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  • Mamhidir, Anna-Greta, et al. (författare)
  • Weight increase in patients with dementia, and alteration in meal routines and meal environment after integrity promoting care
  • 2007
  • Ingår i: JOURNAL OF CLINICAL NURSING. - 0962-1067. ; 16:5, s. 987-996
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To follow weight changes in patients with moderate and severe dementia and analyse how these changes related to biological and psychological parameters after staff education and support in integrity promoting care. A further aim was to describe meal environment and routines relative to the intervention. BACKGROUND: Weight loss in patients with dementia and in particular Alzheimer's disease is common. The aetiology appears multifactorial with the meal environment and a decreased independence while eating among the factors. METHOD: Over a three-month intervention period, an integrity-promoting care training programme was conducted with the staff of a long-term ward. Alzheimer's disease patients, 18 from an intervention ward and 15 from a control ward were included and possible effects were evaluated. Weighing was conducted at the start and after completion of the intervention. Weight changes were analysed in relation to psychological and biochemical parameters. In addition, the staff wrote diaries about, for example changes made in the environment and in their work. RESULTS: The most prominent difference observed was weight increases in 13 of 18 patients compared with two of 15 patients in the control ward. No weight changes were related to the type of dementia. The individual weight changes correlated significantly to changes in the intellectual functions. Relationships between weight change, increased motor function and increased appetite were non-significant. There was no significant relationship between weight changes and changes in biochemical parameters. According to the staff, increased contact with the patients and a more pleasant atmosphere resulted when the meal environment and routines were changed. RELEVANCE TO CLINICAL PRACTICE: Weight gain in patients with moderate and severe dementia was achieved by adjusting the meal environment to the individual's needs. Staff education was profitable, as increased competence seemed to promote individually adapted feeding situations. Ensuring good meal situations need to be given high priority.
  • Öresland, Stina, et al. (författare)
  • Nurses as guests or professionals in home health care
  • 2008
  • Ingår i: Nursing Ethics. - 0969-7330. ; 15:3, s. 371-383
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to explore and interpret the diverse subject of positions, or roles, that nurses construct when caring for patients in their own home. Ten interviews were analysed and interpreted using discourse analysis. The findings show that these nurses working in home care constructed two positions: ;guest' and ;professional'. They had to make a choice between these positions because it was impossible to be both at the same time. An ethics of care and an ethics of justice were present in these positions, both of which create diverse ethical appeals, that is, implicit demands to perform according to a guest or to a professional norm.
  • Öresland, Stina, et al. (författare)
  • Patients as 'safeguard' and nurses as 'substitute' in home health care
  • 2009
  • Ingår i: Nursing Ethics. - Sage Publications. - 0969-7330. ; 16:2, s. 219-230
  • Tidskriftsartikel (refereegranskat)abstract
    • One aim of this study was to explore the role, or subject position, patients take in the care they receive from nurses in their own home. Another was to examine the subject position that patients say the nurses take when giving care to them in their own home. Ten interviews were analysed and interpreted according to a discourse analytical method. The findings show that patients constructed their subject position as 'safeguard', and the nurses' subject position as 'substitute' for themselves. These subject positions provided the opportunities, and the obstacles, for the patients' possibilities to receive care in their home. The subject positions described have ethical repercussions and illuminate that the patients put great demands on tailored care.
  • Fagerberg, Ingegerd, et al. (författare)
  • “Learning by doing” : Or how to reach an understanding of the research method phenomenological hermeneutics
  • 2009
  • Ingår i: Nurse Education Today. - 0260-6917. ; 29:7, s. 735-739
  • Tidskriftsartikel (refereegranskat)abstract
    • One problem addressed in teaching graduate students qualitative research methods is practising the cognitive and conative skills that students need to generate both rich data and meaningful analysis.The aim of the study was to illuminate development in a group of pre-doctoral and doctoral students as they learnt the phenomenological hermeneutics research method.In a course comprising 18 doctoral students we used the “guided path” pedagogical approach and decided to use a subject of which everyone has lived experience, “troubled conscience”, for the phenomenological hermeneutic analysis conducted with the students. As the students progressed in their learning experience of the research method, they analysed their data according to the steps in the method, and we as teachers conducted separate analyses of the same data.The results point in the same direction as previous studies in the field. This is discussed in terms of strength of the pedagogical approach and the students’ learning, since despite the fact that their data are limited and not very detailed they were able to come up with results that were in line with previous research.
  • Hedman, Ragnhild, et al. (författare)
  • How people with Alzheimer's disease express their sense of self : Analysis using Rom Harré's theory of selfhood
  • 2013
  • Ingår i: Dementia. - 1471-3012. ; 12:6, s. 713-733
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to use Harré’s social constructionist theory of selfhood to describe how people with mild and moderate Alzheimer’s disease (AD) express their sense of self. The findings show that Self 1, the embodied sense of being a person, was expressed fluently by participants through the use of first-person indexicals. Self 2, the experienced personal attributes and life narrative, had undergone changes. Those changes were not entirely for the worse; participants had also developed new skills in managing life with AD. In a lifetime perspective, those changes were minor and participants perceived themselves to be basically the same people that they were before having AD. When constructing Self 3, the social personae, participants usually described being supported by others, but sometimes described being exposed to malignant positioning. They also feared that they might become more exposed to negative attitudes as their AD progressed. However, participants were understanding towards the offensive behaviours of others.
