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- Björkman Randström, Kerstin, et al.
(författare)
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Activity and participation in home rehabilitation : Older people's and family members perspectives
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 45:2, s. 211-216
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore the experiences of older people and their supporting family members in relation to home rehabilitation, with a focus on activity and participation. Methods: Qualitative interviews were carried out with 6 older people and 6 family members at 1 and 6 months after the older person’s discharge to their home. Qualitative content analysis of the data was carried out. The International Classification of Functioning, Disability and Health provides a guiding framework for rehabilitation. Results: Informants’ experiences of home rehabilitation contributed to the formation of 6 categories: (i) living with a frail body; (ii) striving for well-being in daily life; (iii) being close at hand; (iv) feeling dependent in daily life; (v) struggling to carry on; and (vi) striving to be at home. Conclusion: Older people’s goals were to return to daily routines and to perform meaningful activities without feeling dependent on other people. Family members’ participation was crucial. Psychosocial support and autonomy were essential for facilitating activity and participation. Healthcare professionals should consider each individual’s unique experiences along with the significance of being at home.
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| 2. |
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| 3. |
- Björkman Randström, Kerstin
(författare)
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Hemmet som arena för äldres rehabilitering
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Avhandlingens övergripande syfte var att studera multidisciplinära teams, äldre personers och familjemedlemmars erfarenheter av hemrehabilitering. Avhandlingen baseras på fyra studier (I-IV). Alla studierna har en kvalitativa beskrivande design. Datamaterialet utgjordes av fokusgruppsintervjuer med personal arbetande i team i kommunal hälso- och sjukvård (I), intervjuer med äldre personer, över 65 år, som vårdats på sjukhuset och därefter fortsatt rehabilitering i hemmet (II,III,IV), samt familjemedlemmar involverade i de äldres rehabilitering (II).Studie I visade på betydelsen av att möta äldres individuella behov och att arbeta utifrån ett rehabiliterande förhållningssätt i avsikt att ge en hjälp som inte innebär att ta över handlingar från den äldre. Väsentligt var att i teamet reflektera över hur man agerar utifrån den egna professionen för att kunna utveckla ett rehabiliterande förhållningssätt i det dagliga arbetet. I resultatet framkom att teamen uppfattade hemrehabilitering som positiv för de äldre, men mindre lämpligt om de äldre var svårt sjuka och de kände sig otrygga i sitt hem. Respekt för de äldres integritet i deras hem och att göra de närstående delaktiga i rehabiliteringen betonades. Resultatet visade på att för att kunna utveckla samarbetet i teamet finns behov av att diskutera varje professions ansvarsområde och klargöra gränser mellan varandras ansvarområden. Behovet av att tillföra psykosocial kompetens i teamet framhölls för att möta de äldres behov. I studie II framkom att de äldre upplevde rehabiliteringen vara en balansgång i att känna av vad kroppen orkar med för dagen och vad som är realistiskt att uppnå för att känna välbefinnande. Tryggheten i att ha någon i familjen nära sig i hemmet var oumbärligt för att våga utföra träning och vardagliga aktiviteter. Resultatet visar på de äldres upplevelse av otillfredsställelse med att vara beroende av andra. Familjemedlemmar var engagerade i de äldres rehabilitering genom att finnas till hands, hjälpa till och vara stödjande, vilket var en självklar handling men också utmanande i att kunna hjälpa på rätt sätt. Bristande information om hjälpmedels funktion och användning skapade frustration. Resultatet visar att både de äldre och deras familjemedlemmar ser