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| 2. |
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| 3. |
- Blomqvist, Kerstin, et al.
(författare)
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Living with persistent pain : experiences of older people receiving home care
- 2002
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Ingår i: Journal of Advanced Nursing. - OXFORD : BLACKWELL PUBLISHING LTD. - 0309-2402 .- 1365-2648. ; , s. 297-306
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Tidskriftsartikel (refereegranskat)abstract
- Background. Although the topic of pain among older people has received increasing interest, little is still known about how pain is experienced or handled by those who no longer manage independently but depend on professionals for help with daily living. Developing pain management for older people requires such knowledge. Aim. To explore sense of self, sense of pain, daily living with pain, sense of others and ways of handling pain in older people with persistent pain. Methods. Interviews with 90 older people receiving home care from nursing auxiliaries in their own homes or in sheltered accommodation were collected from January to June 2000. A typology of older people in persistent pain was developed. Activities for handling pain were examined using content analysis. Findings. Respondents' experiences of themselves and their pain varied. Two groups of older people, considered as 'competent and proud' and 'confident and serene', expressed satisfaction in spite of pain, while the groups 'misunderstood and disappointed' and 'resigned and sad' expressed dissatisfaction. The most common strategies used were medication, rest, mobility, distracting activities and talking about pain. Respondents chose strategies by balancing the advantages of the activities against the disadvantages these brought for their daily living. Conclusion. This study indicates that characteristics of the older people, such as their way of experiencing themselves, how pain affects their daily life and how they perceive effects and side-effects of pain management are areas that need to be identified when staff assess pain and plan pain management. Caring for older people in pain could be improved by listening to and believing their complaints, evaluating effects and side-effects from medications and nonpharmacological pain management and by emphasising the importance of common everyday activities such as mobility and distraction to relieve pain.
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| 4. |
- Blomqvist, Kerstin, 1953-, et al.
(författare)
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Living with persistent pain : experiences of older people receiving home care
- 2002
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Ingår i: Journal of Advanced Nursing. - OXFORD : BLACKWELL PUBLISHING LTD. - 0309-2402 .- 1365-2648. ; 40:3, s. 297-306
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although the topic of pain among older people has received increasing interest, little is still known about how pain is experienced or handled by those who no longer manage independently but depend on professionals for help with daily living. Developing pain management for older people requires such knowledge. AIM: To explore sense of self, sense of pain, daily living with pain, sense of others and ways of handling pain in older people with persistent pain. METHODS: Interviews with 90 older people receiving home care from nursing auxiliaries in their own homes or in sheltered accommodation were collected from January to June 2000. A typology of older people in persistent pain was developed. Activities for handling pain were examined using content analysis. FINDINGS: Respondents' experiences of themselves and their pain varied. Two groups of older people, considered as 'competent and proud' and 'confident and serene', expressed satisfaction in spite of pain, while the groups 'misunderstood and disappointed' and 'resigned and sad' expressed dissatisfaction. The most common strategies used were medication, rest, mobility, distracting activities and talking about pain. Respondents chose strategies by balancing the advantages of the activities against the disadvantages these brought for their daily living. CONCLUSION: This study indicates that characteristics of the older people, such as their way of experiencing themselves, how pain affects their daily life and how they perceive effects and side-effects of pain management are areas that need to be identified when staff assess pain and plan pain management. Caring for older people in pain could be improved by listening to and believing their complaints, evaluating effects and side-effects from medications and nonpharmacological pain management and by emphasising the importance of common everyday activities such as mobility and distraction to relieve pain.
