| 1. |
|
|
| 2. |
- Andreassen Devik, Siri, et al.
(författare)
-
Meanings of being old, living on one's own and suffering from incurable cancer in rural Norway
- 2013
-
Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 17:6, s. 781-787
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to explore and understand the lived experience of older people living alone and suffering from incurable cancer in rural Norway. Methods and sample: Narrative interviews were conducted with five older people with incurable cancer (three women and two men, aged 71-79), receiving outpatient and life-prolonging chemotherapy and living alone in their homes in rural areas. A phenomenological hermeneutical approach was used to interpret the meaning of the lived experience. Key results: Four main themes were found: enduring by keeping hope alive, becoming aware that you are on your own, living up to expectations of being a good patient and being at risk of losing one's identity and value. Enduring this situation means struggling with terminal illness and facing death in a brave manner, and replacing former ways of living. The process of providing treatment may threaten dignity and cause additional distress. Conclusions: These results show a complex and comprehensive situation where physical symptoms and emotions are interwoven. Further the results describe how the ways of suffering caused by the manner in which care is delivered, suffering related to the cancer disease and existential suffering, may increase each other's impact. The social and rural context calls for special attention as the patients may lack recourses to gain sufficient care. Their comfort depends to a large extent on the health professionals' sensitivity. © 2013 Elsevier Ltd.
|
|
| 3. |
- Andreassen Devik, Siri, et al.
(författare)
-
Nurses’ experiences of compassion when giving palliative care at home
- 2020
-
Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 27:1, s. 194-205
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Compassion is seen as a core professional value in nursing and as essential in the effort of relieving suffering and promoting well-being in palliative care patients. Despite the advances in modern healthcare systems, there is a growing clinical and scientific concern that the value of compassion in palliative care is being less emphasised.Objective: This study aimed to explore nurses’ experiences of compassion when caring for palliative patients in home nursing care. Design and participants: A secondary qualitative analysis inspired by hermeneutic circling was performed on narrative interviews with 10 registered nurses recruited from municipal home nursing care facilities in Mid-Norway. Ethical considerations: The Norwegian Social Science Data Services granted permission for the study (No. 34299) and the re-use of the data.Findings: The compassionate experience was illuminated by one overarching theme: valuing caring interactions as positive, negative or neutral, which entailed three themes: (1) perceiving the patient’s plea, (2) interpreting feelings and (3) reasoning about accountability and action, with subsequent subthemes.Discussion: In contrast to most studies on compassion, our results highlight that a lack of compassion entails experiences of both negative and neutral content.Conclusion: The phenomenon of neutral caring interactions and lack of compassion demands further explorations from both a patient – and a nurse perspective.
|
|
| 4. |
- Andreassen Devik, Siri, et al.
(författare)
-
"Picking up the pieces" - Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area
- 2015
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa Healthcare. - 1748-2623 .- 1748-2631. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients’ strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context.
|
|
| 5. |
- Andreassen Devik, Siri, et al.
(författare)
-
When expressions make impressions-Nurses' narratives about meeting severely ill patients in home nursing care : A phenomenological-hermeneutic approach to understanding
- 2013
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 8, s. Art. no. 21880-
-
Tidskriftsartikel (refereegranskat)abstract
- Registered nurses (RNs) working in homecare encounter severely ill and palliative patients whose expressions may cause ethical challenges and influence their daily work. The aim of this qualitative study was to illuminate and interpret the meaning of nurses' lived experiences when meeting these patients. Narrative interviews were conducted with 10 RNs working in home nursing care. These interviews were audiotaped and transcribed verbatim to a text and interpreted by a phenomenological-hermeneutic method inspired by Ricoeur. The meaning of the RNs' lived experience of patients' expressions was formulated into four themes. The first theme, Being open for the presence of the Other, includes two subthemes: "Sensing vulnerability" and "Empathizing with." The second theme, Being satisfied, entails the subthemes, "Feeling exceptional" and "Being trusted." The third theme, Being frustrated, contains the subthemes, "Being disappointed" and "Being angry." The fourth and final theme, Being ambivalent, includes one subtheme: "Being generous or reserved." Patients' expressions that make impressions on nurses create emotional waves. Expressions leave impressions that call upon the nurse, and confront her with taking the risk of letting intuition and pre-reflexive feelings gain entry to her care. Allowing for the Other's presence is seen as a precondition, which means facing humanity and sensing a vulnerability in herself as well as in the Other. Understanding and balancing this emotional dimension in care seems to cause confusion and distress within the nurses. Realizing how their feelings may lead to either generosity or aloofness towards the patient is upsetting. Our interpretation suggests that these impressions echo confusion according to the role of being a professional nurse. There is a need to pay more attention to how the emotional dimension in care is understood and impacts the way nurses perform their professional role.
|
|
| 6. |
- Devik Andreasen, Siri, et al.
(författare)
-
Bereaved family members' perspectives on suffering among older rural cancer patients in palliative home nursing care: A qualitative study
- 2017
-
Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 0961-5423 .- 1365-2354. ; 26:6
-
Tidskriftsartikel (refereegranskat)abstract
- Little is known about experiences with receiving home nursing care when old, living in a rural area, and suffering from end-stage cancer. The aim of this study was thus to investigate bereaved family members' perceptions of suffering by their older relatives when receiving palliative home nursing care. Qualitative semi-structured interviews were conducted with 10 family members, in Norway during autumn 2015, and directed content analysis guided by Katie Eriksson's theoretical framework on human suffering was performed upon the data. The two main categories identified reflected expressions of both suffering and well-being. Expressions of suffering were related to illness, to care and to life and supported the theory. Expressions of well-being were related to other people (e.g. familiar people and nurses), to home and to activity. The results indicate a need to review and possibly expand the perspective of what should motivate care. Nursing and palliative care that become purely disease and symptom-focused may end up with giving up and divert the attention to social and cultural factors that may contribute to well-being when cure is not the goal.
|
|
| 7. |
- Eivergård, Kristina, et al.
