| 1. |
- Andersson, Jenny, et al.
(författare)
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Decision‐Making in Seeking Emergency Care for Stroke Symptoms
- 2022
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Ingår i: Stroke: Vascular and Interventional Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 2694-5746. ; 2:6
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious studies have shown that rapid treatment for stroke, especially ischemic stroke, reduces mortality and disability. The focus has mainly been on reducing time from arrival at hospital to start of treatment. However, the main reason for delay is often time from symptom onset to arrival at hospital. This study therefore aimed to explore decision‐making processes after the onset of stroke symptoms in patients experiencing a first‐time stroke.MethodsWe included 36 patients aged 18 and older, all of whom were hospitalized with a first‐time stroke between October 2018 and April 2020. All patients were interviewed once within 4 weeks of symptom onset and before hospital discharge. Eligible patients were identified retrospectively through a targeted review of medical records. The data were collected and analyzed according to the grounded theory methodology.ResultsIn total, 43 potential patients were identified and asked to participate. Overall, 36 patients were included in the study: 17 women (median age 77.0 years, interquartile range 17.5) and 19 men (median age 65.7 years, interquartile range 17.2). All interviewees felt fear, and this affected their decision to seek emergency care. The decision‐making processes were described by the core category of “Acting on fear.” The reason for feeling frightened determined the actions taken. The reasons were sorted into 3 main categories: (1) “seeking care”–recognized stroke symptoms and acted immediately; (2) “pending and reluctance”–suspected stroke but awaited to seek care; and (3) “seeking an explanation”–confused by symptoms.ConclusionWe found that decision‐making when experiencing stroke symptoms was complex. All patients felt fear, which determined their actions. Some patients knew about stroke symptoms and acted immediately. Others suspected stroke but still chose to wait, whereas others were confused and tried to find answers. These results could contribute to form future awareness campaigns.
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| 2. |
- Andersson, Jenny, et al.
(författare)
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Patient´s description of onset stroke symptoms : Oral Presentations. ESOC 2023 Abstract Book
- 2023
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Ingår i: European Stroke Journal. - : Sage Publications. - 2396-9873 .- 2396-9881. ; 8:2, s. 427-427
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Stroke symptoms vary and could be hard to recognize. In addition, stroke severity has decreased according to the National Institutes of Health Stroke Scale (NISSH), with less pronounced symptoms expression. Knowledge on the patient’s description of stroke symptoms is therefore needed. The aim was to describe patient’s symptoms at stroke onset.Methods: A qualitative content analysis was used. Data were collected through individual interviews with 27 patients (16 men and 11 women, median age 70.4 years). All patients were hospitalized with a first-time stroke. The interviews were conducted within 4 weeks of symptoms onset and before hospital discharge.Results: All patients had symptoms that affected their daily life. Some patients described having multiple symptoms at the same time, others had symptoms that began insidiously and worsened over time. Symptoms such as overwhelming fatigue or nausea were described as Premonition of becoming ill, feeling unwell or that something was wrong. Motoric bodily changes were multifaceted as slurred speech or dizziness, balance difficulties and losing control of the body or motor dysfunction. But also, that the surroundings were distorted, and solid objects moved around. Symptoms of Dazed and affected senses included confusion and visual impairment or headache.Conclusions: Stroke is a complex disease with several different symptoms’ expressions and could be difficult to recognize, especially when symptoms are less typical or perceived as not serious. Increased awareness of stroke symptoms among caregivers and among members of the community is important and needed.
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| 3. |
- Andersson, Jenny, et al.
(författare)
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Symptoms at stroke onset as described by patients: a qualitative study
- 2024
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Ingår i: BMC Neurology. - : Springer Nature. - 1471-2377. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stroke is a common and severe disease that requires prompt care. Symptom expressions as one-sidedweakness and speech difficulties are common and included in public stroke campaigns. For some patients stroke canpresent with subtle and less common symptoms, difficult to interpret. The symptom severity assessed by the NationalInstitutes of Health Stroke Scale has decreased, and symptoms at onset may have changed. Therefore, we aimed toinvestigate how patients describe their symptoms at the onset of a first-time stroke.Methods:The study used a qualitative descriptive design and conventional content analysis. Data were collectedthrough recorded interviews with 27 patients aged 18 years and older hospitalised with a first-time stroke betweenOctober 2018 and April 2020. Data were analysed on a manifest level.Results: Symptoms at stroke onset were presented in two themes: Altered Reality and Discomfort and Changed BodyFunctions and described in five categories. Various types of symptoms were found. All symptoms were perceivedas sudden, persistent, and never experienced before and this appear as a “red thread” in the result. Regardless ofsymptom expressions, no specific symptom was described as more severe than another.Conclusions: Stroke symptoms were described with a variety of expressions. Many described complex symptomsnot typical of stroke, which can make it difficult to recognise the symptoms as a stroke and delay medical care. Publicstroke campaigns should emphasize the importance of seeking medical care at the slightest suspicion of stroke andcould be designed to help achieve this.
