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- Ekman, Inger, 1952, et al.
(författare)
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The person-centred approach to an ageing society
- 2013
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Ingår i: European Journal for Person Centered Healthcare. - : University of Buckingham Press. - 2052-5656 .- 2052-5648. ; 1:1, s. 132-137
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Tidskriftsartikel (refereegranskat)abstract
- Modern care is often based on investigations such as laboratory markers and imaging - for example, x-ray or ultrasound. The results contribute to a diagnosis and, if judged necessary, treatment is initiated. This diseased-oriented approach is the prevailing mode of management in modern medicine. In contrast, person-centered care (PCC) takes the point of departure from each person´s subjective experience of illness and its impact on daily life. A patient is considered as a person with emotions and feelings. PCC is considered present within clinical care according to a definition articulated by the Centre for Person Centred Care at the University of Gothenburg (GPCC) when three core components are present: elicitation of a detailed patient narrative; formulated partnership between caregiver and patient and documentation of the partnership in the patient record. Accordingly, when there is an illness requiring care and the person is attended using these components, PCC is being applied. In most situations today, PCC is not applied as the narrative is not fully elicited or the partnership and/or the documentation are not included. It is proposed that the challenge to Society arising from changing demographics can be addressed by implementing PCC and creating an alternative to existing healthcare. The importance and benefits of such an approach on a wider scale is not yet clear as research has been limited to date. Studies in selected patient populations (heart failure and hip fractures), however, have shown promising results. As the population ages, there will be a dramatic increase in healthcare consumption. Even with technological developments, there will be a need for tremendous resources to be dedicated to care. A new organization and attitude from healthcare policymakers and providers above and beyond the present model appears required in order to respond to this demand. As part of such change, person-centred care, with the interaction between healthcare providers and the person of the patient, can facilitate, compensate and develop more effective healthcare services for the future.
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| 2. |
- German Millberg, Lena, et al.
(författare)
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Tensions related to implementation of postgraduate degree projects in specialist nursing education
- 2011
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Ingår i: Nurse Education Today. - Oxford : Elsevier. - 0260-6917 .- 1532-2793. ; 31:3, s. 283-288
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Tidskriftsartikel (refereegranskat)abstract
- In conjunction with the introduction of the Bologna process in Sweden, specialist nursing education programmes were moved up to the second cycle of higher education with the opportunity to take a one-year master's degree, which also meant that students would undertake a degree project carrying 15 ECTS. The purpose of this study was to examine the introduction of postgraduate degree projects on the second-cycle level into Swedish specialist nursing programmes in accordance with the Bologna process. Five universities were involved and the study design took the form of action research. Problem formulation, planning, evaluation and follow-up with reflection led to new actions over a period of 2 1/2 years. Through a review of local curriculum documents, the implementation of a postgraduate degree project was monitored and these reviews, together with field notes, were analysed by means of constant comparative analysis. The results revealed a variety of tensions that arose when postgraduate degree projects were introduced, taking the form of differing views on the relationship between research, clinical development, specific professional objectives and academic objectives. These tensions were reflected in six areas of change. In summary, it can be noted that implementation of the postgraduate degree projects highlighted tensions related to basic views of learning. © 2010 Elsevier Ltd.
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| 3. |
- Lindström, Irma, 1947, et al.
(författare)
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A Tentative Didactic Model for Theses in Collaboration with Clinical Practice: The Swedish Case of the Implementation of the Bologna Process in Specialist Nurse Programs
- 2010
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Ingår i: 2010 Nursing education in a global community: Collaboration and networking for the future. 3rd International Nurse Education Conference. 11-14 April, 2010 Sydney, Australia. ; 2010:Abstract Book, www.NETNEP-conference.elsevier.com
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Konferensbidrag (refereegranskat)abstract
- Introduction: The European higher education reform known as the “Bologna Process” implies further integration and harmonization of nursing education programs into the higher education system. The consequences for the specialist nurse programs are the following: all courses within the programs are on master’s level, called second cycle, and the programs include a degree project which corresponds to a master’s thesis. A collaborative project was initiated in the beginning of this implementation in order to jointly facilitate the development of structures for students’ degree projects. The purpose of this presentation is to report a tentative didactic model for degree projects in collaboration between universities and clinical practice. Methods: Framed by action research, an inductive multi-case study design was chosen. Five collaborating universities constitute one case respectively. A combination of methods has been used: questionnaires to students, focus groups with faculty members, descriptive analysis of curricula and field notes. Results: A tentative model for degree projects within the specialist nurse programs will be presented: didactic intentions, integration of evidence-based experienced-based and improvement knowledge, balancing generic skills with professional skills, and balancing aims and prerequisites from the university and clinical practice. Four collaborative foci are emphasized: identification of problems for research and development (R&D) in dialogues with clinical practice, development of R&D projects driven by clinical practitioners, thesis supervision by clinical practitioners and researchers, feedback of degree projects’ results to clinical practice. Discussion: The model could serve as a resource for enhancing the collaboration between educational and clinical settings, and thereby, constitute a significant facilitator for students to perform projects as part of clinical R&D projects. This is particularly important in the implementation of the Bologna process in the specialist nurse programs. Since we lack tradition to include theses in clinical R&D projects, we have a tendency to foremost connect students’ projects mostly to university driven research. Key words: Bologna Process, Master Thesis, Implementation, Tentative Didactive Model
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| 4. |
- Lindström, Irma, 1947, et al.
