| 1. |
- Björck, Maria, et al.
(författare)
-
Sjuksköterskans stöd till hemtjänstpersonal i samband med vård i livets slutskede : ur ett sjuksköterskeperspektiv
- 2016
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Äldre personer i ordinärt boende som befinner sig i livets slut har behov av palliativvård för att ges förutsättningar att leva med värdighet och välbefinnande. Hemtjänstpersonal är undersköterskor och vårdbiträde som till stora delar utförden praktiska omvårdanden vid vård i livets slut till äldre personer i ordinärt boende. Sjuksköterskan är ytterst ansvarig för att den äldre får den vård som behövs och har därmed också ett ansvar att ge personalen det stöd som behövs för god palliativvård. Syftet var att beskriva sjuksköterskors erfarenheter av att vara ett stöd till hemtjänstpersonal i samband med allmän palliativ vård till äldre personer i livets slutskede. Datainsamlingen bestod av 19 individuella intervjuer som analyserades med kvalitativ innehållsanalys. I resultatet framkom kategorierna; Indirekt stöd och Direkt stöd. Det indirekta stödet handlade om att vara tillgänglig, att samverka med andra professioner och organisationer samt att kommunicera och bekräfta hemtjänstpersonalen. Det direkta stödet handlade om att vara delaktig i det direkta patientarbetet och att ”ta” svåra samtal med närstående. Det framkom att sjuksköterskan alltid upplever sig tillgänglig via telefon för hemtjänstpersonalen i samband med vård i livets slutskede. Något regelbundet strukturerat direkt eller indirekt stöd verkar inte till att förekomma i någon större utsträckning.
|
|
| 2. |
- Björck, Maria, et al.
(författare)
-
Sjuksköterskans stöd till hemtjänstpersonal i samband med vård i livets slutskede : ur ett sjuksköterskeperspektiv
- 2016
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Äldre personer i ordinärt boende som befinner sig i livets slut har behov av palliativvård för att ges förutsättningar att leva med värdighet och välbefinnande. Hemtjänstpersonal är undersköterskor och vårdbiträde som till stora delar utförden praktiska omvårdanden vid vård i livets slut till äldre personer i ordinärt boende. Sjuksköterskan är ytterst ansvarig för att den äldre får den vård som behövs och har därmed också ett ansvar att ge personalen det stöd som behövs för god palliativvård. Syftet var att beskriva sjuksköterskors erfarenheter av att vara ett stöd till hemtjänstpersonal i samband med allmän palliativ vård till äldre personer i livets slutskede. Datainsamlingen bestod av 19 individuella intervjuer som analyserades med kvalitativ innehållsanalys. I resultatet framkom kategorierna; Indirekt stöd och Direkt stöd. Det indirekta stödet handlade om att vara tillgänglig, att samverka med andra professioner och organisationer samt att kommunicera och bekräfta hemtjänstpersonalen. Det direkta stödet handlade om att vara delaktig i det direkta patientarbetet och att ”ta” svåra samtal med närstående. Det framkom att sjuksköterskan alltid upplever sig tillgänglig via telefon för hemtjänstpersonalen i samband med vård i livets slutskede. Något regelbundet strukturerat direkt eller indirekt stöd verkar inte till att förekomma i någon större utsträckning.
|
|
| 3. |
- Abrahamsson, Caroline, et al.
(författare)
-
Att drabbas av sorg i samband med vuxen närståendes död : En allmän litteraturöversikt om anhörigas upplevelser av sorg och vad som förvärrar och lindrar sorgen
- 2021
-
Rapport (populärvet., debatt m.m.)abstract
- Bakgrund: Sorg är en normal reaktion i samband med närståendes död. Sorg är inteen sjukdom men kan ge besvär som liknar dem som uppkommer vid sjukdom. Om sorgeninte kan hanteras av personen som drabbas av sorg kan den leda till kompliceradsorg och sorgeprocessen förlängs. Sjuksköterskor som arbetar inom vård och omsorgmöter anhöriga som upplever sorg i samband med närstående döende och död ochbehöver ha kunskap och förståelse för hur deras situation kan vara för att kunna geadekvat stöd för anhöriga i sorg.Syfte: Syftet var att beskriva anhörigas upplevelser av sorg i samband med vuxen närståendesdöd.Metod: En allmän litteraturöversikt baserad på vetenskapliga artiklar med kvalitativstudiedesign. Vetenskapliga artiklar söktes fram i databaserna Cinahl Complete, Pub-Med och PsycINFO. Artiklarna kvalitetsgranskades utifrån kvalitativa kvalitetskriterieroch analysen av studiernas resultat genomfördes utifrån Fribergs analysmetod för litteraturöversikter.Resultat: Upplevelsen av sorg delas in i två kategorier och tio underkategorier. En känslomässigbelastning och att känna sig vilsen och oviss med underkategorierna Chockoch oförmåga att minnas, Smärta, Ångest och ledsenhet, Skuld och lättnad, Ensamhetoch saknad, Ovisshet samt Vilsenhet. Omgivningens agerande förvärrar och lindrarsorgen med underkategorierna Att mötas av personer som inte förstår, Att få informationsom ger förståelse samt Att få känslomässigt stöd.Diskussion: Studiens kvalitet diskuteras utifrån trovärdighetsbegreppen tillförlitlighet,verifierbarhet, pålitlighet och överförbarhet. I resultatdiskussionen diskuteras de trecentrala fynden: upplevelser av skuld, ovisshet och betydelsen av känslomässigt stödvid sorg. Fynden diskuteras i relation till personcentrerad vård och sjuksköterskorsbehov av kunskap för att kunna möta personer i sorg.
|
|
| 4. |
- Abrahamsson, Caroline, et al.
