| 1. |
- Larsson, Helena, et al.
(författare)
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Contrasts in older persons' experiences and significant others' perceptions of existential loneliness
- 2019
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 26:6, s. 1623-1637
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: As frail older people might have difficulties in expressing themselves, their needs are often interpreted by others, for example, by significant others, whose information health care staff often have to rely on. This, in turn, can put health care staff in ethically difficult situations, where they have to choose between alternative courses of action. One aspect that might be especially difficult to express is that of existential loneliness. We have only sparse knowledge about whether, and in what way, the views of frail older persons and their significant others concerning existential loneliness are in concordance.OBJECTIVE: To contrast frail older (>75) persons' experiences with their significant others' perceptions of existential loneliness.METHODS: A case study design was chosen for this study. Individual interviews with frail older persons (n = 15) and interviews with their significant others (n = 19), as well as field notes, served as a basis for the study. A thematic analysis was used to interpret data. Ethical considerations: This study was conducted in accordance with the principles of research ethics.FINDINGS: The findings showed three themes: (1) Meaningless waiting in contrast to lack of activities, (2) Longing for a deeper connectedness in contrast to not participating in a social environment and (3) Restricted freedom in contrast to given up on life.DISCUSSION: Knowledge about the tensions between older persons' and their significant others' views of existential loneliness could be of use as a basis for ethical reflections on the care of older people and in the encounter with their significant others.CONCLUSION: It is of importance that health care professionals listen to both the frail older person and their significant other(s) and be aware of whose voice that the care given is based on, in order to provide care that is beneficial and not to the detriment of the older person.
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| 2. |
- Sundström, Malin, et al.
(författare)
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Encountering existential loneliness among older people : perspectives of health care professionals
- 2018
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Existential loneliness is part of being human that is little understood in health care, but, to provide good care to their older patients, professionals need to be able to meet their existential concerns. The aim of this study was to explore health care professionals' experiences of their encounters with older people they perceive to experience existential loneliness.METHOD: We conducted 11 focus groups with 61 health professionals working in home care, nursing home care, palliative care, primary care, hospital care, or pre-hospital care. Our deductive-inductive analytical approach used a theoretical framework based on the work of Emmy van Deurzen in the deductive phase and an interpretative approach in the inductive phase.RESULTS: The results show that professionals perceived existential loneliness to appear in various forms associated with barriers in their encounters, such as the older people's bodily limitations, demands and needs perceived as insatiable, personal shield of privacy, or fear and difficulty in encountering existential issues.CONCLUSION: Encountering existential loneliness affected the professionals and their feelings in various ways, but they generally found the experience both challenging and meaningful.
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| 3. |
- Sundström, Malin
(författare)
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Existentiell ensamhet hos sköra äldre personer : vårdpersonals och volontärers erfarenheter och behov av stöd
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the thesis was to explore healthcare professionals’ and volunteers’ experiences of encountering older persons’ existential loneliness, the significance of the care context, and first-line managers’ view of support. Three of the studies were qualitative with a descriptive design (studies I–III) and the fourth was quantitative with a cross-sectional design (Study IV). The data collection for studies I and II was based on focus group interviews with healthcare professionals (i.e., nurse assistant, registered nurse, physician, occupational therapist, physiotherapist, social counsellor, and social worker) in home care, residential care, hospital care, palliative care, primary care, and pre-hospital care. The data collection for Study III was based on focus group interviews and individual interviews with volunteers from various organisations. Study IV was based on a questionnaire sent to first-line managers in municipal care, examining their views of support for staff and volunteers encountering existential issues among older persons. The findings of Study I indicated that, during the everyday care of older people, healthcare professionals experienced existential loneliness in various ways and situations related to ageing, illness, and end of life. The professionals’ stories about encountering older persons’ existential loneliness revealed that they often felt insecure about how to talk about existential issues. They also felt inadequate