| 1. |
- Benzein, Eva, et al.
(författare)
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The level of and relation between hope, hopelessness and fatigue in patients and family members in palliative care
- 2005
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Ingår i: Palliative Medicine. - 0269-2163 .- 1477-030X. ; 19:3, s. 234-240
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Tidskriftsartikel (refereegranskat)abstract
- Hope, hopelessness and fatigue are important experiences for patients and family members in palliative care. The aim of the study was to describe the level of and relation between hope, hopelessness and fatigue in patients and family members in palliative care. Eighty-five participants completed the Herth Hope Index, Beck's Hopelessness Scale and rated their level of fatigue from none to severe. The level of hope proved to be significantly lower among the family members than among the patients. For the family members, correlations were found between hope and age (–0.358*), fatigue and hope (–0.439*), hopelessness and age (0.484**), age and fatigue (0.403**) and between hope and hopelessness (–0.723**). For the patients, correlations were found between age and hopelessness (0.555**) and between hopelessness and hope (–0.580**). Efforts to increase the experience of hope and decrease hopelessness and fatigue must include not only the patient but also the family members. (*=P<0.5, **=P<0.01).
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| 2. |
- Bergdahl, Elisabeth, et al.
(författare)
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Co-creating possibilities for patients in palliative care to reach vital goals - a multiple case study of home-care nursing encounters
- 2013
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Ingår i: Nursing Inquiry. - : Wiley-Blackwell. - 1320-7881 .- 1440-1800. ; 20:4, s. 341-351
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Tidskriftsartikel (refereegranskat)abstract
- The patients home is a common setting for palliative care. This means that we need to understand current palliative care philosophy and how its goals can be realized in home-care nursing encounters (HCNEs) between the nurse, patient and patients relatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been a reliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliative care. The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation building phase. The results show that planned palliative HCNEs can be described as a process of co-creating possibilities for the patient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However, in some HCNEs, co-creation did not occur: Wishes and needs were discouraged or made impossible and vital goals were not reached for the patients or their relatives. Further research is needed to understand why. The co-creative process presented in this article can be seen as a concretization of the palliative care ideal of working with a person-centered approach.
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| 3. |
- Carlsund, Åsa, 1969-
(författare)
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Children`s Mental Health -with focus on family arrangements
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main aim of this thesis was to study children’s mental health with focus on family arrangements. The thesis was based on four studies (I-IV). Study number I, III and IV were quantitative studies with cross sectional design, using the Swedish version of Health behaviour in School- aged children (HBSC), including children aged 11, 13 and 15 years. The data was analysed with multiple linear regression analysis (I) and multivariate logistic regression analysis (III, IV). Study II was of qualitative descriptive design, based on 28 interviews with parents living in shared physical custody with their children. The qualitative study was analysed with inductive latent content analysis.Study I showed that lower levels of SHC and higher levels of SWB were associated with higher degrees of social capital in the family, school and neighbourhood. Social capital in family, school and neighbourhood had a cumulative influence on children’s SHC and SWB. In study II the participating parents described their own as well as the perceptions of their children and former partners. Parents’ perceptions changed from the beginning of shared physical custody, through the current situation, ending with perception of the future. The fifteen year old boys and girls (III) living in shared physical custody were more at risk of being a smoker or having been drunk compared with children living in two parent families. The results of sex <15 years and conduct problems showed that the risks didn’t differ significantly between these two groups. Study IV showed that children living in shared physical custody with their parents were more likely than children in two parent families to report multiple SHC, and low SWB. The variable of communication did not moderate the SHC and SWB of the children in any of these two groups.This thesis contribute with new and deeper understanding of the relatively new phenomenon: shared physical custody, and its associations to children’s mental health. The parent’s perceptions were an important complement to the children’s self reported health. In order to influence the decreasing mental health among children and adolescents, their opinions contributes to further understanding. Narratives from children, parents and practitioners are required in order to further study the association between children’s health outcomes and different family arrangements. Additional studies are needed to clarify how children’s mental health and different family arrangements are related to school, community economy, and society.
