| 1. |
- Ahlberg, Mona, 1966-
(författare)
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Being cared for in an Intensive Care Unit – family functioning and support
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- When COVID-19 came as an uninvited guest into our everyday lives, nursing in intensive care was affected and thus the studies contain data from both before and during the COVID-19 pandemic.Before the pandemic, most intensive care units, which care for patients with critical illness in a technical setting, allowed family members to visit the patient 24 hours a day. The intensive care unit is a stressful and frightening environment for both the patient and their family. They can be affected both mentally and physically, showing symptoms such as difficulty sleeping, stress and depression. The intensive cared patient often does not remember anything from the time they were cared for in the intensive care unit, and the family needs to explain and recount this unconscious time. During the pandemic, this changed, with restrictions and limited opportunities to visit the hospital and patient due to virus outbreaks. Family members received information about the patient's medical condition by phone from a physician. The overall aim of this thesis was to explore and conceptualise the family functioning of families with a family member treated in the intensive care unit. There was also an intention to describe and evaluate how an intervention affects the family and individual family members in families where a family member received intensive care.In these studies, qualitative, quantitative, as well as mixed methods were utilised. Participants were adult intensive cared patients from seven intensive care clinics, and their families. The results examined between families are based on the patient and family characteristics. The results from study I show that families who have experienced COVID-19 and with a family member who was cared for in an intensive care unit, have existential thoughts. Study II shows no major impact on family function between families, but the answers differ within the families who experienced intensive care. In study III, concerning families experiencing intensive care and attending family health conversations, there was an awareness of family function. The conversations brought the family closer together, through improved understanding of each other. In study IV family functioning, hope and sense of coherence were com-pared among the participants in two intervention groups: Family health conversations and support group conversations. Family functioning and hope were higher in the group that participated in the family health conversations and comprehensibility, meaningfulness and vitality were higher among the participants in the support group conversation. By exploring how family function affects the individual family member and the family as a unit during critical illness and intensive care, new ways of working can be strengthened in the care of patients and their families.
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| 2. |
- Ahlberg, Mona, et al.
(författare)
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Exploring family functioning and - hardiness in families' experiencing adult intensive care - A cross-sectional study
- 2023
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:7
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Tidskriftsartikel (refereegranskat)abstract
- Being cared for in an intensive care unit affects both the patient being cared for and the family in various ways. The family is of great importance for the recovery of the former intensive-care patient. The aim is to explore family functioning and family hardiness in families of former intensive care patients. A cross-sectional study using two self-reported questionnaires. Former adult intensive care patients and their family were recruited to participate between December 2017 and June 2019. The data were coded and entered the Statistical Package for the Social Sciences version 25, for analysis. To explore questionnaire data, descriptive and inferential statistical analyses were performed. Scale values were calculated on, both family wise and between the patients and the family members. STROBE checklist was used. Data was collected from 60 families (60 former intensive cared patients and 85 family members) and showed that 50 families scored healthy family functioning and 52 high strengths in hardiness. The data showed small variations between and within families for family functioning and family hardiness, there were only two families scoring low for both family functioning and hardiness. The variation was higher within the families, but there was no significance level.The conclusions were that family functioning and hardiness was, to a large extent, assessed as good by the families. Nevertheless, it is important to help the family obtain information and support. So, the family need to continue to communicate, finding coping abilities and strengths in adopting new strategies to protect the family unit. The family are very important for members' mental and physical recovery as the health of one family member affects the family as a unit.
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| 3. |
- Ahlberg, Mona, et al.
(författare)
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Family Health Conversations Versus Support Group Conversations When a Family Member Has Been Critically Ill : A Mixed Methods Study
- 2021
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Ingår i: Families, Systems & Health. - : American Psychological Association (APA). - 1091-7527 .- 1939-0602. ; 39:2, s. 293-305
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: When a family member has been critically ill and cared for at an intensive care unit the individual family member as well as the family system are affected and in need of support. The aim of this study was to compare and contrast the responses from 2 different types of follow-up interventions for families of critically ill persons, focusing on individual hopes, health-related quality of life, family functioning and ability to cope with challenges.Method: Adult family members from 3 hospitals attended 1 of 2 interventions 2 months after intensive care. The family health conversation included the family. The support group conversation included just family members and not the patient who had experienced intensive care. Data were collected via self-reported questionnaires and follow-up interviews with family members. Quantitative and qualitative data were first analyzed separately, and the results were then integrated through mixed methods analysis.Results: A total of 38 family members took part in the interventions. Family members in the 2 intervention groups talked about how they had more hope for the future, and about how talking within the family and the group had helped them justify their feelings, which empowered them in the transition toward a healthier quality of life. Comparisons of the interventions show a higher significance of family function and hope in the family health conversation.Discussion: The article illustrates a disparity between how family members function and the needs they have for follow-up. We discuss what kind of follow-up these persons need.