and frustrated when encountering barriers such as the older person’s bodily limitations, demands and needs (perceived as insatiable), personal privacy, or fear and difficulty in encountering existential issues. Study II was a multiple case study of the care contexts of home care, residential care, hospital care, and palliative care. The findings indicated that the care context matters regarding professionals’ views and interpretations of the origin of existential loneliness. In home care and residential care, these views and interpretations concerned life, the present, and the past. In hospital and palliative care, existential loneliness mainly concerned the older person’s forthcoming death. Professionals considered creating relationships an important part of their role in all care contexts, although the meanings, purposes, and conditions of these relationships differed (Study II). Study III showed that being a volunteer meant being a fellow human being, alleviating others’ and one’s own loneliness. Becoming a volunteer was 11 12 a way of finding meaning, and volunteering made the volunteers feel rewarded and simultaneously emotionally challenged. Encountering loneliness, including existential loneliness, required sensitivity to others’ needs for both closeness and distance. The findings of Study IV, based on a questionnaire, indicated that 88% of the first-line managers found that older persons sometimes or often expressed existential loneliness. They also reported that staff insecurity was the major obstacle to talking about existential issues with the older persons. Support was provided in the form of structured reflection, but provision of systematic supervision was reported by only 6% of first-line managers. The managers reported that most support was provided by themselves or by registered nurses. Almost half of the managers (44%) reported that, at their units, volunteers were engaged in activities such as everyday conversations and/or music/entertainment. In addition, they also reported a desire for volunteers to be more involved in both everyday and existential conversations. In conclusion, one of the most important findings of this thesis was the insecurity of the professionals, manifested in a fear of discussing existential issues. This was revealed in the interviews with the professionals and confirmed by the first-line managers. According to both professionals and volunteers, the relationship with the older person was important when encountering existential issues. The thesis demonstrates the importance of helping professionals focus on existential issues about life and death and of the potential of volunteers as an important complement in the care of older people.
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| 4. |
- Bolmsjö, Ingrid, et al.
(författare)
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The use of drama to support reflection and understanding of the residents' situation in dementia care : a pilot study
- 2014
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Ingår i: International Journal of Older People Nursing. - : Blackwell Munksgaard. - 1748-3735 .- 1748-3743. ; 9:3, s. 183-191
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Tidskriftsartikel (refereegranskat)abstract
- Background. One key aspect of person-centredness is striving to understand both the patients' experiences and behaviours from their perspective. These aspects are precisely those that staff in dementia care highlight as causing them most difficulty because the people in their care have major problems expressing themselves. There is thus a need to develop a method to help the staff to achieve interpretation through reflection.Aim. The aim of this study was to explore the use of drama as a tool to support reflection among staff working in the residential care of people with dementia.Design. A qualitative evaluation of a programme consisting of three drama sessions with staff working in residential care (n = 10 nurse assistants).Methods. Data comprised observations and tape recordings of the sessions, the researchers' reflections after each session and a focus-group interview with the participants. The texts were analysed using qualitative content analysis.Results. The analysis showed that: (i) the exercises stimulate reflection about daily caring practice; (ii) the participants must receive extensive information about the purpose of the sessions; (iii) the research team must secure the defined frames and conditions and have practical knowledge about caring for people with dementia and (iv) the management needs to be stable, committed and supportive.Conclusion. Drama seems to be a valid tool to aid reflection, but several adjustments are needed concerning both the content of the sessions and the methodology. When designing a larger intervention study, it would be preferable to the sessions to be combined with staff support to effect changes in care provision resulting from their increased awareness of the residents' situation and experience.Implications for practice. Our results showed that drama can be a means to enhance reflection among staff in residential care for people with dementia. Further research is however needed concerning the effects for the staff's situation and nursing care quality.
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| 5. |
- Bolmsjö, Ingrid, et al.
(författare)
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The use of drama to support reflection and understanding of the residents' situation in dementia care : a pilot study.
