| 1. |
- Fläckman, Birgitta, et al.
(författare)
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Consequences of working in elder care during changes and cutbacks in the organisation while education and clinical supervision was provided : A mixed methods study
- 2015
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 5:9, s. 813-827
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reorganization and downsizing can disrupt a competent staff and conflicts can arise between what the employee is being asked to do and their knowledge and competences. Reduced job satisfaction among nursing home staff with increased workload and strain can occur. Aim and Objectives: The aim was to investigate the organizational climate and prevalence of burnout symptoms among caregivers over time in three Swedish nursing homes (NH I-III) undergoing organizational changes, while education and clinical supervision were provided. Design: The study design combines qualitative and quantitative methods in a longitudinal two-year follow-up project in NH I-III. Methods: Support through education and clinical supervision was provided for caregivers only at NH I and NH II. At NH I-III caregiver self-assessments and interviews were completed and analysed three different times. Results: NH I revealed improvement and increased innovation over time, while NH II showed a decline with no ability to implement new knowledge. NH III retained a more status quo. Conclusions: Organizational changes and cutbacks, occurring at different times, appeared to cause major stress and frustration among the three personnel groups. They felt guilty about not meeting their perceived obligations, seemed to have lost pride in their work but kept struggling. The changes seemed to over-shadow attempts to improve working conditions through education and clinical supervision initially. Implications for practice: It will be important to learn from reorganizations and the consequences they will have for the staff and quality of care. Important topics for future research are to study financial cutbacks and changes in organizational processes in care of older people to be able to develop a more person centered care for older people.
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| 2. |
- Fläckman, Birgitta, et al.
(författare)
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Despite shattered expectations a willingness to care for elders remains with education and clinical supervision
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 21:3, s. 379-389
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to describe nursing home (NH) caregivers' work experiences while receiving education and clinical supervision for 2 years. Working in elder care seems to be losing its attraction especially with organizational changes, cutbacks and changes in work place conditions. Clinical supervision has been reported to increase job satisfaction and creativity. Semi-structured interviews from caregivers working at an NH in Sweden were conducted, at the start and again at 12 and 24 months. At about 12 months the caregivers were informed of planned cutbacks. Content analysis was the method used to analyse the interviews from seven caregivers who participated throughout the entire period. Findings show that the value of a caring milieu was one category generated by the subcategories: experiences related to work activities and changes, and experiences related to relationships. The value of knowledge was the other category that was influenced by the experiences related to the different backgrounds and the experiences related to increased knowledge gained from the support through education and clinical supervision. The categories contained positive as well as negative influences on care. The initial focus on practical duties associated with the opening of the NH shifted towards caregiver activities with the elders they spoke warmly about. After 2 years the caregivers' willingness to care continued despite their disappointment in the worsened working conditions. The main theme that resulted was: Despite shattered expectations a willingness to care for elders remained. Continued education and clinical supervision seems to be one factor behind the retained willingness. These findings demonstrate that support and caregiver involvement in educational programmes are important during times of change and when disappointments arise in the workplace.
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| 3. |
- Forslund, Kerstin, et al.
(författare)
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Operators' experiences of emergency calls
- 2004
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Ingår i: Journal of Telemedicine and Telecare. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 10:5, s. 290-297
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, the operators at emergency dispatch centres are responsible for allocating resources (e.g. ambulances, fire brigade, police) in response to calls. We analysed situations that the emergency operators experienced as difficult and their reflections on how they managed them. Interviews were conducted with all 16 emergency operators at a centre that serves a population of 275,000 and receives about 700,000 emergency calls annually. A phenomenological-hermeneutic approach was used for the analysis. Situations that operators experienced as difficult were characterized by uncertainty, communication difficulties and insufficient resources. Skills, knowledge and experience were regarded as important in the management of these situations, as were personal qualities such as sensitivity, insight, empathy and intuition. The emergency operators stated that they needed more guidance, feedback and education in their work. This would lead to an increased sense of certainty, which would lead to decreased stress and a better outcome for those in need.
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| 4. |
- Häggström, Elisabeth, et al.
(författare)
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Relatives' struggle for an improved and more just care for older people in community care
- 2007
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:9, s. 1749-1757
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. The aim of the present study was to describe the relatives' experience concerning older family members living in special housing facilities. Background. During the 21st century, the relatives of older people and their efforts related to the care and nursing of older people have been observed. The interest in these relatives is because of factors such as demographic changes, where the number of older people has increased and the increasing gap between the resources that are available for geriatric care and the care needed for older people. Design. The present study has a descriptive design and is part of a project including 24 specific residences, called special housing facilities. Method. The study focused on the narratives supplied by the relatives that were analysed using qualitative latent content analysis, an interpretative process where the researcher considers the content of the text. Results. The relatives' experience of having an older person in a special housing facility that emerged from the study, was expressed in one main theme: The relatives' struggle for an improved and just care for older people and four sub-themes: (i)'To trust in caregivers'; (ii) 'To be confirmed'; (iii) 'To trust in care'; (iv) 'To receive the kind of care that one considers one has the right to receive'. Conclusions. The study shows that the relatives need more support and more opportunities, so that they can participate in the care. The study shows the relatives engagement in working for a just society's obligation towards the protection of older peoples rights and the staff's working conditions. Relevance to clinical practice. It is important that caregivers and management working with older people realize that they, together with them and their relatives, are a part of society and that all individuals are influenced by the discourse of that society.
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| 5. |
- Häggström, Elisabeth, et al.
(författare)
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To feel betrayed and to feel that you are betraying the older residents : caregivers' experiences at a newly opened nursing home
- 2004
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 13:6, s. 687-696
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In Sweden and internationally, little research has focused on the working situation of Enrolled Nurses and Nurses' Aides who form the majority of workers in geriatric care today. With this in mind, it is important to focus on how these occupational groups experience their working situation with older residents in municipal care.AIMS AND OBJECTIVES: The aim of the study was to investigate the deeper meaning of work satisfaction and work dissatisfaction at a newly opened nursing home for older residents. The study focused on the narratives supplied by the caregivers at the nursing home. The participants included: one Registered Nurse, sixteen Enrolled Nurses, and three Nurses' Aides. All were directly involved in patient care.DESIGN: The present study is part of a larger longitudinal study within the municipal geriatric care system in Sweden, with a quasi-experimental design.METHOD: The interviews were analysed with a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur.RESULT: The caregivers experiences of work satisfaction and work dissatisfaction was expressed in four themes: (i) 'Experience of betrayal' describes how the staff felt let down in several ways; (ii) 'Experience of failing others' describes how the staff felt that they did not pay enough attention to older people, in several different ways; (iii) 'Experience of insufficiency' describes how the staff encountered overwhelming demands from several directions; (iv) 'Experience of work satisfaction' describes how the staff felt that they were given support in various ways. Each theme emerged from several subthemes that originated from the caregivers' narratives.CONCLUSIONS: The study shows that the caregivers' experience of work dissatisfaction overshadows their experience of work satisfaction. It also suggests that their feelings of failing the older residents are connected to their own experiences of feeling betrayed.RELEVANCE TO CLINICAL PRACTICE: The findings can be used when other nursing homes in municipal care are opened, as a means of preventing work dissatisfaction and increasing work satisfaction among future employees.
