| 1. |
- Beck, Ingela, 1965-, et al.
(författare)
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Applying a palliative care approach in residential care : effects on nurse assistants' work situation
- 2015
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Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 13:3, s. 543-553
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership.Method: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110).Results: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased.Significance of results: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.
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| 2. |
- Borglin, Gunilla, et al.
(författare)
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Older people in Sweden with various degrees of present quality of life : their health, social support, everyday activities and sense of coherence.
- 2006
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Ingår i: Health & Social Care in the Community. - : Blackwell Publishing. - 0966-0410 .- 1365-2524. ; 14:2, s. 136-146
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Tidskriftsartikel (refereegranskat)abstract
- Public health policies in most European countries are concerned with how to keep older people living independently with a qualitatively good life in the community as long as possible. However, knowledge about what may characterise those seemingly 'healthy' older people is sparse. The aim of the study was to investigate the characteristics of a sample of people (75+) reporting various degrees of Quality of Life (QoL) with respect to QoL in different areas, as well as self-rated health, health problems, social support, everyday activities and sense of coherence. A postal questionnaire was sent out in spring 2001 to a randomly selected population-based sample (n= 600) in the southern parts of Sweden. A two-step cluster analysis was performed (n= 385, mean age 84.6, SD = 5.7) with 'present QoL' as clustering attribute. Three groups were disclosed, classified as high, intermediate and low present QoL, of which 33.8% could be regarded being at risk of low QoL. Those with low present QoL (18.4%) were the oldest and most vulnerable, a majority were women with 'poor or bad' self-rated health, high frequencies of health problems, low total QoL, low social support and sense of coherence and less physically active. Those with high present QoL (47.8%) reported more 'excellent or good' self-rated health, physical activity, satisfactory social support and higher sense of coherence and total QoL than the other two groups. Those with intermediate present QoL (33.8%) had more of 'poor or bad' self-rated health, more health problems were less physically active, had lower total QoL and sense of coherence, and less social support than those with high present QoL. The sample seemed to reflect the ageing process in that the respondents were at different stages of ageing. However, the fact that the level of social support, sense of coherence and self-rated health followed the same curve as QoL may indicate that some are more vulnerable to low present QoL given the same health and these should be targeted in preventive programmes since they report low QoL.
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| 3. |
- Orrung Wallin, Anneli, et al.
(författare)
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Psychometric properties concerning four instruments measuring job satisfaction, strain, and stress of conscience in a residential care context
- 2013
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 57:2, s. 162-171
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Tidskriftsartikel (refereegranskat)abstract
- There are many instruments assessing the wellbeing of staff, but far from all have been psychometrically investigated. When evaluating supportive interventions directed toward nurse assistants in residential care, valid and reliable instruments are needed in order to detect possible changes. The aim of the study was to investigate validity in terms of data quality, construct validity, convergent and divergent validity and reliability in terms of the internal consistency and stability of the Job Satisfaction Questionnaire, the Psychosocial Aspects of Job Satisfaction, the Strain in Dementia Care Scale (SDCS), and the Stress of Conscience Questionnaire (SCQ) in a residential care context. The psychometric properties of the instruments were investigated in terms of data quality, construct validity, convergent and divergent validity and reliability, including test-retest reliability, in a residential care context with a sample consisting of nurse assistants (n=114). The four instruments responded with different psychometric-related problems such as internal missing data, floor and ceiling effects, problems with construct validity and low test-retest reliability, especially when assessed on the item level. These problems were however reduced or disappeared completely when assessed for total and factor scores. From a psychometric perspective, the SDCS seemed to stand out as the best instrument. However, it should be modified in order to reduce floor effects on item level and thereby gain sensitivity. The Job Satisfaction Questionnaire seemed to have problems both with the construct validity and test-retest reliability. The final choice of instrument must, however, be made dependent on what one intends to measure.
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| 4. |
- Andersson, Magdalena, et al.
(författare)
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Health care consumption and place of death among old people with public home care or in special accommodation in their last year of life
- 2007
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 19:3, s. 228-239
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS:Developing care for older people in the last phase of life requires knowledge about the type and extent of care and factors associated with the place of death. The aim of this study was to examine age, living conditions, dependency, care and service among old people during their last year of life, but also their place of death and factors predicting it.METHODS:The sample (n=1198) was drawn from the care and services part of the Swedish National Study on Ageing and Care (SNAC). Criteria for inclusion were being 75+ years, dying in 2001-2004, and having public care and services at home or in special accommodation.RESULTS:In the last year of life, 82% of persons living at home and 51% living in special accommodation were hospitalized; median stays were 10 and 6.7 days respectively. Those living at home were younger and less dependent in ADL than those living in special accommodation. Those living at home and those having several hospital stays more often died in hospital. In the total sample, more visits to physicians in outpatient care predicted dying in hospital, whereas living in special accommodation and PADL dependency predicted dying outside hospital.CONCLUSIONS: Old people in their last year of life consumed a considerable amount of both municipal care and outpatient and in-hospital medical care, especially those living at home, which in several cases ended with death in hospital.
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| 5. |
- Andersson, Magdalena, et al.