hemmiljön bidra till att underlätta rehabilitering. Det som försvårar är när gränsen för det egna hemmet inskränkts i och med att och personal ofta gick "in och ut" i det egna hemmet.Studie III visar på ett flertal faktorer i de äldres vardag och i det omgivande samhället som inverkat underlättande eller hindrande på aktiviteter och delaktighet vid hemrehabilitering. Resultatet beskrivs utifrån Klassifikation av funktionstillstånd, funktionshinder och hälsa (ICF) i 19 kategorier i domänen omgivningsfaktorer. Som underlättande faktorer framträder bl.a. tillgång till hjälpmedel, en fysisk miljö tillgänglig för aktiviteter samt att få stöd från närstående, vänner och personal i hälso- och sjukvård och omsorg. I resultatet framkom betydelsen av ett empatiskt förhållningssätt när personal möter den äldre personen i dennes hem. Resultatet indikerar att hemrehabilitering inte till fullo tillgodoser äldres behov av rehabilitering. I studie IV framkommer personliga faktorer som inre styrka, motivation, engagemang och tålamod för att nå positiva resultat i en rehabilitering som sträcker sig över flera år. Rehabilitering beskrivs i fysiska och psykiska faser som övergick i att hantera en fysisk funktionsnedsättning med svårigheter att gå i dagligt liv. Resultatet visar på betydelsen av adekvat information, vikten av socialt stöd och tillgänglighet till hälso- och sjukvårdspersonal under rehabiliteringsprocessen.Avhandlingen bidrar till en ökad kunskap om hur multidisciplinära team, äldre personer och familjemedlemmar upplever rehabilitering i hemmiljö. Nyttan med avhandlingen kan medföra att hemrehabilitering som vårdform kan bli föremål för diskussioner om hur det utformas och organiseras för att på bästa sätt stödja de äldre och närstående med utgångspunkt från de äldres och närståendes erfarenheter och upplevelser. Detta kan ses gagna deltagarna på individnivå men även för utveckling inom yrkesprofessionen. Avhandlingen har även visat på möjligheten att implementera ICF i rehabiliterande omvårdnad.
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| 5. |
- Paulson, Margareta, et al.
(författare)
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Living in the shadow of fibromyalgic pain : The meaning of female partners' experiences
- 2003
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Ingår i: Journal of Clincal Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 12:2, s. 235-243
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to elucidate the meaning of being a female partner living with a man with fibromyalgic pain. Fourteen partners were interviewed about the meaning of their experiences, using a narrative approach. A phenomenological hermeneutic method, inspired by the French philosopher Ricoeur, was used to interpret the interview text. The structural analysis is presented in three major themes: struggling to give support and comfort, struggling to keep going on, and experiencing lack of understanding and support. The findings elucidate that the meaning of living with a man with fibromyalgic pain meant living a life strongly influenced by the man's illness and in the shadow of the man's pain. Taking daily life for granted was interrupted and restricted family and social life. Prominent in this study was the frustration partners felt as a result of men's reluctance to communicate. This led to feelings of being excluded from men's emotions. The responsibility day in and day out meant that women's own caring and tenderness were replaced, which brought about an almost constant sense of fatigue. Women became drained by the long duration of men's illness. This gave them a feeling of being alone, although they were a couple. Gaining comfort outside the family helped partners to reach a new insight and appreciation for life, which was viewed from a renewed perspective. This involved feelings of both togetherness and separateness in the relationship. The findings also consider the lack of support from the health care system for female partners living with men with fibromyalgic pain.
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| 6. |
- Paulson, Margareta, et al.