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| 6. |
- Häggström, Elisabeth, et al.
(författare)
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Work satisfaction and dissatisfaction : caregivers' experiences after a two-year intervention in a newly opened nursing home
- 2005
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 14:1, s. 9-19
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: The aim of the study was to investigate, from the narratives of nine enrolled nurses and one nurses' aide directly involved in patient care, the deeper meaning of work satisfaction and dissatisfaction when working with the older people.BACKGROUND: Both nationally and internationally, there is little research documented regarding the working situation of the enrolled nurses and nurses' aides who make up the majority of care for older people today. With this in mind, it is important to focus on how these occupational groups experience their work with the older residents in municipal care, following a two-year intervention.DESIGN: The study is part of a larger longitudinal study, with a quasi-experimental design within the municipal system of care for older people in Sweden. The investigation was carried out following a two-year intervention, which included: education, support and clinical supervision.METHOD: The interviews were performed 12 and 24 months after start of the intervention and were analysed with a phenomenological-hermeneutic method inspired by Ricoeur's philosophy.RESULTS: The findings from these narratives illustrated a change compared with the findings from the first interviews, when the nursing home had just opened. There was a shift from a dominance of dissatisfaction with work, to a dominance of work satisfaction and this was expressed in the following themes: experience of a changed perspective, experience of open doors, and experience of closed doors. Each theme emerged from several different subthemes and each subtheme that had been expressed in the caregivers' narratives was interpreted.CONCLUSIONS: The study shows that the caregivers' experience of work satisfaction in the workplace exceeded their experience of dissatisfaction and that the intervention, consisting of: education, support, and supervision might have facilitated this positive development where the older residents were prioritized. It also shows that communication and understanding between management and staff had increased as the nursing home had opened.RELEVANCE TO CLINICAL PRACTICE: The findings can be used to help to prevent work dissatisfaction, and thereby increase work satisfaction for caregivers working in nursing homes.
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| 7. |
- Kihlgren, Annica Larsson, 1957-, et al.
(författare)
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Referrals from home care to emergency hospital care : basis for decisions.
- 2003
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 12:1, s. 28-36
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Tidskriftsartikel (refereegranskat)abstract
- The Swedish government implemented a reform, the Adel reform, in the care of older citizens in 1992, so that the communities where older people live became responsible for their care and housing. Nurses were appointed to make sure that older people were given accurate care and to act as supervisors for nurses' aides. In this study, 10 Registered Nurses from community home care services and four consultant head physicians in primary care were interviewed in order to illuminate what they thought influenced nurses' decisions to refer patients for emergency treatment and what support they requested to facilitate the decision. Content analysis showed the necessity of feeling secure in one's role as a community nurse. The categories that developed were: own competence, knowledge about the patient and a supportive working environment. The main theme was To feel safe in one's role - a basis for decision-making. High demands were put on the nurses' competence and their burden of responsibility became too great. This influenced decision-making negatively, if nurses felt that they were lacking in their own personal competence. Training in documentation for the nurses was required, as well as the need for organizations to provide staff with sufficient time for accurate documentation. A greater input of nursing and medical care was required to make it possible for patients to be cared for at home if they so wished. Respondents described considerable deficiencies in their working environment and in co-workers' competence, and nurses' professional roles within the community were not made clear. If these problems were remedied, this would improve working conditions, increase understanding, and reduce feelings of uncertainty among decision-makers.
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| 8. |
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| 9. |
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| 10. |
- Mamhidir, Anna-Greta, et al.
(författare)
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Underweight, weight loss and related risk factors among older adults in sheltered housing--a Swedish follow-up study.
- 2006
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Ingår i: J Nutr Health Aging. - 1279-7707 .- 1760-4788. ; 10:4, s. 255-62
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Tidskriftsartikel (refereegranskat)abstract
- Medial displacement of the navicular has been considered a major explanation for residual forefoot adduction (FFA) in congenital clubfoot and also a frequent reason for dissatisfaction after limited surgery. In this study, it was hypothesized that there would be an association between the degree of medial displacement of the navicular and residual FFA in clubfeet. The position of the navicular was retrospectively measured by ultrasonography in 49 clubfeet in 35 children at ages 3 to 6 years and correlated to residual FFA measured on footprints and radiographs (talo-first metatarsal angle). In the 49 clubfeet, the navicular was significantly more medially displaced toward the medial malleolus than in the 21 contralateral normal feet (P < 0.001). However, there was no correlation between the degree of medial displacement of the navicular and the degree of FFA measured on footprints (P = 0.690) or on radiographs (P = 0.390). Thus, there were clubfeet with straight forefoot and a medially displaced navicular, that is, "spurious correction," and clubfeet with FFA and the navicular in correct position in relation to the head of the talus. Both patient satisfaction and foot score declined with larger FFA. The results support the view that ultrasonography is a helpful tool for assessing the position of the navicular. The critical issue for analysis is whether the FFA is due to malalignment in the talonavicular joint or more distally.
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| 11. |
- Skovdahl, Kirsti, 1964-, et al.
(författare)
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Dementia and aggressiveness : video recorded morning care from different care units
- 2003
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 12:6, s. 888-898
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to illuminate, from video recorded sequences, interactions between individuals with dementia and aggressive behaviour and caregivers who reported problems dealing with such behaviour and caregivers who did not. Nine caregivers and two residents participated.The video recordings were later transcribed into text and analysed by using a phenomenological hermeneutic approach, inspired by Ricoeur's philosophy.The main themes that emerged from the analysis were 'Being involved and developing a positive interaction' and 'Being confined to routines and remaining in negative interaction'.The findings indicated the interactions either to be in a positive or negative spiral. Caregivers who had reported problems dealing with behavioural and psychiatric symptoms in dementia focused on accomplishing the task, where the main focus was on 'the goal itself'. In other sequences with caregivers who had been satisfied with their capability the focus was placed on 'how' the caregivers could reach their goal.Power was central in the material, in different ways, either as a possible way to handle the situation or as a possible way of defending oneself. Parts of Kitwood's framework and Fromm's theory about power 'over' and power 'to', has been used in the comprehensive understanding. Our conclusion is that caregivers should use power 'to' when they have to help persons with dementia and aggressive behaviour, as a part of behavioural and psychiatric symptoms of dementia, for being able to give help in the best possible way. They should also act in a sensitive and reflective manner, with the individual in focus.