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| 5. |
- Blomqvist, Kerstin
(författare)
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Older People in Persistent Pain : Nursing and Paramedical Staff Perceptions and Pain Management
- 2003
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Ingår i: Journal of Advanced Nursing. - : Blackwell. - 0309-2402 .- 1365-2648. ; 41:6, s. 575-584
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Tidskriftsartikel (refereegranskat)abstract
- Background. Persistent pain is a common problem for older people. Knowledge about how nursing and paramedical staff perceive these people and what they do to relieve the pain seems scarce. Aim. To explore nursing and paramedical staff perceptions of older people in persistent pain and their day-to-day management of pain. Methods. Interviews in Swedish with 52 nursing auxiliaries, Registered Nurses, physiotherapists and occupational therapists were collected from February to May 2000. The analysis was based on their stories (n = 150) about older people in persistent pain who received help in their own homes or in special accommodation. A typology of staff perceptions of pain in older people was developed. Activities to manage pain were examined using content analysis. Results. Respondents perceived the pain as real, exaggerated, trivial, care-related, endured, concealed, self-caused or inarticulate. Older people perceived as exaggerating the pain, those with care-related and self-caused pain evoked frustration in the staff, while those perceived as enduring their pain evoked satisfaction. Various strategies to manage pain were used: no activity, medication, mediating contacts, distracting activities, physical therapies, mobility, work in a gentle way, rest or relieving pressure on body part, and communication concerning pain. The activities differed between the types, as well as between staff with different professional backgrounds. Conclusion. Care and treatment provided by staff should be based on older people's needs rather than on staff attitudes and preferences. The typology revealed that staff perceived older people in pain as a heterogeneous group and that their perceptions affected the pain-relieving activities that were offered. It seems urgent to address how to handle pain in older people who never complain and those who complain a great deal, as well as how to handle pain in people with impaired communicative ability. Reflective discussions on feelings related to different individuals are needed.
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| 6. |
- Blomqvist, Kerstin, 1953-
(författare)
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Older people in persistent pain : nursing and paramedical staff perceptions and pain management
- 2003
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Ingår i: Journal of Advanced Nursing. - : Blackwell. - 0309-2402 .- 1365-2648. ; 41:6, s. 575-584
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Persistent pain is a common problem for older people. Knowledge about how nursing and paramedical staff perceive these people and what they do to relieve the pain seems scarce. AIM: To explore nursing and paramedical staff perceptions of older people in persistent pain and their day-to-day management of pain. METHODS: Interviews in Swedish with 52 nursing auxiliaries, Registered Nurses, physiotherapists and occupational therapists were collected from February to May 2000. The analysis was based on their stories (n = 150) about older people in persistent pain who received help in their own homes or in special accommodation. A typology of staff perceptions of pain in older people was developed. Activities to manage pain were examined using content analysis. RESULTS: Respondents perceived the pain as real, exaggerated, trivial, care-related, endured, concealed, self-caused or inarticulate. Older people perceived as exaggerating the pain, those with care-related and self-caused pain evoked frustration in the staff, while those perceived as enduring their pain evoked satisfaction. Various strategies to manage pain were used: no activity, medication, mediating contacts, distracting activities, physical therapies, mobility, work in a gentle way, rest or relieving pressure on body part, and communication concerning pain. The activities differed between the types, as well as between staff with different professional backgrounds. CONCLUSION: Care and treatment provided by staff should be based on older people's needs rather than on staff attitudes and preferences. The typology revealed that staff perceived older people in pain as a heterogeneous group and that their perceptions affected the pain-relieving activities that were offered. It seems urgent to address how to handle pain in older people who never complain and those who complain a great deal, as well as how to handle pain in people with impaired communicative ability. Reflective discussions on feelings related to different individuals are needed.
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| 7. |
- Boström, Barbro, et al.
(författare)
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Cancer-related pain in palliative care : patients' perceptions of pain management
- 2004
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Ingår i: Journal of Advanced Nursing. - : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 45:4, s. 410-419
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pain is still a significant problem for many patients with cancer, despite numerous, clear and concise guidelines for the treatment of cancer-related pain. The impact of pain cognition on patients' experiences of cancer-related pain remains relatively unexplored. Aim: The aim of this study was to describe how patients with cancer-related pain in palliative care perceive the management of their pain. Method: Thirty patients were strategically selected for interviews with open-ended questions, designed to explore the pain and pain management related to their cancer. The interviews were analysed using a phenomenographic approach. Findings: Patients described 10 different perceptions of pain and pain management summarized in the three categories: communication, planning and trust. In terms of communication, patients expressed a need for an open and honest dialogue with health care professionals about all problems concerning pain. Patients expressed an urgent need for planning of their pain treatment including all caring activities around them. When they felt trust in the health care organization as a whole, and in nurses and physicians in particular, they described improved ability and willingness to participate in pain management. While the findings are limited to patients in palliative care, questions are raised about others with cancer-related pain without access to a palliative care team. Conclusion: The opportunity for patients to discuss pain and its treatment seems to have occurred late in the course of disease, mostly not until coming in contact with a palliative care team. They expressed a wish to be pain-free, or attain as much pain relief as possible, with as few side effects as possible.
