| 1. |
- Edberg, Anna-Karin, et al.
(författare)
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Effects of clinical supervision on nurse-patient cooperation quality - A controlled study in dementia care.
- 1996
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Ingår i: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 5:2, s. 127-146
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Tidskriftsartikel (refereegranskat)abstract
- An intervention consisting of individualized planned care for patients and regular clinical systematic supervision for nurses was carried out on a ward for dementia care (the experimental ward, EW). On a similar control ward (CW), no changes were made. Observations of nurse-patient cooperation during morning care were collected at both wards, before and during the intervention. The observations (N = 107) were analyzed blindly and sorted into already-developed categories. The distribution of the cooperation-style categories was then analyzed statistically. The patients who survived throughout the study period (N = 18) were also compared over time. Nurse-patient cooperation at the EW improved significantly during the intervention period, whereas, at the CW, it deteriorated (p = .02). Status of surviving patients followed the same pattern (p = .001). The findings indicate that such interventions can improve the quality of nurse-patient cooperation in dementia care.
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| 2. |
- Edberg, Anna-Karin, et al.
(författare)
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Initiating and terminating verbal interaction between nurses and severely demented patients regarded as vocally disruptive.
- 1995
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 2:3, s. 159-167
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Tidskriftsartikel (refereegranskat)abstract
- The care of demented patients requires clear communication during care procedures. Earlier studies have shown that nurses were often vague in their verbal communication and unpublished observations indicated that in some cases demented patients continued to be verbally active after the nurses had left. This study aimed at exploring further the initiating and terminating phases of verbal interaction episodes between nurses and severely demented patients, to explore any relationship between nurses' communication style and vocally disruptive patients. Nine severely demented patients identified as vocally disruptive were tape-recorded between 07.00 h and 13.00 h. Any nurse–patient interaction episode lasting more than 30 s (n= 58) during care procedures was transcribed verbatim and its verbal communication activity was analysed for content and meta communication, and a communication index was calculated. The results showed strong task orientation and decreased verbal interaction during the course of the interaction. The data supported the assumption that the nurses' communication style increases or decreases patients' vocal activity. Vocal activity after the actual interaction episode seemed to coincide with the parties' communication on various levels, with a different focus of content, and with several nurses being involved in the same procedure. Nurses may become impatient and stressed by their patients' severe communication problems and therefore need to be relieved of this stress and supported so that they can remain close to the patient and be able to interpret his/her communication.
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| 3. |
- Edberg, Anna-Karin
(författare)
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The nurse-patient encounter and the patients' state: Effects of individual care and clinical group supervision in dementia care.
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of thesis was to investigate the nurse-patient encounter in dementia care (n=9 patients), functional and cognitive ability, behaviours and mood of the patients as well as the reliability of the instruments used (n=75 nursing home patients). A further aim was to investigate the effects on the aspects mentioned above of a one-year controlled intervention (individually planned care and clinical group supervision) on one ward (EW) in comparison to a control ward (CW), each housing 11 patients. The nurse-patient encounter was studied by means of tape recorded interaction episodes including patients' regarded as vocally demanding. The inter-rater reliability of the Patient Mood Assessment Scale (PMAS), the General Behaviour Assessment Scale (GBAS), the Gottfries-Bråne-Steen Scale and the patients' state were investigated using nurses' assessments of the patients. The intervention effects were investigated at baseline and throughout the year, for the patients' state using PMAS, GBAS, Organic Brain Syndrome scale, Multi Dimensional Dementia Assessment Scale, Demanding Behaviour Assessment Scale and Mini Mental State Examination, and for the nurse-patient encounter using non-participant observations during morning care and analysis of notes from clinical supervision sessions. Patients actively seeking contact and nurses mediating "caring about", i.e. mutuality and confirming actions, characterised high quality encounters. Nurses' or patients' withdrawal, nurses being inattentive i.e. unilaterality and disconfirming actions, characterised poor quality encounters. The inter-rater reliability of the nurses' assessments of patients' state was acceptable for ADL and intellectual functions but low for emotional dimensions. Significant improvements were seen on the EW for nurse-patient encounters, patients' sensitivity and demanding behaviours while significant detoriations were seen on CW in nurse-patient encounters, patients' functional performance and orientation in the ward, speech performance and strength. Thus the nurse-patient encounters and the patients' state developed in opposite directions on the two wards, positively on the EW and seemingly the intervention supported the nurses in their encounters with the patients, which in turn was reflected in the patients' state.
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| 4. |
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| 5. |
- Holst, Göran, et al.
(författare)
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Nurses’ narrations and reflections about caring for patients with severe dementia as revealed in systematic clinical supervision sessions.
- 1999
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Ingår i: Journal of Aging Studies. - 0890-4065. ; 1:13, s. 89-107
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Tidskriftsartikel (refereegranskat)abstract
- This study explored nurses' narrations about and reflections on caring for patients with severe dementia and their interpretation of the meaning for patients as revealed in clinical supervision sessions. The encounters between patient and nurse could confirm or threaten the patient's identity as a person or the nurse's identity as a person and a professional. Nurses searched for the meaning of these caring encounters, for both the patients and themselves, based on their knowledge of each patient's earlier life and/or sensitivity to the patient's reactions in the current situation. They pieced together these fragments of knowledge into a meaningful whole and then acted upon this interpretation, thus restorying patients' lives. Acting in this way involves risks but also benefits. Reflective discussion about various possible interpretations balanced against the current situation seems essential so as not to override the integrity of both patients and nurses.
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| 6. |
- Rahm Hallberg, Ingalill, et al.
(författare)
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Cooperation During Morning Care Between Nurses and Severely Demented Institutionalized Patients
- 1995
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Ingår i: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 4:1, s. 78-104
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Tidskriftsartikel (refereegranskat)abstract
- Nurse-patient cooperation during morning care in two wards for the care of severely demented patients (107 observations) were analyzed by using a hermeneutic-phenomenological approach. Nurse-patient cooperation was found to be characterized by their acting in mutuality or unilaterality and in or out of pace with each other. When acting in pace and mutuality, the nurse and patient turned to each other as persons as well as to the task. This theme related to confirming nurse actions and actions that provided opportunities for the patient to participate. When acting out of pace and unilaterality, cooperation was mainly task oriented and related to acts of resistance, the use of force, loss of attention or turning to others, or the patient wanted to escape. The findings were interpreted within the contexts of power, empowerment, and powerlessness and may serve as indicators of low- or high-quality nurse-patient cooperation during morning care provided for demented patients.
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