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| 12. |
- Skovdahl, Kirsti, 1964-, et al.
(författare)
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Dementia and aggressiveness : stimulated recall interviews with caregivers after video-recorded interactions
- 2004
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Ingår i: Journal of Clinical Nursing. - Oxon, United Kingdom : Wiley. - 0962-1067 .- 1365-2702. ; 13:4, s. 515-525
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In a previous study, nine caregivers and two residents with dementia showing aggressive behaviour, were video recorded. Caregivers who reported problems when dealing with such behaviour and caregivers, who did not, were included in this study.AIM: The aim of the present study was to obtain insight into the reasoning of the caregivers who had reported problems when dealing with older people with dementia and aggressiveness and those who did not relative to their respective video-recorded interactions with these residents. A further aim was to gain insight by discussing their reasoning in relation to each other.METHOD: Stimulated recall interviews were carried out with all the caregivers who had been video taped in the previous study. The text was analysed by thematic content analysis.FINDINGS: Two main ways of thinking and discussing the care situations emerged. The caregivers, who had reported problems in handling behavioural and psychiatric symptoms in dementia earlier, reasoned that they were more focused on their duties, this included being responsible for the resident receiving her weekly shower. For this group of caregivers, the well being of the resident was in focus, but their attention was concentrated on the resident's well being and comfort after their shower. However, these caregivers seemed therefore unwittingly to prevent a positive interaction with the resident. The other caregivers were able to reflect spontaneously and appeared to be self-critical. This caregiver group seemed to sustain a positive interaction with the resident both during and after the shower.RELEVANCE TO CLINICAL PRACTICE: In this study a nurturing and supportive climate and competence seemed to be the conditions necessary to facilitate reflections and promote creativity in the caregivers such that they are able to develop possible ways of handling difficult situations like aggressiveness in residents with dementia.
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| 13. |
- Skovdahl, Kirsti, 1964-, et al.
(författare)
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Different attitudes when handling aggressive behaviour in dementia : narratives from two caregiver groups.
- 2003
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Ingår i: Aging & Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 7:4, s. 277-286
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Tidskriftsartikel (refereegranskat)abstract
- This study highlights the experiences of 15 formal caregivers, during interactions with elderly residents suffering from dementia disease and showing aggressive behaviour. The purpose was to study caregivers' reflections about and attitudes to behavioural and psychiatric symptoms of dementia (BPSD) and how they dealt with the symptoms. This was done by comparing care units with high or low levels of aggressive behaviour in residents. A phenomenological-hermeneutic approach was used for the analysis of the interviews. The main themes that emerged were: a need for balance between demands and competence; and a need for support. The findings indicated the importance of a balance for the residents as well as for the caregivers, if a positive relationship was to develop. Furthermore, caregivers stated that support was crucial, not only for the residents but also for themselves, if they were expected to cope with demanding situations. Different types of support were necessary and included: confirmation, feedback, and supervision. Residents who feel appreciated and respected may be less likely to act out their frustrations in an inappropriate manner. Caregivers who strive to understand the meaning behind a resident's behaviour and who master the necessary care-giving skills, and their implementation, could be more successful at curbing distressing behaviour, than caregivers who act merely in a custodial role.
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| 14. |
- Sørlie, Venke, et al.
(författare)
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Meeting ethical challenges in acute care work as narrated by enrolled nurses.
- 2004
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 11:2, s. 179-88
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Tidskriftsartikel (refereegranskat)abstract
- Five enrolled nurses (ENs) were interviewed as part of a comprehensive investigation into the narratives of registered nurses, ENs and patients about their experiences in an acute care ward. The ward opened in 1997 and provides patient care for a period of up to three days, during which time a decision has to be made regarding further care elsewhere or a return home. The ENs were interviewed concerning their experience of being in ethically difficult care situations and of acute care work. The method of phenomenological-hermeneutic interpretation inspired by the French philosopher Paul Ricoeur was used. The most prominent feature was the focus on relationships, as expressed in concern for society's and administrators' responsibility for health care and the care of older people. Other themes focus on how nurse managers respond to the ENs' work as well as their relationships with fellow ENs, in both work situations and shared social and sports activities. Their reflections seem to show an expectation of care as expressed in their lived experiences and their desire for a particular level and quality of care for their own family members. A lack of time could lead to a bad conscience over the 'little bit extra' being omitted. This lack of time could also lead to tiredness and even burnout, but the system did not allow for more time.
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| 15. |
- Sørlie, Venke, et al.
(författare)
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Meeting ethical challenges in acute nursing care as narrated by registered nurses
- 2005
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 12:2, s. 133-42
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Tidskriftsartikel (refereegranskat)abstract
- Five registered nurses were interviewed as part of a comprehensive investigation by five researchers into the narratives of five enrolled nurses (study 1, published in Nursing Ethics 2004), five registered nurses (study 2) and 10 patients (study 3) describing their experiences in an acute care ward at one university hospital in Sweden. The project was developed at the Centre for Nursing Science at Orebro University Hospital. The ward in question was opened in 1997 and provides care for a period of up to three days, during which time a decision has to be made regarding further care elsewhere or a return home. The registered nurses were interviewed concerning their experience of being in ethically difficult care situations in their work. Interpretation of the theme 'ethical problems' was left to the interviewees to reflect upon. A phenomenological hermeneutic method (inspired by the French philosopher Paul Ricoeur) was used in all three studies. The most prominent feature revealed was the enormous responsibility present. When discussing their responsibility, their working environment and their own reactions such as stress and conscience, the registered nurses focused on the patients and the possible negative consequences for them, and showed what was at stake for the patients themselves. The nurses demonstrated both directly and indirectly what they consider to be good nursing practices. They therefore demand very high standards of themselves in their interactions with their patients. They create demands on themselves that they believe to be identical to those expected by patients.