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| 8. |
- Dahlman, Gull-Britt, et al.
(författare)
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Patients' evaluation of pain and nurses' management of analgesics after surgery. The effect of a study day on the subject of pain for nurses working at the thorax surgery department
- 1999
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 30:4, s. 866-874
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Tidskriftsartikel (refereegranskat)abstract
- The effect of a study day on the subject of pain for nurses working at the thorax surgery department The aims of this investigation were: to describe patients' evaluation of pain and the treatment of pain after thorax surgery via sternotomy; to repeat the evaluation with another group of patients following a study day for nurses, featuring pain and pain treatment; and to examine whether the study day influenced the nurses in their treatment of pain. The investigation included daily evaluation of pain using a visual analogue scale (VAS), and an interview with the patients before discharge, where they were asked to review their experience of pain and its treatment. The nurses on the thorax surgery ward and on the intensive care unit (ICU) completed a questionnaire before and after the study day. Finally, a retrospective study of the case notes of the patients taking part was carried out. The results of the investigation showed a low assessment of pain by most patients during the daily evaluation. Asked to recall their pain when interviewed, the rating was higher. A small group of patients had more evident pain than others. When administering opiates the ICU nurses often chose a lower dose than the standing order prescribed. After the study day the nurses gave larger doses of intravenous opioids and the patients experienced less pain.
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| 9. |
- Ekwall, Anna K, et al.
(författare)
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Loneliness as a predictor of quality of life among older caregivers.
- 2005
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 49:1, s. 23-32
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper reports a study investigating quality of life in relation to loneliness, caregiving, social network, gender, age and economic status among caregiving men and women in a population-based sample aged 75 years or older.Background. Because of demographic changes, in the future more care for older people will be given by informal caregivers who are themselves older. Being old and caring for another older person may affect various aspects of life, such as physical and emotional health and decreased time for respite, which may affect social life and quality of life.Method. A postal questionnaire including the Short Form Health Survey was used. The sample consisted of 4278 people, aged 75 years and over, living in Sweden. Of these, 783 (18) were caregivers.Findings. Caregivers had a larger social network and reported feelings of loneliness less often than non-caregivers. Forty per cent of caregivers helped every day. There were gender differences in experiences of loneliness during the last year, with the frequency of intense feelings of loneliness being higher among women. Loneliness and a small or non-existent network were significantly associated with low quality of life among caregivers, as well as in the total sample. The results showed significant association between loneliness, weak social network and low mental quality of life.Conclusions. The fact that loneliness was the most important factor predicting low quality of life among caregivers, as well as older people in general, indicates that it is crucial in the care of older people. From a nursing perspective, the findings indicate the advantage of helping older people to keep up and develop their social networks. Nursing care should involve steps to maintain the social network before an older person becomes too weak, since decreased health status makes social contacts more difficult.
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| 10. |
- Elmståhl, Sölve, et al.
(författare)
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Malnutrition in geriatric patients : A neglected problem?