(författare)
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Old people receiving municipal care, their experiences of what constitutes a good life in the last phase of life : a qualitative study
- 2008
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 45:6, s. 818-828
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundOld people's life situation when receiving municipal help and care in their last period of life is sparsely investigated from their own perspective.ObjectiveThe aim of this study was to investigate the experiences of aspects that bring about a good life in the last phase of life among people (75+ years) receiving municipal care.ParticipantsOlder people living in a municipality in Southern Sweden being 75 years or older, receiving help and/or care from the municipality, and having a life-threatening disease and/or receiving palliative care were asked to participate. In all 17 people, 10 women and 7 men, aged 78–100 years were included.MethodsQualitative interviews, with the emphasis on their present life situation especially what brought about a good life, were performed. The interviews were analysed using qualitative content analysis.ResultsThe experience was interpreted to be Turning inwards to come to peace with the past, the present and approaching death while being trapped by health complaints. Six categories embraced the experience of aspects that constitute a good life in the last phase of life: Maintaining dignity, Enjoying small things, Feelings of “being at home”, Being in the hands of others, trying to adjust, Still being important for other people and Completing life while facing death.ConclusionThis study confirm theories suggesting that the last phase of life in old age meant focusing inwards, reflecting on the entire life as a way of completing it as well as enjoying small things and also viewing oneself in the perspective of contributing to the future. It also indicated that this phase of life meant being trapped by health complaints and functional limitations. The struggle to maintaining dignity as opposed to being in the hands of others implies that the concept of palliative care may be useful as a framework for providing nursing care to very old people, especially at the end of life.
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| 6. |
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Att möta personer med demenssjukdom
- 2020. - 3
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Denna tredje upplaga har bland annat utökats med kapitel om palliativ vård och ledarskapets betydelse för att skapa ett personcentrerat vårdklimat. Boken är omarbetad efter det aktuella kunskapsläget och innehåller flertalet referenser, vilket möjliggör ytterligare fördjupning i ämnet.Omvårdnad för personer med demenssjukdom utgår från det mänskliga mötet och vår förmåga att se in i, och förstå, den andres livsvärld. Boken ger läsaren redskap som underlättar i detta möte. I fokus står personens upplevelse av att drabbas, upplevelsen av att vara anhörig men även olika aspekter av vårdandet är centrala. Innehållet genomsyras av ett personcentrerat och hälsofrämjande förhållningssätt, samt betonar värdegrundens, vårdmiljöns och ledarskapets betydelse. Några kapitel har fokus på existentiella aspekter och vårdfilosofi, medan andra är mer konkreta och praktiska. Sist i boken finns ett kapitel som översiktligt beskriver de olika demenssjukdomarna. Sammantaget kompletterar kapitlen varandra och ger stöd för både varandet och görandet i personalens möte med dessa personer. Kapitlen syftar också till att stimulera till eftertanke och reflektion.Målgruppen är sjuksköterskestudenter på grundnivå och avancerad nivå, men även andra yrkeskategorier som möter personer med demenssjukdom i sitt arbete har nytta av boken.
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| 7. |
- Beck, Ingela, 1965-, et al.
(författare)
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Applying a palliative care approach in residential care : effects on nurse assistants' experiences of care provision and caring climate
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 28:4, s. 830-841
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA palliative care approach aims to integrate psychosocial and existential as well as relationship aspects in the care and is an approach that can be used in residential care. Nurse assistants are the ones who are closest to the residents but have limited prerequisites for working in accordance with the palliative care approach. We aimed to investigate the effects on nurse assistants' experiences of care provision and the caring climate of an intervention applying a palliative care approach in residential care.MethodsAn intervention involving nurse assistants (n = 75) and their leaders (n = 9), in comparison with controls (n = 110), was evaluated using a questionnaire at three points in time.ResultsIn the intervention group, positive effects were seen concerning the nurse assistants' reports of the care provision in that they focused more on the residents' stories about their lives and on communicating with the residents about what gave meaning to their lives. Also, negative effects were seen when the nurse assistants rated that the residents' needs for medical and nursing care had not been met at the facility directly after the intervention. No effects were seen concerning the caring climate or the prerequisites of providing more person-centred care.ConclusionThe intervention seemed to have encouraged the nurse assistants to focus on relationship aspects with the residents. So as not to jeopardise the NAs' well-being and to support NAs in keeping themselves involved in existential issues, their support most certainly needs to be continuous and ongoing. However, in spite of the leaders' involvement, the intervention was not sufficient for changing the organisational prerequisites for more person-centred care.
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| 8. |
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| 10. |
- Berggren, Vanja, 1972-, et al.
(författare)
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Being victims or beneficiaries? : perspectives on female genital cutting and reinfibulation in Sudan
- 2006
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Ingår i: African Journal of Reproductive Health. - 1118-4841. ; 10:2, s. 24-36
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Tidskriftsartikel (refereegranskat)abstract
- Female Genital Mutilation (FGM) or the more value neutral term, Female Genital Cutting (FGC) is widely practised in northern Sudan, where around 90% of women undergo the most extensive form of FGC, infibulation. One new approach to combating FGC in Sudan is to acknowledge the previously hidden form of FGC, reinfibulation (RI) after delivery, when the woman is sewn back so much as to mimic virginity. Based on a qualitative study in Khartoum State, this article explores Sudanese women's and men's perceptions and experiences of FGC with emphasis on RI after delivery. The results showed that both genders blame each other for the continuation of the practices, and the comprehensive understanding of the perceptions and experiences was that both the women and the men in this study were victims of th e consequences of FGC and RI. The female narratives could be understood in the three categories: viewing oneself as being "normal" in having undergone FGC and RI; being caught between different perspectives; and having limited influence on the practices of FGC and RI. The male narratives could be understood in the three categories: suffering from the consequences of FGC and RI, trying to counterbalance the negative sexual effects of FGC and striving in vain to change female traditions. The results indicate that the complexity of the persistence of FGC and RI goes far beyond being explained by subconscious patriarchal and maternalistic actions, related to socially constructed concepts of normality, female identity,tradition and religion a"silent" culture betweenmen and women.
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