| 1. |
- Alverbratt, Catrin, et al.
(författare)
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A New Working Method in Psychiatric Care : the impact of implementation
- 2016
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Ingår i: International Journal of Public Administration. - : Informa UK Limited. - 0190-0692 .- 1532-4265. ; 40:3, s. 295-304
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Tidskriftsartikel (refereegranskat)abstract
- An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.
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| 2. |
- Alverbratt, Catrin, et al.
(författare)
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The process of implementing a new working method - a project towards change in a Swedish psychiatric clinic
- 2014
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Ingår i: Journal of Hospital Administration. - : Sciedu Press. - 1927-6990 .- 1927-7008. ; 3:6, s. 174-189
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Tidskriftsartikel (refereegranskat)abstract
- The implementation of evidence-based methods in hospital settings is difficult and complex. The aim of the present study was to highlight the implementation process concerning a new working method, i.e. a new assessment tool, based on the International Classification of Functioning Disability and Health (ICF), among psychiatric nursing staff on five participating wards at a Swedish county hospital. Descriptive, qualitative data were collected through focus group interviews pre- and post-implementation. Data were analysed using directed content analysis, guided by Normalization Process Theory (NPT). The results revealed that just one of the five participating wards met the criteria for a successful implementation process. The results confirm previous studies showing the difficulty of implementation. Although participants agreed with the intention of the model, they were reluctant to apply it in practice. The implementation process seemed to be influenced by factors such as: time pressure; heavy workload; stress; lack of routines in using the tool; lack of nursing staff; as well as cultural characteristics and resistance to change.
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| 3. |
- Antonsson, Helena, et al.
(författare)
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Caregivers' reflections on their interactions with adult people with learning disabilities
- 2008
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Ingår i: Journal of Microscopy. - : Wiley. - 0022-2720 .- 1365-2818. ; 15:6, s. 484-91
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Tidskriftsartikel (refereegranskat)abstract
- People with learning disabilities and their professional carers often have difficulty interacting. The aim of this study was to illuminate carers' reflections on their interactions with adult people with learning disabilities. In a previous study, interactions between 16 carers and 11 residents with learning disabilities were recorded on video. In this study, stimulated recall interviews about the interactions were carried out with all the carers. The text was analysed using qualitative content analysis. The findings indicate that the carers reflected on both successful and unsuccessful interaction. Examples of successful interaction included understanding cues, satisfying needs, and managing challenging behaviours, and the carers reflected on the influences that successful interaction had on security, confidence, and satisfaction among the residents. Examples of unsuccessful interaction included failing to understand cues, failing to satisfy needs and failing to manage challenging behaviours, and the carers reflected on the consequences of such interaction, which included irritation, aggression and violence among the residents. Our findings have implications for interventions aimed at strengthening the competence of carers and developing strategies for managing challenging behaviour, in order to ensure high-quality care and a good working climate. © 2008 The Authors.
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| 4. |
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| 5. |
- Antonsson, Helena, et al.
(författare)
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Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior : A Pilot Study with SSED-Design
- 2016
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 37:10, s. 734-743
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Tidskriftsartikel (refereegranskat)abstract
- The interaction between people with intellectual disabilities and professional carers is often influenced by communicative difficulties contributing challenging behaviours. The aims of this study were to evaluate to a web-based training program aimed at improving carers' abilities to interact with people with learning disabilities who exhibit challenging behaviours and to explore carers' experiences of participating in such a program. A single-subject experimental design and mixed methods were used to integrate qualitative and quantitative data. Triangulation of questionnaires, interviews with carers, and assessments of one woman's behaviour was performed. The participants were professional carers aged 20 to 55 years. The web-based training program increased carers' abilities to handle challenging behaviours and decreased challenging behaviours in daily care. The program improved the opportunities to offer training to carers who work in community-based accommodations with limited time to receive training.
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| 6. |
- Antonsson, Helena, 1962-
(författare)
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Interaktion i särskilt boende för personer med utvecklingsstörning och utmanande beteende
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Många personer med utvecklingsstörning har kommunikativa svårigheter och har därför behov av att utveckla olika sätt att kommunicera för att kunna förstå andra och göra sig förstådda. Svårigheter i kommunikationen påverkar interaktionen mellan personer med utvecklingsstörning och deras vårdare. Detta ställer höga krav på vårdare att kunna tolka och förstå den enskilda individens sätt att uttrycka önskningar och behov. På samma sätt riskerar vårdares budskap att missförstås. Om vårdaren misslyckas att förstå den boendes kommunikation och vice versa, kan det leda till situationer med utmanande beteende exempelvis i form av vägran, verbal eller fysisk aggressivitet.Syfte: Det övergripande syftet med avhandlingen är att studera interaktion mellan vuxna personer med utvecklingsstörning och vårdare i gruppbostäder, samt att studera effekter av en utbildningsintervention för vårdare som arbetar i gruppbostäder.Metod: Avhandlingens samtliga delstudier har genomförts i gruppbostäder för personer med utvecklingsstörning bland boende och vårdare i ett län i norra Sverige. I studie I insamlades data kring 556 personer med utvecklingsstörning. I studie II och III deltog 16 vårdare och 11 personer med utvecklingsstörning. I studie IV deltog 7 vårdare. Studie I bygger på personalens skattningar av funktionsnivåer och förekomst av begränsningsåtgärder. I Studie II och III utgörs data av videoobservationer och narrativa intervjuer. I studie IV användes flera datainsamlingsmetoder i en mixed method design med både vårdarnas skattningar, med hjälp av instrument och semi-strukturerade intervjuer. Analys av materialet i studie II, III och IV har gjorts med kvalitativ innehållsanalys och i studie I och IV har data analyserats statistiskt.Resultat: I studie I framkom att av 556 boende hade 99 (18%) varit föremål för fysiska begränsningsåtgärder under den senaste veckan. Av dessa 99 hade nästan alla varit föremål för mer än en typ av begränsningsåtgärd. Den vanligaste begränsningsåtgärden var bälte i stol (74%). Användningen av begränsningsåtgärder var relaterade både till fysiska funktionsnedsättningar och till beteende.I studie II reflekterade vårdare över videoinspelad interaktion där vårdarna medverkat, både framgångsrik och misslyckad interaktion. Exempel på framgångsrik interaktion var att förstå tecken, kunna möta behov och hantera situationer med utmanande beteenden. Vårdarna reflekterade över att framgångsrik interaktion ledde till säkerhet, trygghet och självförtroende hos de boende. Vårdarna reflekterade även över de konsekvenser misslyckad interaktion fick i form av irritation, aggression och våld från de boende.I studie III studerades videoinspelad interaktion mellan 11 personer med utvecklingsstörning och 16 av deras vårdare. Verbal och icke-verbal interaktion identifierades. Fyra inspelade situationer valdes ut för att belysa framgångsrikt samspel. Resultatet visade att framgångsrikt samspel mellan personer med utvecklingsstörning och deras vårdare bland annat bygger på möjligheten att bekräfta varandra, dela vardagshändelser, ge tid och utrymme och på att använda ett kongruent och tydligt språk.I studie IV utvärderades effekterna av en web-baserad utbildningsintervention, vars syfte var att förbättra interaktionen mellan personer med utvecklingsstörning och vårdare samt att därmed reducera förekomsten av situationer med utmanande beteende. Resultatet visade att vårdarna hade förbättrat sin förmåga att hantera situationer med utmanande beteende och att förekomsten av utmanande beteende minskat. Vårdarna beskrev att den web-baserade utbildningen upplevts givande och möjlig att ta del av parallellt med arbetet.Slutsats: Fysiska begränsningsåtgärder förekommer i gruppbostäder för personer med utvecklingsstörning. Användningen av begränsningsåtgärder kan vara relaterade både till fysiska funktionsnedsättningar och till beteenden i samspelet mellan brukare och vårdare. Vårdare upplever användningen av fysiska begränsningsåtgärder svår och tröttande. Brott i kommunikationen mellan personer med utvecklingsstörning och deras vårdare kan leda till försvårad interaktion med risk för situationer med utmanande beteenden. När vårdare är framgångsrika i interaktionen med personer med utvecklingsstörning ger det tillfredsställelse både för de boende och vårdarna. Vårdarna upplever dock ofta hjälplöshet och osäkerhet i relation till hantering av situationer med utmanande beteende och efterfrågar utbildning. Web-baserad utbildning om interaktion med personer med utvecklingsstörning och utmanande beteende har i vår studie visat sig ge lovande effekter och bör vara möjlig att utveckla för både introduktion av nyanställda vårdare och för kompetensutveckling bland mer erfaren personal.