- 1997
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 26:5, s. 851-855
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Tidskriftsartikel (refereegranskat)abstract
- The nutrient intake in geriatric long-stay patients and the mortality risk associated with low energy intake were studied in 61 patients, 43 women and 18 men, with a mean age of 87 years, at a geriatric long-stay care hospital during a 6-month follow-up. Dietary intake was assessed with a 9-day dietary record. Energy expenditure was calculated assuming a physical activity level of 1.33 × basal metabolic rate (BMR), predicted from equations given by FAO/WHO. Mean energy intakes were 1557 kcal in men and 1280 kcal in women; 84% of the patients had an intake below estimated energy expenditure and 30% were below estimated BMR. Only 5% received dietary supplement. Eleven out of the 61 patients died during the follow-up and the deceased had lower energy intake than the others (1185 kcal vs 1401 kcal, P<0.05). An energy intake below median (1378 kcal) was associated with an age adjusted increased 6-month mortality risk, odds ratio 12.5. A high proportion of geriatric long-stay patients report dietary intake far below present recommendations and are thereby at risk for having/developing malnutrition. Improved surveillance of geriatric long-stay patients' dietary habits seems justified.
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| 11. |
- Hellström, Ylva, et al.
(författare)
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Quality of life and symptoms among older people living at home
- 2004
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 48:6, s. 584-593
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper reports a study comparing the socio-demographic data, quality of life (QoL) and symptoms of older people living at home with and without help. Background. Despite growing numbers of older people worldwide, little is know about the differences between older people receiving help to live at home and those not receiving this, especially as regards QoL and symptoms. Not only symptoms but also dependency on others per se may reduce older people's QoL. From a nursing perspective, knowledge about such issues is important because the impact of symptoms may be reducible, even when diseases cannot be cured. Method. A postal questionnaire was sent to an age-stratified random sample of 1866 people aged 75 years or over. Of the respondents (n = 1248) 448 received help and 793 did not. Results. The group receiving help had a significantly higher age, more women, more people widowed and living alone, more children, a higher number of self-reported diseases and symptoms, greater inability to remain alone at home and lower QoL. Loneliness, depressed mood and abdominal pain were significantly related to low QoL in both groups. Living alone, not being able to remain alone at home without help, and fatigue were also predictive of low QoL among those receiving help, and number of diseases and sleep problems in those without. Conclusion. Receiving help with daily living seems to be significantly related to low QoL and goes along with a high number of symptoms that need to be considered in nursing care. Through regular visits, systematic assessment and intervention, especially focusing on older people's symptoms, nurses may contribute to improved QoL for this section of the population.
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| 12. |
- Hjelm, Katarina G, et al.
(författare)
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Beliefs about health and diabetes in men of different ethnic origin
- 2005
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Ingår i: Journal of Advanced Nursing. - Oxon, UK : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 50:1, s. 47-59
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper reports the findings of a study exploring the health and illness beliefs of men with diabetes, who were from different cultural backgrounds and living in Sweden.BACKGROUND: No studies have been reported that have focused on the beliefs about health and illness in men with diabetes mellitus of different ethnic origin. Beliefs may affect self-care and care-seeking behaviour.METHOD: An explorative study design and purposive sampling procedure was used. Focus-group interviews were held with 35 men with diabetes and aged between 39 and 78 years. Fourteen participants were born in Arabic countries, 10 in former Yugoslavia and 11 in Sweden.FINDINGS: Important factors for health were the ability to be occupied/employed and economically independent and, especially among Arabs and former Yugoslavians, sexual functioning. Swedes focused on heredity, lifestyle and management of diabetes, while non-Swedes claimed the influence of supernatural factors and emotional stress related to the role of being an immigrant and migratory experiences as factors related to development of diabetes and having a negative influence on health. Swedes and Arabs described health as "freedom from disease" in contrast to many former Yugoslavians who described health as "wealth and the most important thing in life". Knowledge about diabetes was limited among the men studied, but Arabs showed an active information-seeking behaviour compared with Swedes and former Yugoslavians. Non-Swedish respondents, particularly Arabs, had sought help from health care professionals to a greater extent than Swedes, who were more likely to use self-care measures.CONCLUSION: Being occupied/employed and having knowledge about the body and management of diabetes are important for positive health development. There are dissimilarities in beliefs about health and diabetes that influence self-care behaviour and health care seeking. Men's cultural backgrounds and spiritual beliefs need to be considered in diabetes care.
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| 13. |
- Hjelm, Katarina, et al.