(författare)
-
Att drabbas av sorg i samband med vuxen närståendes död : En allmän litteraturöversikt om anhörigas upplevelser av sorg och vad som förvärrar och lindrar sorgen
- 2021
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Sorg är en normal reaktion i samband med närståendes död. Sorg är inteen sjukdom men kan ge besvär som liknar dem som uppkommer vid sjukdom. Om sorgeninte kan hanteras av personen som drabbas av sorg kan den leda till kompliceradsorg och sorgeprocessen förlängs. Sjuksköterskor som arbetar inom vård och omsorgmöter anhöriga som upplever sorg i samband med närstående döende och död ochbehöver ha kunskap och förståelse för hur deras situation kan vara för att kunna geadekvat stöd för anhöriga i sorg. Syfte: Syftet var att beskriva anhörigas upplevelser av sorg i samband med vuxen närståendesdöd. Metod: En allmän litteraturöversikt baserad på vetenskapliga artiklar med kvalitativstudiedesign. Vetenskapliga artiklar söktes fram i databaserna Cinahl Complete, Pub-Med och PsycINFO. Artiklarna kvalitetsgranskades utifrån kvalitativa kvalitetskriterieroch analysen av studiernas resultat genomfördes utifrån Fribergs analysmetod för litteraturöversikter. Resultat: Upplevelsen av sorg delas in i två kategorier och tio underkategorier. En känslomässigbelastning och att känna sig vilsen och oviss med underkategorierna Chockoch oförmåga att minnas, Smärta, Ångest och ledsenhet, Skuld och lättnad, Ensamhetoch saknad, Ovisshet samt Vilsenhet. Omgivningens agerande förvärrar och lindrarsorgen med underkategorierna Att mötas av personer som inte förstår, Att få informationsom ger förståelse samt Att få känslomässigt stöd. Diskussion: Studiens kvalitet diskuteras utifrån trovärdighetsbegreppen tillförlitlighet,verifierbarhet, pålitlighet och överförbarhet. I resultatdiskussionen diskuteras de trecentrala fynden: upplevelser av skuld, ovisshet och betydelsen av känslomässigt stödvid sorg. Fynden diskuteras i relation till personcentrerad vård och sjuksköterskorsbehov av kunskap för att kunna möta personer i sorg.
|
|
| 5. |
- Andersson, Martina, et al.
(författare)
-
Erfarenhet av att bedöma äldre personers problem i livets slutskede : en fokusgruppsstudie ur ett sjuksköterskeperspektiv
- 2020
-
Rapport (populärvet., debatt m.m.)abstract
- Andelen äldre personer i Sverige ökar och en del äldre personer drabbas av en eller flera kroniska sjukdomar. Allt fler personer önskar att vårdas hemma vid livets slut och kan då vara i behov av allmän palliativ vård. Vid palliativ vård i livets slutskede är det en eftersträvan att lindra lidande och förbättra livskvaliteten genom att tidigt uppmärksamma och lindra personers fysiska, psykiska, sociala och existentiella problem. Äldre personer i livets slutskede har ofta flera komplexa problem som påverkar varandra. För att lindra lidande behöver sjuksköterskor kunna bedöma och tolka olika problem som äldre personer kan uppleva i livets slutskede. Syftet med studien var att beskriva sjuksköterskors erfarenhet av att bedöma problem som äldre personer besväras av i livets slutskede inom kommunal hemsjukvård. En kvalitativ metod har använts. Data samlades in med fyra fokusgruppsintervjuer. Totalt deltog 13 sjuksköterskor verksamma inom hemsjukvård från tre olika kommuner i studien. Data analyserades med Kvalitativ innehållsanalys. I resultatet framkom ett övergripande tema: strävan efter kontinuitet för att lära känna personen genom återkommande hembesök underlättar bedömning av problem som behöver tillgodoses i livets slutskede samt kategorierna; att bygga en relation underlättar bedömningen, att samtala för att erhålla information, att observera kroppsspråket skapar en bild och att ta del av andras iakttagelser som stöd. Resultatet visade att relationen till den äldre var viktig för att bedöma den äldres problem och att sjuksköterskor till stor del förlitade sig på sin kliniska blick vid bedömningen. Vidare framkom att sjuksköterskorna sällan använde sig av skattningsinstrument, vilket de uttryckte en önskan att bli bättre på. Slutsatsen är att en ökad användning av skattningsinstrument skulle kunna förenkla bedömning av problem hos äldre personer som sjuksköterskorna inte sedan tidigare har någon relation till. Detta skulle kunna skapa en känsla av trygghet för sjuksköterskorna och stärka dem i deras professionella roll. Användningen av skattingsinstrument skulle kunna öka kvaliteten på den allmänna palliativa vården som utförs i kommunal hemsjukvård. För att sjuksköterskorna ska få stöd i att öka användningen av skattningsinstrument har organisationen en viktig roll för att skapa rutiner och se till att etablerade arbetsformer utvecklas.
|
|
| 6. |
- Andersson, Martina, et al.