(författare)
-
Disciplined into Good Conduct : Gender Constructions of Users in a Municipal Psychiatric Context in Sweden
- 2021
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 30:15-16, s. 2258-2269
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To examine how gendered discursive norms and notions of masculinity and femininity were (re)produced in professional conversations about users of long-term municipality psychiatric care. Focus is on the staff's use of language in relation to gender constructions.BACKGROUND: Psychiatric care in Sweden has undergone tremendous changes in recent decades from custodian care in large hospitals to a care mainly located in a municipal context. People who need psychiatric care services often live in supporting houses. In municipal psychiatric care, staff conduct weekly professional meetings to discuss daily matters and the users' needs. Official reports of the Swedish government have shown that staff in municipal care services treat disabled women and men differently. Studies exploring gender in relation to users of long-term psychiatric care in municipalities have problematised the care and how staff, through language, construct users' gender. Therefore, language used by staff is a central tool for ascribing different gender identities of users.DESIGN: The content of speech derived from audio recordings were analysed using Foucauldian discursive analysis. The COREQ checklist was used in this article.RESULTS: The results indicate that by relying on gender discourses, staff create a conditional care related to how the users should demonstrate good conduct. In line with that, an overall discourse was created: Disciplined into good conduct. It was underpinned by three discourses inherent therein: The unreliable drinker and the confession, Threatened dignity, Doing different femininities.CONCLUSION: The community psychiatric context generates a discourse of conduct in which staff, via spoken language (re)produces gendered patterns and power imbalances as a means to manage daily work routines. Such practices of care, in which constant, nearly panoptic, control despite the intention to promote autonomy, urgently require problematising current definitions of good conduct and normality.
|
|
| 8. |
- Eivergård, Kristina, et al.
(författare)
-
Subordinated masculinities : A critical inquiry into the reproduction of gender norms in forensic psychiatric care.
- 2020
-
Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 29:21-22, s. 4227-4238
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender.BACKGROUND: During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms.DESIGN: Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used.RESULTS: While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family-oriented care. The overarching discourse, which we labelled subordinated masculinities, was supported by three other discourses: being unable to take responsibility, being drug-addicted and performing masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms.CONCLUSION: The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients´ responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them.RELEVANCE TO CLINICAL PRACTICE: Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care.
|
|
| 9. |
- Eivergård, Kristina, et al.
(författare)
-
The Importance of Being Acceptable - Psychiatric Staffs' Talk about Women Patients in Forensic Care
- 2019
-
Ingår i: Issues in Mental Health Nursing. - : Taylor & Francis. - 0161-2840 .- 1096-4673. ; 40:2, s. 124-132
-
Tidskriftsartikel (refereegranskat)abstract
- Currently, women comprise about ten percent of those sentenced to psychiatric forensic clinics in Sweden. Those who are sentenced to forensic care because of offending and violent behaviour have already taken a step away from the usually expected female behaviour. On the other hand, there are many women in forensic care who have not committed crimes, but who instead self-harm. Studies have identified a gender bias in diagnosing and care in psychiatric settings, but there are few studies conducted on women in forensic care. The present study therefore examined how the situation of women patients and female norms are expressed in the staff's talk about these women during verbal handovers and ward rounds at a forensic clinic in Sweden. The aim was to explore how psychiatric staff, in a context of verbal handovers and ward rounds, talk about women who have been committed to forensic psychiatric care, and what consequences this might have for the care of the patients. The content of speech was examined using audio recordings and a method of analysis that was inspired by thematic analysis. The analysis identified that the staff talked about the women in a way that indicates that they expected the women to follow the rules and take responsibility for their bodies in order to be regarded as acceptable patients.
|
|
| 10. |
- Eivergård, Kristina, et al.
(författare)
-
The Talk About the Psychiatric Patient
- 2016
-
Ingår i: Issues in Mental Health Nursing. - : Taylor & Francis. - 0161-2840 .- 1096-4673. ; 37:10, s. 756-764
-
Tidskriftsartikel (refereegranskat)abstract
- Essential to psychiatric nursing practice and care, verbal handovers and ward rounds are reporting systems for communication that shapes psychiatric staff's ability to recognize, understand, and construct patients, as well as patients’ ability to construct themselves. Given the centrality of such language in psychiatric practice, the aim of this study was to describe how psychiatric staff talk about patients in psychiatric wards, what their talk encompasses, and what consequences it might pose for patient care. Empirical data were collected from audio recordings of staff discussions of patients during nine verbal handovers and three ward rounds in six different general psychiatric wards in mid and southern Sweden. Findings showed that to describe patients’ mood, characteristics, and behavior, nurses used culturally common words and concepts related to three themes—good patients, bad patients, and to stay or be discharged—and six subthemes—looking well, looking poorly, desirable patients, undesirable patients, continuing work, and being discharged. However, since assessments of and decisions about patients’ conditions and care used everyday language and did not involve patients’ participation, opportunities for patients to participate in their own care were rare.
|
|