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| 4. |
- Berndtsson, Ina, 1953-, et al.
(författare)
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Nursing students' attitudes toward care of dying patients : A pre- and post-palliative course study
- 2019
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Ingår i: Heliyon. - : Elsevier. - 2405-8440. ; 5:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many nursing students are not prepared to encounter death and care for patients who are at the end of life as newly educated nurses. The Frommelt Attitude Toward Care of Dying Scale (FATCOD) has been used to assess nursing students' attitudes during their education and changes have been noted.Objective: To examine nursing students' attitudes towards care of dying patients before and after a course in palliative care.Design: A descriptive study with a pre and post design.Settings & participants: Nursing students (n = 73) enrolled in a mandatory palliative course in the nursing programme at a Swedish university.Methods: Data were collected before and after a palliative care course using FATCOD and qualitative open-ended questions. Data from FATCOD were analysed using descriptive and analytical statistics. The open-ended questions were analysed with qualitative content analysis.Results: The students' mean scores showed a statistically significant change toward a more positive attitude toward care of dying. Students with the lowest pre-course scores showed the highest mean change. The qualitative analysis showed that the students had gained additional knowledge, deepened understanding, and increased feelings of security through the course.Conclusions: A course in palliative care could help to change nursing students' attitudes towards care of patients who are dying and their relatives, in a positive direction. A course in palliative care is suggested to be mandatory in nursing education, and in addition to theoretical lectures include learning activities such as reflection in small groups, simulation training and taking care of the dead body.
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| 5. |
- Bjalkefur, K., et al.
(författare)
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Self-rated health over the first five years after stroke
- 2020
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Ingår i: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Self-rated health (SRH) focuses on the patient's own perception, and represents an important patient-reported outcome. The aim was to investigate SRH one to 5 years after stroke, follow the development over time and search for factors associated with SRH. Methods Consecutive stroke patients admitted to Stroke Units at the Skaraborg Hospital, Sweden were included 2007-2009 (n = 2190). Patient-reported outcomes were collected annually over 5 years using a postal questionnaire. SRH was assessed by the question about general health from SF-36. Factors associated with SRH were investigated by multiple logistic regression analysis. Results Response-rate was > 90% at all time points. Overall, 40.2, 41.9, 40.7, 45.0 and 46.3% of the patients reported good SRH, 1 to 5 years after stroke. Performance in activities of daily living (ADL) was strongly associated with good SRH; 49.8 and 14.7% after 1 year in independent and dependent survivors respectively, p < 0.001. In independent survivors 1 year after stroke, good SRH was positively associated with female sex (OR = 2.0; p = < 0,001), physical activity (OR = 2.14; p = < 0,001), car driving (OR = 2.25; p = < 0,001), and negatively associated with age (OR = 0.99; p = < 0,001), pain (OR = 0.49; p = < 0,001), depression (OR = 0.30; p = < 0,001), and self-perceived unmet care needs (OR = 0.39; p = < 0,001). In dependent survivors, depression (OR = 0.23; p = < 0,001) and age (OR = 0.96; p = < 0,05), were negatively associated with good SRH 1 year after stroke. Similar patterns were observed throughout the follow-up. Conclusion The proportion stroke survivors reporting their health as good is slightly increasing over time. After stroke, SRH is associated with pain, depression, ability to perform activities and self-perceived unmet care needs, indicating that efforts to support stroke survivors in the chronic phase after stroke should concentrate on targeting these factors.
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| 6. |
- Eriksson, K., et al.
(författare)
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Stroke
- 2023
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Ingår i: Teamarbete i neurologisk vård. - Lund : Studentlitteratur AB. - 9789144158174 ; , s. 73-114
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Forsgren Gebring, Susanne, 1961-, et al.