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| 4. |
- Oscarsson, Marie, 1956-
(författare)
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Healthy women or risk patients? : Non-attendance in a cervical cancer screening program
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Women afflicted with cervical cancer who have the highest morbidity and mortality rates have been the least likely to be screened. The overall aim of this research project was to investigate non-attendance in a cervical cancer screening (CCS) program among women with no registered cervical smear during the previous five years. Both quantitative (I,III) and qualitative methods (II) as well as costeffectiveness analysis (IV) were used in this research project. In Kalmar County women (aged 23-65 years) are invited to CCS every third year. All cervical smears taken both in opportunistic and organised CCS are coordinated in a register called Sympathy. The coverage is 88.4 %. From Sympathy, a random sample of 400 women served as a study group and another 400 women as a control group (III,IV). From the study group, 133 women participated in study I and 14 women in study II. Data was collected by telephone interviews based on a questionnaire (I), qualitative face-to-face interviews (II), questionnaire, promotive efforts and outcome (III), costs and effectiveness (IV). Quantitative data was analysed by descriptive and analytic statistics (I,III), qualitative data was analysed by content analysis. In study IV, cost-effectiveness analysis was used.The women believed that CCS was a good idea for all other women, but tended to refer to various circumstances resulting in their own non-attendance. One of the most common reasons for non-attendance was the feeling of being healthy. The women prioritized family and work commitments, and the invitation to attend CCS was sometimes experienced as a stressful disturbance. The feeling of discomfort was related to the gynaecologic examination, or to health care visits in general (I,II). Of 133 women, 120 could consider having a cervical smear taken and their two most common requirements for doing so were to be assured they would be treated in a friendly way (19%) and to find a suitable time (18%) for having the cervical smear. Fifty women wanted to be helped to have a cervical smear taken. Promotive efforts ranged from making a simple telephone call to arranging an appointment time to a combination of promotive efforts including repeated encounters in order to create a trusting relationship with respect to taking the smear. In the study group, 29.5% (n=118) had a registered cervical smear at follow-up compared to 18.5% (n=74) in the control group, (p<0.001) (III). In the study group, the cost per cervical smear taken was 66.87 €, and in the control group it was 16.62 €. The incremental cost per additional cervical smear taken was 151.36 € (IV). In conclusion, women’s reasons for not attending CCS are complex and are influenced by both present and earlier circumstances. In settings with high coverage, further contact in order to promote women’s attendance at CCS seems to be associated with high costs in relation to the number of additional cervical smears taken.
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| 5. |
- Rask, Mikael, 1958-, et al.
(författare)
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Validity and reliability of a Swedish version of the Relationship Assessment Scale (RAS) : a pilot study
- 2010
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Ingår i: Canadian journal of cardiovascular nursing. - Ottawa : Canadian Council of Cardiovascular Nurses. - 0843-6096. ; 20:1, s. 16-21
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a need for a short and easily administered scale, in the Swedish language, for assessing partner relationships in the health care of persons with cardiac disease. PURPOSE: To establish the reliability and validity of the Swedish version of the Relationship Assessment Scale (RAS). DESIGN: The present pilot study has a methodological design. FINDINGS: Content validity has been tested for relevance, clarity and readability. The scale was tested for construct validity with explorative factor analysis. The reliability was tested by internal consistency and test-retest analysis. The result showed a two-factor solution, which does not correspond to the original proposed one-factor solution. The factor analyses revealed two quite distinct factors of RAS, labelled "Relationship built on expectations and satisfaction of needs" and "Relationship built on love and devotion". CONCLUSIONS: The scale has satisfactory psychometric properties in terms of content validity, construct validity, homogeneity and stability in a population of persons with cardiac disease. Wider evaluations of the RAS for other populations and settings are recommended.
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| 6. |
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| 7. |
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| 8. |
- Ternestedt, Britt-Marie, et al.