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| 7. |
- Antonsson, Helena, et al.
(författare)
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Skilled interaction among professional carers in special accommodations for adult people with learning disabilities.
- 2013
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 20:7, s. 576-583
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Tidskriftsartikel (refereegranskat)abstract
- Communicative difficulties affect interactions between people with learning disabilities and their carers. Despite such difficulties, however, some carers seem to interact successfully with people who have limited ability to communicate verbally and exhibit challenging behaviour. This study aims to illuminate skilled interaction among carers working in special accommodations for people with learning disabilities. Interactions between 16 caregivers and 11 residents with learning disabilities were recorded on video. Verbal and non-verbal interaction skills among the carers were identified. Four caring situations with people with learning disabilities were chosen to illuminate skilled interaction. The transcribed text was subjected to qualitative content analysis and core stories were created. The results show that skilled interaction between the carers and the people with learning disabilities is based upon being confirming, sharing daily life experience, giving time and space, and using congruent and distinct language. In this paper we present examples that offer concrete suggestions of how to promote successful interaction and create meaning in the shared day-to-day life in special accommodations for people with learning disabilities.
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| 8. |
- Asplund, Sofia, et al.
(författare)
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Experiences of being a manager in the municipal sector in rural northern Sweden
- 2022
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to describe experiences of being a manager in the municipal sector in rural northern Sweden.METHODS: Semi-structured interviews were performed with 15 managers working in the municipal sector. The interviews were subjected to inductive qualitative content analysis.RESULTS: The managers' experiences were interpreted in the main theme, Striving for stability on shaky ground. They struggled within slimmed-down organizations with substitute shortages and reduced means. They expressed being burdened by conflicting demands, a work overload, work conflicts and a requirement to be present. They had to endure the negative consequences of working in small municipalities, and handling health and family life impairments. The managers expressed the importance of being strengthened by inner and outer resources, such as being motivated, having social support and finding strategies to cope. They also expressed benefits of working in small municipalities, such as great opportunities to influence and efficiency in decision-making.CONCLUSION: This study illuminates managers' adverse psychosocial working conditions, insights into working in a small municipality in the rural context and also the importance of organizational support. Future studies could focus on applying adapted workplace support interventions among managers in the municipal sector in rural northern Sweden.
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| 9. |
- Asplund, Sofia, et al.
(författare)
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Experiences of work-related stress among highly stressed municipal employees in rural northern Sweden
- 2022
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this qualitative study was to describe experiences of work-related stress among highly stressed municipal employees in rural northern Sweden. METHODS: We interviewed 15 employees in the municipal sector in rural northern Sweden using a semi-structured guide and subjected the interviews to qualitative content analysis. RESULTS: Under the main theme of Suffering Through Endless Chaos, we summarized four themes: facing incompatible interests and high demands due to lack of time and resources; feeling powerless, trapped, and ignored due to lack of control; feeling insufficient, insecure, and guilty due to challenging relations and high expectations; and struggling with consequences such as health problems, spillover effects on family life, and difficulty coping. CONCLUSION: Findings from this study suggest the importance of acknowledging suffering among municipal employees in a stressful work environment. An imbalance between job demands and resources is affecting both health and family lives of employees, and also their ability to work. It seems important to improve the work environment through supportive leadership, job control, and reasonable job demands to prevent stress, reduce suffering, and create a healthy organization.
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| 10. |
- Asplund, Sofia, et al.
(författare)
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Organizational and psychosocial environmental work factors associated with self-rated exhaustion disorder among municipal employees in rural northern Sweden
- 2023
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 75:4, s. 1215-1229
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Tidskriftsartikel (refereegranskat)abstract
- Background: Research indicates that good organizational and psychosocial environments are vital to well-functioning workplaces and employee health. Working in the municipal sector and in the rural context may contribute to more health problems, poorer organizational and psychosocial work environments, and higher sick-leave rates.Objective: The aim of this study was to explore organizational and psychosocial environmental work factors among municipal employees with or without self-rated exhaustion disorder (s-ED) in rural northern Sweden.Methods: The Modern Work Life Questionnaire and the Self-Rated Exhaustion Disorder Scale were used among 1093 municipal employees.Results: The results showed that there were significant differences between the s-ED and the non-s-ED group in all but one of the organizational and psychosocial environmental work factors. Various demands, i.e. quantitative, emotional, intellectual, and IT demands were some factors associated with the s-ED group. Social support, resources, and time for work and reflection were some factors associated with the non-s-ED group. Both the s-ED and the non-s-ED groups assessed significantly higher emotional demands and less resources compared to national reference values.Conclusion: Findings from this study are relevant to a better understanding what organizational and psychosocial work environmental work factor the employer need to pay extra attention to. Addressing risk and protective factors in the work environment could tribute to promote occupational well-being, preventing exhaustion disorder and long-term sick leave among municipal employees in rural northern Sweden.
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| 11. |
- Asplund, Sofia, et al.
(författare)
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Self-rated exhaustion disorder and associated health-related factors among municipal employees in rural areas of northern Sweden
- 2021
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; , s. 659-668
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aims of this study among municipal employees in rural areas of northern Sweden were to assess the prevalence of self-rated exhaustion disorder (s-ED), describe plausible between-group differences in self-reported health-related factors among employees with or without s-ED, and identify health-related factors associated with s-ED.METHODS: In a cross-sectional study, data were collected from 1093 municipal employees (76.1% women) in two rural areas using an instrument measuring s-ED and health variables drawn from the Modern Worklife Questionnaire (MWQ), the Perceived Stress Scale (PSS), and the National Board of Health and Welfare's questions about physical activity. Comparisons were made between an s-ED and a non-s-ED group. Health-related factors associated with s-ED were identified through a logistic regression.RESULTS: Self-rated exhaustion disorder was reported by 21.5% of the participants. Health-related factors associated with s-ED were cognitive problems, sleep problems, depressive symptoms, high stress, poor self-rated health, and stomach problems. There was no statistically significant difference in the prevalence of participants who met the criteria of physical activity among s-ED and non-s-ED group.CONCLUSION: Findings from this study suggest that s-ED is more common among municipal employees in rural areas than in other working populations in Sweden. Several health-related factors were associated with s-ED. Regular use of a self-rated instrument in evaluating the organizational and social work environment can identify people at risk of developing exhaustion disorder and requiring long-term sick leave.