(författare)
-
Erfarenhet av att bedöma äldre personers problem i livets slutskede : en fokusgruppsstudie ur ett sjuksköterskeperspektiv
- 2020
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Andelen äldre personer i Sverige ökar och en del äldre personer drabbas av en eller flera kroniska sjukdomar. Allt fler personer önskar att vårdas hemma vid livets slut och kan då vara i behov av allmän palliativ vård. Vid palliativ vård i livets slutskede är det en eftersträvan att lindra lidande och förbättra livskvaliteten genom att tidigt uppmärksamma och lindra personers fysiska, psykiska, sociala och existentiella problem. Äldre personer i livets slutskede har ofta flera komplexa problem som påverkar varandra. För att lindra lidande behöver sjuksköterskor kunna bedöma och tolka olika problem som äldre personer kan uppleva i livets slutskede. Syftet med studien var att beskriva sjuksköterskors erfarenhet av att bedöma problem som äldre personer besväras av i livets slutskede inom kommunal hemsjukvård. En kvalitativ metod har använts. Data samlades in med fyra fokusgruppsintervjuer. Totalt deltog 13 sjuksköterskor verksamma inom hemsjukvård från tre olika kommuner i studien. Data analyserades med Kvalitativ innehållsanalys. I resultatet framkom ett övergripande tema: strävan efter kontinuitet för att lära känna personen genom återkommande hembesök underlättar bedömning av problem som behöver tillgodoses i livets slutskede samt kategorierna; att bygga en relation underlättar bedömningen, att samtala för att erhålla information, att observera kroppsspråket skapar en bild och att ta del av andras iakttagelser som stöd. Resultatet visade att relationen till den äldre var viktig för att bedöma den äldres problem och att sjuksköterskor till stor del förlitade sig på sin kliniska blick vid bedömningen. Vidare framkom att sjuksköterskorna sällan använde sig av skattningsinstrument, vilket de uttryckte en önskan att bli bättre på. Slutsatsen är att en ökad användning av skattningsinstrument skulle kunna förenkla bedömning av problem hos äldre personer som sjuksköterskorna inte sedan tidigare har någon relation till. Detta skulle kunna skapa en känsla av trygghet för sjuksköterskorna och stärka dem i deras professionella roll. Användningen av skattingsinstrument skulle kunna öka kvaliteten på den allmänna palliativa vården som utförs i kommunal hemsjukvård. För att sjuksköterskorna ska få stöd i att öka användningen av skattningsinstrument har organisationen en viktig roll för att skapa rutiner och se till att etablerade arbetsformer utvecklas.
|
|
| 7. |
- Andrisan, Loredana, et al.
(författare)
-
Att uppmärksamma och tillgodose äldre personers behov utifrån ett palliativt förhållningssätt på vård och omsorgsboende : omvårdnadspersonals perspektiv
- 2018
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Äldre personer som bor på vård- och omsorgsboende befinner sig i livetsslut och är ofta svårt sjuka. Palliativ vård är ett förhållningssätt som syftar till att förbättralivskvaliteten för patienter och deras familjer i samband med livshotande sjukdom.Förhållningssättet lämpar sig väl att använda vid vård- och omsorgsboende. Syfte:Syftet med studien var att beskriva omvårdnadspersonalens uppfattningar om vad de gör och kan göra för att uppmärksamma och tillgodose äldres behov på vård- ochomsorgsboende utifrån ett palliativt förhållningssätt. Metod: Sju fokusgruppdiskussioner som representerades av omvårdnadspersonal på fyra olika vård- och omsorgsboende genomfördes, sex fokusgruppdiskussioner genomfördes 2010 och en 2017. Intervjuerna analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultat:Genom analysen framträdde ett övergripande tema Att möta den äldre utifrån dennes tankar, känslor och värderingar och tre huvudkategorier Att lära känna den äldre, Att sörja för den äldres angelägenheter och Att den äldre ges valmöjligheter. Slutsats: Föratt kunna tillgodose äldre personers behov utifrån ett palliativt förhållningssätt behöver omvårdnadspersonal möta den äldre personen utifrån dennes tankar, känslor och värderingar vilket kräver resurser i form av tid men också handledning i att samtala omexistentiella frågor.
|
|
| 8. |
- Andrisan, Loredana, et al.
(författare)
-
Att uppmärksamma och tillgodose äldre personers behov utifrån ett palliativt förhållningssätt på vård och omsorgsboende : omvårdnadspersonals perspektiv
- 2018
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Äldre personer som bor på vård- och omsorgsboende befinner sig i livetsslut och är ofta svårt sjuka. Palliativ vård är ett förhållningssätt som syftar till att förbättralivskvaliteten för patienter och deras familjer i samband med livshotande sjukdom.Förhållningssättet lämpar sig väl att använda vid vård- och omsorgsboende. Syfte:Syftet med studien var att beskriva omvårdnadspersonalens uppfattningar om vad de gör och kan göra för att uppmärksamma och tillgodose äldres behov på vård- ochomsorgsboende utifrån ett palliativt förhållningssätt. Metod: Sju fokusgruppdiskussioner som representerades av omvårdnadspersonal på fyra olika vård- och omsorgsboende genomfördes, sex fokusgruppdiskussioner genomfördes 2010 och en 2017. Intervjuerna analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultat:Genom analysen framträdde ett övergripande tema Att möta den äldre utifrån dennes tankar, känslor och värderingar och tre huvudkategorier Att lära känna den äldre, Att sörja för den äldres angelägenheter och Att den äldre ges valmöjligheter. Slutsats: Föratt kunna tillgodose äldre personers behov utifrån ett palliativt förhållningssätt behöver omvårdnadspersonal möta den äldre personen utifrån dennes tankar, känslor och värderingar vilket kräver resurser i form av tid men också handledning i att samtala omexistentiella frågor.