(författare)
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Gender influences beliefs about health and illness in diabetic subjects with severe foot lesions.
- 2002
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 40:6, s. 673-684
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Tidskriftsartikel (refereegranskat)abstract
- Background. No studies have been found regarding beliefs about health and illness in patients with diabetic foot ulcers investigated from a patient perspective. Beliefs might affect self-care and health. Aim. To explore beliefs about health and illness among patients with severe diabetic foot lesions that might affect self-care practice and care-seeking behaviour. Method. The study design was explorative. A purposive sampling procedure was used. Focus group interviews were held, with 10 women and 11 men under 65 years (working age) and six women and 12 men over 65 years (range 23–83 years) with present or previous diabetic foot lesions managed at a specialized multidisciplinary diabetic foot clinic. Findings. Foot problems were perceived by participants as caused by both external and internal factors related to the individual. Self-care was practised to restore health when ill and in daily foot care. When help was needed it was sought in the professional sector. Women were active in self-care and preventive care, searched for information and tried to adapt to the situation. Men more often sought help for acute problems, discussed more foot-related problems, had a pessimistic view of the future, showed a passive attitude, accepted information given and used more complementary care from the lay sector (wife) and/or the professional sector (district nurse, home care staff, podiatrist). Foot lesions caused deterioration of perceived health and quality of life due to decreased ability to be active. Conclusion. The present study emphasizes the need to take into account the existence of different beliefs about health and illness, especially regarding gender, in the prevention and management of the diabetic foot.
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| 14. |
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| 15. |
- Kristensson Ekwall, Anna, et al.
(författare)
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Older caregivers' coping strategies and sense of coherence in relation to quality of life.
- 2007
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 57:6, s. 584-596
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper reports a study to investigate coping strategies and sense of coherence in relation to gender, the extent of care, caregiving activities and health-related quality of life in a population-based sample of caregivers aged 75 and over. Background. Caring for another person can be stressful both emotionally, and caregiver burden may affect quality of life in a negative way for the carer. Caregivers’ experience of burden may depend on for example, the behaviour of the person cared for, their own health and their sense of coherence. Older people take a great part of caregiving responsibility and thus understanding of their strain and coping is required. Methods. A postal survey was carried out in 2001 with 171 informal caregivers, aged 75 or older. The response rate was 47%. The questionnaire included the Short-Form 12, Carer's Assessment of Managing Index, and Sense of Coherence instrument. Results. Almost 70% of caregivers provided help every day. Higher health-related quality of life was predicted by using self-sustaining coping strategies and by high sense of coherence. Poor economic situation and demanding social and practical support predicted low scores. Conclusion. These findings could help identify those at risk of low quality of life due to caregiving, dysfunctional coping or lack of information about care. Early intervention, including education about alternative coping strategies and practical information, might allow caregivers better possibilities to continue caring with less negative effects on their lives.
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| 16. |
- Lindholm, Marie, et al.
(författare)
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Nurse managers' professional networks, psychosocial resources and self-rated health.
- 2003
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 42:5, s. 506-515
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Tidskriftsartikel (refereegranskat)abstract
- Background. Nurse managers act under constant pressure to develop strategies in response to professional challenges within a changing and restructured health care system. When such environmental stress is present, they need access to sufficient psychosocial recourses. Aim. The study aimed to investigate whether nurse managers' professional networks, psychosocial work conditions, job support, social network and support were associated with self-rated health, sick-leave and salary. Methods. From a total of 268 Swedish nurse managers, active in management positions, 205 (77%) agreed to participate in the study by answering a self-report questionnaire. Cronbach's α was used to calculate internal consistency. Odds ratios were used to estimate the bivariate association between self-rated health and psychosocial resources. Results. Nurse managers exposed to high job demands had significantly increased odds for low self-rated health. It was also found that low level of support from professional network, job support, social network and social support outside work displayed increased odds for low self-rated health, independently of age, gender and education. There were additive (but no synergistic) effects found for job demand in combination with professional networks, job support and emotional support and in relation to self-rated health. Conclusion. The study showed that nurse managers exposed to high job demands had elevated odds for low self-rated health, regardless of level of psychosocial resources within or outside work. Two-thirds of the nurse managers who were affiliated to professional networks did not consider this a supporting factor in their management work. Those with low job support had increased odds for sick-leave compared with those with high support. No significant associations were found between psychosocial characteristics and salary.