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| 12. |
- Berglund, Sara, et al.
(författare)
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Patients' Experiences After Attempted Suicide : A Literature Review
- 2016
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 37:10, s. 715-726
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Forskningsöversikt (refereegranskat)abstract
- The aim of this study has been to synthesize research on suicidal patients' experiences of the suicide process. A literature search was performed in CINAHL, PubMed, and PsycINFO, and the analysis of the 15 articles covered was based on meta-synthesis. Patients experience a wide variety of feelings regarding their situation during the suicide process, and these exist on two levels: they relate to the different aspects of care that the patients receive and the patients' need to communicate with others and regain hope. The patients in this study described the struggle to maintain hope when life became too difficult and their suffering despite a sense of security, and they sought to achieve emotional balance. A good understanding of how suicidal individuals live with and manage suicidal ideation, while maintaining hope is important for planning effective nursing care. Further research from the patient perspective is needed to further develop psychiatric care for people at risk of suicide.
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| 13. |
- Carlbo, Adam, et al.
(författare)
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Nurses' Experiences in using Physical Activity as Complementary Treatment in Patients with Schizophrenia.
- 2018
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 39:7, s. 600-607
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Schizophrenia is a common disease with a high risk of comorbidity in both psychiatric and somatic diseases. Physical activity is proven effective in reducing symptoms of schizophrenia and increasing overall health. Still it is not used systematically in the care of persons with schizophrenia.AIM: The aim of this study is to describe nurses' experience, including personal motivation, in using physical activity as complementary treatment in patients with schizophrenia.METHOD: Interviews in three focus groups with 12 participating nurses were conducted. Qualitative content analysis was used to analyze data.RESULTS: Physical activity was commonly used. Although several nurses signaled positive patient response, i.e. less anxiety and better quality of sleep, the overall consensus was an uncertainty regarding the benefits. It was perceived as non-evidence based form of intervention.CONCLUSION: The uncertainty of the benefits of physical activity is evident in nursing staff and poses a resistance to implement systematic physical activity as a complementary treatment in schizophrenia. A new awareness of evidence based nursing is suggested to promote a wider and more receptive attitude to reduce patient vulnerability in persons with schizophrenia.
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| 14. |
- Egberg Thyme, Karin, 1943-, et al.
(författare)
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Individual brief art therapy can be helpful for women with breast cancer : A randomized controlled clinical study
- 2009
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Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 7:1, s. 87-95
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Recent research shows that almost every second woman with breast cancer is depressed or has anxiety; the risk for younger women is even higher. Moreover, research shows that women are at risk for developing depression, also a threat for women with breast cancer. The aim of this randomized controlled clinical trial was to study the outcome of five sessions of art therapy given at a 5-week period of postoperative radiotherapy.Methods: The participants were between 37 and 69 years old; six participants in each group were below 50 years of age. Half of the participants (n = 20) received art therapy and the other half (n = 21) were assigned to a control group. At the first measurement, at least 17% (n = 7) of the participants medicated with antidepressants. Data were collected before and after art therapy and at a 4-month follow-up using self-rating scales that measure self-image (the Structural Analysis of Social Behaviour) and psychiatric symptoms (the Symptom Check List–90).Results: At follow-up, significant lower ratings of depression, anxiety, and somatic symptoms and less general symptoms were reported for the art therapy group compared to the control group. The regression analysis showed that art therapy relates to lower ratings of depression, anxiety, and general symptoms; chemotherapeutic treatment predicts lower depressive symptoms; in contrast to axilliary surgery and hormonal treatment as well as being a parent predicts higher ratings of anxiety and general symptoms.Significance of results: The conclusion suggests that art therapy has a long-term effect on the crisis following the breast cancer and its consequences.
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| 15. |
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| 16. |
- Erlingsson, Christen, et al.
(författare)
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Dilemmas in witnessing elder abuse in caregiving situations: A family member perspective
- 2009
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Ingår i: Southern Online Journal of Nursing Research. - 1538-0696. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Family members who witness elder abuse could be valuable partners to nurses and support personnel in case identification and intervention. The aim of this study was to explore an adult family member’s experiences of witnessing family situations of elder abuse. Interviews were conducted with a woman who had witnessed situations of elder abuse involving her uncle, his wife with disabilities, and health care personnel. Interviews were analyzed using van Manen’s thematic analysis and conception of narrative anecdotes, and development of poetic representations. The witness described conflictual feelings about her family and caregiving situation but felt there were no support personnel she could trust. She felt powerless and remained passive out of loyalty to family, need to protect family, and feeling shame that this was her family. Although she knew what she ought to do she could not live up to her ideals and instead tolerated escalating abuse. The family member witness viewed healthcare personnel as also tolerating and carrying responsibility for the abuse situation. For nurses and support personnel these findings point to the importance of personal and professional reflection and collegial discussions on morality, practice, what we see, and more importantly, what we do not see or want to see.
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| 17. |
- Erlingsson, Christen
(författare)
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Elder abuse through a prism of perceptions : perspectives of potential witnesses
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to deepen understanding of elder abuse (EA) by exploring and comparing perceptions held by experts, older persons, representatives of potential support organizations, and family members. Experts’ perspectives (I) were examined through risk indicators and screening questions (a) located in EA literature and (b) selected by an international Delphi panel. Risk indicators most commonly found in the literature or selected by the panel were compiled into consensus lists. There were differences between risk indicators and questions in the two lists. In papers II and III participants were interviewed in focus groups about their perceptions of EA. Older persons (II) considered EA to be due to changing society and family systems where children are not brought up to respect older persons. EA was mainly conceptualized as ageism, criminal actions, mistreatment in residential care, and societal abuse. The abuser was perceived as a stranger or a healthcare worker. Fear was discussed as a major consequence of EA; especially fear among women. Abused persons were described as carrying the responsibility to seek help. Witnesses were described as hesitant to get involved. Improvements in society such as educating children and healthcare workers were considered ways to cope with EA. Besides family and friends there were few spontaneous suggestions for where to seek help and support in society. These suggestions included healthcare, police, church, and volunteer organizations. Representatives of these suggested organizations were interviewed in focus groups about their perceptions of EA (III). Perceptions of both causes and conceptions of EA were very similar to perceptions of older persons (II). Four themes emerged in the data; good intentions in abusive situations, older generation’s responsibility for EA, failing to report abuse, and prevention of abuse. Participants (III) also expressed ageist attitudes themselves and findings included victim blaming and tolerance for EA. Participants perceived that anyone could be provoked to abuse, and that abusers can be considered victims in abusive situations. Confidentiality was discussed as a barrier to reporting and the need for educating children to show respect for older persons was identified. Interviews with an adult family member (IV) explored her experiences of witnessing abuse situations between her uncle and his wife. In her desire to protect and remain loyal to her family she felt powerless and tolerated abuse. She longed for support she could trust but was locked into passivity by her feelings of shame. Synthesis of findings (I – IV) revealed issues of isolation, autonomy, vulnerability, victim blaming, perceiving the abuser as a victim of circumstances, ageism, tolerating EA, shame, and power as essential elements in EA. Based on the findings, alternative descriptions of EA are offered as a challenge to existing EA definitions. Findings suggest that a key to unlocking EA is compassion, understood as the ability to see a situation as if we were in it ourselves, experiencing the potential for disrespect, shame and unworthiness inherent in abusive acts.