|
|
| 9. |
- Beck, Ingela
(författare)
-
An intervention applying a palliative care approach in residential care : influences on nurse assistants' work situation
- 2013
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionPalliative care is an approach characterized by a holistic view of the person, which supports the individual for living with dignity and with the best possible level of wellbeing until the end of life. Those who, in practice, provide care in Swedish residential care facilities for older people (RCFs) are nurse assistants (NAs), a work group with limited education. They also often stand alone with difficult decisions with regards to the care provision, as the registered nurse has the role of consultant rather than leader. In an explorative qualitative study we found that NAs experienced that it was difficult to focus on relationship aspects in their work, as the main discourse in the residential care focused on tasks. Palliative care was described as something that was applied only during a short define phase i.e. last days of the residents’ life. These results were used as a basis for development of an intervention focus on a palliative care approach in RCFs. The intervention consisted of study circles with NAs, and workshops together with their leaders, focusing on improvement work.AimTo investigate how an intervention focusing on a palliative care approach in RCFs influenced the NAs and their work. MethodTwo quantitative studies, based on a questionnaire, including several measurements, that was answered pre-, and post- intervention and one qualitative study based on individual interviews after the intervention. A total of 75 nurse assistants participated in the intervention and answered the questionnaire at baseline and at two follow-ups, in comparison with 110 nurse assistants who served as controls. ResultsThe evaluation of the intervention showed that the NAs, after the intervention, had increased their focus on the residents’ situation and to a greater extent stated that they focused on the residents’ life stories and on aspects that brought meaning to their lives. The NAs also stated that they experienced less criticism from their superiors as well as from the residents after the intervention. However, the evaluation also showed that the NAs had a more negative view of the leadership, were more critical to the medical and the nursing care, and that their job satisfaction had decreased after the intervention. Interviews after the intervention showed that they, as a result of the intervention, had not only gained increased insight into their own significance in their encounter with residents and their relatives, but also an increased awareness of the needs of the residents and their relatives. The intervention also contributed to an increased openness in the workgroup. However, the nurse assistants also expressed frustration over barriers, primarily in the form of a lack of resources and limited leadership, standing in the way of the implementation of changes. ConclusionThe results indicate that the NAs, through discussions and reflections over praxis in their ordinary work group, developed an increased awareness about, and focus on relationship aspects. However, in spite of the leaders’ involvement, the intervention was not sufficient for changing the organizational prerequisites for working in line with the palliative care approach. When implementing a palliative care approach in RCFs, more focus on support to the leaders in needed in order to maintain sustainable changes.
|
|
| 10. |
- Beck, Ingela
(författare)
-
An intervention applying a palliative care approach in residential care : influences on nurse assistants' work situation
- 2013
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction Palliative care is an approach characterized by a holistic view of the person, which supports the individual for living with dignity and with the best possible level of wellbeing until the end of life. Those who, in practice, provide care in Swedish residential care facilities for older people (RCFs) are nurse assistants (NAs), a work group with limited education. They also often stand alone with difficult decisions with regards to the care provision, as the registered nurse has the role of consultant rather than leader. In an explorative qualitative study we found that NAs experienced that it was difficult to focus on relationship aspects in their work, as the main discourse in the residential care focused on tasks. Palliative care was described as something that was applied only during a short define phase i.e. last days of the residents’ life. These results were used as a basis for development of an intervention focus on a palliative care approach in RCFs. The intervention consisted of study circles with NAs, and workshops together with their leaders, focusing on improvement work. Aim To investigate how an intervention focusing on a palliative care approach in RCFs influenced the NAs and their work. Method Two quantitative studies, based on a questionnaire, including several measurements, that was answered pre-, and post- intervention and one qualitative study based on individual interviews after the intervention. A total of 75 nurse assistants participated in the intervention and answered the questionnaire at baseline and at two follow-ups, in comparison with 110 nurse assistants who served as controls. Results The evaluation of the intervention showed that the NAs, after the intervention, had increased their focus on the residents’ situation and to a greater extent stated that they focused on the residents’ life stories and on aspects that brought meaning to their lives. The NAs also stated that they experienced less criticism from their superiors as well as from the residents after theintervention. However, the evaluation also showed that the NAs had a more negative view of the leadership, were more critical to the medical and the nursing care, and that their job satisfaction had decreased after the intervention. Interviews after the intervention showed that they, as a result of the intervention, had not only gained increased insight into their own significance in their encounter with residents and their relatives, but also an increased awareness of the needs of the residents and their relatives. The intervention also contributed to an increased openness in the workgroup. However, the nurse assistants also expressed frustration over barriers, primarily in the form of a lack of resources and limited leadership, standing in the way of the implementation of changes. Conclusion The results indicate that the NAs, through discussions and reflections over praxis in their ordinary work group, developed an increased awareness about, and focus on relationship aspects. However, in spite of the leaders’ involvement, the intervention was not sufficient for changing the organizational prerequisites for working in line with the palliative care approach. When implementing a palliative care approach in RCFs, more focus on support to the leaders in needed in order to maintain sustainable changes.
|
|
| 11. |
- Beck, Ingela, et al.
(författare)
-
An intervention applying a palliative care approach in residential care-effects on care provision and caring climate
- 2013
-
Konferensbidrag (refereegranskat)abstract
- Introduction: The palliative care approach aims to integrate psychosocial and existential aspects as well as relationship aspects in the care and can be used in all care contexts. In residential care, nurse assistants (NAs) are the ones who are closest to the residents, but have limited prerequisites to work in accordance with the palliative care approach. We aimed to investigate the effects of an intervention applying a palliative care approach in residential care, on NAs experience of care provision and caring climate.Method: In this quasi-experimental study we evaluated the intervention involving NAs (n=75) and their leaders (n=9), focusing on emotional, existential and relationship aspects within the palliative care approach, in comparison with controls (n=110). Data consisted of a questionnaire that the NAs answered at three time points.Results: In the intervention group, effects were seen concerning the NAs reports of the care provision in that they focused more on to ease for residents to narrate about their lives, and on communication with residents in what gives them meaning in life. In the intervention group effects were also seen in that the NAs rated the residents medical and nursing care needs being less met at the facility after the intervention. No effects were seen concerning the caring climate or the possibilities to provide a more person-centered care.Conclusion: The intervention seemingly facilitated for the NAs to focus on relationship aspects with the residents. But the intervention was not sufficient to change the organizational prerequisites for the staff to provide a more person-centered care.
|
|
| 12. |
- Beck, Ingela, et al.