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| 4. |
- Blomquist, Karin, et al.
(författare)
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Motivation and Life Circumstances Affecting Living Habits Prior to Gastrointestinal Cancer Surgery- An Interpretative Phenomenological Analysis
- 2023
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Ingår i: Inquiry. - : SAGE PUBLICATIONS INC. - 0046-9580 .- 1945-7243. ; 60
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore the patients experiences to get insights into their living habits prior to gastrointestinal cancer surgery. An interpretative phenomenological analysis (IPA) approach was used. Six in-depth interviews with participants recruited from a hospital in southeast Sweden. The IPA analysis identified 3 themes: The influence of the cancer diagnosis on awareness and motivation, Life circumstances affecting living habits, and Activities bringing mental strength. The participants expressed their motivation level and circumstances in life. Various types of activities and support promoted physical and mental health. Motivation level and circumstances in life both influence living habits. Various kinds of activities and support promote patients physical and mental health. Nurses need to investigate patients experiences when developing person-centered support to achieve health-promoting behavior prior to cancer surgery.
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| 5. |
- Börjeson, Sussanne, et al.
(författare)
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Nurses' experiences in the relief of postoperative nausea and vomiting
- 2010
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 19:13-14, s. 1865-1872
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of the study was to illuminate the experience of nurses in relieving postoperative nausea and vomiting. Background. Postoperative nausea and vomiting has been shown to be one of the most common and distressing side effects of surgery. In spite of this, there has been little research on the role of nurses in caring for patients with postoperative nausea and vomiting. Design. Qualitative approach using narratives. Methods. Ten female nurses from two general surgical departments were interviewed. The transcribed interviews were analysed using the hermeneutic narrative method inspired by Polkinghorne. Results. The nurses report that they have what may be described as a set of different tools at their disposal. These tools can be entitled 'listen and understand', 'information', 'the clinical eye' and 'availability', all of which can be used in solving several needs. However, some nurses have better skills or more opportunities to use the available tools than do others. By using these tools, the nurses can increase their possibilities for enhancing the patients' efforts to gain control over their own situation and thereby increase the quality of their care. Conclusion. Nurses use different types of tools to relieve postoperative nausea and vomiting and it is possible to create a positive nursing care situation if patients are given the opportunity to be in control and handle their own situation. Relevance to clinical practice. When it comes to relieving postoperative nausea and vomiting, the findings of this study are important as the study highlights the practical actions taken by nurses and their experiences. When nurses have the possibility to use their nursing tools in an optimal way, together with their experience and knowledge and then follow their nursing actions by being able to reflect on them, they can further develop their approach to nursing and thereby increase their competence as nurses.
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| 6. |
- Carina, Hellqvist, et al.
(författare)
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A national Swedish self- management program for people with Parkinson’s disease : patients and relatives view
- 2017
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To identify and describe experiences that people with PD and their relatives after participation inthe self-management intervention NPS (National Parkinson School) find valuable for managing daily life. Background: A self-management program called NPS was developed as a collaboration of healthcare providers, researchers and patient organizations. NPS is aiming to provide tools and strategies for people with PD and their relatives to increase ability to manage symptoms and consequences of disease and thereby improving conditions for a good life. Self-monitoring and self-management are central concepts. NPS focuses on life with PD, which via 7 sessions consisting of education/lectures and group discussions are mediated. Home assignments make participants practice the new skills in their own life. Methods: The last session, evaluation of the NPS, was audio recorded in its whole and transcribed verbatim. Data was collected from five separate clinics and analysed both inductively and deductively usingThematic Analysis and by applying the Self-and Family management theory. Results: Through inductive analysis three themes; Exchanging experiences and feeling support, Adjustment and acceptance of PD for managing daily life and Promoting life satisfaction, were identified and described. The themes are capturing the meaning, value and experience of being a participant of NPS. Deductive analysis indicated thatthe Self-and Family management theory was useful and valid for this group of patients and generated a modified framework applicable for patients with PD and their families [figure1]. Conclusions: Living with PD affects patients as well as relatives. Meeting others in the same situation gives support and strengthen their self- image. Having the opportunity sharing experiences and practical advices showed that there was a hopeful future to come. Techniques to accept and manage life with PD included seeking information about disease and treatments, self-monitoring in order to adjust to new situations and improve symptoms of disease and having a positive mind-set. Living an active life, participating in enjoyable social, cultural, and physical activities were important to feel happy and satisfied with life. Participation in NPS covered many areas of importance for the ability of self-management in PD. The framework for self-management in chronic disease was found relevant also for the PD population
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| 7. |
- Hellqvist, Carina, 1976-, et al.