(författare)
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To Attend or Not : The Reasoning Behind Nursing Students' Attendance at Lectures : A Qualitative Study
- 2021
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Ingår i: Scandinavian Journal of Educational Research. - : Informa UK Limited. - 0031-3831 .- 1470-1170. ; 65:3, s. 500-509
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Tidskriftsartikel (refereegranskat)abstract
- There is a rising tendency for students in higher education not to attend lectures. Therefore, the aim of the study was to describe the reasoning behind nursing students’ decisions on whether or not to attend lectures. This qualitative study was performed in a nursing education programme at a Swedish University. One hundred and thirty-one students participated. Data were collected through a questionnaire comprising open-ended questions. Qualitative content analysis was performed. The results are presented in eight categories: four concerning reasons for attending lectures and four concerning reasons for not attending lectures. Decisions, both to attend and to not attend lectures, were based on conscious choices guided by the students’ self-governing of their own personal needs for learning. © 2020, © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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| 8. |
- Godskesen, Tove, et al.
(författare)
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Etik i samverkan
- 2023
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Ingår i: Samverkan i vården. - Stockholm : Liber. - 9789147145416 ; , s. 93-112
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 9. |
- Gustafsson, Anna, et al.
(författare)
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Oral health plays second fiddle in palliative care: an interview study with registered nurses in home healthcare
- 2021
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Ingår i: BMC Palliative Care. - : Springer Science and Business Media LLC. - 1472-684X. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Oral health is crucial to the experience of well-being, and symptoms from the mouth are common at the end of life. Palliative care aims to identify and treat symptoms early to avoid unnecessary suffering and is thus an important part of nursing in home healthcare. The aim of this study was to illustrate the professional reflections of registered nurses about oral health amongst patients in palliative care, who are being cared for in a home healthcare setting.Results: The results showed oral health in end-of-life care, to be an area marked by responsibility and ethical considerations. This was seen in all four partly overlapping themes that emerged through the analysis: Oral health is easily overlooked in palliative care, Oral health is everybody’s but in reality nobody’s responsibility, Patient integrity can be an obstacle for oral health, and Focus on oral health is urgently needed. The mouth is often not included as part of the daily basic care routine, by the registered nurses and the home healthcare staff, until the patient is near end of life. Moreover, neither does the patient tell about symptoms from the mouth. The interpreted whole indicates that the registered nurses had a bad conscience about not doing what they are actually responsible for and ought to do.Conclusion: The oral health of patients at the end of life risks being forgotten or falling between the cracks, due to the nurses’ scattered tasks and unclear delimitations between their, and other professionals’ responsibilities. The responsibilities of registered nurses are also ethically demanding, since their intent to respect the patient’s integrity could mean that in some cases the patients does not allow them to help with oral health. To reduce the risk that oral health is overlooked, clearer demarcation and guidelines on the division of responsibilities are required. Routines that clearly implement early and recurring oral health assessments in home healthcare as well as continuing education updates on oral health and oral care are also needed.
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| 10. |
- Palmryd, Lena, Doktorand, et al.
(författare)
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Integrity at end of life in the intensive care unit : a qualitative study of nurses' views.
- 2021
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Ingår i: Annals of Intensive Care. - : Springer Science and Business Media LLC. - 2110-5820. ; 11:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Integrity is a core value for delivering ethical health care. However, there is a lack of precision in defining what integrity is and how nurses understand it. In the setting of nurses caring for critically ill and dying patients in intensive care units (ICUs), integrity has not received much attention. Therefore, the aim of this study was to explore how nurses perceive and maintain the integrity of patients during end-of-life care in the ICU setting.METHODS: This study had a qualitative descriptive design. Data were collected using individual semi-structured interviews with 16 intensive care nurses working at ICUs in four Swedish hospitals. The data were analysed by applying qualitative content analysis.RESULTS: Five overall categories were explored: seeing the unique individual; sensitive to patient vulnerability; observant of patients' physical and mental sphere; perceptive of patients' religion and culture; and being respectful during patient encounters. Many nurses found it difficult to define integrity and to explain what respecting integrity entails in the daily care of dying patients. They often used notions associated with respect and patient-centred attitudes, such as listening and being sensitive or by trying to describe good care. Integrity was nonetheless seen as a central value for their clinical work and a precondition for ethical nursing practice. Some nurses were concerned about patient integrity, which is at risk of being "wiped out" due to the patient's illness/injury, unfamiliarity with the ICU environment and utter dependence on others for care. Protecting patients from harm and reducing patient vulnerability were also seen as important and a way to maintain the integrity of patients.CONCLUSIONS: The study results show that even though integrity is a fundamental ethical concept and a core value in nursing, ethical codes and guidelines are not always helpful in clinical situations in the end-of-life care of ICU patients. Hence, opportunities must regularly be made available for ICU nurses to reflect on and discuss ethical issues in terms of their decision-making and behaviour.
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