(författare)
-
An intervention applying a palliative care approach in residential care-effects on care provision and caring climate
- 2013
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The palliative care approach aims to integrate psychosocial and existential aspects as well as relationship aspects in the care and can be used in all care contexts. In residential care, nurse assistants (NAs) are the ones who are closest to the residents, but have limited prerequisites to work in accordance with the palliative care approach. We aimed to investigate the effects of an intervention applying a palliative care approach in residential care, on NAs experience of care provision and caring climate. Method: In this quasi-experimental study we evaluated the intervention involving NAs (n=75) and their leaders (n=9), focusing on emotional, existential and relationship aspects within the palliative care approach, in comparison with controls (n=110). Data consisted of a questionnaire that the NAs answered at three time points. Results: In the intervention group, effects were seen concerning the NAs reports of the care provision in that they focused more on to ease for residents to narrate about their lives, and on communication with residents in what gives them meaning in life. In the intervention group effects were also seen in that the NAs rated the residents medical and nursing care needs being less met at the facility after the intervention. No effects were seen concerning the caring climate or the possibilities to provide a more person-centered care. Conclusion: The intervention seemingly facilitated for the NAs to focus on relationship aspects with the residents. But the intervention was not sufficient to change the organizational prerequisites for the staff to provide a more person-centered care.
|
|
| 13. |
|
|
| 14. |
- Beck, Ingela, 1965-, et al.
(författare)
-
Applying a palliative care approach in residential care : effects on nurse assistants' work situation
- 2015
-
Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 13:3, s. 543-553
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership.Method: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110).Results: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased.Significance of results: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.
|
|
| 15. |
- Beck, Ingela, 1965-, et al.
(författare)
-
Applying a palliative care approach in residential care : effects on nurse assistants' experiences of care provision and caring climate
- 2014
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 28:4, s. 830-841
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundA palliative care approach aims to integrate psychosocial and existential as well as relationship aspects in the care and is an approach that can be used in residential care. Nurse assistants are the ones who are closest to the residents but have limited prerequisites for working in accordance with the palliative care approach. We aimed to investigate the effects on nurse assistants' experiences of care provision and the caring climate of an intervention applying a palliative care approach in residential care.MethodsAn intervention involving nurse assistants (n = 75) and their leaders (n = 9), in comparison with controls (n = 110), was evaluated using a questionnaire at three points in time.ResultsIn the intervention group, positive effects were seen concerning the nurse assistants' reports of the care provision in that they focused more on the residents' stories about their lives and on communicating with the residents about what gave meaning to their lives. Also, negative effects were seen when the nurse assistants rated that the residents' needs for medical and nursing care had not been met at the facility directly after the intervention. No effects were seen concerning the caring climate or the prerequisites of providing more person-centred care.ConclusionThe intervention seemed to have encouraged the nurse assistants to focus on relationship aspects with the residents. So as not to jeopardise the NAs' well-being and to support NAs in keeping themselves involved in existential issues, their support most certainly needs to be continuous and ongoing. However, in spite of the leaders' involvement, the intervention was not sufficient for changing the organisational prerequisites for more person-centred care.
|
|
| 16. |
- Beck, Ingela, et al.
(författare)
-
Applying a palliative care approach in residential care : effects on nurse assistants' experiences of care provision and caring climate
- 2014
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell Publishing Ltd. - 0283-9318 .- 1471-6712. ; 28:4, s. 830-841
-
Tidskriftsartikel (refereegranskat)abstract
- Background A palliative care approach aims to integrate psychosocial and existential as well as relationship aspects in the care and is an approach that can be used in residential care. Nurse assistants are the ones who are closest to the residents but have limited prerequisites for working in accordance with the palliative care approach. We aimed to investigate the effects on nurse assistants' experiences of care provision and the caring climate of an intervention applying a palliative care approach in residential care. Methods An intervention involving nurse assistants (n = 75) and their leaders (n = 9), in comparison with controls (n = 110), was evaluated using a questionnaire at three points in time. Results In the intervention group, positive effects were seen concerning the nurse assistants' reports of the care provision in that they focused more on the residents' stories about their lives and on communicating with the residents about what gave meaning to their lives. Also, negative effects were seen when the nurse assistants rated that the residents' needs for medical and nursing care had not been met at the facility directly after the intervention. No effects were seen concerning the caring climate or the prerequisites of providing more person-centred care. Conclusion The intervention seemed to have encouraged the nurse assistants to focus on relationship aspects with the residents. So as not to jeopardise the NAs' well-being and to support NAs in keeping themselves involved in existential issues, their support most certainly needs to be continuous and ongoing. However, in spite of the leaders' involvement, the intervention was not sufficient for changing the organisational prerequisites for more person-centred care.
|
|
| 17. |
- Beck, Ingela, et al.
(författare)
-
Applying a palliative care approach in residential care: Effects on nurse assistants' work situation.
- 2015
-
Ingår i: Palliative & Supportive Care. - 1478-9515. ; 13:3, s. 543-553
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership. Method: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110). Results: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased. Significance of results: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.
