| 1. |
- Liedström, Elisabeth, 1952-
(författare)
-
Life situation of next of kin to persons in need of care-cronic sorrow, burden, quality of life
- 2014
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Nursing research has been performed during the last 20-30 years, about the next of kin’s vulnerability. Despite this, the health care system has had difficulties to integrate the next of kin in a way that gives support. The overall aim of the thesis was to describe and further explore the life situation of the next of kin to persons who are long-term ill, disabled, and/or older, and in need of care. Method: Multiple methods were used. Study I had a descriptive design, 44 next of kin of patients with multiple sclerosis were interviewed, latent content analysis was used for the analysis. Study II had a mixed method approach; the descriptive core study was analyzed with directed content analysis. The supplementary study with descriptive, correlative design was analyzed with descriptive and correlative statistics. Forty-four next of kin of patients with multiple sclerosis were interviewed; thereafter 37 of them answered a questionnaire about Quality of Life. Study III had a descriptive, explorative design. Twelve next of kin of older persons were interviewed with repeated informal conversational interviews, analyzed with latent content analysis. Study IV was cross-sectional with a descriptive, correlative design. Eighty-four next of kin of persons who were long-term ill, disabled, and/or older answered two questionnaires about Burden and Quality of Life that were analyzed with descriptive and correlative statistics. Results and Conclusions: Next of kin described a balance/imbalance in their relations to others and a high burden, but in general a good Quality of Life. Some next of kin also experienced chronic sorrow. Significant correlations were found between interpersonal relations and Quality of Life as a whole. Love and obligations were two anchor points on a continuum, describing the next of kin’s relationship to the ill/disabled person. The relationship with the health care personnel was described through cooperation and obligations. Good communication was seen as the key to balance the relationship with others. One possibility to achieve symmetrical communications is to adapt the Partnership Model, as a tool for creating good relationships. Honest and specific communication between the health care personnel, the next of kin, and the care receiver are necessary.
|
|
| 2. |
- Olsson, Annakarin
(författare)
-
Daily life of persons with dementia and their spouses supported by a passive positioning alarm
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim was to describe how persons with dementia (PwDs) reflect on being outdoors and to investigate the support provided by a passive positioning alarm (PPA) in making daily life safer for PwDs and their spouses.Repeated conversations were held with 11 PwDs living in their own homes regarding their reflections on being outdoors (Study I). Interview study with 14 spouses to a person with dementia (PwD) with their reflections on different kinds of information and communication technology (ICT) devices that were used or can be used in the daily care of PwDs (Study II). An ethnographic approach with participant observations and conversations with five couples, a PwD and his/her spouse, describing and exploring their use and experiences of using a PPA, over time, in daily life (Study III). An experimental single-case ABAB-design with three cases, a PwD and his spouse, investigating the effects of using tracking technology on independent outdoor activities and psychological well-being (Study IV).In summary, the results of the thesis show that being outdoors was described by the PwDs as a confirmation of their identity, the `Self´. The use of ICT in daily care of PwDs was described by the spouses as shifting between their own needs for safety and security and the perceived need for safety and security from the perspective of the PwD. The use of a PPA in daily life among PwDs living in their own homes can give a sense of freedom, support and strengthen the feeling of independence for both PwDs and their spouses as well as give a feeling of safety and security for them both. Use of the PPA may also increase PwDs’ independent outdoor activities and decrease spouses’ worries.
|
|
| 3. |
- Barzangi, Jir, 1978-
(författare)
-
Infant Dental Enucleation in Sweden : Perspectives on a Practice among Residents of Eastern African Origin
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Infant dental enucleation (IDE) is a practice consisting of the removal of deciduous canine tooth buds in infants. Practiced mainly in Eastern Africa, the purpose is to treat or to prevent bodily symptoms and diseases. IDE can cause both general and oral complications. The occurrence of IDE among Eastern African immigrants in a few European countries has been reported. However, knowledge surrounding the practice in Sweden was poor. The overall aim of this work was to explore IDE in the Swedish context. Four studies were conducted. Paper I presents a review of scientific publications. An overview of IDE was gained, and some knowledge gaps were identified. Paper II describes a cross-sectional study to determine the prevalence of IDE in small children. Dental records of 1133 children (mean age 4.6 years, SD 1.4) from a multi-ethnic area were studied. Missing deciduous canines without any registered reason were documented. One or more deciduous canines were missing in 21% of the children with known Eastern African origin (n=101), compared to only three children in the rest of the population (n=1032). Six adults of Somali origin were interviewed to explore their experiences and perceptions of IDE (paper III). These experiences and perceptions were categorised in four essentially different ways: an effective and necessary treatment, a disputed tradition, an option to failure and a desperate measure. Their experiences and perceptions were found to be highly influenced by contexts. In the final study (paper IV), the knowledge, experiences and attitudes among dental and health care personnel were examined. Questionnaires were sent to licensed personnel working in emergency departments, midwifery and child health centres, school health services and public dental health services in ten municipalities. Less than 20% had any knowledge of IDE, while 12.5% of the respondents encountering children had seen at least one patient subjected to IDE. Different attitudes were reported between clinical settings regarding responsibilities and possibilities concerning the management and prevention of IDE. From the findings presented in this thesis, it was concluded that there is a need for initiatives to increase awareness of and knowledge on IDE among dental and health care professionals. Legally obligated responsibilities in these professions regarding IDE need to be clarified, and initiatives should include guidelines regarding both the management of IDE and its prevention in Sweden. Educational programmes should also be produced for residents of Eastern African origin to change their perceptions of IDE, and a culturally sensitive approach should be adopted to ensure that such programmes are effective.
|
|
| 4. |
|
|
| 5. |
- Rasoal, Dara, 1980-
(författare)
-
Perspectives on clinical ethics support and ethically difficult situations : reflections and experiences
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Healthcare personnel encounter ethically difficult situations in their everyday work and clinical ethics support might be important to support healthcare personnel to deal with these situations. The overall aim of this thesis was to describe perspectives on clinical ethics support, experiences of being in ethically difficult situations and experiences of facilitating ethics reflection. Methods. Study I had a descriptive design in which research articles were reviewed (n=54). In study II audio-recorded moral case deliberation (n=70) in 10 Swedish workplaces in hospitals and community care were analysed. In study III interviews were conducted with facilitators (n=11) of moral case deliberation. Study IV used non-participant observation during three weeks as well as informal conversations with healthcare personnel (n=12) in community home healthcare. Results and conclusion. In study I, two perspectives emerged on clinical ethics support, a “Top-down” perspective, where an individual or a group of “experts” in ethics could recommend the best course of action and a “Bottom-up” perspective that allows healthcare personnel to manage ethically difficult situations through ethical reflections led by a facilitator. Studies II and IV showed how ethically difficult situations on different levels are often connected with emotions and uncertainties. Study III showed the role of the facilitator to be fundamental in creating a space for self-reflection among healthcare personnel. Study IV showed that healthcare personnel face complex demands and expectations from the healthcare organization regarding the provision of care as well as having to meet the needs of patients and their next-of-kin. To conclude, healthcare personnel needed to find a balance among demands and expectations in order to satisfy those stakeholders involved and they had to seek compromise. There is a need for clinical ethics support that helps healthcare personnel reflect individually and collectively on ethically difficult situations they encounter in their everyday clinical practice. From this standpoint, a “Bottom-up” perspective may reduce the risk of moral distress among healthcare personnel and promote care based on person-centred values.
|
|
| 6. |
|
|