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| 17. |
- Nilsson, Gunilla, et al.
(författare)
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Patients' experiences of illness, operation and outcome with reference to gastro-oesophageal reflux disease.
- 2002
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 40:3, s. 307-15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Describing the illness-story from a patient perspective could increase understanding of living with a chronic disease for health professionals and others, facilitate decision-making about treatment and enhance information about the outcome from a patient perspective. AIM: To illuminate patients' illness experiences of having a gastro-oesophageal reflux disease (GORD), going through surgery and the outcome. METHODS: Twelve patients were interviewed 5 years after having had the operation; six patients had had fundoplication via laparoscopy and six via open surgery. Each patient was asked to talk openly about their experiences, thoughts, feelings and consequences of living with the illness, going through surgery and the period from surgery to the day of interview. A qualitative content analysis was performed concerning the context of the data and its meaning. FINDINGS: Three central categories were identified and nine subcategories: living with GORD- symptoms of the disease affecting daily living, taking medicines, work, family and social life; concerns related to surgery- decision-making about the operation, influence by physicians; life after the operation- outcomes and consequences, side-effects and complications of the operation, sick leave, information and sharing experiences with future patients. All patients were free from symptoms of the illness after surgery independent of type of surgery, but side-effects from surgical treatment varied individually. Interviewees would have liked information concerning side-effects after surgery from previous patients. CONCLUSIONS: This study contributes to knowledge about patients' long-term suffering, their control of symptoms and how they have tried to cure themselves, but also about their concerns about surgery and the importance of surgical treatment to their quality of life. They wanted information about treatment, outcome and consequences, not only from a health care perspective but also from previous patients having had the same treatment.
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| 18. |
- Oleni, M, et al.
(författare)
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Nursing care at night: An evaluation using the night nursing care instrument
- 2004
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Ingår i: Journal of Advanced Nursing. - Oxford : Wiley. - 0309-2402 .- 1365-2648. ; 47:1, s. 25-32
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Night nurses carry overall nursing responsibility for approximately half the time that patients spend in hospital. However, there is a paucity of literature that focuses on nursing care provided at night. Aim The aim of this study was to evaluate nursing care provided at night from the perspective of both nurses and patients. Methods The study, which had an evaluative and a comparative design, was carried out using the Night Nursing Care Instrument at a hospital in southern Sweden. Nurses (n = 178) on night duty were consecutively selected, while the patients (n = 356) were selected by convenience sampling. Results The results showed a statistically significant difference between nurses' assessments and patients' perceptions of the nursing care provided at night in nursing interventions (P < 0.0001). In the areas of medical interventions and evaluation, no statistically significant differences were found between nurses and patients. For eight of 11 items, patients reported that they were satisfied (greater than or equal to80%) with the nursing care provided at night. Conclusions These findings suggest that night nurses need to improve their ability to assess patients' needs for nursing care at night. A first step in this direction is for them to become aware of how patients perceive night nursing. As a second step, nurses need to increase their knowledge of which nursing actions promote patients' rest at night.
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| 19. |
- Olsson, A, et al.
(författare)
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Caring for demented people in their homes or in sheltered accommodation as reflected on by home care staff during clinical supervision sessions.