- 2012
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Ingår i: International Journal of Older People Nursing. - : Blackwell Munksgaard. - 1748-3735 .- 1748-3743. ; 9:3, s. 183-191
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Tidskriftsartikel (refereegranskat)abstract
- The use of drama to support reflection and understanding of the residents' situation in dementia care: a pilot study. International Journal of Older People Nursing doi: 10.1111/j.1748-3743.2012.00333.x Background. One key aspect of person-centredness is striving to understand both the patients' experiences and behaviours from their perspective. These aspects are precisely those that staff in dementia care highlight as causing them most difficulty because the people in their care have major problems expressing themselves. There is thus a need to develop a method to help the staff to achieve interpretation through reflection. Aim. The aim of this study was to explore the use of drama as a tool to support reflection among staff working in the residential care of people with dementia. Design. A qualitative evaluation of a programme consisting of three drama sessions with staff working in residential care (n = 10 nurse assistants). Methods. Data comprised observations and tape recordings of the sessions, the researchers' reflections after each session and a focus-group interview with the participants. The texts were analysed using qualitative content analysis. Results. The analysis showed that: (i) the exercises stimulate reflection about daily caring practice; (ii) the participants must receive extensive information about the purpose of the sessions; (iii) the research team must secure the defined frames and conditions and have practical knowledge about caring for people with dementia and (iv) the management needs to be stable, committed and supportive. Conclusion. Drama seems to be a valid tool to aid reflection, but several adjustments are needed concerning both the content of the sessions and the methodology. When designing a larger intervention study, it would be preferable to the sessions to be combined with staff support to effect changes in care provision resulting from their increased awareness of the residents' situation and experience. Implications for practice. Our results showed that drama can be a means to enhance reflection among staff in residential care for people with dementia. Further research is however needed concerning the effects for the staff's situation and nursing care quality.
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| 6. |
- Carlsson, Ingela, et al.
(författare)
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Hand-injured Patients' Experiences of Cold Sensitivity and the Consequences and Adaptation for Daily Life: A Qualitative Study.
- 2010
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Ingår i: Journal of Hand Therapy. - : Elsevier BV. - 1545-004X .- 0894-1130. ; 23, s. 53-61
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Qualitative descriptive. INTRODUCTION: Cold sensitivity is a common and persistent complaint after hand injuries. PURPOSE OF THE STUDY: To explore the experiences of severe cold sensitivity, its consequences for daily life, and the strategies for enduring and enabling occupation. METHODS: Fifteen hand-injured patients with abnormal cold sensitivity were interviewed. The transcribed text was analyzed using manifest and latent content analysis. Experiences of triggering factors, symptoms, and relieving strategies were described. RESULTS: The consequences and adaptation in daily life entailed a change in life roles, a struggle to maintain self-image and changed occupational performance and/or occupational patterns. CONCLUSIONS: Our findings highlight the importance of a holistic approach, including a screening of patients' occupational roles and patterns as well as psychosocial needs, to obtain the information needed to support patients with severe cold sensitivity to achieve a sense of control and self-mastery. LEVEL OF EVIDENCE: not applicable.
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| 7. |
- Edberg, Anna-Karin, et al.
(författare)
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Exploring existential loneliness among frail older people as a basis for an intervention : protocol for the development phase of the LONE study
- 2019
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Ingår i: JMIR Research Protocols. - : JMIR Publications. - 1929-0748 .- 1929-0748. ; 8:8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: International research concerning end-of-life issues emphasizes the importance of health care professionals (HCPs) being prepared to deal with existential aspects, like loneliness, in order to provide adequate care. The last phase of life is often related to losses of different kinds, which might trigger feelings of isolation in general and existential loneliness (EL) in particular. There is a large body of research concerning loneliness among older people in general, but little is known about the phenomenon and concept of EL in old age.OBJECTIVE: This study aims to describe the framing, design, and first results of the exploratory phase of an intervention study focusing on EL among older people: the LONE study. This stage of the study corresponds to the development phase, according to the Medical Research Council framework for designing complex interventions.METHODS: The LONE study contains both theoretical and empirical studies concerning: (1) identifying the evidence base; (2) identifying and developing theory through individual and focus group interviews with frail older people, significant others, and HCPs; and (3) modeling process and outcomes for the intervention. This project involves sensitive issues that must be carefully reviewed. The topic in itself concerns a sensitive matter and the study group is vulnerable, therefore, an ethical consciousness will be applied throughout the project.RESULTS: The results so far show that EL means being disconnected from life and implies a feeling of being fundamentally separated from others and the world, whether or not one has family, friends, or other close acquaintances. Although significant others highlighted things such as lack of activities, not participating in a social environment, and giving up on life as aspects of EL, the older people themselves highlighted a sense of meaningless waiting, a longing for a deeper connectedness, and restricted freedom as their origins of EL. The views of HCPs on the origin of EL, the place of care, and their own role differed between contexts.CONCLUSIONS: The studies focusing on identifying the evidence base and developing theory are published. These results will now be used to identify potential intervention components, barriers, and enablers for the implementation of an intervention aimed at supporting HCPs in encountering EL among older people.