(författare)
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Effects of self-management education for persons with Parkinson's disease and their care partners : A qualitative observational study in clinical care
- 2020
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Ingår i: Nursing and Health Sciences. - : John Wiley & Sons. - 1441-0745 .- 1442-2018. ; 22:3, s. 741-748
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Tidskriftsartikel (refereegranskat)abstract
- Persons with Parkinson's disease and their care partners want support from healthcare to develop the skills to handle everyday life with disease. Earlier findings indicate that participants of the self‐management program Swedish National Parkinson School experience several benefits of the program. The purpose of this qualitative observational study was to explore if participants had implemented the strategies of self‐monitoring included in the program, and use them to communicate health care status and needs in clinical encounters. Data was collected 3–15 months after participation in the program and analysed using constant comparative analysis. Three categories were evident: “Self‐observation in everyday life”, “Self‐care activities to promote health” and “Managing emotional impact of Parkinson's Disease”. Categories were linked together in a core category that highlight the use of self‐management strategies described by participants during clinical encounters. Results confirmed that persons with Parkinson's disease and care partners use the techniques of self‐observation in their everyday lives. Observations of effects in clinical care can be a valuable approach to evaluate the outcomes educational interventions and their benefits for individuals and health care.This article is protected by copyright. All rights reserved.
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| 8. |
- Hellqvist, Carina, et al.
(författare)
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Improving self-management for persons with Parkinson's disease through education focusing on management of daily life : patients' and relatives' experience of the Swedish National Parkinson School.
- 2018
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Ltd. - 0962-1067 .- 1365-2702. ; 27:19-20, s. 3719-3728
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVE: The two folded aim of this study was firstly to identify and describe experiences valuable for managing daily life after participation in the NPS self-management intervention. The second part was to explore the applicability of the Self- and family management framework by Grey and colleagues for persons with Parkinson's Disease and their relatives. BACKGROUND: The impact of PD is evident on the lives of both patients and relatives. The National Parkinson School (NPS) is a Swedish self-management program designed for patients and relatives, aiming at teaching strategies helpful for the ability of self-management, in order to promote life satisfaction. DESIGN: Qualitative explorative with inductive and deductive analysis. METHODS: Five group discussions with NPS participants were audio-recorded. Verbatim transcriptions were analysed inductively with thematic analysis according to Braun and Clarke, and the findings were then applied deductively to the existing model for patients with chronic disease. RESULTS: Through the first step of inductive analysis three themes capturing the meaning, value and experience of being a participant at the NPS were identified: Exchanging experiences and feeling support, Adjustment and acceptance of PD for managing daily life, and Promoting life satisfaction. The deductive analysis applied the inductive findings to the Self-and family management framework of chronically ill to explore the fit to persons with PD and relatives attending the NPS program. CONCLUSIONS: The NPS program is a promising approach for helping persons with PD and their relatives to achieve better self-management of disease and improved life satisfaction. Further evaluations of program outcomes in clinical practice are warranted. RELEVANCE OF CLINICAL PRACTICE: Self-management programs like the NPS is a promising approach in facilitating a positive mind-set and outlook on life and gain knowledge to understand, adapt and handle chronic disease, such as PD, better. This article is protectedby copyright. All rights reserved.
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| 9. |
- Hellqvist, Carina, 1976-, et al.
(författare)
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Self-management education for persons with Parkinson's disease and their care partners : a quasi-experimental case-control study in clinical practice
- 2020
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Ingår i: Parkinson's Disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2020, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Background Parkinson's disease is a neurodegenerative condition with both physical and mental consequences that affect many aspects of everyday life. Persons with Parkinson's disease and their care partners want guidance from healthcare services in order to develop skills to adjust to life with a long-term condition. The Swedish National Parkinson School is a dyadic self-management programme to support both persons with Parkinson's disease and care partners. Objective To assess the outcomes of the Swedish National Parkinson School as reported by participants. Design A quasi-experimental case-control study in clinical care using self-reported questionnaires. Participants Swedish National Parkinson School was offered by health care professionals working in clinical care. Participants in the programme were also asked to participate in the study. A matched control group was recruited for a comparison of findings. In total, 92 persons with Parkinson's disease and 55 care partners were included. Settings. Five Swedish geriatric and neurologic outpatient clinics. Method Data were collected during 2015-2017, before and after participation in the National Parkinson School or before and after seven weeks of standard care. Outcomes were assessed using generic and Parkinson's specific questionnaires. Descriptive statistics were used to describe baseline characteristics. Mann-Whitney U and Chi(2) tests were used to test for between-group differences and within-group differences were tested by the Wilcoxon signed-ranks test. Results Improvements regarding health status, constructive attitudes and approaches, and skill and technique acquisition were found after the intervention among persons with Parkinson's disease. No changes were found among care partners. Conclusion The findings indicate that the Swedish National Parkinson School may improve health status and self-management among persons with Parkinson's disease, but further studies are needed to better understand the effects of the programme.