|
|
| 18. |
- Beck, Ingela, 1965-
(författare)
-
Att fokusera på "varandet" i en värld av görande : stöd till personalen i ett palliativt förhållningssätt vid vård- och omsorgsboende för äldre
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to study nurse assistants’ experience of palliative care and to investigate how an intervention with a focus on a palliative care approach in residential care facilities influenced the nurse assistants and their work situation. The thesis is based on two qualitative and two quantitative studies, focusing on nurse assistants working at residential care facilities for older people. The qualitative studies were based on focus-group interviews before the intervention (I) and individual interviews after the intervention (IV). The quantitative studies (II, III) were based on a questionnaire, including several measurements, that was answered pre-, and post- intervention. The intervention consisted of study circles with nurse assistants, and workshops together with their leaders, focusing on improvement work. A total of 75 nurse assistants participated in the intervention and answered the questionnaire at baseline and at two follow-ups, in comparison with 110 nurse assistants who served as controls. The results show that the nurse assistants experienced that it was difficult to focus on “being”, i.e. on relationship aspects in their work, since the main discourse in residential care focused on “doing”, i.e. on task oriented aspects. Palliative care was described as something that was only applied during a short and defined phase, namely the very last days of the residents’ life. The results also show that nurse assistants experienced difficulties facing emotional and existential issues with regards to both the residents and their relatives (I). The results of study I were, in turn, used as a basis for the development of the intervention. The evaluation of the intervention showed that the nurse assistants, after the intervention, had increased their focus on the residents’ situation and to a greater extent stated that they focused on the residents’ life stories and on aspects that brought meaning to their lives (III). The nurse assistants also stated that they experienced less criticism from their superiors as well as from the residents after the intervention (II). However, the evaluation also showed that the nurse assistants had a more negative view of the leadership (II), were more critical to the medical and the nursing care (III), and that their job satisfaction had decreased (II) after the intervention. Interviews after the intervention showed that they, as a result of the intervention, had not only gained increased insight into their own significance in their encounter with residents and their relatives, but also an increased awareness of the needs of the residents and their relatives. The intervention also contributed to an increased openness in the workgroup. However, the nurse assistants also expressed frustration over barriers, primarily in the form of a lack of resources and limited leadership (IV), standing in the way of the implementation of changes. The results indicate that the nurse assistants, through discussions and reflections over praxis in their ordinary work group, developed an increased awareness about, and focus on “being”, i.e. on relationship aspects. However, it would seem that essential prerequisites, such as support from the leaders and sufficient resources for working in line with a palliative care approach, were not provided. When implementing a palliative care approach in residential care facilities, more focus on support to the leaders is needed in order to maintain sustainable changes.
|
|
| 19. |
- Beck, Ingela
(författare)
-
Att fokusera på "varandet" i en värld av görande. Stöd till personalen i ett palliativt förhållningssätt vid vård- och omsorgsboende för äldre
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to study nurse assistants’ experience of palliative care and to investigate how an intervention with a focus on a palliative care approach in residential care facilities influenced the nurse assistants and their work situation. The thesis is based on two qualitative and two quantitative studies, focusing on nurse assistants working at residential care facilities for older people. The qualitative studies were based on focus-group interviews before the intervention (I) and individual interviews after the intervention (IV). The quantitative studies (II, III) were based on a questionnaire, including several measurements, that was answered pre-, and post- intervention. The intervention consisted of study circles with nurse assistants, and workshops together with their leaders, focusing on improvement work. A total of 75 nurse assistants participated in the intervention and answered the questionnaire at baseline and at two follow-ups, in comparison with 110 nurse assistants who served as controls. The results show that the nurse assistants experienced that it was difficult to focus on “being”, i.e. on relationship aspects in their work, since the main discourse in residential care focused on “doing”, i.e. on task oriented aspects. Palliative care was described as something that was only applied during a short and defined phase, namely the very last days of the residents’ life. The results also show that nurse assistants experienced difficulties facing emotional and existential issues with regards to both the residents and their relatives (I). The results of study I were, in turn, used as a basis for the development of the intervention. The evaluation of the intervention showed that the nurse assistants, after the intervention, had increased their focus on the residents’ situation and to a greater extent stated that they focused on the residents’ life stories and on aspects that brought meaning to their lives (III). The nurse assistants also stated that they experienced less criticism from their superiors as well as from the residents after the intervention (II). However, the evaluation also showed that the nurse assistants had a more negative view of the leadership (II), were more critical to the medical and the nursing care (III), and that their job satisfaction had decreased (II) after the intervention. Interviews after the intervention showed that they, as a result of the intervention, had not only gained increased insight into their own significance in their encounter with residents and their relatives, but also an increased awareness of the needs of the residents and their relatives. The intervention also contributed to an increased openness in the workgroup. However, the nurse assistants also expressed frustration over barriers, primarily in the form of a lack of resources and limited leadership (IV), standing in the way of the implementation of changes. The results indicate that the nurse assistants, through discussions and reflections over praxis in their ordinary work group, developed an increased awareness about, and focus on “being”, i.e. on relationship aspects. However, it would seem that essential prerequisites, such as support from the leaders and sufficient resources for working in line with a palliative care approach, were not provided. When implementing a palliative care approach in residential care facilities, more focus on support to the leaders is needed in order to maintain sustainable changes.
|
|
| 20. |
|
|
| 21. |
|
|
| 22. |
|
|
| 23. |
|
|
| 24. |
|
|
| 25. |
|
|
| 26. |
- Beck, Ingela, et al.
(författare)
-
Encountering older people : a person-centered communication training model
- 2024
-
Konferensbidrag (refereegranskat)abstract
- Encountering older people - a person-centered communication training model Introduction: Being recognised as a person is a universal human need and central to the transition to a person-centred elderly care. A prerequisite for acknowledging the person, is to pay attention to the persons emotional and existential concerns. One way to encounter such concerns is through person-centred communication. However, such communication has been described as challenging for nurses caring for older people. To prepare nursing students with this skill, a training model in communication has been introduced into the nursing programmes at Kristianstad University. The model is flexible with the learning activities: attend a filmed lecture; carry out a recorded conversation training in pairs; review and reflect on the recorded conversation; attend filmed general feedback on the conversations and own reflections; reflect on the feedback. The aim of this study was to explore nursing students' experiences of participating in the training. Method: Written reflection tasks (n=301) and semi-structured interviews with students (n=19) were conducted and content analysed. Result: The overall experience was that the skill training was important, challenging, rewarding, and learning. Listening to own recorded conversation made it possible to reflect on own strengths and shortcomings in communicating about emotional and existential concerns. Feedback on the recorded conversations and reflections was instructive. Conclusion: The skill training model is considered as meaningful and important for future work as a nurse in person-centred elderly care. Learning outcomes: Conference participants will gain insight into how to use a model that, despite a large number of students, provides possibility to repeatedly train conversations about emotional and existential issues in person-centred elderly care.
|
|
| 27. |
- Beck, Ingela, et al.