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| 18. |
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| 19. |
- Hajdarevic, Senada, et al.
(författare)
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Need of support perceived by patients primarily curatively treated for breast, colorectal, or prostate cancer and close to discharge from hospital - A qualitative study
- 2022
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 31:9-10, s. 1216-1227
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe perceived needs of support among patients close to discharge from the hospital and at the end of primary curative radiotherapy for breast, colorectal or prostate cancer.BACKGROUND: Few studies have specifically explored patients' early support needs when ending primary curative treatment.DESIGN: Qualitative interview study design.METHODS: A purposive sample of 27 participants with breast, colorectal or prostate cancer aged 33-88 years. The interviews were analysed by qualitative content analysis. Reporting followed the COREQ guidelines.RESULTS: Personal support to reach a sense of control and Social support for personal growth were two main themes, highlighting that people required adapted support from health care since needs of support could change over time. This support from health care was also relying on that trust-based relationships were developed. Through mutuality with others and engagement in meaningful activities people became enabled and felt further supported. Personal support from health care seems specifically important for the patients' feelings of control and could be a facilitator for patients to identify further support for personal growth in how to manage, on the one hand, illness and insecurity, and on the other, their well-being and everyday life with cancer.CONCLUSION: To empower patients who are ending primary treatment and being close to discharge from hospital, healthcare professionals should recognise patients' shifting needs and adapt the support. Adapted support is significant for patients' sense of safety. Biomedical information is not sufficient to fully support patients.RELEVANCE TO CLINICAL PRACTICE: Offering easy access to supportive care when primary treatment is finished could diminish people's stress, insecurity and avoidable use of healthcare services. Even after discharge, nurses preferably should adapt and offer support tailored to patients' needs. Such support may improve patients' sense of control and safety, trust in health care, feelings of community and encourage personal growth.
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| 20. |
- Holm, Anne Lise, et al.
(författare)
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Going around in a Circle : A Norwegian Study of Suicidal Experiences in Old Age
- 2014
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Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437.
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Tidskriftsartikel (refereegranskat)abstract
- Depression has repeatedly been found to be a risk factor for completed suicide, particularly when coupled with a pervasive sense of hopelessness. The aim of this study was to evaluate depressed older persons’ suicidal experiences. Data were collected by means of individual in-depth interviews with nine informants living in two districts of Norway. A hermeneutic analysis was performed. Onemain theme: Going around in a circle and two themes: being alone without meaning in life and struggling to achieve reconciliation emerged from the analysis. An important implication for mental healthcare practice is the need to develop a person’s ability to shape and take control of her/his life. The healthcare organisation must be committed to a plan that sets out strategies enabling suicidal individuals to avoid the negative experience of meaninglessness. It was concluded that suicidal depressed elderly persons need helpto escape from their desperate situation. More research is urgently required in order to prevent suicide in depressed elderly persons whose emotional pain is unbearable.
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| 21. |
- Holm, Anne Lise, et al.
(författare)
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Social Capital and Depressive Ill-Health : An Evaluative Approach to the Implementation of the Chronic Care Model (CCM)
- 2014
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 4:10, s. 683-694
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social capital has been described as a person's sense of belonging as a result of the number and type of relationships she/he has, in which trust and reciprocity are especially important. Aim: To illuminate older persons' experiences of social capital and depressive ill-health after implementation of the CCM. Methods: Data were collected from nine participants resident in two districts of Norway by means of individual in-depth interviews. A qualitative hermeneutic analysis was performed. Results: Two overall themes, desire for a guardian and a wish for independence despite being dependent, and two themes emerging from the analysis. The first theme—searching for protection was based on three sub-themes overwhelmed by the emotional pain of other people, a sense of exclusion and worries about the future, while the second theme—the need for a relationship with trustworthy persons comprised two sub-themes, namely, emotional pain was not understood and powerlessness to change the situation. The result of this study highlights the need for greater understanding on the part of healthcare professionals of how older persons manage their social relationships. Healthcare professionals require more knowledge about how negative self-beliefs held by older persons suffering from emotional pain, which can lead to reduced ability to trust other people. Another consequence is that fear of being dependent on other people can result in unwillingness to admit the need for help. Conclusion: This study highlights the lack of social capital in older persons who suffer from depressive ill-health. The implementation of the CCM does not appear to improve the situation. Older persons need to be more aware of their social needs and productive interactions in order to protect themselves and obtain support from their social network.
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| 22. |
- Hällgren Graneheim, Ulla, 1947-, et al.
(författare)
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Until Death Do Us Part : Adult Relatives' Experiences of Everyday Life Close to Persons with Mental Ill-Health
- 2016
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 37:8, s. 602-608
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Tidskriftsartikel (refereegranskat)abstract
- This study illuminates adult relatives' experiences of everyday life close to a person with mental ill-health. The study was based on nine diaries and four narrative interviews with relatives of people with mental ill-health. Data were subjected to qualitative content analysis. The participants experienced everyday life as a constant fight, for better and for worse, with psychiatric care. They were fighting for the mentally ill person's right to care; sometimes they felt resigned, but yet they had a confidence in the care. Their mission in life was to sacrifice themselves, meaning that they felt indispensable and became lonely and socially isolated. They considered their mission to last until death set them apart because they were keeping a family secret, and had great worries about the future. We conclude that relatives experience a two-folded stigma in living close to a person with mental ill-health and in becoming lonely and socially isolated.
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| 23. |
- Høye, Sevald, et al.
(författare)
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Encounters between multicultural family members and the nurses in the context of intensive care
- 2015
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Ingår i: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 3:1, s. 89-99
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Tidskriftsartikel (refereegranskat)abstract
- The increase in people on the move creates populations that are culturally diverse. People meet various challenges regarding the migration process, social life, jobs and health issues. When a person suffers from acute and critical illness, he/she may be in need of intensive care. The aim of this study was to explore the comprehension of culture, caring and gender among first and second generation immigrant women as relatives on their encounters with intensive care nurses in Norwegian hospitals. A design based upon discursive psychology to explore subject positions, interpretative repertoires and ideological dilemmas focused immigrant female relatives’ experiences with a cultural and gender perspective. Immigrants who were relatives to critically ill people were interviewed. The results of the discourse analysis revealed the following themes: being the caring person as woman, being intertwined between the Western hospital culture and the original family culture and belonging to a minority in a Western majority culture. Conclusion: The women in the families with a critically ill family member mainly act as the caring person. There are dilemmas in how much every family transfer the responsibility for their loved one to the nurses. Anxious attitudes regarding caring activities are rarely linked to their cultural background.
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| 24. |
- Isaksson, Ulf, et al.