- 1998
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 2:27, s. 241-252
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to illuminate both the content of and the care given to demented people and the reflections of home care staff about it as revealed in two clinical group supervision sessions (n=36). Verbatim transcriptions were analysed using a phenomenological hermeneutic approach and the following were found to be reflected on: the pensioners' personal situation- disease-related behaviour, ADL-functions, social network and self-esteem; the pensioners' environment - their relationships to significant others, adequate level of housing/care, access to activities, and satisfactory personal space; pensioner/staff interaction - their relations to each other, the staffs' relation to the pensioners' family, and the balance between reality-orientation vs. validation; the staff's situation- co-operation with other professionals, in primary health care, hospital, and within the social services; job satisfaction, lack of knowledge and sharing of knowledge, and lack of resources, especially time. The reasoning of the participants under supervision was found to be based on medical, historical, psychological, and environmental explanations, or personal beliefs. Feelings explored during supervision were directed towards the pensioners or the pensioners' families, towards themselves or towards the management. The findings were interpreted within a nursing model based on the four central concepts of nursing; person, environment, nursing intervention and health. The reasoning about nursing care revealed in the supervision sessions reflected a holistic approach and the relationship between the staff and the demented person stood out as central for care quality. Thus focusing on what promotes or, respectively, obstructs this relationship is likely to be one important focus in clinical supervision not only to achieve improvement and high quality in home care but also to develop and enhance the quality of the working life of the staff. Since the results could be understood within a theoretical nursing care model, it may well be that if the supervisor functions within some theoretical model the participants may reach a more conscious approach and the risk of losing important aspects of caring will decrease.
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| 20. |
- Olsson, Malin, et al.
(författare)
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The meaning of fatigue for women with multiple sclerosis
- 2005
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 49:1, s. 7-15
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper reports the findings of a study that aimed to elucidate the meaning of fatigue for women with multiple sclerosis (MS). Background. Living with chronic illness can involve giving up usual activities. MS is a chronic autoimmune disease of the central nervous system. Fatigue is a common experience among people with MS; however, little is known about the meaning of fatigue experienced by women with this condition. Method. Ten women with MS were interviewed about their experience of fatigue. A phenomenological hermeneutic method influenced by Ricoeur was used to interpret the transcribed interviews. Findings. The findings were presented in two major themes with five subthemes; experiencing the body as a barrier and experiencing a different absence. Fatigue seemed to give rise to an experience of being absent and divided into two parts. This also led to a feeling of not being able to participate in the surrounding world. The feeling of being an outsider and lacking the ability as a healthy person is interpreted as a form of suffering. Although the fatigue had a great impact on the women's daily life, the women still hoped for some relief. Fatigue seemed to imply that instead of working as an implement to manage in the world the body has become an enemy of survival. Conclusion. This study highlights the importance for nurses of understanding how women with MS experience fatigue, which is a prerequisite for communication based on a shared understanding. This awareness would enhance nurses' opportunities to alleviate suffering. More research is needed to investigate what kinds of interventions can help these women to manage their everyday lives and to maintain a sense of normality despite their fatigue and illness. Such interventions should be subject to empirical evaluation research.
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| 21. |
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| 22. |
- Wann-Hansson, Christine, et al.
(författare)
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Health-related quality of life after revascularization for peripheral arterial occlusive disease: long-term follow-up
- 2005
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Ingår i: Journal of advanced nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 51:3, s. 227-35
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper reports a study to measure quality of life, before and after revascularization, in patients with intermittent claudication and critical limb ischaemia from a long-term perspective. BACKGROUND: Patients with peripheral arterial occlusive disease have a number of problems which affect their quality of life and a successful revascularization results in immediate improvements in quality of life. However, knowledge of the durability of the improvements is sparse. Therefore, research on the outcomes of treatment and nursing care should investigate the long-term effects on quality of life and daily activities. METHODS: A quasi-experimental longitudinal follow-up study was conducted with 80 patients with intermittent claudication and 62 with critical ischaemia. Assessment with the Nottingham Health Profile was made before revascularization and 6 months, 12 months and up to 4 years afterwards. The data were collected between 1995 and 2000. RESULTS: Quality of life was improved 6 and 12 months after revascularization in patients with intermittent claudication in energy, pain, emotional reactions and physical mobility, while those with critical limb ischaemia also had improvements in pain and sleep. The improvement in pain was particularly evident for both groups and remained significantly improved up to 4 years after revascularization. Patients with critical limb ischaemia, however, deteriorated significantly with regard to physical mobility between 12 months and 4 years. Being a woman and belonging to the critical ischaemia group was significantly associated with high total Nottingham Health Profile score. Thus, patients with intermittent claudication had more durable benefits from revascularization than those with critical limb ischaemia. However, both groups had less pain than at baseline after 4 years. CONCLUSION: The degree to which quality of life was durable over time seems to depend on the severity of the disease and gender. Patients with critical limb ischaemia were older, had more other diseases and a lower quality of life than patients with intermittent claudication, which confirmed that patients with critical limb ischaemia need more ongoing nursing support to maintain independence in daily life a long time after revascularization.
