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- Bjuresäter, Kaisa, 1970-
(författare)
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Home enteral tube feeding - from patients’, relatives’ and nurses’ perspectives
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Changes in the health-care system during the past decades have led to an increased transfer of health care to the home environment which also concerns patients treated with home enteral tube feeding (HETF). Research is scarce about how HETF care is functioning. Therefore, the overall aim with this thesis was to describe and explore HETF care and treatment from patients', relatives' and nurses' perspectives. Three qualitative and one quantitative study were used. The findings showed that the HETF treatment and care had a great impact on daily life for both patients and their relatives and implied many practical, emotional and social problems in their daily life, which they strived to manage. Side effects were common and the patients' reported low HRQL and general health. The amount and quality of received guidance and support from the health care, not least before discharge, turned out to have impact on the patients' and the relatives' daily life and how they could manage their situation. Lack of guidance and support meant insecurity, worries and distress. Cooperation in the care trajectory was found to be decisive for how well the care was running. Nurses' knowledge about tube feeding and discharge planning procedures, their commitment to the patients' care, as well as clarity regarding responsibility of HETF care were factors of crucial importance on how the cooperation worked, and the quality of the HETF care. This thesis shows the need of improvements regarding the care of HETF patients and their relatives.
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- Björkström, Monica, 1953-
(författare)
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Den professionella sjuksköterskan : i relation till den akademiska sjuksköterskeutbildningen
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Professional Nurse in Relation to Academic Nursing EducationThe increasing demands on the nurse’s competence in the society are reflected in laws and ordinances as well as in the transition of the nursing education to universities. The overall aim of this thesis was to illuminate, describe and understand nurses’ professional awareness in relation to academic nursing education.The longitudinal studies I and II of the thesis included novice nursing students (n= 164/163), senior students (n=123/124), and nurses three to five years after graduating (n=83/82). Study III of the thesis covered a nationally random selection of nurses graduated during four different years before and after the implementation of the academic education (n=289). Study IV focused on senior students (n=155). The data were collected by means of three questionnaires: open questions where the respondents were asked to describe their views of a good nurse and a bad nurse (I); a scale for assessing the professional self in relation to others (modified Nurse Self Description Form) (II); and finally, a questionnaire designed to asses the nurses’ (III) and the students’ (IV) attitudes to and awareness of research within nursing (as developed in study III). The data were analysed by means of content analysis (I) and parametric and non-parametric statistical methods (II, III, IV), and factor analysis (III).The result was that the characteristic of a good nurse ”to do good for others” emerged strongly and retained its dominant position throughout the education and beyond. ”To be competent and skilled” was also highly favoured and gained ground during and after the training. ”To have professional courage and pride” and ”to seek professional development” were considerably less prominent but increased slightly in importance over time (I). The professional self in relation to others in similar situations were generally rated as both strong among students and experienced nurses (II). Also in this respect there was an emphasis on the aspect of doing good for others. The professional self grew stronger over time in the areas of drive, objectivity, flexibility, ability to teach, ability to communicate and sociability, whereas the desire to contribute through research and knowledge mastery decreased over time (II). The process of developing into an experienced nurse, however, entailed increased awareness of the complexity of the nursing profession. The instruments for measuring attitudes to nursing research were validated through factor analysis, which generated seven factors termed ”research language,” ”need of research knowledge,” ”participation,” ”the profession,” ”meaningfulness,” ”study literature,” and ”developing–resources” (III). Nurses (III) as well as students (IV) expressed a positive attitude to nursing research and its application to the nursing profession. However, the nurses in particular stated that they seldom read scientific journals and seldom applied nursing research in their daily work.To sum up, the research in this thesis shows that students and nurses only to a moderate extent displayed the professional awareness that the academic nursing education aims for. The traditional image of a good nurse was the most clearly manifested form of awareness, whereas insufficient awareness was registered in areas related to own responsibility for research-based practice. The result indicates a need for further collaboration between the nursing education and the health care sector, as well as for academically highly qualified nurses as resource persons in nursing practice, to support quality development in nursing, and serve as role models for students.
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- Helgesen, Ann Karin, 1962-
(författare)
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Patient participation in everyday life in special care units for persons with dementia
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to acquire knowledge about patient participation in everyday life of persons with dementia living in SCUs in nursing homes. Data collection and analysis in studies I-III was carried out according to Grounded Theory. Data was collected by open non- participant observations during 51 hours, and conversations with 8 residents and 17 health care personnel (I), interviews carried out twice with 12 relatives (II) and 11 nursing personnel (III), and by a study specific questionnaire based on the findings from study I-II to 233 relatives (IV). Descriptive and non-parametric statistics were used (IV).Presence of nursing personnel in body, mind and morality was found to be the prerequisite for patient participation (I). This required personnel with high competence in dementia care, commitment to and interest in the resident, and continuity in their work (I, III). Wellbeing and dignity in the resident’s everyday life was found to be the most important goal, not necessarily a high level of patient participation (II-III). The level of participation had to be adjusted to the resident’s ability and wish to take part in decisions in the very moment. However, the level was often primarily adjusted to suit the personnel’s ideas about how to carry out daily care (I, III). Relatives had an important role in the participation process by interacting, and exchanging information, with the personnel. By forming a basis for individualised care in this way, relatives made a difference to the resident’s everyday life and contributed to their wellbeing and dignity (II-IV). The SCU’s context also affected patient participation (I-IV).Patient participation must be given attention by leaders and be prioritised in dementia care. Nursing personnel can enhance patient participation by promoting relatives’ partaking in the participation process, as this has potential for further contributing to quality of care.
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