| 1. |
- Leppänen, Vesa
(författare)
-
Power in Telephone-advice Nursing
- 2010
-
Ingår i: Nursing Inquiry. - : Wiley. - 1440-1800 .- 1320-7881. ; 17:1, s. 14-25
-
Tidskriftsartikel (refereegranskat)abstract
- Power is a central aspect of nursing, especially in telephone-advice nursing, where nurses assess callers' medical problems and decide what measures that need to be taken. This article presents a framework for understanding how power operates in social interaction between nurses and callers in telephone-advice nursing in primary care in Sweden. Power is analysed as the result of nurses and callers being oriented to five social structures that are relevant to their actions in this context, namely the organization of telephone-advice nursing, the social stock of medical knowledge, the professional division of labour between nurses and doctors, structures of social interaction and structures of emotions. While structural constraints govern some actions to a high degree, calls take place in an organizational free room that give nurses more leeway for acting more creatively. The discussion focuses on the introduction of new technologies of control, for instance computerized decision support systems and audio recording of calls, and on how they reduce the free room. Empirical data consist of 276 audio-recorded telephone calls to 13 nurses at six primary-care centres and of qualitative interviews with 18 nurses.
|
|
| 2. |
- Aléx, Lena, 1948-, et al.
(författare)
-
Shift in power during an interview situation : methodological reflections inspired by Foucault and Bourdieu
- 2008
-
Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 15:2, s. 169-176
-
Tidskriftsartikel (refereegranskat)abstract
- This paper presents methodological reflections on power sharing and shifts of power in various interview situations. Narratives are said to be shaped by our attempts to position ourselves within social and cultural circumstances. In an interview situation, power can be seen as something that is created and that shifts between the interviewer and the interviewed. Reflexivity is involved when we as interviewers attempt to look at a situation or a concept from various perspectives. A modified form of discourse analysis inspired by subject positioning was used to reflect on power relations in four different interview situations. The analyses indicate that reflection on the power relations can lead to other forms of understanding of the interviewee. The main conclusion that can be drawn from this study is that power relations are created within an interview situation and therefore it is important to be aware of dominant perspectives. Researchers and nurses face the challenge of constantly raising their level of consciousness about power relationships, and discursive reflexivity is one way of doing this. Thus, reflexivity is an important part of the qualitative research process.
|
|
| 3. |
- Benzein, Eva Gunilla, et al.
(författare)
-
'Being appropriately unusual' : a challenge for nurses in health-promoting conversations with families.
- 2008
-
Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 15:2, s. 106-115
-
Tidskriftsartikel (refereegranskat)abstract
- This study describes the theoretical assumptions and the application for health-promoting conversations, as a communication tool for nurses when talking to patients and their families. The conversations can be used on a promotional, preventive and healing level when working with family-focused nursing. They are based on a multiverse, salutogenetic, relational and reflecting approach, and acknowledge each person's experience as equally valid, and focus on families' resources, and the relationship between the family and its environment. By posing reflective questions, reflection is made possible for both the family and the nurses. Family members are invited to tell their story, and they can listen to and learn from each other. Nurses are challenged to build a co-creating partnership with families in order to acknowledge them as experts on how to lead their lives and to use their own expert knowledge in order to facilitate new meanings to surface. In this way, family health can be enhanced.
|
|
| 4. |
- Bergdahl, Elisabeth, 1962-, et al.
(författare)
-
Development of nurses´ abilities to reflect on how to create good caring relationships with patients in palliative care : an action research approach
- 2011
-
Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 18:2, s. 111-122
-
Tidskriftsartikel (refereegranskat)abstract
- In this paper we present an action research process aimed at enhancing nurses’ abilities to reflect on how to create good caring relationships with patients in advanced home care. Another aim was to examine the usefulness of an emerging theory, derived from results from a previous study. The request for this project to take place came from an advanced home care unit which had received complaints concerning patients in the palliative phase. The action performed was clinical supervision, structured around abilities that nurses need in order to create good caring relationships. During the action research process 42 narratives were analysed by the participating group. Three different data collections were carried out and analysed with qualitative content analysis in a triangulation procedure. The emerging theory was found to be useful and was also refined. The nurses reported that they felt strengthened and had developed their ability to reflect over good caring relationships. Some changes to practice were carried out by the participating nurses. The result also indicates that action research can be helpful in examining the usefulness of an emerging theory.
|
|
| 5. |
- Blomqvist, Kerstin, 1953-, et al.
