personer yngre än 55 år som överlevt sin första hjärtinfarkt. Vi har analyserat 17 intervjuer med fenomenologisk-hermeneutisk metod. Huvudtemat, och det centrala fenomenet var en daglig kamp för att återvinna balansen i livet, vilket inkluderar en existentiell, fysisk och emotionell kamp för att återfå fotfästet i dagligt liv. Efterspelet till denna livshotande händelse involverade en transition/förändringsprocess samtidigt som en ny livsmening skapades. Informanternas berättelser färgades av en energibrist som påverkade deras liv och interagerade med orimliga krav från arbetsgivare och vårdpersonal. Kunskapen från denna studie kan utgöra ett värdefullt tillskott till kvalitetsarbete inom omvårdnad och till utveckling av omvårdnadsinterventioner för hjärtrehabilitering av yngre personer efter hjärtinfarkt.
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| 3. |
- Andersson, Ewa, et al.
(författare)
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Registered nurses’ descriptions of caring : A phenomenographic interview study
- 2015
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Ingår i: BMC Nursing. - : BioMed Central. - 1472-6955. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nursing has come a long way since the days of Florence Nightingale and even though no consensus exists it would seem reasonable to assume that caring still remains the inner core, the essence of nursing. In the light of the societal, contextual and political changes that have taken place during the 21st century, it is important to explore whether these might have influenced the essence of nursing. The aim of this study was to describe registered nurses’ conceptions of caring. Methods: A qualitative design with a phenomenographic approach was used. The interviews with twenty-one nurses took place between March and May 2013 and the transcripts were analysed inspired by Marton and Booth’s description of phenomenography. Results: The analysis mirrored four qualitatively different ways of understanding caring from the nurses’ perspective: caring as person-centredness, caring as safeguarding the patient’s best interests, caring as nursing interventions and caring as contextually intertwined. Conclusion: The most comprehensive feature of the nurses’ collective understanding of caring was their recognition and acknowledgment of the person behind the patient, i.e. person-centredness. However, caring was described as being part of an intricate interplay in the care context, which has impacted on all the described conceptions of caring. Greater emphasis on the care context, i.e. the environment in which caring takes place, are warranted as this could mitigate the possibility that essential care is left unaddressed, thus contributing to better quality of care and safer patient care.
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| 4. |
- Andersson, Ewa, et al.
(författare)
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Registered nurses views of caring in coronary care - a deductive and inductive content analysis
- 2015
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:23-24, s. 3481-3493
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To extend nurses' descriptions of how they understood caring, as reflected in the findings of an earlier study (i.e. the hierarchical outcome space) and to gain additional understandings and perspectives of nurses' views of caring in relation to a coronary care patient case. Background. Scientific literature from the 1970s-1990s contains descriptions of caring in nursing. In contrast, the contemporary literature on this topic - particularly in the context of coronary care - is very sparse, and the few studies that do contain descriptions rarely do so from the perspective of nurses. Design. Qualitative descriptive study. Methods. Twenty-one nurses were interviewed using the stimulated recall interview technique. The data were analysed using deductive and inductive qualitative content analysis. Results. The results of the iterative and integrated content analysis showed that the data mainly reproduced the content of the hierarchical outcome space describing how nurses could understand caring; however, in the outcome space, the relationship broke up (i.e. flipped). The nurses' views of caring could now also be understood as: person-centredness 'lurking' in the shadows; limited 'potential' for safeguarding patients' best interests; counselling as virtually the 'only' nursing intervention; and caring preceded by the 'almighty' context. Their views offered alternative and, at times, contrasting perspectives of caring, thereby adding to our understanding of it. Conclusion. Caring was described as operating somewhere between the nurses caring values and the contextual conditions in which caring occurred. This challenged their ability to sustain caring in accordance with their values and the patients' preferences. Relevance to clinical practice. To ensure that the essentials of caring are met at all times, nurses need to plan and deliver caring in a systematic way. The use of systematic structures in caring, as the nursing process, can help nurses to work in a person-centred way, while sustaining their professional values.
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| 5. |
- Andersson, Åsa, et al.
(författare)
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Adverse events in nursing : a retrospective study of reports of patient and relative experiences
- 2015
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Ingår i: International Nursing Review. - : International Council of Nurses. - 0020-8132 .- 1466-7657. ; 62:3, s. 377-385
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Tidskriftsartikel (refereegranskat)abstract
- Patient safety is an important global issue. While it is well known that patients can suffer from adverse events in nursing care, there is a lack of knowledge as to how they experience them. The aim was to examine adverse events in nursing care as they are experienced by patients and relatives. This was a retrospective study taking both a qualitative and quantitative approach. It was based on data regarding 242 adverse events in nursing care, as reported by patients and relatives to Sweden's Medical Responsibility Board, content analysis was used to analys the reports. Patients' and relatives' experiences were analysed into four categories of adverse events, as concerning participation, clinical judgement, nursing intervention and the essentials of care. The reports were classified by the Medical Responsibility Board, without a standardized system. The adverse events reported were few in number and were reported by patients and relatives only. Lack of participation has negative consquences and contributes to adverse events. Adverse events occur through missed care as well as through carer errors. Nurses need to improve their skills that support patient participation. Patient participation needs to be incorporated into nurses' duties. Resources for patients to participate in their own care needs to be a priority underpinning policy-making in health systems. Nursing education systems need to teach students about the value and benefits of involving patients in their care.
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| 6. |
- Gustafsson, Markus, et al.