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| 23. |
- Wennick, Anne, et al.
(författare)
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Families' lived experience one year after a child was diagnosed with type 1 diabetes
- 2007
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 60:3, s. 299-307
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper is a report of a study to elucidate families' lived experience of diabetes one year after a child was diagnosed with type 1 diabetes. Background. The incidence of type 1 diabetes is rapidly increasing worldwide, with a shift towards younger age groups. This illness is treated by means of an intensive management regimen that often disrupts the child's usual activities and requires disease-focused behaviours from the child and his or her family. However, research elucidating families' lived experience from the perspective of all its members is sparse. Method. A hermeneutic phenomenological study was carried out in 2004, based on interviews one year after diagnosis with 11 consecutively chosen Swedish-speaking family members with children aged between 9 and 14 years. Findings. The families described their one year of lived experience as living an ordinary yet different life. They experienced their lives to be neither particularly difficult nor as easy as they had been before the child was diagnosed with diabetes. Related themes were 'feeling acceptance yet frustration', 'being healthy yet invisibly ill', 'feeling independent yet supervised' and 'feeling confident yet insecure'. Conclusion. It may be helpful if healthcare professionals make use of the knowledge and experience of families living with the illness to meet their specific needs, especially when the affected child is experiencing fluctuating blood sugar levels. Thus, health-promoting collaboration should be tailor-made for every individual and proceed from each family's everyday life.
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| 24. |
- Westergren, Albert, et al.
(författare)
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Eating difficulties, complications and nursing interventions during a period of three months after a stroke
- 2001
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 35:3, s. 416-426
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to describe eating difficulties and especially swallowing in patients with dysphagia, types of nursing intervention, and the development of complications over 3 months. The aim was also to explore common characteristics of eating difficulties that influenced the ability to finish meals. METHODS: Twenty-four consecutive patients admitted because of stroke and dysphagia were included. Nursing interventions, based on assessments, were individually designed. RESULTS: Three subgroups could be identified: those (n=9) who were unable to complete a meal, despite assisted feeding, because of reduced alertness/energy and impaired swallowing function; those (n=5) who could complete a meal, despite suffering from reduced alertness/energy; and those (n=10) who could complete meals with minor difficulties. Patients in the first two groups developed complications such as respiratory infections and/or malnutrition. There was a tendency towards that complications in the third group were less frequent and the hospital stay was significantly shorter than in the other groups. CONCLUSION: The level of alertness/energy in patients with dysphagia after stroke was important for the ability to eat and swallow and the development of complications over time, and thus of great importance for the interventions applied.
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| 25. |
- Widäng, Ingrid, et al.
(författare)
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Self-respect, dignity and confidence : Conceptions of integrity among male patients
- 2003
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Ingår i: Journal of Advanced Nursing. - Oxford : Wiley. - 0309-2402 .- 1365-2648. ; 42:1, s. 47-56
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Tidskriftsartikel (refereegranskat)abstract
- A mapping of fatigue crack growth rates in thick plates of a high strength aluminium alloy has been done. The plate thicknesses investigated was 100, 150 and 200 mm. In this work, material from near edge at near surface and mid-thickness has been investigated. Measurements of crack length has been performed using DC potential drop. Cyclic condensation is used in order to reveal crack growth behaviour for stage I and the earlier part of stage II crack growth. Influence of crack closure, crack branching and slow growing side cracks on fatigue crack growth rate of S-L and L-T oriented specimens are discussed. Variation of difference in growth rate in the upper part of the stage II growth between near surface and mid thickness positioned L-T specimens are found to vary with plate thickness.
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