(författare)
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Being flexible and tuning in : Professional caregivers’ reflections on management of violent behaviour in nursing homes
- 2013
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Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 8:4, s. 290-298
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: This qualitative, descriptive study aimed to illuminate professional caregivers’ reflections on managing residents’ violent behaviour in nursing homes. Background: Violence towards caregivers in the care of older people is a challenge attracting increasing attention in nursing research. However, studies that focus on the approaches caregivers in nursing homes resort to and how they manage everyday care situations involving threats and violent situations are relatively few. Methods: The study was based on 41 interviews in which the caregivers reflected on their own courses of action in violent situations. The interviews were subjected to qualitative content analysis. Results: This study showed that caregivers were flexible and in tune with the resident by averting and defusing threatening and violent situations. The caregivers tried to give care in line with the residents’ condition, control their own spontaneous reactions and interpret the residents’ reactions as communicative signs indicating how they should interact with the resident in the situation. As a last resort, when previous approaches had been unsuccessful, the caregivers took a firm stand, confronted the resident and the violent behaviour more directly, but with respect and with the residents’ best interests in mind. Conclusions: These findings illuminate how caregivers successfully can manage threatening and violent behavior in nursing homes by being flexible and tuning in with the resident but also by taking a firm stand with the residents’ best interests in mind. To be flexible and in tune with residents, it is important to know the residents’ personal histories. This may mean involving stakeholders, such as family members and friends, in the care of residents with violent behaviour. Implications for practice: We believe that it is important to involve stakeholders in the care of threatening and violent residents in nursing homes as it is important to get information on the residents’ personal history. However, there are risks when interpreting residents’ behaviour in light of their personal histories as relatives experiences may be subjective and the information may give the caregivers preconceived ideas about the resident. © 2012 Blackwell Publishing Ltd.
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| 25. |
- Isaksson, Ulf, et al.
(författare)
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Exposure to violence in relation to personality traits, coping abilities, and burnout among caregivers in nursing homes : a case-control study.
- 2008
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 22:4, s. 551-559
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although violence toward caregivers occurs often and caregivers' ability to interact and deal with difficult situations is relevant in preventing such violence, few studies have been conducted that focus on caregivers' characteristics.AIM: This study explores the relationship between perceived exposure to violence and demographical factors, parental rearing, personality traits including coping abilities, defence styles, and burnout among caregivers working in nursing homes.METHOD: A total of 196 caregivers working in nursing homes were included. They were asked to complete questionnaires concerning demographical factors and exposure to violence. One group of female caregivers reporting no exposure to violence (n = 20) was matched with one group of exposed to violence (n = 20). Both groups were asked to complete questionnaires concerning parental rearing, personality traits, coping abilities, and burnout.RESULT: Around 68.4% of the caregivers had been exposed to violence during the previous year and 22.4% several times a week. Caregivers 50 years of age or younger and employed in geriatric care for more than 3 years were more frequently exposed to violence. Inter-group differences were found regarding 'maternal rejection' and 'burnout'. No statistical differences could be found concerning defence styles, coping ability, temperament, or character aspects.CONCLUSION: Violence toward caregivers occurs frequently and appears to be influenced by several factors. 'Maternal rejection' and 'burnout' among caregivers exposed to violence might influence the communication between caregivers and residents, rendering more violence. However, personality traits among caregivers do not seem to be associated with exposure to violence.
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| 26. |
- Isaksson, Ulf, et al.
(författare)
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Female caregivers' experiences of exposure to violence in nursing homes
- 2009
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 16:1, s. 46-53
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Tidskriftsartikel (refereegranskat)abstract
- Although earlier studies have examined caregivers' experiences of exposure to violence, few have investigated female caregivers working in nursing homes with a specific focus on experiences throughout the entire scenario of a violent situation. This study illuminates female caregivers' experiences of being exposed to violence in nursing homes. Twenty caregivers working in three nursing homes located in northern Sweden were asked to narrate about a situation in which they had been exposed to violence. Their narratives were analysed by using qualitative content analysis. We found that the caregivers had preconceived ideas about violent behaviour, that they experienced a loss of control over the situation, and that they then strove to regain control. Experiences such as these may influence caregivers' interactions with residents who display violent behaviour. As a result of violent interactions, caregivers may distance themselves from the residents, an attitude that may decrease the quality of care. There is a risk that violence in nursing homes is accepted and normalized as a part of the job and hence persists.
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| 27. |
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| 28. |
- Isaksson, Ulf, et al.
(författare)
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Physically violent behaviour in dementia care : characteristics of residents and management of violent situations
- 2011
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Ingår i: Aging & Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 15:5, s. 573-579
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Physically violent behaviour (PVB) is common among residents with dementia and often complicates nursing care. This study aims to explore types of caring situations, resident characteristics related to PVB and professional caregivers' management of PVB.Methods: The study included 40 group homes for 309 residents with dementia. Data was gathered by means of structured interviews, the Multi-Dimensional Dementia Assessment Scale and the Geriatric Rating Scale.Results: Ninety-eight of the residents (31.7%) were assessed as showing PVB during the preceding week. Three factors were independently associated with PVB: male gender, antipsychotic treatment and decline in orientation. Violent residents were more likely to have impaired speech, difficulties understanding verbal communication and prescribed analgesics and antipsychotics than were non-violent residents. PVB occurred mainly in intimate helping situations and was managed by symptom-oriented approaches, such as distraction, medication and isolation. The working team also held frequent discussions about the residents with PVB.Conclusion: This study shows that PVB is frequently displayed among residents in group homes for persons with dementia and the caregivers mainly manage PVB in a symptom-oriented way. To enhance the quality of care for patients with dementia, there is a need for interventions that aim to understand and manage the residents' physical violent behaviour.
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| 29. |
- Isaksson, Ulf, et al.
(författare)
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Supporting the oldest old when completing a questionnaire : risking bias or gaining reliable results?
- 2007
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Ingår i: Research on aging. - : SAGE Publications. - 0164-0275 .- 1552-7573. ; 29:6, s. 576-89
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to elucidate the process of completing a questionnaire in a supportive face-to-face manner. A total of 12 participants, age 90 years or older, were asked to answer the Resilience Scale. The statements were read aloud and the participants answered verbally or by pointing to an enlarged copy of the reply form. Transcribed dialogues were analyzed by means of qualitative content analysis. Four types of dialogues were formulated: “Making a prompt decision,” “Deciding after a pensive dialogue,” “Deciding after an explanatory dialogue,” and “Deciding after an encouraging dialogue.” This article discusses risk for bias and ways to overcome the problem. The authors concluded that support via face-to-face interview in answering a questionnaire is valuable to obtaining valid data from very old persons.
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| 30. |
- Isaksson, Ulf, et al.
(författare)
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Violence in nursing homes : perceptions of female caregivers.
- 2008
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Ingår i: Journal of clinical nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 17:12, s. 1660-6
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This study illuminates how female caregivers in nursing home perceive violence.BACKGROUND: Previous studies have focused on prevalence and types of violence and injuries in various settings and among various professionals. There are, however, few studies that examine how caregivers perceive violence.METHODS: Forty-one female caregivers at nursing homes were asked to reflect on a vignette containing a situation where a female caregiver is exposed to violence from a male resident. The reflections were analysed by qualitative content analysis.FINDINGS: The main finding indicates that perceiving an action as violent is in the eye of the beholder. Caregivers perceive violence to be challenging, intentional, excusable, ordinary and contextual relative to their own experience and attitudes.CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE: As the perception of violence is subjective, there is a risk that violent incidents will be under-reported as well as over-reported. To avoid this, it is important to construct a well-defined operationalised definition of violence for research purposes. Our findings also indicate the need for individually structured and adjusted support for caregivers. To explore the complexity of violence, further research should focus on how caregivers and residents experience violence in a nursing home.