(författare)
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Ett vårdvetenskapligt perspektiv på forskning i livets slutskede – erfarenheter från Sverige
- 2009
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Ingår i: Omsorg. - Oslo : Rådet for omsorg for alvorlig syke og døende, Norske kreftforening. - 0800-7489. ; :4, s. 19-22
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- Denna artikel belyser kortfattat utvecklingen av vårdvetenskaplig forskning om vård i livets slutskede i Sverige från 1970-talet fram till idag. Den visar en ökning av forskningen när det gäller den döende personens, närståendes och personalens perspektiv. Vidare beskrivs exempel på forskning som bedrivs vid Enheten för forskning om vård i livets slutskede vid Ersta Sköndal högskola; en forskningsmiljö som kunnat formaliseras till innehåll och struktur med hjälp av en donation. Exempel ges på projekt med beskrivande och intervenerande designer. Områden som behöver studeras ytterligare är individers/familjens situation i samband med döende och död, döende personer med demenssjukdom och döende och död ur ett mångkulturellt perspektiv och ur ett genusperspektiv. Större mångvetenskapliga forskningsprojekt behövs. En stor utmaning är också att överbrygga gapet mellan forskning och klinisk verksamhet.
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| 9. |
- Wallerstedt, Birgitta, 1952-, et al.
(författare)
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Identification and documentation of persons being in palliative phase regardless of age, diagnosis and place of care, and their use of sitting service at the end of life
- 2012
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Ingår i: Scandinavian Journal of Caring Sciences. - Hoboken, USA : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 26:3, s. 561-568
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older persons and persons with diseases other than cancer are often discriminated against when applying for palliative care despite growing numbers of both older persons and individuals with chronic diseases. An intention for palliative care in Sweden is that all persons in the final stage of life, irrespective of age, domicile, diagnosis, and care place shall have access to palliative care on equal terms. One way to support these persons in final stage of life and their relatives is to offer sitting service.Aims: To describe individuals who were identified and documented as being in a palliative phase in a Swedish municipality, with respect to demographics, use of a sitting service, continuity of care in the last month of life and the place of death. A second aim was to describe and compare the groups who received/did not receive sitting services related to the aforementioned variables.Method: Retrospective data from nursing records and palliative care identification forms were analyzed with descriptive and analytic statistical methods.Findings: Among individuals deceased during 2007, 51% were identified and documented as being in palliative phase. The majority was older people (mean 83 years) with a noncancer diagnosis (58%). Twenty-eight individuals (16%) had received a sitting service between 8 and 249 hours (one extreme value = 2211). It is indicated that sitting service significantly increased the possibility of dying at home (p = 0.00004), but did not affect how often the place of care changed during the last month of life.Limitation: A small sample from a Swedish context must be considered.Conclusion: These results can be related to an awareness in the municipality that led to adopting the concept of palliative care as not only for those with a cancer diagnosis.
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| 10. |
- Ahlström, Gerd, et al.
(författare)
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Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design : a study protocol
- 2018
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Ingår i: BMC Palliative Care. - : BioMed Central. - 1472-684X. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: The demography of the world is changing as the population is ageing. Because of this change to a higher proportion of older people, the WHO has called for improved palliative care for older persons. A large number of all deaths in the industrialised world occur while older people are living in nursing homes and therefore a key question becomes how the principles of palliative care can be implemented in that context. The aims of this study are: a) to describe a model of an educational intervention with the goal of implementing knowledge-based palliative care in nursing homes, and b) to describe the design of the evaluation of the effectiveness regarding the implementation of knowledge-based palliative care. Methods/design: A complex intervention is evaluated by means of a cross-over design. An educational intervention concerning palliative care consisting of five seminars during 6 months for staff and managers has been developed and conducted in 20 nursing homes in two counties. Before the intervention started, the feasibility was tested in a pilot study conducted in nursing homes not included in the main study. The intervention is evaluated through a non-randomized experimental design with intervention and control groups and pre- and post-assessments. The evaluation includes older persons living in nursing homes, next-of-kin, staff and managers. Data collection consists of quantitative methods such as questionnaires and register data and qualitative methods in the form of individual interviews, focus-group interviews and participant observations. Discussion: The research will contribute to new knowledge about how to implement knowledge-based palliative care in a nursing home setting. A strength of this project is that the Medical Research Council framework of complex intervention is applied. The four recommended stages, Development, Feasibility and piloting, Evaluation and Implementation, are combined for the educational intervention, which functions as a strategy to achieve knowledge-based palliative care in the nursing homes. Implementation is always a question of change and a good theoretical understanding is needed for drawing valid conclusions about the causal mechanisms of change. The topic is highly relevant considering the world's ageing population. The data collection is completed and the analysis is ongoing.
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