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| 16. |
- Anderzén-Carlsson, Agneta, 1966-
(författare)
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Children with cancer : focusing on their fear and on how their fear is handled
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Various fears in children with cancer have previously been identified as a result of studying e.g. symptom experiences, distress and uncertainty within this population. Studies of the meaning the children give to their fear, as well as the handling of their fear seem to be sparse, however. Also, fear has not been an exclusive focus in previous studies. Professionals in clinical practice have pointed to the need for such research, which has prompted the present research work. The overall aim of this thesis was therefore twofold; firstly, the aim was to elucidate fear in children and adolescents with cancer in order to gain an understanding from the perspective of adolescents and parents. Secondly, it was to elucidate parents’ and professionals’ handling of the fear. This in order to gain a deeper understanding of what performances and manners the children and adolescents can face when being fearful. A qualitative descriptive design was adopted in the five included studies. The methods used in the data analysis were phenomenological hermeneutical method (studies I–III) and qualitative content analysis (studies IV–V). In study I six adolescent girls, aged 14–16 years, with experiences of various cancer diagnoses, but now declared fit, were interviewed. The results reveal that they experience their fear as embodied, which in the comprehensive understanding of the results was interpreted as a threat to their personal self, their whole existence. Their fear was seen as a holistic intertwined experience, including fear related to the physical body and to the social self. Also, existential fear was described. Their described experience was interpreted as suffering. Studies II and III share the same data. Fifteen parents of children at various ages with various cancer diagnoses were interviewed in focus groups about their experience of their child’s fear. In study II the result reveals how the parents experienced and understood their child’s fear. The fear was described as a multidimensional phenomenon, which was not always easy to identify. It was contrasted to feelings of unease and to absence of fear. In the comprehensive understanding the fear was interpreted as a suffering, as that was regarded to be what was the common meaning in the narratives. The suffering was interpreted as an ethical demand to the parents to take action. In study III the parents described their actions, i.e. they described how they dealt with the fear. Their actions were described as acting in the best interests of the child, which included striving to make the child feel secure and experience wellbeing, up to a certain point. However, after this point the parents used their parental authority to maintain the child’s physical health rather than trying to prevent or relieve the child’s fear. In the comprehensive understanding the parents’ handling of their child’s fear was interpreted as revealing mercy and as being synonymous with meeting the ethical demand put on them. In study IV ten experienced nurses and physicians were individually interviewed about how they handled fear in children with cancer. The result reveals that the existential issues were dealt with within the relationship with the child, on a sliding scale between closeness and distance, and that the fear related to medical procedures occurred on a continuum between support and lack of support. The various actions involved, and the manner in which these actions were performed, was described. In the observational study (study V) eleven parents and their children as well as eleven health professionals participated. They were observed at children’s routine visits at the outpatient clinic. The aim was to study the interactions related to fear. The result reveals that when children were fearful they expressed this both verbally and non-verbally. The parents’ and professionals’ actions and interactions in these situations were found to be characterized by recognition of the fear or lack of attention to the fear. The findings can contribute to a broadened knowledge on fear in children and adolescents with cancer. Awareness and understanding of the meaning adolescents give to their fear, and furthermore, of the parents’ experience and understanding of their child’s fear can provide tools for interacting with these groups. The findings on how fear is dealt with by the ones children have claimed as important sources for support, can give insights into what the child may face when being fearful. These insights can form the basis for individual, as well as collegial, reflections on what is done when children face fear, how fear is handled on an everyday basis and why it is handled in this way. Such reflections could lead to an ethical awareness of handling fear in children with cancer.
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| 17. |
- Anderzén-Carlsson, Agneta, et al.
(författare)
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Children's fear as experienced by the parents of children with cancer
- 2007
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Ingår i: Journal of Pediatric Nursing. - Amsterdam : Elsevier. - 0882-5963 .- 1532-8449. ; 22:3, s. 233-244
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Tidskriftsartikel (refereegranskat)abstract
- It is known that children with cancer experience and express fear, but little is found in the literature about how the parents experience their child's fear. This study aimed to highlight the parents' lived experience and understanding of their child's fear. Focus group interviews with 15 parents were performed. Data were analyzed through a phenomenological hermeneutic method. Fear in children with cancer is described by the parents as a multidimensional phenomenon, which is somehow difficult to identify. It appears in contrast to the absence of fear. The comprehensive understanding of the results reveals that the parents experience their children's fear as both a suffering and an ethical demand for the parents to answer.
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| 18. |
- Anderzén-Carlsson, Agneta, 1966-, et al.
(författare)
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Fear in children with cancer : observations at an outpatient visit
- 2008
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Ingår i: Journal of Child Health Care. - London : Sage. - 1367-4935 .- 1741-2889. ; 12:3, s. 191-208
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe interactions within the family and between them and professionals on a routine visit at a paediatric oncology outpatient clinic where the visiting child was likely to be fearful. Observations were performed. Data were analysed by qualitative content analysis. The behaviours most frequently observed as expressing fear were being quiet, withdrawn or providing detailed descriptions of experiences. Within the theme `Recognition of the fear', an attentive attitude to the fear was traced; fear was confirmed and cooperation was seen. Although many efforts were made to meet the fear, this was not always successful. Within the theme `Lack of attention to the fear', the fear was not in focus due to parental worries and concerns about the child's health, and organizational disturbances. The results can serve as a basis for collegial reflections of how to handle fear in children with cancer.
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| 19. |
- Anderzén-Carlsson, Agneta, et al.
(författare)
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How physicians and nurses handle fear in children with cancer
- 2007
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Ingår i: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 22:1, s. 71-80
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Tidskriftsartikel (refereegranskat)abstract
- Previous research on fear in children with cancer has often focused on interventions to alleviate fear related to medical procedures and less on how to meet the challenges related to existential fear. This study aimed to describe how experienced nurses and physicians handle fear in children with cancer. Ten nurses and physicians with more than 10 years of experience in child oncology from a university hospital in Sweden were interviewed, and a qualitative content analysis was performed on the data. Nurses' and physicians' handling of fear encompasses commitment and closeness and yet also a distancing from fear and its expressions
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| 20. |
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| 21. |
- Anderzén-Carlsson, Agneta, et al.
(författare)
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Parental handling of fear in children with cancer : caring in the best interests of the child
- 2010
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Ingår i: Journal of Pediatric Nursing. - New York, USA : Elsevier. - 0882-5963 .- 1532-8449. ; 25:5, s. 317-326
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to gain a deeper understanding of how parents of children with cancer handle the fear in their children. Fifteen parents of 11 children participated in focus-group interviews. Data were analyzed by a phenomenological hermeneutical method. The results suggest that the parents' handling was equivalent with caring in the best interests of the child. This included striving for the security and well-being of the child up to a certain point where the parents instead used their authority to maintain the child's physical health rather than trying to prevent or relieve the child's fear.
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| 22. |
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| 23. |
- Fagerberg, Ingegerd, et al.
(författare)
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Experiencing a nurse identity : the meaning of identity to Swedish registered nurses 2 years after graduation
- 2001
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 34:1, s. 137-145
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Tidskriftsartikel (refereegranskat)abstract
- The professional identity and experiences of nurses have been focused upon in different studies AIM: This is a longitudinal study whose aim was to understand how nurses experience the meaning of their identity as nurses, when they are students and nurses 2 years after graduation. DESIGN: Data were collected through interviews once a year during education and two years after graduation, and were analysed using a phenomenological hermeneutic method, inspired by the philosophy of Paul Ricoeur. FINDINGS: The analyses of the narratives resulted in four perspectives: 'Having the patient in focus', 'Being a team leader', 'Preceptorship' and 'Task orientation'. The nurses did not change perspectives but the perspective showed a transition over time.