  • Hedman, Ragnhild, et al. (författare)
  • Social positioning by people with Alzheimer's disease in a support group
  • 2014
  • Ingår i: Journal of Aging Studies. - 0890-4065. ; 28, s. 11-21
  • Tidskriftsartikel (refereegranskat)abstract
    • People with Alzheimer's disease (AD) are often negatively positioned by others, resulting in difficulties upholding a positive sense of self. This might cause them to withdraw socially and apparently 'lose their minds'. Conversely, the sense of self can be strengthened with the support from others. This study aimed to describe, in accordance with positioning theory, how people with moderate AD positioned themselves and each other in a support group for people with AD. We describe five first-order positions; the project manager, the storyteller, the moral agent, the person burdened with AD, and the coping person. In the interactions that followed among the support group participants, those positions were mainly affirmed. This enabled participants to construct strong and agentic personae, and to have the severity of their illness acknowledged. Despite their language impairment participants managed to position and reposition themselves and others by assistance of the trained facilitator.
  • Oresland, Stina, et al. (författare)
  • Nurses as ’guests’ : a study of a concept in light of Jacques Derrida’s philosophy of hospitality
  • 2013
  • Ingår i: Nursing Philosophy. - 1466-7681. ; 14:2, s. 117-126
  • Tidskriftsartikel (refereegranskat)abstract
    • As revealed in previous empirical research, nurses describe their position in home-based nursing care (HBNC) as that of ‘guests’ in the patient's home. Such a description is problematic as ‘guests’ might not be considered to belong to the realm of professionalism. As Jacques Derrida's work on hospitality has received wide publicity, sparking theoretical and philosophical discussion about host and guest, the aim of this study was to explore how the concept ‘guests’ can be understood in the light of Derrida's philosophy of hospitality. The study revealed that (a) guest must be considered a binary concept; and (b) hospitality should be regarded as an exchange of giving and receiving between a host and a guest. The present study demonstrated that it is important to reflect on the meaning of the concepts used by nurses in HBNC. Further theoretical and empirical exploration of the concept ‘hospitality’ would be fruitful, i.e. what is patients' understanding of ‘hospitality’ and ‘hostility’ related to nurses' descriptions of themselves as ‘guests’ in the patient's home.
  • Sundin, Karin, et al. (författare)
  • Suffering from care as expressed in the narratives of former patients in somatic wards
  • 2000
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 14:1, s. 16-22
  • Tidskriftsartikel (refereegranskat)abstract
    • To illuminate patients' experiences of suffering from care, ten former patients in somatic wards narrated a desirable care episode (n = 39) and an undesirable care episode (n = 51). The interviews were analysed using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. Four themes were found: having a good rest, suffering through, searching for autonomy and being cared for by attentive and committed staff. The findings were interpreted in light of Eriksson's description of suffering, which describes three kinds of suffering: 'suffering of life', 'suffering of illness' and 'suffering of caring'. Although not mentioned explicitly, it was evident that cases of suffering from care were indicated in the patients' narratives. The themes were related to the patients' states of health, their experience of the care situation and their descriptions of themselves, and could be understood as related to the acts of the 'drama of suffering' described by Eriksson. The study highlights the need for the patient to find a co-actor in the drama of suffering in order to prevent suffering from care, i.e. prevent hindrance to the patient in her/his struggle against the 'suffering of illness' and the 'suffering of life'. The patients must be seen as the directors of their own dramas of suffering.
  • Ekman, Inger, et al. (författare)
  • Person-centered care - Ready for prime time.
  • 2011
  • Ingår i: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology. - 1873-1953. ; 10:4, s. 248-251
  • Tidskriftsartikel (refereegranskat)abstract
    • Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.
  • Sandvide, Åsa, et al. (författare)
  • From perpetrator to victim in a violent situation in institutional care for elderly persons : exploring a narrative from one involved care provider.
  • 2006
  • Ingår i: Nursing Inquiry. - 1320-7881. ; 13:3, s. 194-202
  • Tidskriftsartikel (refereegranskat)abstract
    • In order to reach a more comprehensive understanding of the dynamics in violent situations in institutional care for elderly people the aim of this study was to explore involved parties' positions, and to illuminate forces and moves related to these positions. One involved care provider's narrative was analysed using narrative analysis and positioning theory. In the narrative the involved parties' positions were fluid and often overlapping, and not exclusively as victim or perpetrator. Across the narrative the narrator altered the involved parties' positions by using available discourses. We understand that the altered positions were a salient way for the care provider to make sense of her experiences. By reading the care provider's narrative we further understand that she was much more than just a perpetrator, which was the origin for her narrative. This study led us to two assumptions important for implications in nursing practice. First, it is of significance how we position ourselves and others in narratives and conversations. Second, there is a difference between being categorised in advance and getting the opportunity to narrate one's own story.
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