(författare)
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Documentation of patients' participation in care at the end of life
- 2006
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:4, s. 394-403
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe how patients' participation in the care they received was documented in their health care records during the last three months of their lives. Two hundred and twenty-nine deceased adult persons were randomly identified from 12 municipalities in a Swedish county and their records were selected from different health care units. Content analysis was used to analyse the text. Four categories of patient participation were described: refusing offered care and treatments; appealing for relief; desire for everyday life; and making personal decisions. The most common way for these patients to be involved in their care at the end of their life was by refusal of the treatment and care offered. Characteristic of the different ways of participation were the diverse activities represented. The description of patients' involvement in their life situation at this time indicated their dissociation from the health care offered more than consenting to it.
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| 6. |
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| 7. |
- Lindström, Irma, 1947, et al.
(författare)
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Patients' participation in end-of-life care: relations to different variables as documented in the patients' records.
- 2010
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Ingår i: Palliative & supportive care. - 1478-9523 .- 1478-9515. ; 8:3, s. 247-53
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Tidskriftsartikel (refereegranskat)abstract
- Patients' participation in care is crucial for assuring patients a high quality of care based on values such as autonomy. The patients are supposed to be actively involved in care and treatment, even though these situations are complex, as in the context of end-of-life-care. The aim in this study was to identify demographic and health-related variables' relation to patients' participation during the last three months in life as documented in patients' records.
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| 8. |
- Segesten, Kerstin, 1939, et al.
(författare)
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Nurses' experiences of change: a new professional collaboration model and all-R.N. staffing.
- 1994
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Ingår i: Nurs Adm Q.. - 0363-9568. ; 18:4, s. 72-8
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Tidskriftsartikel (refereegranskat)abstract
- Changes in staffing toward a higher number of R.N.'s are common in a number of countries today. This article aims at describing the experiences of a management-induced change from mixed to all-R.N. staffing. All R.N.s in a surgical ward at a Swedish university hospital were interviewed two months after such replacements were completed. The nurses described a period of chaos and conflicts but also of support for the idea and enthusiasm for the future. A more careful planning of the change process is to be recommended.
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| 9. |
- Segesten, Kerstin, 1939, et al.
(författare)
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Versatility--consequence of changing from mixed to all registered nurse staffing on a surgical ward.
- 1998
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Ingår i: J Nurs Manag.. - 0966-0429. ; 6:4, s. 223-30
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Pressure on governments to reduce the costs of healthcare whilst improving the quality continue unabated throughout the developed world. As a consequence of budget cuts on a large Swedish University hospital, a decision to change from mixed nurse staffing to all registered nurses (RNs) in one surgical ward was made to evaluate if nursing costs could be reduced. AIM: This study was developed to gain a deeper understanding of the process of change in a hospital ward when all practical nurses were replaced by registered nurses. METHODS: A substantive theory was inductively derived, using a modified version of grounded theory methodology. FINDINGS: The change encouraged the nurses to become versatile. When the nurses adopted a patient focussed philosophy the content of their work changed and individualized care became possible. The versatility fostered a spirit of creativity, permitted a high degree of freedom of choice and increased the competence, but also led to some negative reactions in the form of complaints about weariness, lack of support and vulnerability with regard to the working environment. CONCLUSION: Versatility can be an opportunity for the nurses to expand their knowledge and develop nursing care but there is a risk that versatility results in weariness.
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