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| 24. |
- Fagerberg, Ingegerd, et al.
(författare)
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Registered nurses’ experiences of caring for the elderly in different health-care areas
- 2001
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Ingår i: International Journal of Nursing Practice. - 1322-7114 .- 1440-172X. ; 7:4, s. 229-236
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Tidskriftsartikel (refereegranskat)abstract
- Caring for elderly patients is an undertaking for a majority of Swedish nurses in different health-care sectors. The purpose of the study was to understand how nurses experienced the meaning of caring for elderly patients after 2 years as Registered Nurses. Interviews were conducted with 20 nurses 2 years after graduation. Data were analysed with a phenomenological–hermeneutic method and resulted in two themes: (i) providing the elderly with a sense of trust; and (ii) commitment to elderly patients. Each theme was made up of four subthemes, expressing both positive and negative aspects. Caring for the elderly means that the core of caring is in focus. Nurses need a supportive context for their care of the elderly, especially when they experience that they or their staff cannot provide the optimal quality of care for the patients.
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| 25. |
- Fagerberg, Ingegerd, et al.
(författare)
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Registered nurses' experiences of caring for the elderly in different health care areas
- 2001
-
Ingår i: International Journal of Nursing Practice. - : Wiley. - 1322-7114 .- 1440-172X. ; 7:4, s. 229-236
-
Tidskriftsartikel (refereegranskat)abstract
- Caring for elderly patients is an undertaking for a majority of Swedish nurses in different health-care sectors.The purpose of the study was to understand how nurses experienced the meaning of caring for elderly patients after 2 years as Registered Nurses. Interviews were conducted with 20 nurses 2 years after graduation. Data were analysed with a phenomenological-hermeneutic method and resulted in two themes: (i) providing the elderly with a sense of trust; and (ii) commitment to elderly patients. Each theme was made up of four subthemes, expressing both positive and negative aspects. Caring for the elderly means that the core of caring is in focus. Nurses need a supportive context for their care of the elderly, especially when they experience that they or their staff cannot provide the optimal quality of care for the patients.
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| 26. |
- Fläckman, Birgitta, et al.
(författare)
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Consequences of working in eldercare during organizational changes and cut backs while education and clinical supervision was provided : a mixed methods study
- 2015
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Ingår i: Open Journal of Nursing. - Irvine, USA : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 5:9, s. 813-827
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Forskningsöversikt (refereegranskat)abstract
- Background: Reorganization and downsizing can disrupt a competent staff and conflicts can arise between what the employee is being asked to do and their knowledge and competences. Reduced job satisfaction among nursing home staff with increased workload and strain can occur. Aim and Objectives: The aim was to investigate the organizational climate and prevalence of burnout symptoms among caregivers over time in three Swedish nursing homes (NH I-III) undergoing organizational changes, while education and clinical supervision were provided. Design: The study design combines qualitative and quantitative methods in a longitudinal two-year follow-up project in NH I-III. Methods: Support through education and clinical supervision was provided for caregivers only at NH I and NH II. At NH I-III caregiver self-assessments and interviews were completed and analysed three different times. Results: NH I revealed improvement and increased innovation over time, while NH II showed a decline with no ability to implement new knowledge. NH III retained a more status quo. Conclusions: Organizational changes and cutbacks, occurring at different times, appeared to cause major stress and frustration among the three personnel groups. They felt guilty about not meeting their perceived obligations, seemed to have lost pride in their work but kept struggling. The changes seemed to over-shadow attempts to improve working conditions through education and clinical supervision initially. Implications for practice: It will be important to learn from reorganizations and the consequences they will have for the staff and quality of care. Important topics for future research are to study financial cutbacks and changes in organizational processes in care of older people to be able to develop a more person centered care for older people.
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| 27. |
- Fläckman, Birgitta, et al.
(författare)
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Unmet expectations : why nursing home staff leave care work
- 2008
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Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 3:1, s. 55-62
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Tidskriftsartikel (refereegranskat)abstract
- Background. The shortages of healthcare professionals have been a common topic in care of older people.Aim and objectives. The aim of the present study was to illuminate what caused the nursing home caregivers to decide to leave their employment.Design. A two-year intervention study was performed in three nursing homes in Sweden.Method. This qualitative interview study was conducted with 18 caregivers who decided to leave their employment during the first year. Content analysis was the method used to analyse the interviews.Result. The caregivers’ decisions to leave their work in care of older people could be encompassed in one main category: ‘Unmet Expectations’. Their experiences were of lack of encouragement and trust and professional development. Feelings of insecurity, different opinions on the care delivered, being disregarded and betrayed followed as did thoughts of leaving work and pursuing other opportunities.Conclusions. The main findings indicated that organizational work pressure with information about pending financial cutbacks caused the caregivers to leave the nursing homes.Relevance to clinical practice. The study’s results show the value of meeting the needs of caregivers, as caregivers consider that they meet the needs of the older people. Optimal use of caregivers’ skills, experiences, competence and respect for their aspirations is also likely to result in cost-efficient care.
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| 28. |
- Forslund, Kerstin, et al.
(författare)
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Experiences of adding nurses to increase medical competence at an emergency medical dispatch centre
- 2006
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Ingår i: Accident and Emergency Nursing. - : Elsevier BV. - 0965-2302 .- 1532-9267. ; 14:4, s. 230-236
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Prehospital care begins when the call is placed to the emergency medical dispatch (EMD) centre and ends when the patient is cared for at the emergency department. The highly technical and specialized character demands advanced medical competence. Communication problems, serious and unpredictable situations can often occur during the emergency calls. A two-year intervention study involved the addition of registered nurses to an EMD-centre team to increase medical competence. AIM: To describe registered nurses' and emergency-operators' experiences of working together at an EMD-centre after adding registered nurses to increase medical competence. METHODS: Qualitative content analysis was used to analyse the text from interviews with four registered nurses and 15 emergency-operators involved in the intervention. RESULTS: Initial frustration and scepticism changed to more positive experiences that resulted in improved cooperation and service. The registered nurses had difficulties dealing with the more urgently acute calls, while the emergency-operators had difficulties with the more complicated, somewhat diffuse cases. The two professions complemented each other. CONCLUSION: Combining the registered nurses' and emergency-operators' knowledge and experience at an EMD-centre can perhaps improve the prehospital care for those requiring emergency medical care.