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| 31. |
- Isaksson, Ulf, 1959-
(författare)
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Våld mot vårdare i sjukhemsvård
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis aimed to explore factors related to the prevalence of violence towards caregivers working in a nursing home context. The aim was also to describe caregivers’ perceptions and experiences of violence in a nursing home context. The thesis comprises four studies. Study I includes data regarding environmental and organizational factors, residents’ and caregivers’ characteristics, and violence. Data concerning job satisfaction and working climate were also obtained. In study II, questionnaires were used to collect data concerning caregivers’ exposure to violence and their personal characteristics. Data concerning personality traits, coping resources, and burnout were collected by means of instruments. In order to illuminate caregivers’ perceptions of violence (III) and experiences of being exposed to violence (IV) interviews were performed. Quantitative data were analyzed by means of comparative and descriptive statistics. The interviews were transcribed and interpreted using a qualitative content analysis method. The results showed that 15 percent of the residents exhibited violent behaviour during the week of in-vestigation. A significant higher proportion of male residents were assessed by the caregivers to present violent behaviour compared to female residents. A discriminate analysis showed that the prevalence of behavioural symptoms and psychiatric symptoms, residents needing assistance with dressing, the caregivers’ psychological workload, and job satisfaction were the strongest discriminators between nursing home wards with a high versus low proportion of residents with violent behaviour (I). The results from study II showed that among the 196 caregivers participating in the study, 68 % re-ported exposure to violence during the previous year. Twenty-two percent reported exposure several times per week, and 51 % reported exposure at least once during the previous month. A higher proportion of caregivers 50 years or younger were exposed to violence compared to older caregivers. A higher proportion of caregivers with a work experience of three years or more reported exposure to violence compared to less experienced caregivers. A higher proportion caregivers who reported exposure to violence assessed symptoms on burnout and motherly rejection. No significant differences between the two groups were found concerning coping resources, defence mechanisms, temperament, and character. Study III showed that caregivers’ perceptions of violence are subjective and in the eye of the beholder. The caregivers perceive violence as challenging and expressed that caring situations had to be solved even though their own safety is perceived to be in danger. The caregivers perceive violence as intentional when the residents are judged to have a good cognitive capacity and are perceived to be conscious. However, the care-givers perceive violence as excusable when the residents are described as old and sick. The caregivers perceive violence as ordinary and as a part of the work situation. The caregivers also perceive violence as contextual since similar violence is accepted at the work place but not outside it. The result from study IV showed that the caregivers’ experiences of exposure to violence range be-tween being overwhelmed by contradictory emotions and being resigned. The caregivers have preconceived ideas towards the violent behaviour and describe being on guard in order to avoid being exposed to violence. The caregivers experience that they lose the control over a violent situation and strive to regain the control. They are overwhelmed by emotions such as surprise, anger, and repulsiveness and describe a resignation hav-ing to care for violent residents. Caring for violent residents is described as a constant struggle and the care-givers express a disappointment over insufficient support. The caregivers strive to regain the control by means of seeking excuses for the violent behaviour or by support from colleagues. The conclusions from this thesis are that the prevalence of violence is related to factors among the residents as well as the caregivers, that caregivers’ perceptions of violence are subjective and caregivers’ experi-ences varies between being overwhelmed by contradictory emotions and resignation. There is a risk that vio-lence in nursing homes becomes a norm, is accepted, and in this way is maintained. The boundary between what is acceptable and what is not acceptable becomes erased, the caregiver resigns, and the violence is not looked upon as a divergence but becomes a part of the working situation. It is therefore important that the problems with violence at nursing homes are attended to and that the caregivers are supported in their work.
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| 32. |
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| 33. |
- Johansson, Catrin, 1980-, et al.
(författare)
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Culture as a predictor of resistance to change : a study of competing values in a psychiatric nursing context
- 2014
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Ingår i: Health Policy. - : Elsevier. - 0168-8510 .- 1872-6054. ; 114:2-3, s. 156-162
-
Tidskriftsartikel (refereegranskat)abstract
- It is well known that a conservative organizational culture can hinder the implementation of new organizational models. Prior to introducing something new it is important to identify the culture within the organization. This paper sets out to detect the feasibility of reform in a psychiatric clinic in a Swedish hospital prior to implementation of a new working method - a structured tool based on the International Classification of Functioning Disability and Health. A survey consisting of two instruments - an organizational values questionnaire (OVQ) and a resistance to change scale (RTC) - was distributed to registered and assistant nurses at the clinic. The association between the organizational subcultures and resistance to change was investigated with regression analysis. The results revealed that the dominating cultures in the outpatient centers and hospital wards were characterized by human relation properties such as flexibility, cohesion, belongingness, and trust. The mean resistance to change was low, but the subscale of cognitive rigidity was dominant, reflecting a tendency to avoid alternative ideas and perspectives. An instrument like the one employed in the study could be a useful tool for diagnosing the likelihood of extensive and costly interventions.
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| 34. |
- Johansson, Catrin, 1980-, et al.
(författare)
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Daily Life Dialogue Assessment in Psychiatric Care—Face Validity and Inter-Rater Reliability of a Tool Based on the International Classification of Functioning, Disability and Health
- 2013
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Ingår i: Archives of Psychiatric Nursing. - : Elsevier BV. - 0883-9417 .- 1532-8228. ; 27:6, s. 306-311
-
Tidskriftsartikel (refereegranskat)abstract
- This article describes the development of an assessment tool based on the International Classification of Functioning Disability and Health (ICF) adapted to a psychiatric nursing context where both the patient and the nurse assess the patient's ability to participate in various spheres of life. The aim was to test psychometric properties, focusing on face validity and inter-rater reliability. Three Swedish expert groups participated. Analysis of inter-rater reliability was conducted through simulated patient cases. The results of an unweighted kappa value of 0.38, a linear weighted kappa value of 0.65 and a quadratic weighted kappa value of 0.73 were considered as acceptable when using simulated patient cases.
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| 35. |
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| 36. |
- Lindgren, Britt-Marie, 1961-
(författare)
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Self-harm - hovering between hope and despair : experiences and interactions in a health care context.