(författare)
-
What happens when you involve patients as experts? : a participatory action research project at a renal failure unit
- 2010
-
Ingår i: Nursing Inquiry. - 1320-7881 .- 1440-1800. ; 17:4, s. 317-323
-
Tidskriftsartikel (refereegranskat)abstract
- Although there is a trend towards developing health care in a patient-centred direction, changes are usually planned by the professionals without involving the patients. This paper presents an ongoing participatory action research project where patients with chronic renal failure, nurses at a specialist renal failure unit, a hospital manager and a researcher worked together to develop patient-centred care. The project combined the expertise of patients in their own experiences of living with a chronic condition with the professional expertise of nurses, the manager and the researcher. As the workload on the unit was uneven, the development work needed to be low in intensity but long-term. Based on a number of dialogues in focus groups, four main development areas were identified; access to test results, prerequisites for postponing the progress of the illness, general awareness and understanding of living with chronic renal failure, and family-focused care. A number of changes have been planned or implemented, such as developing a prototype for a web-based feed-back system, expanding patient education to newly diagnosed patients, steering the nurses' role towards a guiding and family-focused function, and planning a digital story-telling workshop. Involving committed people who have the mandate to change practices were prerequisites for success.
|
|
| 6. |
- Blomqvist, Kerstin, et al.
(författare)
-
What happens when you involve patients as experts? : a participatory action research project at a renal failure unit
- 2010
-
Ingår i: Nursing Inquiry. - : Wiley-Blackwell Publishing Ltd. - 1320-7881 .- 1440-1800. ; 17:4, s. 317-323
-
Tidskriftsartikel (refereegranskat)abstract
- Although there is a trend towards developing health care in a patient-centred direction, changes are usually planned by the professionals without involving the patients. This paper presents an ongoing participatory action research project where patients with chronic renal failure, nurses at a specialist renal failure unit, a hospital manager and a researcher worked together to develop patient-centred care. The project combined the expertise of patients in their own experiences of living with a chronic condition with the professional expertise of nurses, the manager and the researcher. As the workload on the unit was uneven, the development work needed to be low in intensity but long-term. Based on a number of dialogues in focus groups, four main development areas were identified; access to test results, prerequisites for postponing the progress of the illness, general awareness and understanding of living with chronic renal failure, and family-focused care. A number of changes have been planned or implemented, such as developing a prototype for a web-based feed-back system, expanding patient education to newly diagnosed patients, steering the nurses' role towards a guiding and family-focused function, and planning a digital story-telling workshop. Involving committed people who have the mandate to change practices were prerequisites for success.
|
|
| 7. |
- Bäckström, Britt, et al.
(författare)
-
The meaning of being a middle-aged close relative of a person who has suffered a stroke, 1 month after discharge from a rehabilitation clinic
- 2007
-
Ingår i: Nursing Inquiry. - : Wiley-Blackwell Publishing Inc.. - 1320-7881 .- 1440-1800. ; 14:3, s. 243-254
-
Tidskriftsartikel (refereegranskat)abstract
- The sudden and unexpected impact of stroke may have a stressful affect on close relatives. To illuminate the essential meaning in the lived experience of a middle‐aged close relative of a person who has suffered a stroke, narrative interviews were conducted with 10 close relatives of people who had suffered their first stroke where both parties were aged over 18 and under 65. A phenomenological‐hermeneutic interpretation of the narratives was then conducted. Three intimately intertwined themes emerged during the analysis: ‘being called to mission’, ‘feeling lost and set adrift’ and ‘struggling to keep going’. The middle‐aged close relatives felt unreflectively duty bound. There was a struggle with suffering and enduring the process of coping with life and overcoming a feeling of helplessness. Life turned out to be a struggle with overwhelming feelings. They felt alienated in a restricted life situation, disconnected from themselves and others, and from a world that supports feelings of being lost and set adrift (i.e. feeling homeless). Strength was found in moments when the situation improved, in being related to oneself and others, and when feelings of normality were regained.
|
|
| 8. |
- Bäckström, Britt, et al.