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| 8. |
- Edberg, Anna-Karin, et al.
(författare)
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Exploring existential loneliness among frail older people as a basis for an intervention : protocol for the development phase of the LONE study
- 2019
-
Ingår i: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 8:8
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: International research concerning end-of-life issues emphasizes the importance of health care professionals (HCPs) being prepared to deal with existential aspects, like loneliness, in order to provide adequate care. The last phase of life is often related to losses of different kinds, which might trigger feelings of isolation in general and existential loneliness (EL) in particular. There is a large body of research concerning loneliness among older people in general, but little is known about the phenomenon and concept of EL in old age. OBJECTIVE: This study aims to describe the framing, design, and first results of the exploratory phase of an intervention study focusing on EL among older people: the LONE study. This stage of the study corresponds to the development phase, according to the Medical Research Council framework for designing complex interventions. METHODS: The LONE study contains both theoretical and empirical studies concerning: (1) identifying the evidence base; (2) identifying and developing theory through individual and focus group interviews with frail older people, significant others, and HCPs; and (3) modeling process and outcomes for the intervention. This project involves sensitive issues that must be carefully reviewed. The topic in itself concerns a sensitive matter and the study group is vulnerable, therefore, an ethical consciousness will be applied throughout the project. RESULTS: The results so far show that EL means being disconnected from life and implies a feeling of being fundamentally separated from others and the world, whether or not one has family, friends, or other close acquaintances. Although significant others highlighted things such as lack of activities, not participating in a social environment, and giving up on life as aspects of EL, the older people themselves highlighted a sense of meaningless waiting, a longing for a deeper connectedness, and restricted freedom as their origins of EL. The views of HCPs on the origin of EL, the place of care, and theirown role differed between contexts. CONCLUSIONS: The studies focusing on identifying the evidence base and developing theory are published. These results will now be used to identify potential intervention components, barriers, and enablers for the implementation of an intervention aimed at supporting HCPs in encountering EL among older people.
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| 9. |
- Krantz, Oskar, et al.
(författare)
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The Experience of Active Wheelchair Provision and Aspects of Importance Concerning the Wheelchair Among Experienced Users in Sweden
- 2011
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Ingår i: The Review of Disability Studies. - : University of Hawaiʻi at Mānoa. - 1552-9215. ; 7:2, s. 21-37
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Tidskriftsartikel (refereegranskat)abstract
- This qualitative study describes the experience of active ultra lightweight rigid frame wheelchairs (active wheelchairs) provision. Eleven interviews with experienced users showed that the wheelchair should support physical as well as social functioning, but that users experienced injustice and unfairness when negotiating their wheelchair needs and felt insecure within the system. Changes of attitudes and organization are suggested.
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| 10. |
- Krantz, Oskar, et al.
(författare)
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The experience of active wheelchair provision and aspects of importance concerning the wheelchair among experienced users in Sweden
- 2011
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Ingår i: Review of Disability Studies: An International Journal. - : University of Hawaiʻi at Mānoa. - 1553-3697. ; 7:2, s. 21-37
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Tidskriftsartikel (refereegranskat)abstract
- This qualitative study describes the experience of active ultra lightweight rigid frame wheelchairs (active wheelchairs) provision. Eleven interviews with experienced users showed that the wheelchair should support physical as well as social functioning, but that users experienced injustice and unfairness when negotiating their wheelchair needs and felt insecure within the system. Changes of attitudes and organization are suggested.
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