| 1. |
- Häggström, Elisabeth, et al.
(författare)
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Relatives' struggle for an improved and more just care for older people in community care
- 2007
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:9, s. 1749-1757
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. The aim of the present study was to describe the relatives' experience concerning older family members living in special housing facilities. Background. During the 21st century, the relatives of older people and their efforts related to the care and nursing of older people have been observed. The interest in these relatives is because of factors such as demographic changes, where the number of older people has increased and the increasing gap between the resources that are available for geriatric care and the care needed for older people. Design. The present study has a descriptive design and is part of a project including 24 specific residences, called special housing facilities. Method. The study focused on the narratives supplied by the relatives that were analysed using qualitative latent content analysis, an interpretative process where the researcher considers the content of the text. Results. The relatives' experience of having an older person in a special housing facility that emerged from the study, was expressed in one main theme: The relatives' struggle for an improved and just care for older people and four sub-themes: (i)'To trust in caregivers'; (ii) 'To be confirmed'; (iii) 'To trust in care'; (iv) 'To receive the kind of care that one considers one has the right to receive'. Conclusions. The study shows that the relatives need more support and more opportunities, so that they can participate in the care. The study shows the relatives engagement in working for a just society's obligation towards the protection of older peoples rights and the staff's working conditions. Relevance to clinical practice. It is important that caregivers and management working with older people realize that they, together with them and their relatives, are a part of society and that all individuals are influenced by the discourse of that society.
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| 2. |
- Häggström, Elisabeth, et al.
(författare)
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To feel betrayed and to feel that you are betraying the older residents : caregivers' experiences at a newly opened nursing home
- 2004
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 13:6, s. 687-696
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In Sweden and internationally, little research has focused on the working situation of Enrolled Nurses and Nurses' Aides who form the majority of workers in geriatric care today. With this in mind, it is important to focus on how these occupational groups experience their working situation with older residents in municipal care.AIMS AND OBJECTIVES: The aim of the study was to investigate the deeper meaning of work satisfaction and work dissatisfaction at a newly opened nursing home for older residents. The study focused on the narratives supplied by the caregivers at the nursing home. The participants included: one Registered Nurse, sixteen Enrolled Nurses, and three Nurses' Aides. All were directly involved in patient care.DESIGN: The present study is part of a larger longitudinal study within the municipal geriatric care system in Sweden, with a quasi-experimental design.METHOD: The interviews were analysed with a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur.RESULT: The caregivers experiences of work satisfaction and work dissatisfaction was expressed in four themes: (i) 'Experience of betrayal' describes how the staff felt let down in several ways; (ii) 'Experience of failing others' describes how the staff felt that they did not pay enough attention to older people, in several different ways; (iii) 'Experience of insufficiency' describes how the staff encountered overwhelming demands from several directions; (iv) 'Experience of work satisfaction' describes how the staff felt that they were given support in various ways. Each theme emerged from several subthemes that originated from the caregivers' narratives.CONCLUSIONS: The study shows that the caregivers' experience of work dissatisfaction overshadows their experience of work satisfaction. It also suggests that their feelings of failing the older residents are connected to their own experiences of feeling betrayed.RELEVANCE TO CLINICAL PRACTICE: The findings can be used when other nursing homes in municipal care are opened, as a means of preventing work dissatisfaction and increasing work satisfaction among future employees.
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| 3. |
- Kihlgren, Annica, 1957-, et al.
(författare)
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Older patients referred by community nurses to emergency departments - a descriptive cross-sectional follow-up study in a Swedish context
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 28:1, s. 97-103
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThe objective of this study was to examine on what extent nursing home (NH) older patients aged 75 or older, referred to hospitals by registered nurses (RNs) in the community, utilise the emergency department (ED) over a 1-year period and for what reason. A further objective was to identify factors that may explain these referrals. MethodsA cross-sectional follow-up study, examining older patients' disabilities, resources and needs, was carried out in a county in Sweden. Assessments were made using Residents Assessment Instrument/Minimum Data Set, among 719 individuals in 24 NHs and the RNs' documentation were followed. ResultsThe result showed that of 719 residents, 209 accounted for 314 referrals to an ED over the 1-year period. No gender differences were observed. The main reasons for referrals were falls (23%), cardiovascular problems (16%), gastrointestinal problems (12%) and infections (11%). Most of the referrals (65%) were made on weekdays during daytime hours. In 62% of the cases, there had been a consultation with a physician prior to the referral. The nursing documentation was poor in connection with the referral. ConclusionOlder patients with dementia diseases were significant less refereed and questions are raised whether this group is undetected and undertreated, and therefore, it is important with further investigation.
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| 4. |
- Kihlgren, Annica, 1957-, et al.