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| 10. |
- Hellqvist, Carina, 1976-
(författare)
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Self-management support to handle everyday life with Parkinson´s disease
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Being diagnosed with Parkinson´s disease (PD) is a life-altering experience. The long-term condition requires continuous adjustments to the everyday life not only of the person affected, but also for care partners. There is still insufficient knowledge on how best to support this process of acceptance and adjustment to encourage self-management.Aims: The aim of this thesis is to enhance the knowledge and understanding of self-management for persons with PD (PwPD) and their care partners. Furthermore, to investigate whether the self-management intervention Swedish National Parkinson School can be used as a tool to support self-management, and how nurses specialised in the care of persons with Parkinson´s disease can tailor their support to encourage self-management in everyday life. Method and design: Both qualitative and quantitative designs and methods were used in the three studies included in this thesis. Participants included a total of 209 persons. Of these, 127 were persons with PD and 75 were care partners. Participants with PD were largely in the middle stages of the disease. The time since diagnosis ranged from less than one year to over 20 years, and most participants had lived with the disease for around five years. Participants were cared for at five separate outpatient clinics, both geriatric and neurological, in three county and two university hospitals across Sweden. Data collection included observations, interviews, self-reported questionnaires and audio-recordings of the National Parkinson School in clinical care. The overall results of this thesis were obtained using a qualitative approach, where the results of the three studies were analysed using qualitative thematic analysis as described by Braun and Clarke (2006).Results: In combining the results of the separate studies through thematic analysis three distinct but interrelated themes were evident. These described the processes and efforts of persons to accept, manage and adjust to everyday life with PD. The theme “A changed reality” involves participants´ descriptions of how life changed after the diagnosis of PD. For many this was a shock, and both the person affected and their care partners experienced a variety of emotions such as anger, denial and hopelessness. It changed their personal identities, their perception of themselves as individuals and as a couple. They worried about what the future would hold, and the uncertainty was hard to accept and handle. One strategy for processing and beginning to acknowledge the new situation involved speaking openly about the diagnosis. The second theme “Finding a new path”, involves a description of how, after accepting or at least acknowledging, their new reality, participants started to find ways of managing the impact of PD on everyday life, incorporating it into their current life and identity. Many felt new knowledge was needed and turned to books and websites on PD. An intervention which was appreciated in terms of providing tools for self-observation and self-knowledge was the Swedish National Parkinson School. Participants later used these techniques to communicate and observe symptoms and healthcare needs. Being an active participant in life and performing activities such as physical exercise or other activities they enjoyed were also used as a strategy to feel satisfaction in life. Participants frequently worked out self-care and compensatory strategies to handle everyday tasks. Another strategy they found comforting and helpful involved retaining a positive mind-set and believing that a good future lay ahead. In the third category “The companions”, the participants described self-management in everyday life as a task they performed together. Management of PD was considered the shared responsibility of the person affected and the care partner, but was also influenced by others such as family members and close friends. The Swedish National Parkinson School provided knowledge as a form of common ground for the person affected and the care partner. During the Swedish National Parkinson School, the social interaction involved in exchanging experiences and feeling support from others in the same situation was considered helpful and was much appreciated.Conclusions: Management of PD in everyday life involves both the person affected and the care partner. After the initial emotional reactions, alongside feelings of lost identity and an altered life, persons started to look to the future and were ready to find ways of handling the changed conditions of their everyday lives. Persons with PD and their care partners were now willing to learn more about PD and to find tools and strategies to help them manage its impact on their everyday lives. During this phase, they appreciated the support of the Swedish National Parkinson School intervention. In the intervention, they would meet others in the same situation to find support and exchange experiences. They also turn to healthcare for support in the process of self-management in everyday life. Nurses working specifically to support PwPD and their CP will need to tailor support taking into account the disease trajectory as well as the psychological processes involved in accepting and adjusting to PD to best fit the unique needs and wishes of every person with PD and their care partner.
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