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| 29. |
- Forslund, Kerstin, et al.
(författare)
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Patients with acute chest pain : experiences of emergency calls and pre-hospital care
- 2005
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Ingår i: Journal of Telemedicine and Telecare. - 1357-633X .- 1758-1109. ; 11:7, s. 361-367
-
Tidskriftsartikel (refereegranskat)abstract
- Acute chest pain is a common reason why people call an emergency medical dispatch (EMD) centre. We examined how patients with acute chest pain experience the emergency call and their pre-hospital care. A qualitative design was used with a phenomenological-hermeneutic approach. Thirteen patients were interviewed, three women and 10 men. The patients were grateful that their lives had been saved and in general were satisfied with their pre-hospital contact. Sometimes they felt that it took too long for the emergency operators to answer and to understand the urgency. They were in a life-threatening situation and their feeling of vulnerability and dependency was great. Time seemed to stand still while they were waiting for help during their traumatic experience. The situation was fraught with pain, fear and an experience of loneliness. A sense of individualized care is important to strengthen trust and confidence between the patient and the pre-hospital personnel. Patients were aware of what number to call to reach the EMD centre, but were uncertain about when to call. More lives can be saved if people do not hesitate to call for help.
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| 30. |
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| 31. |
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| 32. |
- Hallgren, Anita, et al.
(författare)
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Ways of Relating During Childbirth : An ethical responsibility and challenge for midwives
- 2005
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 12:6, s. 606-621
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Tidskriftsartikel (refereegranskat)abstract
- The way in which midwives relate to expectant parents during the process of childbirth greatly influences the parents´childbirth experiences for a long time. We believe that examining and describing ways of relating in naturally occurring interactions during childbirth should be considered as an ethical responsibility. This has been highlighted in relation to parents´experiences and in the light of the relational ethics of Logstrup. Four couples´and nine midwives´ways of relating were documented by 27 hours of observation, including 14,5 hours of video-recording sessions. A qualitative content analysis was conducted. The midwives strongly influenced the different ways of relating and three aspects of professional competence were disclosed. The results can contribute to reflections about current praxis as an ethical demand for midwives.
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| 33. |
- Hansebo, Görel, et al.
(författare)
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Carers' interactions with patients suffering from severe dementia : a difficult balance to facilitate mutual togetherness.
- 2002
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 11:2, s. 225-36
-
Tidskriftsartikel (refereegranskat)abstract
- 1. A phenomenological-hermeneutic approach was used to illuminate carers' video-recorded interactions in connection with supervision for individualized nursing care. 2. In order to disclose any changes in the carers' interactions with patients suffering from severe dementia the video recordings were conducted before, during and after the intervention. 3. The content of the videos was transcribed as a text, mainly verbal communication. Due to the rich data the videos and text were kept together as a whole in every step of the analysis. 4. After an initial naïve understanding, different subthemes emerged in the structural analyses: promoting competence, struggling for co-operation, deep communication for communion, showing respect for the unique person, skills in balancing power, distance in a negative point of view, and fragmentary nursing situations. 5. The overall theme was 'Carers' balancing in their interactions, verbal as well as non-verbal, to promote a sense of mutual togetherness with the patient'. 6. The supervision intervention contributed to an improvement in carers' skills in balancing in their interactions. In the caring process carers' and patients' shared experiences and, due to patients' disabilities, interactions depended mainly on carers' qualities and capabilities for this confirming nursing care.
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| 34. |
- Hansebo, Görel, et al.
(författare)
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Nursing home care : changes after supervision.
- 2004
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 45:3, s. 269-79
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: An intervention project was conducted in three nursing home wards in Sweden. Most patients had severe dementia. The intervention consisted of supervision for individualized and documented nursing care, based on multidimensional assessment. AIM: To illuminate changes in carers' approach after the intervention. METHODS: Several data collections were conducted across the intervention and consisted of nursing documentation, patient life stories as told by carers, video recorded interactions, stimulated recall interviews and a questionnaire. Both quantitative and qualitative methods were used in the analyses. FINDINGS: The findings from the different methods mirrored each other and added to the credibility of the intervention. Communicated knowledge about patients improved in nursing documentation and also as told by carers. Carers were differently skilled in managing the complexity of nursing care situations before as well as after the intervention, but the intervention contributed to developing carers in 'confirming nursing care'. They also improved in their ability to verbalize reflections about their everyday life with patients with dementia. CONCLUSION: Supervision made it possible for carers to share their lived experiences about their day-to-day life with patients, which could promote personal and professional development and thus improve care quality. It also appeared that a detailed assessment tool used as part of the nursing process contributed to seeing a patient as a real person behind a dementia surface.
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| 35. |
- Häggström, Elisabeth, et al.
(författare)
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Caregivers working with older people experience work dissatisfaction and low self-esteem orginating from power relations in municipal care organization
- 2009
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Ingår i: Tidsskrift for Sygeplejeforskning. - 0900-3002. ; 25:2, s. 27-33
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Tidskriftsartikel (refereegranskat)abstract
- This study explores how a combined gender and power perspective might explain and help us understand caregivers´ expressions of low self-esteem and dissatisfaction in their work with older people. The aim of the study was to discover whether caregivers’ experiences in the nursing home can be understood on the basis of Ås´ framework of the Five Master Techniques. The study was conducted within the municipal gerontological care system in Sweden and has an explorative, qualitative design. Twenty caregivers were interviewed, and the interviews were analysed using a qualitative content approach. Based on Ås´ theory of Five Master Techniques, the caregivers’ experiences of being made to feel invisible, ridiculed, deprived of information, receiving double punishment and feelings of guilt and shame emerged from the analyses. The study shows that the caregivers’ experiences, listed above, were all obvious at the nursing home and that these experiences also affected their feelings of work dissatisfaction and low self-esteem. The findings show the importance of using a gender perspective in caring, so that power relations in the organization can be explored, understood and combated.
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| 36. |
- Johansson, Inger
(författare)
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Quality of care and assessment of health among elderly in actue care.