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background The definition of self-harm used in this project is repeated, impulsive behaviour causing tissue damage, yet not intended as a suicide attempt. Instead of wishing to die, the person who self-harms wishes to be relieved from anxiety. The thesis comprises four studies and the overall aim was to describe experiences of care among people who self-harm, professional caregivers, and close relatives (parents), and to explore interpretative repertoires that jointly construct the interaction between people who self-harm and their professional caregivers. Methods The participants were nine women who self-harmed (I), six nurses, three of each sex (II), five mothers and one stepfather (III), and six women who self-harmed in two psychiatric inpatient wards and their caregivers (IV). Data were collected through narrative interviews (I, II, III), participant observations (IV), and informal interviews (IV). The interviews lasted between 40 and 50 minutes (I), between 40 and 65 minutes (II), and between 30 and 85 minutes (III). The observations including informal interviews in study IV comprised 150 hours of descriptive observations and 40 hours of focused observations. The data were analysed using qualitative content analysis (I, II), phenomenological hermeneutics (III), and discursive psychology (IV). Results People who self-harmed experienced care as inferior, not satisfying their needs. The findings presented a paradox; on the one hand, the women realised that society considered self-harm an inappropriate way to alleviate mental suffering, and on the other hand, they experienced self-harm as the only way to survive and to foster hope in themselves (I). Caregivers felt powerless and burdened when unable to identify and satisfy the women’s needs. Feelings of fear, frustration, and abandonment created a significant burden for caregivers (II). Parents’ lived experience of the professional care and caregivers of their self-harming adult children could be described as a hostage drama. As in a hostage situation, parents felt held to emotional ransom by deficient care and sometimes hostile caregivers (III). The interpretative repertoires that jointly constructed the interaction between those who self-harmed and their professional caregivers, were for the caregivers a fostering and a supportive repertoire, and for the women who self-harmed a victim and an expert repertoire. The interactions between a fostering caregiver and a woman as expert or as victim, and between a supportive caregiver and a woman as victim, were complicated and promoted feelings of hopelessness among the participants. Interactions between a supportive caregiver and a woman as expert were more satisfying and raised hope among the participants (IV). Synthesis of findings Hope and hopelessness ran together as a thread of meaning throughout the studies. All participants experienced and expressed hope and hopelessness in various ways. The self-harming women hovered between hope and hopelessness, hoping for help and support, but led back to hopelessness by their experiences in care. The women used self-harm as a way to cope and to maintain hope in themselves. The parents initially had confidence in healthcare and hoped for help. However, their experiences of meeting deficient care often made them feel hopeless. Parents paid an emotional ransom when they accepted deficient care for their daughters. The caregivers felt frustrated, angry, and powerless, and their view of self-harm as an endless behaviour led to hopelessness. However, they struggled to see the women’s abilities, not only their difficulties, and described how they had to try to see self-harm in another way. Caregivers who were convinced that it was possible to stop self-harming and leave it behind were able to bring hope to themselves, to parents, and to the women who self-harmed. The present studies suggest that there is a difference between self-harm and suicide attempts or suicide. Other researchers echo these findings. Conclusions Paradoxically, self-harm usually seems to be a life sustaining act, a way of raising hope in oneself. The importance of caregivers who listen and try to understand people who self-harm, as well as their close family members, is evident. By asking open-ended questions and being non-judgemental, listening, and showing a genuine interest in the person’s lived experience; caregivers can inspire hope in people who self-harm.
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| 37. |
- Lindgren, Britt-Marie, et al.
(författare)
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'They don't understand…you cut yourself in order to live.' : Interpretative repertoires jointly constructing interactions between adult women who self-harm and professional caregivers
- 2011
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 6:3, s. 7254-
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to illuminate interpretative repertoires that jointly construct the interaction between adult women who self-harm and professional caregivers in psychiatric inpatient care. Participant observations and informal interviews were conducted among six women who self-harm and their professional caregivers in two psychiatric inpatient wards, and analysed using the concept of interpretative repertoires from the discipline of discursive psychology. The analysis revealed four interpretative repertoires that jointly constructed the interaction. The professional caregivers used a "fostering repertoire" and a "supportive repertoire" and the women who self-harmed used a "victim repertoire" and an "expert repertoire." The women and the caregivers were positioned and positioned themselves and people around them within and among these interpretative repertoires to make sense of their experiences of the interaction. It was necessary to consider each woman's own life chances and knowledge about herself and her needs. The participants made it clear that it was essential for them to be met with respect as individuals. Professional caregivers need to work in partnership with individuals who self-harm-experts by profession collaborating with experts by experience. Caregivers need to look beyond behavioural symptoms and recognise each individual's possibilities for agency.
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| 38. |
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| 39. |
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| 40. |
- Lundström, Mats, et al.
(författare)
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Personality impact on experiences of strain among caregivers exposed to violence in care of people with learning disabilities
- 2007
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Ingår i: Journal of Policy and Practice in Intellectual Disabilities. - : Wiley-Blackwell Publishing Inc.. - 1741-1122 .- 1741-1130. ; 4:1, s. 30-39
-
Tidskriftsartikel (refereegranskat)abstract
- Explored are the relationships among personality and emotional reactions, work‐related strain, and experiences of burnout among staff exposed vs. not exposed to violence when caring for people with intellectual disabilities (ID). Questionnaires measuring personality, emotional reactions, strain and burnout, and exposure to violence were distributed to staff (n = 112) working in 22 group homes for people with ID aged 18 years and older in a community in northern Sweden. The results did not show evidence of a direct influence of personality variables on exposure to violence when working with people with ID and no direct relationships were found between exposure to violence and the staff members’ personality traits as measured with the Temperament and Character Inventory and Rosenberg’s Self‐Esteem Scale. Although the influence of personality traits on how the staff members experienced violence could not be clearly determined, the authors found an association between personality and strain and the risk of burnout in that certain staff exposed to violence felt more emotionally exhausted than did staff who were not exposed. The knowledge of the relationships among violence, personality, and risk of burnout may be important for the understanding which staff need special supports when working with people with ID.
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| 41. |
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| 42. |
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| 43. |
- Lundström, Mats, 1956-
(författare)
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Våld - utmaning och utmattning : vårdares utsatthet och upplevelser i samband med våld i gruppbostäder för personer med utvecklingsstörning
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- ABSTRACT This thesis aims to explore the prevalence of violence towards caregivers working in group home for people with learning disabilities, as well as the influence of work climate and personality on the caregivers’ experiences of strain and exposure to violence. The thesis comprises four studies conducted among caregivers working in group homes for people with learning disabilities in one urban district in Sweden. Study I includes data regarding caregivers’ exposure to violence and their demographics. In study II and III data were collected by instruments for measuring caregivers’ personalities and experiences of the work climate as well as emotional reactions, strain, and experiences of burnout. Data were also collected by 50 narrative interviews with 44 caregivers reporting exposure to violence. In order to illuminate caregivers’ experiences of being exposed to violence, the interviews were transcribed and interpreted using qualitative content analysis. The results showed that 31% of the caregivers (n=120) had been exposed to violence during the preceding year, with physical violence being the most common type. Weak relationships were found between reported exposure to violence and caregivers’ age and education (I). Among those in studies II and III who completed all instruments (n=112), 45 caregivers (40%) reported exposure to violence. A significant difference in age was found between exposed and not exposed caregivers. In the total sample of studies II and III, 30% (n=41) of the caregivers were at risk of developing burnout. The relationship between exposure to violence and the caregivers’ experiences of the work climate (CCQ) showed that “debates” was the only factor that on average was significantly higher among caregivers reporting violence from the residents. The caregivers’ emotional reactions, strain, and work climate factors explained 35% of the variance in burnout scores (II). No significant relationships were found between the caregivers’ personalities (TCI and RSES) and their exposure to violence. Personality dimensions explained 32% of the variance of the caregivers’ experiences of burnout. The results did not show a significant relationship between a caregiver’s personality and exposure to violence. However, those exposed to violence reported more emotional exhaustion than those not exposed (III). Caregivers exposed to violence reported feelings of powerlessness, insufficiency, anger and violence was very seldom followed by support from the managers at the group homes (I). Interviews show that caregivers’ experiences are about “falling apart” and “keeping it together”. Falling apart involves fear, powerlessness, sadness, anger, and timelessness, while keeping it together involves joy, respect, self-reflection, and habituation. Destructive experiences are balanced by a more constructive view of the situation by keeping the situation, and the caregivers themselves, together. The findings show that exposure to violence occurs frequently and a large proportion of the exposed caregivers are at risk for burnout. It was not possible to confirm the relationships between the caregivers’ personality, experiences of the work climate, and exposure to violence but partly to emotional reactions, strain and burnout. The findings of the four studies are discussed in relation to how it is to live and work in an environment where violence is of frequent occurrence.
