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Sökning: swepub > Umeå universitet > Refereegranskat > Norberg Astrid > Henriksen Nils > Normann Hans Ketil

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  • Norman, Hans Ketil, et al. (författare)
  • Lucidity in a woman with severe dementia related to conversation : a case study
  • 2005
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 14:7, s. 891-6
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVES: The aim of this study was to explore the presence of lucidity in a woman with severe dementia during conversations and whether it occurred when conversational partners or the woman with severe dementia initiated the conversation topics about the present, past or future time and whether she was presented with support or demands during the conversation. BACKGROUND: Communication problems as well as episodes of lucidity in people with dementia are reported in the literature. DESIGN: A researcher held 20 hours of conversation with a woman with severe dementia. A daughter participated for about three and a half hours. The conversation was tape-recorded and transcribed verbatim. METHODS: The text was divided into units of analysis. Each unit of analysis was then assessed separately and discussed among the authors. Chi-square tests and logistic regression analysis were performed. An ethics committee approved the study. RESULTS: The woman as initiator of the conversation topic and support to the women during conversation from the conversation partner were found to be the most significant factors explaining lucidity, while conversation about the present or past time showed no connection with lucidity. Very few topics (n = 7) concerned future time and they were not used in the statistical analysis. The researcher initiated 41%, the woman 43% and the daughter 16% of the topics. Support was registered in 49%, demands in 15% and both support and demands in 16% of the units of analysis. There were 58% topics about present and 40% about the past time. CONCLUSIONS: The presented study is a case study and the results cannot be generalized. For the woman with severe dementia, lucidity was promoted by the conversational parties carefully focusing on conversation topics initiated by the woman while supporting her during conversation. RELEVANCE TO CLINICAL PRACTICE: To share the same perception of reality, focusing on the topics initiated by the patient with severe dementia and a supporting attitude to what the patient tells, will hopefully give more episodes of lucidity in the patient. This approach in caring for patients with severe dementia might give more meaning and well-being to the conversational partners in daily care.
  • Fjelltun, Aud-Mari, et al. (författare)
  • Functional levels and nurse workload of elderly awaiting nursing home placement and nursing home residents : a comparative study.
  • 2009
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 23:4, s. 736-747
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was twofold: to compare the functional levels of elderly awaiting nursing home placement and nursing home residents, and to compare their nurses' physical and psychological workloads. In Norway, the demand for nursing home placement has increased greatly. Elderly awaiting placement can receive care from home health care services and/or from their families. Documenting elderly's functional levels may illuminate the extent of the carers' workloads and the need for support during the waiting period. The study was conducted in 2005 on two groups in northern Norway. Using the Multi-Dimensional Dementia Assessment Scale to assess functional levels, one group of nurses assessed elderly awaiting nursing home placement (n = 36) and another group of nurses assessed nursing home residents (n = 47). The nurses also reported physical and psychological workloads in caring for these elderly. A comparison of the functional levels between elderly awaiting nursing home placement and nursing home residents showed few statistically significant differences. Nursing home residents had two lower motor functions, needed more assistance with activities of daily living, more regular administration of enemas, were more often unable to speak, and showed lower orientation levels. Clinically significant similarities were found in five motor functions, including rising from lying to sitting, rising out of bed and walking, and in behavioural and psychiatric symptoms. Both groups of elderly had a high prevalence of sadness and fearfulness. The results of this study indicate that elderly awaiting nursing home placement can be as frail as nursing home residents. These results highlight the elderly's need for assistance and reveal the need for more nursing home beds. Nurses in home health care and nursing homes rated physical and psychological workloads similarly. As many carers provide care 24 hours a day, these results also illuminate the need to support carers during the waiting period.
  • Fjelltun, Aud-Mari Sohini, et al. (författare)
  • Carers' experiences with overnight respitecare : a qualitative study
  • 2009
  • Ingår i: Vård i Norden. - 0107-4083. ; 29:3, s. 23-27
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim The aim of this study was to explore experiences with overnight respite care (ORC) of Norwegian carers who provided care to frail elderly awaiting nursing home placement.Background In many Western countries respite care has become part of health care service provision, and various types of respite care are available. The intent with respite care can be twofold; caring for the care receiver and supporting the carer.Methods This was a descriptive qualitative study. Interviews were conducted with 15 carers, transcribed and analysed by qualitative content analysis.Findings The carers described various experiences with ORC. If ORC supported the family unit, it was welcomed by carers and experienced as supportive. If ORC did not support the family unit, many carers rejected ORC, and it was experienced as non-supportive. Two categories were constructed: 'experiencing ORC as supportive for the family as a unit' and 'not experiencing ORC as supportive for the family as a unit'.Conclusion To support more carers, nurses have to listen to carers’ experiences about ORC. Nurses need to take responsibility for the family as a unit and provide more flexible ORC services based on both carers’ and elderly’s needs.