(författare)
-
The meaning of middle-aged female spouses' lived experience of the relationship with a partner who has suffered a stroke, during the first year postdischarge
- 2010
-
Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 17:3, s. 257-268
-
Tidskriftsartikel (refereegranskat)abstract
- Stroke consequences present a great long-term challenge to the spouses of the stroke sufferer. A longitudinal study with a phenomenological hermeneutic approach was used to illuminate the meanings of middle-aged female spouses' lived experience of their relationship with a partner who has suffered a stroke, during the first year postdischarge. Four middle-aged female spouses of stroke sufferers participated in the study. Narrative interviews were conducted 1, 6 and 12 month postdischarge (total of 12 interviews), audio-taped and transcribed verbatim to a text and interpreted by a phenomenological hermeneutic method inspired by Ricoeur. The findings showed a process over time during which spouses come to know, recognize and acknowledge the residual changes in their partners' cognitive and emotional conditions and the impact on their relationship. Spouses showed grief due to the loss of the marital relationship they once had and anxiety that they would not be able to continue in an undesired relationship in the future. Even if the partner is still alive, there is a loss to grieve and to be understood, an important meaning of the transition process in the relationship during the first year after the partner's discharge.
|
|
| 9. |
- Fex, Angelika, 1955-, et al.
(författare)
-
Living with an adult family member using advanced medical technology at home
- 2011
-
Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 18:4, s. 336-347
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Living with an adult family member using advanced medical technology at home An increased number of chronically ill adults perform self-care while using different sorts of advanced medical technology at home. This hermeneutical study aimed to gain a deeper understanding of the meaning of living with an adult family member using advanced medical technology at home. Eleven next of kin to adults performing self-care at home, either using long-term oxygen from a cylinder or ventilator, or performing peritoneal or haemodialysis, were interviewed. The qualitative interviews were analysed using a Gadamerian methodology. The main interpretation explained the meaning as rhythmical patterns of connectedness versus separation, and of sorrow versus reconciliation. Dependence on others was shown in the need for support from healthcare professionals and significant others. In conclusion, next of kin took considerable responsibility for dependent-care. All next of kin were positive to the idea of bringing the technology home, even though their own needs receded into the background, while focusing on the best for the patient. The results were discussed in relation to dependent-care and transition, which may have an influence on the self-care of next of kin and patients. The study revealed a need for further nursing attention to next of kin in this context.
|
|
| 10. |
- Fläckman, Birgitta, et al.
(författare)
-
Struggling to adapt : caring for older persons while under threat of organizational change and termination notice
- 2009
-
Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 16:1, s. 82-91
-
Tidskriftsartikel (refereegranskat)abstract
- FLACKMAN B, HANSEBO G and KIHLGREN A. Nursing Inquiry 2009; 16: 82-91 Struggling to adapt: caring for older persons while under threat of organizational change and termination notice Organizational changes are common in elder care today. Such changes affect caregivers, who are essential to providing good quality care. The aim of the present study was to illuminate caregivers' experiences of working in elder care while under threat of organizational change and termination notice. Qualitative content analysis was used to examine interview data from 11 caregivers. Interviews were conducted at three occasions during a two-year period. The findings show a transition in their experiences from 'having a professional identity and self-confidence', to 'being a professional in a threatening situation caused by someone else' and to 'struggling to adapt to a changed working environment as a person and a professional'. The caregivers experienced a loss of pride and satisfaction. Previous literature indicates that this may have consequences for the quality of care and that employees may be at risk of negative health effects. However, the caregivers continued to struggle, doing their best to complete their duties. The study has implications for high-level decision-makers, managers and caregivers in similar work-life situations in that it deals with factors that facilitate or impede similar transitions.
|
|