(författare)
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Referrals to Emergency departments- The processes and Factors That Influence Decision-Making among Community Nurses
- 2014
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Ingår i: Open Journal of Nursing. - Irvine, CA : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 4:5, s. 366-374
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe the basis on which municipal care registered nurses (RN) make decisions and their experiences when referring older persons from nursing homes to emergency departments (EDs). RNs in the community are to ensure that older adults receive good care quality in nursing home. This study used a descriptive design with a qualitative content analysis. The analysis of the data from the 13 interviews revealed one theme “Shared responsibilities in the best interests of the older person reduce feelings of insufficiency”. The content was formulated, which revealed the RNs’ feelings, reasoning and factors influencing them and their actions in the decision-making situation, before the patients were referred to an emergency department. Complex illnesses, non-adapted organizations, considerations about what was good and right in order to meet the older person’s needs, taking account of her/his life-world, health, well-being and best interests were reported. Co-worker competencies and open dialogues in the “inner circle” were crucial for the nurses’ confidence in the decision. Hesitation to refer was associated with previous negative reactions from ED professionals. The RN sometimes express that they lacked medical knowledge and were uncertain how to judge the acute illness or changes. Access to the “outer circle”, i.e. physicians and hospital colleagues, was necessary to counteract feelings of insecurity about referrals. When difficult decisions have to be made, not only medical facts but also relationships are of importance. To strengthen the RNs’ and staff members’ competence by means of education seems to be important for avoiding unnecessary referrals. Guidelines and work routine need to be more transparent and referrals due to the lack of resources are not only wasteful but can worsen the older persons’ health.
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| 5. |
- Mamhidir, Anna-Greta, et al.
(författare)
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Fewer referrals to Swedish emergency departments among nursing home patients with dementia, comprehensive cognitive decline and multicomorbidity
- 2012
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Ingår i: The Journal of Nutrition, Health & Aging. - Paris, France : Springer. - 1279-7707 .- 1760-4788. ; 16:10, s. 891-7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective was to describe the extent to which nursing home patients had cognitive impairments and were diagnosed with dementia. Furthermore, to describe and compare multicomorbidity, health status and drug use in the three subgroups; dementia diagnosis/not referred, dementia diagnosis/referred and no dementia diagnosis/not referred to an emergency department (ED) over a one-year period.Methods: A cross-sectional follow-up study was carried out in Sweden. RAI/MDS assessments were conducted on 719 patients in 24 nursing homes, of whom 209 were referred to EDs during a one-year period, accounting for 314 visits. This study involved an extensive examination of the population.Results: The 719 patients were reported to suffer from comprehensive cognitive impairments, which not accorded with the dementia diagnoses, they were significantly fewer. Cognitive decline or dementia diagnosis contributed to a significant decrease of referrals to EDs. Patients with dementia diagnosis/not referred had difficulties understanding others, as well as impaired vision and hearing. Patients with dementia diagnosis/referred usually understood messages. Low BMI, daily pain, multicomorbidity and high drug consumption occurred in all groups. Patients with no dementia diagnosis/not referred had significantly less multicomorbidity. Neuroleptica was significantly more prevalent among those with dementia diagnosis.Conclusion: Dementia remains undetected. Patients with cognitive decline and dementia are probably as sick as or even worse than others but may, due to low priority be undertreated or referrals avoided with the objective to provide good care in the setting. Observational studies are needed to identify what is done and could be done in referral situations.
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| 6. |
- Mamhidir, Anna-Greta, et al.
(författare)
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Underweight, weight loss and related risk factors among older adults in sheltered housing--a Swedish follow-up study.
- 2006
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Ingår i: J Nutr Health Aging. - 1279-7707 .- 1760-4788. ; 10:4, s. 255-62
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Tidskriftsartikel (refereegranskat)abstract
- Medial displacement of the navicular has been considered a major explanation for residual forefoot adduction (FFA) in congenital clubfoot and also a frequent reason for dissatisfaction after limited surgery. In this study, it was hypothesized that there would be an association between the degree of medial displacement of the navicular and residual FFA in clubfeet. The position of the navicular was retrospectively measured by ultrasonography in 49 clubfeet in 35 children at ages 3 to 6 years and correlated to residual FFA measured on footprints and radiographs (talo-first metatarsal angle). In the 49 clubfeet, the navicular was significantly more medially displaced toward the medial malleolus than in the 21 contralateral normal feet (P < 0.001). However, there was no correlation between the degree of medial displacement of the navicular and the degree of FFA measured on footprints (P = 0.690) or on radiographs (P = 0.390). Thus, there were clubfeet with straight forefoot and a medially displaced navicular, that is, "spurious correction," and clubfeet with FFA and the navicular in correct position in relation to the head of the talus. Both patient satisfaction and foot score declined with larger FFA. The results support the view that ultrasonography is a helpful tool for assessing the position of the navicular. The critical issue for analysis is whether the FFA is due to malalignment in the talonavicular joint or more distally.
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