(författare)
-
Erfarenheter av specialistsjuksköterskeutbildningen med inriktning vård av äldre och av arbetslivet efter utbildningen : En enkätstudie
- 2024
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Syftet var att undersöka specialistsjuksköterskor vård av äldres erfa-renheter av specialistutbildningen och av arbetet som specialistsjuk-sköterska efter avslutad utbildning. Syftet var även att beskriva erfa-renheter utifrån funktion (chef/utveckling/patientnära arbete) och upplevelse av arbetsmiljö hos de som tog specialistexamen mindre eller mer än 5 år efter sjuksköterskeexamen. Studien är en tvärsnittsstudie där data samlades in med en enkät som skickades ut till specialistsjuksköterskor som tagit examen mellan åren 2016–2020. Enkäten genomfördes som en alumnundersökning inom samverkansarbetet i Nano-syd och nationella nätverket för Spe-cialistsjuksköterskeprogam inom vård av äldre. Totalt valde 7 av 12 lärosäten att genomföra alumnundersökningen. Enkäten skickades ut under augusti till november år 2023 till 188 specialistsjuksköterskor. Totalt besvarade 61 specialistsjuksköterskor enkäten, en svarsfre-kvens på 32%. Specialistsjuksköterskorna är överlag mycket nöjda med sin specia-listutbildning dåden har förberett dem inför deras arbete och ligger i linje med det som arbetsgivare efterfrågar. Möjligheterna till bra arbe-ten som specialistsjuksköterska, arbetsledande funktion eller annat kvalificerat arbete är stora. Det finns dock specialistsjuksköterskor som upplever att arbetsgivare och verksamheter inte tar tillvara speci-alistkompetensen efter genomförd utbildning. Specialistsjuksköters-kor uppger att det finns bristande kunskap hos verksamhetsföreträ-dare om specialistinriktningen. En bidragande faktor som identifierats till att specialistutbildningen inom vård av äldre och de två andra in-riktningarna inte är kända är att klassificeringssystemet SSYK osyn-liggör specialistsjuksköterskan i arbetsförmedlingens och statistik-myndighetens databaser. Specialistsjuksköterskorna påtalar de behov av utveckling som behövs inom hälso- och sjukvården för att äldre personer i behov av vård och omsorg ska erhålla en god och säker vård, och rapporterar att de genom sin specialistutbildning har kompetens att förbättra vården om vårdgivarna tar vara på deras kompetens.
|
|
| 28. |
|
|
| 29. |
|
|
| 30. |
- Beck, Ingela, et al.
(författare)
-
Having to focus on doing rather than being : nurse assistants' experience of palliative care in municipal residential care settings
- 2012
-
Ingår i: International Journal of Nursing Studies. - 0020-7489 .- 1873-491X. ; 49:4, s. 455-464
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Palliative care should be provided, irrespective of setting to all patients facing a life-threatening illness and to their families. The situation and needs of older people differ from those of younger people since they often have several co-existing diseases and health complaints. This implies an extensive need for care and for longer periods of palliative care. The main providers of palliative care for older people are nurse assistants, who are also those with the shortest education. AIM: The aim of this study was to illuminate nurse assistants' experience of palliative care for older people in residential care. DESIGN: The study had an explorative, descriptive design. SETTINGS: Thirteen residential care units in three different districts in a large city in southern Sweden. PARTICIPANTS: Twenty-five nurse assistants selected to represent variations in age, gender workplace and work experience. METHODS: Data were collected from six focus-group interviews and subjected to content analysis to gain an understanding of the phenomenon. RESULTS: The nurse assistants described palliative care as a contrast to the everyday care they performed in that they had a legitimate possibility to provide the care needed and a clear assignment in relation to relatives. Palliative care also meant having to face death and dying while feeling simultaneous that it was unnatural to talk about death and having to deal with their own emotions. They emphasised that they were in need of support and experienced leadership as invisible and opaque, but gained strength from being recognized. CONCLUSION: In order to support nurse assistants in providing high quality end-of-life care, more focus is needed on the trajectory of older peoples' dying, on the importance of involving relatives throughout the period of care provision, and on support when encountering death and dying. There is also a need for engaged care leaders, both registered nurses and managers, to recognize the work of nurse assistants and to support care provision for older people within the framework of palliative care philosophy.
|
|
| 31. |
- Beck, Ingela, et al.
(författare)
-
Having to focus on doing rather than being : nurse assistants' experience of palliative care in municipal residential care settings
- 2012
-
Ingår i: International Journal of Nursing Studies. - : Elsevier Ltd.. - 0020-7489 .- 1873-491X. ; 49:4, s. 455-464
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Palliative care should be provided, irrespective of setting to all patients facing a life-threatening illness and to their families. The situation and needs of older people differ from those of younger people since they often have several co-existing diseases and health complaints. This implies an extensive need for care and for longer periods of palliative care. The main providers of palliative care for older people are nurse assistants, who are also those with the shortest education. AIM: The aim of this study was to illuminate nurse assistants' experience of palliative care for older people in residential care. DESIGN: The study had an explorative, descriptive design. SETTINGS: Thirteen residential care units in three different districts in a large city in southern Sweden. PARTICIPANTS: Twenty-five nurse assistants selected to represent variations in age, gender workplace and work experience. METHODS: Data were collected from six focus-group interviews and subjected to content analysis to gain an understanding of the phenomenon. RESULTS: The nurse assistants described palliative care as a contrast to the everyday care they performed in that they had a legitimate possibility to provide the care needed and a clear assignment in relation to relatives. Palliative care also meant having to face death and dying while feeling simultaneous that it was unnatural to talk about death and having to deal with their own emotions. They emphasised that they were in need of support and experienced leadership as invisible and opaque, but gained strength from being recognized. CONCLUSION: In order to support nurse assistants in providing high quality end-of-life care, more focus is needed on the trajectory of older peoples' dying, on the importance of involving relatives throughout the period of care provision, and on support when encountering death and dying. There is also a need for engaged care leaders, both registered nurses and managers, to recognize the work of nurse assistants and to support care provision forolder people within the framework of palliative care philosophy.