(författare)
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Men living with fibromyalgia-type pain : Experiences as patients in the Swedish health care system
- 2002
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 40:1, s. 87-95
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Individuals with fibromyalgia (FM) frequently use health care services and experience only short-term improvements. They often feel that health care staff do not take them seriously. This increases the burden of living with the illness. AIM: To describe how men living with fibromyalgia-type pain experienced being patients in the Swedish health care system. METHOD: Narrative interviews with 14 men who fulfilled the American College of Rheumatology criteria for classification of fibromyalgia. Content analysis was used when analysing the data. RESULTS: The results are described using five themes. Theme I 'Feeling afraid of being looked upon as being a whiner' highlights how the men endured a lot of pain before they sought health care, and how difficult it was to find a receptive listener. Theme 2 'Feeling like a guinea pig' shows that the men's feelings were twofold; they wanted examinations, even if these made them feel that they were being exposed to numerous treatments without any cure. Theme 3 'Feeling hopeful' describes the hope for a cure after having been referred to a specialist clinic. Theme 4 'Feeling neglected' illustrates being looked upon as an uninteresting patient and theme 5 'Feeling no recovery' illustrates the pain relief they gained, but not the actual cure. CONCLUSION: Men with FM type pain experienced a long wait before treatment at a specialist clinic as well as no continuity and follow-ups in primary care and general hospitals. Encounters with engaged and skilful staff promoted the men's well-being despite the fact that no cure was available. Not being respected led to a feeling of being neglected despite the care received. Thus, the men had to accept the fact that they would never recover.
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| 8. |
- Paulson, Margareta, et al.
(författare)
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Men's descriptions of their experience of nonmalignant pain of fibromyalgia type
- 2001
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 15:1, s. 54-59
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to gather men's descriptions of their experience of nonmalignant pain of fibromyalgia (FM) type in order to to gain a deeper understanding of this phenomenon. Fourteen men participated in the study. A qualitative method with narrative interviews and content analysis were used. The findings showed that the men's experience of pain fell within two major themes: "perceptions of diversified bodily pain" and "perceptions of fluctuating pain". The pain had progressed from being local to being widespread. Characteristic was that the men described both pain that worried them and pain that did not worry them and also that the pain passed through both calm and difficult phases. This study highlights the importance of acknowledgement that men had specific experiences and used metaphorical expressions to make the pain visible. The clinical indication in this study is that health care staff need to listen intently to each man's experience of long-term pain that involve a great variety of both bodily and emotional symptoms. These findings are a crucial prerequisite for the health care staff's possibility to offer support and relief to men with pain of FM type.
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| 9. |
- Paulson, Margareta, et al.
(författare)
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Nurses' and physicians' narratives about long-term non-malignant pain among men
- 1999
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 30:5, s. 1097-1105
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate the meaning of skilled nurses' and physicians' lived experiences in their encounters with men suffering from long-term, non-malignant pain of at least 6 month duration. Seventeen nurses and four physicians participated in the study. A phenomenological-hermeneutic method was used. In the narratives three themes, "needing to be manly", "struggling for relief from pain" and "needing human support" emerged. The phenomenon "confirmation" of the theme "struggling to be manly" means that nurses' and physicians' must have such a relationship with theese men that they really feel respected. Confirmation of the theme "struggling for relief from pain! means thar the care givers must convince these men that they really believe each unique individual's narratives. Confirmation of the theme "needing human support" means that nurses and physicians have to behave in such a way that these men are convinced that the caregivers really care about them. When the men felt confirmation they dared to disclose their pain experiences more honestly. This is a preliminary prerequisite for nurses' and physicians' potential to help these men.
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| 10. |
- Paulson, Margareta, et al.
(författare)
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Struggling for a Tolerable Existence : The meaning of Men's Lived Experiences of Living With Pain of Fibromyalgia Type
- 2002
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Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 12:2, s. 238-249
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Tidskriftsartikel (refereegranskat)abstract
- Chronic pain is a major health problem in Sweden because of its consequences in daily life. Fourteen men with fibromyalgia-type pain were interviewed regarding their experiences. A phenomenological hermeneutic method was used to interpret the transcribed interviews. Three major themes emerged: experiencing the body as an obstruction, being a different man, and striving to endure. Overall, the meaning of men's lived experience of chronic pain was experienced as change in the body, self, and relationships. Striving to live life required achieving balance during both calm and difficult phases of the illness--struggling for a tolerable existence. Information from this study could provide guidelines for health care staff members to give empathic and supportive care to men living with a long-term illness.
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