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| 44. |
- Norberg, Monika, et al.
(författare)
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Breast Cancer Survivorship : Intersecting Gendered Discourses in a 5-Year Follow-Up Study
- 2015
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Ingår i: Health Care for Women International. - : Informa UK Limited. - 0739-9332 .- 1096-4665. ; 36:5, s. 617-633
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Tidskriftsartikel (refereegranskat)abstract
- In this article we present a follow-up study of women's interview narratives about life five to seven years after a breast cancer operation. The women had taken part in a study during the six-month post-operation period. Art therapy contributed to well-being, including strengthening personal boundaries. In the new study, interview analysis informed by critical discursive psychology indicated three problematic discourses that the women still struggled with several years after the operation: the female survivor, the "good woman", individual responsibility. We concluded that many women with a history of breast cancer need support several years after their medical treatment is finished.
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| 45. |
- Olsson, Tommy, et al.
(författare)
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Hypercortisolism revealed by the dexamethasone suppression test in patients with acute ischemic stroke
- 1989
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Ingår i: Stroke. - : American Heart Association. ; 20:12, s. 1685-1690
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Tidskriftsartikel (refereegranskat)abstract
- Using the dexamethasone suppression test, we studied the activity of the hypothalamicpituitary-adrenal axis within the first week after onset in 62 patients with acute ischemic stroke. Compared with two control groups (one comprising 25 elderly patients with various acute medical disorders and the other comprising 33 80-year-old volunteers), stroke patients had higher postdexamethasone cortisol levels (p=0.08 and /?=0.001, respectively). By multiple regression analysis, high postdexamethasone cortisol levels in the stroke patients were significantly associated with proximity of the lesion to the frontal pole of the brain (p=0.008) and with disorientation (p=0.03), whereas no association with major depression was seen. Many stroke patients are exposed to hypercortisolism, which may have negative consequences upon organ functions. The extent to which dexamethasone administration suppresses cortisol levels seems to be determined mainly by the site of brain lesion and cannot be used as an indicator of major depression early after stroke.
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| 46. |
- Richter, Jörg, et al.
(författare)
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Personality characteristics of staff in elderly care-a cross-cultural comparison
- 2012
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Ingår i: Issues in Mental Health Nursing. - : informa plc. - 0161-2840 .- 1096-4673. ; 33:2, s. 96-100
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Tidskriftsartikel (refereegranskat)abstract
- Communication and interaction between carers and residents in elderly and dementia care can be challenging and demanding. The carer's personality, one factor shaping this interaction, seems to have been neglected in the literature. This article looks at cross-cultural comparisons of staff in elderly and dementia care with individuals from the general population matched by age and gender. Compared to individuals in the general population, elderly and dementia care staff are usually slower tempered, more stoic and reflective, tolerant to monotony, and more systematic. They also have more optimistic attitudes in situations that might worry most people, and more confidence in social situations and in the face of danger and uncertainty.
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| 47. |
- Rørtveit, Kristine, et al.
(författare)
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Experiences of guilt as a mother in the context of eating difficulties
- 2009
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 30:10, s. 603-610
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore motherhood in the context of eating difficulties. The research question was: What are mothers' daily life experiences when suffering from ED? An explorative design was used. In-depth interviews (n = 8) focused on experiences of motherhood and eating difficulties. Data were interpreted by hermeneutic analysis. The main theme, "experiencing guilt as a mother in the context of eating difficulties," comprised two themes: (1) having a guilty conscience in relation to being a good enough mother and (2) being preoccupied about not involving the children in the eating difficulties. The study illuminates the importance of identifying mothers with eating difficulties and offering them treatment and support.
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| 48. |
- Rørtveit, Kristine, et al.
(författare)
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The feeling of being trapped in and ashamed of one's own body : A qualitative study of women who suffer from eating difficulties
- 2009
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Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 18:2, s. 91-99
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore women's bodily experiences of suffering from eating difficulties (ED). The research question was: How do women who suffer from ED experience the bodily aspects related to their condition? Women suffering from ED experience problems in both the physical and emotional areas. Few qualitative studies have specifically addressed sufferers' bodily experiences related to ED. An explorative design was used. The data were collected by means of focus group interviews on the subject of ED-related problems, guilt and shame, and being a mother. The interpretation of the qualitative data was inspired by hermeneutic content analysis. The main theme, 'Powerful feelings of being trapped in and ashamed of one's own body', comprised two themes: 'The feeling of being trapped by overwhelming physical sensations' and 'The feeling of being ashamed of one's own body'. Bodily experiences were reported as strong. One clinical implication for nurses is to acknowledge this fact and make it possible for these women to articulate their difficulties, especially those connected to the feelings of being trapped and ashamed. Support groups focusing on these themes could be one way of assisting women and easing some of the negative feelings associated with ED.
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| 49. |
- Rørtveit, Kristine, et al.
(författare)
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The meaning of guilt and shame : a qualitative study of mothers who suffer from eating difficulties
- 2010
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Ingår i: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 19:4, s. 231-239
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate and interpret guilt and shame expressed by mothers with eating difficulties (ED). The research question was: What is the meaning of guilt and shame experienced by mothers with ED? Experiences of guilt and shame in mothers with ED may be strong, yet concealed, and should be addressed when promoting women's mental health. The study design was explorative, and in-depth interviews were conducted with eight mothers suffering from ED. The data were analysed by means of qualitative content analysis and interpreted according to a hermeneutic approach. The main theme 'Struggling in silence with guilt and shame as a mother living with ED and trying to keep it secret' was interpreted on two levels: emotional, 'Feeling worried about failure and wanting to be successful', and cognitive, 'Having condemning thoughts about one's own sense of responsibility'. In addition, each theme contained two subthemes. Feelings and awareness of guilt and shame are strong; they vary between individuals and are intensified in mothers who suffer from ED. It is important for mental health nurses to help mothers with ED articulate such feelings in order to promote health.
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| 50. |
- Sandvide, Åsa, 1959-, et al.
(författare)
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How care providers construct and frame problems related to violence in institutional care for older people
- 2010
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Ingår i: Communication & Medicine. - : Walter de Gruyter GmbH. - 1612-1783 .- 1613-3625. ; 7:2, s. 155-164
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to describe how care providers discursively constructed and framed problems related to the occurrence of violence in their interactions with older persons in institutional care. The study followed a social constructionist approach where violence was considered a social phenomenon constructed in discursive processes. It was based on the assumption that in the way in which a problem is articulated is closely connected to solutions that are possible and relevant in a given context. The analysed corpus comprised narrative interviews with 46 care providers who had been involved in violence that occurred in social interactions with older persons. The analysis was inspired by discourse theory. The problems concerned legitimization, illness, bodily care, competence and profession and relieved responsibility. The constructions of the problems are manifestations of discourses. The prevailing discourses in the text are the medical and the physical. The construction of problems can be used to challenge dominant ways of thinking as well as the beliefs and common understandings about the subject.
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