|
|
| 32. |
|
|
| 33. |
|
|
| 34. |
|
|
| 35. |
|
|
| 36. |
|
|
| 37. |
|
|
| 38. |
|
|
| 39. |
|
|
| 40. |
- Beck, Ingela, et al.
(författare)
-
Nurse assistants’ experience of an intervention focused on a palliative care approach for older people in residential care
- 2014
-
Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 9:2, s. 140-150
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Nurse assistants working in residential care facilities need support to ensure that they provide high-quality care for the residents and support for relatives, from admission to bereavement.Aim. The aim was to describe the nurse assistants’ experience of how an intervention with a palliative care approach, had influenced them in their work in residential care for older people.Participants. Fourteen nurse assistants working in three different municipal residential care facilities.Methods. Data were collected by means of semi-structured individual interviews following an intervention consisting of study circles combined with workshops. The data were analysed using content analysis.Result. The nurse assistants felt that, through the intervention, they had gained insight into their understanding of the importance of quality of care. This included an increased awareness of, and respect for, residents’ and relatives’ needs, and an increased understanding of the importance of the outcome of encounters with residents and their relatives. After the intervention, they also felt there was increased openness and understanding between colleagues. However, the nurse assistants also expressed frustration over obstacles to implementing a palliative care approach, such as lack of resources and supportive leadership.Conclusion. The nurse assistants felt that the intervention was positive and encouraged them to provide more person-centred care within the framework of a palliative care approach. Although the intervention was intended to involve and support the management, it was not sufficient. Nurse assistants described lack of resources and supportive leadership. There is, therefore, a need to place greater emphasis on leadership and their support of nurse assistants so that they can provide high-quality care.
|
|
| 41. |
|
|
| 42. |
|
|
| 43. |
|
|
| 44. |
|
|
| 45. |
- Beck, Ingela, et al.
(författare)
-
Nurses' experiences of using the Integrated Palliative care Outcome Scale with patients in specialized palliative care : A qualitative focus group study
- 2023
-
Ingår i: Nursing Open. - : Wiley-Blackwell Publishing Ltd. - 2054-1058. ; 10:12, s. 7639-7649
-
Tidskriftsartikel (refereegranskat)abstract
- AIM : To explore nurses' experiences of using the Integrated Palliative care Outcome Scale (IPOS) as a communication tool in specialized palliative care. DESIGN : This study employed a qualitative inductive approach. The Standards for Reporting Qualitative Research were followed for reporting. METHODS : Five focus groups were conducted with nurses from four specialized palliative care units, and the discussions were analysed with quality content analysis. RESULTS : Using IPOS for communication with the patient gave an opportunity to understand the patient's care needs and to let these care needs guide care interventions. Prerequisites in terms of relation, atmosphere, skills and flexibility were needed to establish an interactive communication. It was challenging to communicate about issues that evoked emotional reactions in the patient. There was a balancing act between the use of a structured scale and overcoming communication challenges. Nonetheless, when the two complemented each other, IPOS was a useful tool for nurses to promote person-centred care.
|
|
| 46. |
- Beck, Ingela
(creator_code:cre_t)
-
Nyfiken på Omvårdnad - 01 - : Ungdomar och stress
- 2023
-
Konstnärligt arbete (populärvet., debatt m.m.)abstract
- Högskolan Kristianstads omvårdnadspodd med Ingela Beck, Eva-Lena Einberg, Pernilla Garmy och gäster. Avsnitt 1 av HKR:s omvårdnadspodd "Nyfiken på omvårdnad". Intervju med skolsköterskan Camilla Perming om hennes studie om stress hos ungdomar.
|
|
| 47. |
|
|
| 48. |
|
|
| 49. |
- Beck, Ingela
(creator_code:cre_t)
-
Nyfiken på omvårdnad - 04 - : Förbättrad smärtskattning för äldre - effekten av NVP
- 2024
-
Konstnärligt arbete (populärvet., debatt m.m.)abstract
- Högskolan Kristianstads omvårdnadspodd med Ingela Beck, Eva-Lena Einberg, Pernilla Garmy och gäster. Intervju med specialistsjuksköterskorna vård av äldre Camilla Fält och Analya Gomes om deras studie som de genomfört inom utbildningen. Förbättrad smärtskattning för äldre personer i allmän palliativ vård vid användning av Nationell vårdplan för palliativ vård.
|
|
| 50. |
- Beck, Ingela
(creator_code:cre_t)
-
Nyfiken på omvårdnad - 05 - : Knocking On Natures Door
- 2024
-
Konstnärligt arbete (populärvet., debatt m.m.)abstract
- Högskolan Kristianstads omvårdnadspodd med Ingela Beck, Eva-Lena Einberg, Pernilla Garmy och gäster. Intervju med distriktssköterskorna Niklas Kämpargård och Michael Nilsson om deras magisteruppsats Knockin on nature´s door: en litteraturöversikt över betydelsen av naturupplevelser vid psykisk ohälsa. Avsnittet leds av Marie (Mia) Nilsson som är forskare vid Högskolan Kristianstad och undervisar på fakulteten för hälsovetenskap vid Högskolan Kristianstad.
|
|