- 1998
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis describes nursing staff's opinion of quality of care and work satisfaction and elderly patients' perception of health, functional capacity, quality of life and sense of coherence (SOC) from a prognostic point of view. The research was performed within several surgical and orthopaedic wards, and different instruments were developed and tested for reliability and validity. The study groups consisted of nursing staff (n=66), surgical patients clinically ready for discharge (n=53) and a consecutive sample of patients with hip fracture (n=73). All patients were 60+ years of age and livin in their own homes before their stay in hospital.The nursing staff answered questionnaires concerning work satisfaction and perceived quality of care before and one year after the introduction of modular nursing. Among the respondents considerable differences were noted in one ward one year after the intervention, particularly concerning their relationship with colleagues, identification and connnitment, and quality of care. Key factors for this outcome could be related to the quality of the interpersonal relationships and the leadership of the ward.Significant differences between subgroups were revealed when using a Swedish version of the Health Assessment Form (HAF) and a tool measuring Sense of Coherence (SOC) in personal interviews among elderly patients clinically ready for discharge. The patients who could return home showed less discomfort concerning physical variables such as breathing and elimination of urine and scored higher within emotional status and SOC than those who were referred to an institution or were deceased before the one month follow-up. The result indicated that the HAF as well as SOC had some prognostic value for further care as well as for survival/fatal outcome for patients clinically ready for discharge.The Swedish version of the NEECHAM Confusion Scale was found to be reliable and valid for detecting and following up acute confusional states among patients with hip fracture. The part of the scale measuring vital function was found to have predictive power in relation to the Quality of Life Index (QLI) at the four-month follow-up. The parts reflecting cognitive function and urinary continence predicted significantly for function of daily living activities (I-ADL), measured with the Standardized Practical Equipment (SPE). Patients with a stronger SOC, compared with those with a weaker, were discharged earlier from the hospital, reported a higher score on the QLI and performed I-ADL better four months after discharge from the hospital.The findings highlight the importance of having a broad range of valid and reliable instruments when following up organisational changes among nursing staff as well as for assessing the health and functional needs of elderly patients in acute care in order to predict future developments.
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| 37. |
- Kihlgren, Mona, 1938-
(författare)
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Integrity promoting care of demented patients
- 1992
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of the thesis was to investigate if integrity promoting care improves functions in demented patients over time. The Erikson (1982) theory of ”eight stages of man” was used as a basis for training of staff in a three-month intervention study (I-VI) at a nursing home ward. A collective living unit where staff had had support in the performance of the delivery of care was also evaluated and compared with a nursing home in a long-term study (VII). Patients, relatives, staff, and the environments were investigated. Cerebrospinal fluid concentrations of somatostatin increased, and reduction of distractability, anxiety and confusion was seen in the intervention group (I) in contrast to controls. In the collective living group (VII) EEG activities indicated a reduction of supposed dementia induced changes. Better motor and social ability, some improved intellectual ability, more alertness and reduced signs of depression were seen (I, II, VII). Patients expressed more autonomy (IV, VII) and initiatives (II-VII) and showed a lot of competence (V) in conversations. Five patients (V) showed patterns of behaviour which seemed to reflect life-long characteristics in spite of their severe dementia. The improvement in the patients' functions can be attributed to the physical environment and the integrity promoting care, since the medical treatment of the patients remained unchanged. In the thesis medical, psychological, and nursing sciences were connected in a complementary process. The results were congruent, and indicate that patients in the care of staff who had had training and support, declined less than controls.
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| 38. |
- Kihlgren, Mona, et al.
(författare)
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Organizational change and supervision
- 2014. - 1
-
Ingår i: The Wiley international handbook of clinical supervision. - West Sussex : John Wiley & Sons Ltd. - 9781119943327 ; , s. 155-176
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter focuses on the concept of clinical supervision in the context of nursing care, discussing in particular the dementia care of the elderly. The health care system is characterized by many different specialties, each with its specific problems to solve. In the case of nursing, care is a 24-hr ongoing process, with complex caring situations, more or less urgent, which means that it is mostly unpredictable. The chapter provides a detailed synthesis of supervision objectives and considers kinds of resources that are required to provide adequate supervision. It also talks about the influence of clinical supervision on family- and professional caregivers and outlines one of the authors′ studies, which examined organizational factors in relation to supervision. The chapter indicates how efficient interventions can encourage those who care for elderly with cognitive impairment to accept and implement new knowledge about psychosocial methods, improving the quality of care.
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| 39. |
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| 40. |
- Mamhidir, Anna-Greta, et al.
(författare)
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Ethical challenges related to elder care : high level decision-makers' experiences
- 2007
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Ingår i: BMC Medical Ethics. - : Springer Science and Business Media LLC. - 1472-6939. ; 8:3
-
Tidskriftsartikel (refereegranskat)abstract
- Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion The high level decision-makers feel that something worthwhile is at stake in elder care. A risk exists that older adult and decision-maker needs are not being met. The results provide further insight into the ethical challenges and reasoning found among high level decision-makers, which are important since their decisions affect older patients, relatives and caregivers, and can be useful when conducting discussions within health care organisations. Future research is suggested on how people are affected when loyalties to a position come into conflict with personal convictions. Since ethical dilemmas that confront all levels of health care organisation will persist, the concept of organisational ethics also needs further research.
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| 41. |
- Mamhidir, Anna-Greta, et al.
(författare)
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Malnutrition in elder care : qualitative analysis of ethical perceptions of politicians and civil servants
- 2010
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Ingår i: BMC Medical Ethics. - : Springer Science and Business Media LLC. - 1472-6939. ; 11:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundFew studies have paid attention to ethical responsibility related to malnutrition in elder care. The aim was to illuminate whether politicians and civil servants reason about malnutrition in elder care in relation to ethical responsibility, and further about possible causes and how to address them. MethodEighteen elected politicians and appointed civil servants at the municipality and county council level from two counties in Sweden were interviewed. They worked at a planning, control and executive level, with responsibility for both the elder care budget and quality of care. Qualitative method was used for the data analysis. ResultsTwo themes emerged from their reasoning about malnutrition related to ethical responsibility. The theme assumed role involves the subthemes quality of care and costs, competent staff and govern at a distance. Old and ill patients were mentioned as being at risk for malnutrition. Caregivers were expected to be knowledgeable and stated primary responsible for providing adequate nutritional care. Extended physician responsibility was requested owing to patients' illnesses. Little was reported on the local management's role or on their own follow-up routines. The theme moral perception includes the subthemes discomfort, trust and distrust. Feelings of discomfort concerned caregivers having to work in a hurried, task-oriented manner. Trust meant that they believed for the most part that caregivers had the competence to deal appropriately with nutritional care, but they felt distrust when nutritional problems reappeared on their agenda. No differences could be seen between the politicians and civil servants. ConclusionNew knowledge about malnutrition in elder care related to ethical responsibility was illuminated by persons holding top positions. Malnutrition was stressed as an important dimension of the elder care quality. Governing at a distance meant having trust in the staff, on the one hand, and discomfort and distrust when confronted with reports of malnutrition, on the other. Distrust was directed at caregivers, because despite the fact that education had been provided, problems reappeared. Discomfort was felt when confronted with examples of poor nutritional care and indicates that the participants experienced failure in their ethical responsibility because the quality of nutritional care was at risk.
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| 42. |
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| 43. |
- Mamhidir, Anna-Greta, et al.