(författare)
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Case managers for older persons with multi-morbidity and their everyday work -- a focused ethnography
- 2013
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Ingår i: BMC Health Services Research. - : Biomed Central. - 1472-6963. ; 13:496
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Tidskriftsartikel (refereegranskat)abstract
- Background Modern-day health systems are complex, making it difficult to assure continuity of care for older persons with multi-morbidity. One way of intervening in a health system that is leading to fragmented care is by utilising Case Management (CM). CM aims to improve co-ordination of healthcare and social services. To better understand and advance the development of CM, there is a need for additional research that provides rich descriptions of CM in practice. This knowledge is important as there could be unknown mechanisms, contextual or interpersonal, that contribute to the success or failure of a CM intervention. Furthermore, the CM intervention in this study is conducted in the context of the Swedish health system, which prior to this intervention was unfamiliar with this kind of coordinative service. The aim of this study was to explore the everyday work undertaken by case managers within a CM intervention, with a focus on their experiences. Methods The study design was qualitative and inductive, utilising a focused ethnographic approach. Data collection consisted of participant observations with field notes as well as a group interview and individual interviews with nine case managers, conducted in 2012/2013. The interviews were recorded, transcribed verbatim and subjected to thematic analysis. Results An overarching theme emerged from the data: Challenging current professional identity, with three sub-themes. The sub-themes were 1) Adjusting to familiar work in an unfamiliar role; 2) Striving to improve the health system through a new role; 3) Trust is vital to advocacy. Conclusions Findings from this study shed some light on the complexity of CM for older persons with multi-morbidity, as seen from the perspective of case managers. The findings illustrate how their everyday work as case managers represents a challenge to their current professional identity. These findings could help to understand and promote the development of CM models aimed at a population of older persons with complex health needs.
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| 7. |
- Hellström, Amanda, et al.
(författare)
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Association between Sleep Disturbances and Leisure Activities in the Elderly : A Comparison between Men and Women
- 2014
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Ingår i: Sleep Disorders. - : Hindawi Limited. - 2090-3545 .- 2090-3553.
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Tidskriftsartikel (refereegranskat)abstract
- It has been suggested that physical or social activity is associated with fewer sleep disturbances among elderly people. Women report more sleep disturbances than men, which could indicate a variation in activity patterns between the genders. The aim of this study was to investigate associations between sleep disturbances and leisure activities in men and women (n = 945) aged ≥60 years in a Swedish population. Sleep disturbances were measured using eight dichotomous questions and seventeen variables, covering a wide range of leisure activities. Few leisure activities were found to be associated with sleep disturbances and their importance decreased when the models were adjusted for confounders and gender interactions. After clustering the leisure activities and investigating individual activities, socio-intellectual activities were shown to be significant for sleep. However, following adjustment for confounders and gender interactions, home maintenance was the only activity significant for sleep. Being a female increased the effect of home maintenance. Besides those leisure activities, poor/fair self-rated health (OR 7.50, CI: 4.27-11.81) and being female (OR 4.86, CI: 2.75-8.61) were found to have the highest association with poor sleep. Leisure activities pursued by elderly people should focus on activities of a socio-intellectual nature, especially among women, to promote sleep.
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| 8. |
- Hellström, Amanda, et al.
(författare)
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Promoting sleep by nursing interventions in health care settings : A systematic review
- 2011
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 8:3, s. 128-142
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sleep disturbances are a common problem among individuals in hospitals and institutions. Although several studies have explored this phenomenon, there is still a lack of knowledge about the effectiveness of sleep-promoting nursing interventions. This systematic review aims to describe and evaluate the effectiveness of sleep-promoting nursing interventions in health care settings. Design: A systematic review was performed. Method: In June 2009, a literature search was carried out in the following databases: Academic Search Elite, CINAHL, the Cochrane Library and MedLine/PubMed. Fifty-two references were identified and after critical appraisal nine studies were selected. A compilation of the results and the outcomes of the interventions were carried out. Further, the evidence strength of the interventions was assessed. Findings: Evidence for the nursing interventions sleep hygiene, music, natural sound and vision, stimulation of acupoints, relaxation, massage and aromatherapy, is found to be low or very low. Still large effects of interventions where found when using massage, acupuncture and music, natural sounds or music videos. The use of sleep hygiene and relaxation on the other hand showed only small effects. Conclusion: The paucity of studies implies that the confidence in the effects shown, and the lack of high evidence strength for many nursing interventions, most certain will change if further studies are carried out. The uncertainty about the effects calls for more research before implementing the interventions into clinical practice.
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| 9. |
- Hellström, Amanda, et al.
(författare)
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The rhythm of the unit is the pace of life : a study of everyday activities and sleep in Swedish residential care
- 2015
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Ingår i: Open Journal of Nursing. - Irvine : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 5:8, s. 697-706
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Tidskriftsartikel (refereegranskat)abstract
- Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents.The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility.
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| 10. |
- Hjelm, Markus, et al.
(författare)
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Family members of older persons with multi-morbidity and their experiences of case managers in Sweden : an interpretive phenomenological approach
- 2015
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Ingår i: International Journal of Integrated Care. - : Igitur Publishing. - 1568-4156. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers. The aim of the study was to deepen the understandning of the importance of case managers to family members of older persons (75+) with multi-morbidity. The study design was based on an interpretive phenomenological approach. Data were collected through individual interviews with 16 family members in Sweden. The interviews were analysed by means of an interpretive phenomenological approach. The findings revealed one overarching theme: "Helps to fulfil my unmet needs", based on three sub-themes: (1) "Helps me feel secure - Experiencing a trusting relationship", (2) "Confirms and strengthens me - Challenging my sense of being alone" and (3) "Being my personal guide- Increasing my competence". The findings indicate that case managers were able to fulfil unmet needs of family members. The latter recognised the importance of case managers providing them with professional services tailored to their individual needs. The findings can contribute to the improvement of case management models not only for older persons but also for their family members.
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