  • Fjelltun, Aud-Mari Sohini, et al. (författare)
  • Nurses' and carers' appraisals of workload in care of frail elderly awaiting nursing home placement.
  • 2009
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 23:1, s. 57-66
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: The aim of this study is to describe carers' and nurses' appraisals of workload in care of frail elderly awaiting nursing home (NH) placement. BACKGROUND: Carers' workload of care for frail elderly awaiting NH placement has been studied separately from that of nurses' workload. The literature neither addressed a comparison of carers' and nurses' appraisals of psychological and physical workloads nor the most strenuous factors common to the workloads of both nurses and carers in care of the same elderly person. The terms 'carers' and 'nurses' in this paper refer to informal caregivers and to both enrolled nurses and Registered Nurses respectively, when no particular one is stated. METHOD: The sample comprised 11 nurses and 11 carers paired based on care provided to the same elderly person awaiting NH placement in Norway. Data collected by a workload-scale was analyzed by descriptive statistics. Data collected by individual interviews were analyzed by qualitative content analysis. Carers' and nurses' appraisals of workload were compared and contrasted and most strenuous factors described. FINDINGS: The findings show that both carers and nurses rated workload levels maximum. Carers' highest ratings concerned psychological workload, while nurses' highest ratings concerned physical workload. The workload ratings concerning elderly with advanced dementia disease were most similarly aligned. Qualitative content analysis showed three categories that describe the most strenuous factors common to the workloads of both carers and nurses. These were feeling responsible, burdened and ambivalent. CONCLUSION: This study reports carers' and nurses' appraisals of workload in care of frail elderly awaiting NH placement. The results show many similarities and some differences. These results may help guide policy development to address resource allocations to elderly care. Further research is needed to address workloads of care for elderly awaiting NH placement.
  • Fjelltun, Aud-Mari Sohini, et al. (författare)
  • Carers' and nurses' appraisals of needs of nursing home placement for frail older in Norway
  • 2009
  • Ingår i: Journal of Clinical Nursing. - Malden : Wiley-Blackwell. - 0962-1067. ; 18:22, s. 3079-3088
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives. The aim of this paper was to explore carers' and nurses' appraisals concerning if and when nursing home placement for frail older people awaiting placement was needed and to illuminate ethical issues involved in decisions regarding nursing home placement.Background. Requesting nursing home placement can be a complicated decision for carers, causing feelings of failure, anxiety and guilt. After the necessity of nursing home care is determined, the names of the older people are put on waiting lists. While waiting, home health care provides support services. Even with this care, many of the older people and their carers face difficult life situations.Design. This is a descriptive and comparative cross-sectional study using qualitative methods.Methods. The convenience sample (n = 36) comprised 11 carers of older people on a nursing home placement waiting list in Norway and 11 nurses caring for these older people. Every one willingly participated in interviews that were transcribed and analysed by qualitative content analysis.Results. Various similarities and differences between nurses' and carers' appraisals were found. Complex ethical issues of justice, equality, autonomy, beneficence and justifiability in nursing were involved in decision making concerning nursing home placement. Four categories constructed were: 'appraising nursing home to be the level of care needed', 'appraising the older people as able to continue living at home', 'being ambivalent about nursing home placement' and 'being sceptical about use of coercion regarding nursing home placement'.Conclusions. Not all of the older people awaiting nursing home placements could be placed in nursing homes when beds became available. The situations were complex and involved ethical issues. Relevance to clinical practice. Despite insufficient resources in home health care, providing appropriate support for older people and their carers means that nurses have to consider individual concerns in each situation, cooperate with carers, respect their appraisals of needs and argue for the timely nursing home placement of older people.
  • Henriksen, Nils, et al. (författare)
  • Nursing home placement in Norway : characteristics of older people assigned to placement
  • 2015
  • Ingår i: Nordisk sygeplejeforskning. - Universitetsforlaget. - 1892-2678. ; 5:2, s. 133-150
  • Tidskriftsartikel (refereegranskat)abstract
    • To determine the characteristics of older people assigned to nursing home placement and to illuminate the factors emphasised in the assignments, thirty-two home health care leaders in a Norwegian municipality completed a questionnaire regarding their assessment of the levels of functioning of the assigned individuals. These assessments were compared with assessments of individuals who had been placed on a waiting list to receive an assignment and of residents who had already been admitted to a nursing home. The individuals who had received assignments had higher rates of cognitive impairment, memory disturbances, disorientation and psychiatric symptoms compared with the individuals awaiting placement. The individuals with assignments had better motor function and a greater ability to accomplish daily activities without assistance than those in the other two groups. The physical workloads were the lowest for the carers of older people assigned to placement. Individuals without cognitive impairment and with low/worse motor function had to wait longer for nursing home placement than individuals with cognitive impairment. Older people with low/worse motor function required more assistance with their daily activities from informal carers. The implications for nursing are to recognise the physical workloads of carers and the necessity of offering them respite and support.
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