(författare)
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Weight increase in patients with dementia, and alteration in meal routines and meal environment after integrity promoting care.
- 2007
-
Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 16:5, s. 987-96
-
Tidskriftsartikel (refereegranskat)abstract
- Aims. To follow weight changes in patients with moderate and severe dementia and analyse how these changes related to biological and psychological parameters after staff education and support in integrity promoting care. A further aim was to describe meal environment and routines relative to the intervention.Background. Weight loss in patients with dementia and in particular Alzheimer's disease is common. The aetiology appears multifactorial with the meal environment and a decreased independence while eating among the factors.Method. Over a three-month intervention period, an integrity-promoting care training programme was conducted with the staff of a long-term ward. Alzheimer's disease patients, 18 from an intervention ward and 15 from a control ward were included and possible effects were evaluated. Weighing was conducted at the start and after completion of the intervention. Weight changes were analysed in relation to psychological and biochemical parameters. In addition, the staff wrote diaries about, for example changes made in the environment and in their work.Results. The most prominent difference observed was weight increases in 13 of 18 patients compared with two of 15 patients in the control ward. No weight changes were related to the type of dementia. The individual weight changes correlated significantly to changes in the intellectual functions. Relationships between weight change, increased motor function and increased appetite were non-significant. There was no significant relationship between weight changes and changes in biochemical parameters. According to the staff, increased contact with the patients and a more pleasant atmosphere resulted when the meal environment and routines were changed.Relevance to clinical practice. Weight gain in patients with moderate and severe dementia was achieved by adjusting the meal environment to the individual's needs. Staff education was profitable, as increased competence seemed to promote individually adapted feeding situations. Ensuring good meal situations need to be given high priority.
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| 44. |
- Mazaheri, Monir, Associate Professor, Senior lecturer, 1977-, et al.
(författare)
-
Applying the theory of human development by Erik and Joan Erikson when communicating with persons with advanced dementia diseases
- 2022
-
Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 42:4, s. 178-184
-
Tidskriftsartikel (refereegranskat)abstract
- Persons with advanced dementia disease (ADD), here labelled PADDs, are shown to preserve parts of their self, which hasopened up possibilities for involving them in their own care and establishing strategies for improving their communicationwith the surrounding world. Using the well-known theory of human development proposed by Erik and Joan Erikson, herelabelled EJET, can operate as an efficient structure for formal caregivers to support PADDs in reclaiming their space.However, very few studies have used EJET as a framework in improving formal caregivers’ competence and the quality ofcare. This article aims to demonstrate the feasibility of applying EJET in the care of PADDs through two examples of successfulapplication of this framework in interacting with PADDs in residential care settings. The examples demonstrate the significanceof competent caregivers and the important role of tailoring nursing care plans to specific situations of the PADDs in theirpresent and previous developmental phases.
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| 45. |
- Nilsson, Ulrica, 1960-, et al.
(författare)
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Experience of postoperative recovery before discharge : patients’ views
- 2006
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Ingår i: Journal of Advanced Perioperative Care. - 1470-5664. ; 2:3, s. 93-102
-
Tidskriftsartikel (refereegranskat)abstract
- This study focuses on a subgroup of a larger group of patients included in a double-blind,randomised trial with music, music in combination with therapeutic suggestions or controlintervention during hysterectomy under general anaesthesia (Nilsson et al 2001).Thepurpose of this study was to describe patients’ experiences of postoperative recovery beforedischarge from hospital, in two intervention-with-music groups in relation to experience ofthe patients in a control group.Thirty-one women who underwent abdominal hysterectomyunder general anaesthesia were interviewed on their last postoperative day at the hospital.The interviews were analysed with thematic and manifest content analysis.The findingsshowed that patients experienced recovery in terms of a ‘sense of caring’, a ‘sense ofrecovery’ and a ‘sense of coping’.When comparing the three intervention groups there wasno difference in patients’ experiences of caring, recovery or coping.There was, however, asignificant difference gained from the manifest content analysis in experience of fatigue,with the patients in the music group experiencing it more positively.The patients describedcaring in terms of being either cared for or not cared for, which created either positive ornegative feelings such as security and calmness, or isolation and loneliness.‘Sense ofrecovery’was shown as a physical and physiological recovery process in terms of pain,nausea and fatigue. In comparing frequencies of reported pain, nausea and fatigue in allthree groups together it was found that pain was described positively more often thannegatively while the opposite was true for nausea and fatigue.The women also revealeddifferent ways of coping during the recovery process, such as trying to look at the problemobjectively, positive thinking, distraction and use of supportive resources. In conclusion theresults of the present study show that intraoperative music therapy can make theexperience of postoperative fatigue more positive and this finding, together with the resultsfrom the main study (Nilsson et al 2001), gives a more complete view of patients’experiences of postoperative recovery after presence or absence of intervention.
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| 46. |
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| 47. |
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| 48. |
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| 49. |
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| 50. |
- Quell, Robin, et al.
(författare)
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Using tactile stimulation in a dementia care facility with plasma prolactine as an outcome measure : a pilot study
- 2008
-
Ingår i: Archives: the international journal of medicine. - 1791-4000. ; I:3, s. 123-129
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundThere is poor scientific documentation supporting tactile stimulations’ benefit as a nursing intervention. It has been theorized that older adults with dementia experience high anxiety and stress levels. High prolactin levels are associated with psychosomatic reactions and have been used to measure stress levels in adults.AimTo evaluate tactile stimulation’s effectiveness on anxiety and stress in older adults, with dementia diagnosis or signs of dementia and living in a dementia care facility, as manifested by plasma prolactin levels.Materials and MethodsTactile stimulation was given weekly by trained staff members to half the residents of a Swedish dementia care facility.The subjects were randomly selected (n=20) and were tracked in the study for a minimum of 28 weeks. The remaining half elders made up the control team (n=20). Diagnostic groups were formed according the severity of dementia. Plasma prolactin levels were drawn at baseline and post intervention. Medications caused the exclusion of 12 residents and seven dropped out due to other causes. ResultsThere was no difference in plasma prolactin levels between the intervention (n=11) and control (n=12) group. A significant main effect between the diagnostic groups was found as well as a trend towards a positive correlation between age and plasma prolactin levels. There was no gender difference in plasma prolactin levels.ConclusionsOur hypothesis that reduced plasma prolactin levels could be detected in elders treated with tactile stimulation, indicating alleviated stress, was not supported by the preliminary results of the present study. Further evaluation of tactile stimulation with larger study groups and a better understanding of prolactin’s sensitivity, complexity and interaction with medications could contribute to the outcome and problems of the study. The use of neuropsychological assessment could enrich the research data and help the evaluation.
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