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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.
  • Lützen, Kim, 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.
  • 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.
  • 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.
  • von Heideken Wågert, Petra, et al. (författare)
  • Morale in the oldest old : the Umeå 85+ study
  • 2005
  • Ingår i: Age and Ageing. - 0002-0729. ; 34:3, s. 249-255
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: to describe morale among the oldest old, and to investigate       which social, functional and medical factors are associated with morale in       this population. DESIGN: a cross-sectional study. SETTING: a       population-based study in the municipality of Umea, a city in Northern       Sweden. SUBJECTS: half of the 85-year-old population, and the total       population of 90-year-olds and > or = 95-year-olds (95-103) were asked to       participate (n = 319) and 238 were interviewed. METHODS: structured       interviews and assessments during home visits, interviews with relatives       and caregivers and review of medical charts. The 17-item Philadelphia       Geriatric Center Morale Scale (PGCMS) was used to measure morale.       Participants were assessed with the Barthel Activities of Daily Living       (ADL) Index, Geriatric Depression Scale (GDS-15), Mini-Mental State       Examination (MMSE), Mini Nutritional Assessment (MNA), and a symptom       questionnaire. Multiple regression analyses were conducted to find       independent factors to explain the variation in the PGCMS score. RESULTS:       eighty-four per cent (n = 199) of those interviewed answered the PGCMS.       Three-quarters had middle range or high morale. GDS score, type of       housing, previous stroke, loneliness and number of symptoms, adjusted for       age group and sex, explained 49.3% of the variance of total PGCMS score.       CONCLUSIONS: a large proportion of the oldest old had high morale. The       most important factors for high morale were the absence of depressive       symptoms, living in ordinary housing, having previously had a stroke and       yet still living in ordinary housing, not feeling lonely and low number of       symptoms. The PGCMS seems applicable in the evaluation of morale among the       oldest old.
  • Eggers, Thomas, et al. (författare)
  • Nursing Staff's Understanding Expressions of People With Advanced Dementia Disease
  • 2013
  • Ingår i: Research and Theory for Nursing Practice. - 1541-6577. ; 27:1, s. 19-34
  • Tidskriftsartikel (refereegranskat)abstract
    • People with advanced dementia disease (ADD) are known to have communication difficulties and thus it presents a challenge in understanding the expressions of these people. Because successful communication presupposes cooperation at least between 2 individuals, both individual's actions must be acknowledged. The aim of this study is to describe nursing staff's ways of understanding the expressions of people with ADD when communicating with them. Interviews from 8 nursing staff were analyzed using qualitative content analysis. Two themes were constructed: “Being in communication” and “Doing communication.” Being in communication means that nursing staff perceive people with ADD as being capable of communication. Doing communication means that nursing staff attempt different individualized strategies to understand what people with ADD communicate. Good care of people with ADD presupposes nursing staff that are willing and able to relate to other people and to maintain good care for people with ADD continuous education and supervision are needed.
  • Ericson-Lidman, Eva, et al. (författare)
  • Caring for people with dementia disease (DD) and working in a private not-for-profit residential care facility for people with DD
  • 2014
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 28:2, s. 337-346
  • Tidskriftsartikel (refereegranskat)abstract
    • Caring for people with dementia and working in dementia care is described as having both rewarding and unpleasant aspects and has been studied to a minor extent. This study aims to explore care providers' narrated experiences of caring for people with dementia disease (DD) and working in a private not-for-profit residential care facility for people with DD. Nine care providers were interviewed about their experiences, the interviews were recorded, transcribed and analysed using thematic analysis. The analysis revealed that participants were struggling to perform person-centred care, which meant trying to see the person behind the disease, dealing with troublesome situations in the daily care, a two-edged interaction with relatives, feelings of shortcomings and troubled conscience, and the need for improvements in dementia care. The analysis also revealed an ambiguous work situation, which meant a challenging value base, the differently judged work environment, feelings of job satisfaction and the need for a functional leadership and management. The results illuminate participants' positive as well as negative experiences and have identified areas requiring improvements. It seems of great importance to strive for a supportive and attendant leadership, a leadership which aims to empower care providers in their difficult work. Using conscience as a driving force together in the work group may benefit care providers' health.
  • 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, 1962-, 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.
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