| 1. |
- Björk, Annette, et al.
(författare)
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A nurse-led lifestyle intervention for adult persons with attention-deficit/hyperactivity disorder (ADHD) in Sweden
- 2020
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis Group. - 0803-9488 .- 1502-4725. ; 74:8, s. 602-612
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Attention-deficit/hyperactivity disorder (ADHD) is associated with lifestyle-related diseases. Therefore, a nurse-led lifestyle intervention including interpersonal relationships, health education and cognitive support was developed to facilitate healthier lifestyle habits.Aim: The aim was to develop a lifestyle intervention and investigate its impact on mental and physical healthMethod: The 52-week intervention included 35 adults with ADHD. In a pre- and post-test design, symptoms of ADHD were measured with the Adult ADHD Self-Report Scale, quality of life was measured with the Adult ADHD Quality of Life scale and mental health was measured with the Hospital Anxiety and Depression scale. Lifestyle habits and dimensions of health were measured by the Lifestyle-Performance-Health Questionnaire and physical fitness was measured by the VO2 Max Test and calculations of waist circumference and body mass index. Result: Post-tests for a group of 25 persons showed positive changes following the intervention regarding weekly physical activity, quality of life and general and mental health. Lifestyle habit support was found to be important. The impact of the intervention should be confirmed in a long-term study with a control group.Conclusion: This intervention may be beneficial and may be implemented in a primary healthcare setting or in other open care units.
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| 2. |
- Björk, Annette, et al.
(författare)
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Adult Persons with ADHD and Their Lifestyle
- 2023
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Ingår i: Clinical Handbook of ADHD Assessment and Treatment Across the Lifespan. - : Springer. - 9783031417092 ; , s. 161-182
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Attention deficiency hyperactive disorder (ADHD) is a neuropsychiatric disability characterized by attention problems, impulsivity, and hyperactivity that can affect education, working life, social relationships, and physical and mental health. Research shows a shortened life expectancy in adults with ADHD which has to do with impaired lifestyle habits. In the field of health sciences, it is important to alleviate suffering, promote health, and prevent ill health. The purpose of this chapter is to describe factors that affect the health and lifestyle of adults with ADHD. The method is a literature search. Adults with ADHD were affected by cognitive impairments that affected life to a large extent. Lifestyle habits with a sedentary lifestyle, poor diet, and drug use were more common in people with ADHD. In addition, comorbidity with both physical and mental health is common. Loneliness and deteriorating quality of life plague many people with ADHD. Combined treatment methods with psychosocial interventions are important. Health-promoting lifestyle programs where support for physical, mental, and social health is important. Conclusion: Research on lifestyle programs for adults with ADHD is lacking. There is some research that supports the idea that continuous health-promoting lifestyle programs based on interpersonal relationships, health education, and health discussions as well as cognitive support can be useful for lifestyle changes among people with ADHD.
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| 3. |
- Björk, Annette, et al.
(författare)
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Health, lifestyle habits, and physical fitness among adults with ADHD compared with a random sample of a Swedish general population
- 2018
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Ingår i: Society, health and vulnerability. - : Informa UK Limited. - 2002-1518. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Persons with Attention Deficit Hyperactive Disorder (ADHD) represent a high-risk population according to health and lifestyles. In the present study, 48 adults with ADHD were recruited to a forthcoming lifestyle intervention. The ADHD sample was matched to a random sample of 42 persons from a Swedish general population that was selected from LIV (a Lifestyle-Performance-Health project).Objective: To identify potential differences in health, lifestyle habits, and physical fitness between adults with and without ADHD.Method: Self-reported questionnaires and physical fitness tests.Results: The ADHD group show worse health outcomes with higher odds ratios for bad general health (OR;13 CI; (3,4–50)), and poorer lifestyle habits with higher odds ratios for low weekly exercise (OR; 3,8 CI; (1,2–13)). When adjusting for education, employment status, and cash margin, the ADHD sample did not show decreased aerobic fitness (OR; 0,9 CI; (0,8–1,0), but lower odds ratios for doing less sit-ups (OR; 0,6 CI; (0,4–0,9)) compared to the general population group.Conclusion: It is not possible to prove that the ADHD diagnosis itself cause the worse health and lifestyle. Other lifestyle factors may have negative consequences of adult ADHD, such as lower levels of education, less succeed in working life, and minor financial margins.
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| 4. |
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| 5. |
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| 6. |
- Björk, Annette, et al.
(författare)
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Perspectives on Everyday Suffering among People with Adult Attention Deficit Hyperactivity Disorder and Concurrent Mental Disorders
- 2017
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 7, s. 583-598
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the perceptions of everyday suffering among adults with attention deficit hyperactivity disorder (ADHD) and comorbid mental disease. Directed content analysis guided by Eriksson’s theory on human suffering was performed on data from 20 individual interviews. Expressions of both suffering and well-being were identified; the former centred on loneliness and related to life, illness, and care, which supported Eriksson’s theory, whereas expressions of well-being related to ADHD diagnosis and supportive social relationships. Nevertheless, results indicate the need to expand those expressions in order to better contribute to developing a supportive rehabilitation regimen that can provide more interpersonal care.
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| 7. |
- Björk, Annette, et al.
(författare)
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The Importance of Belonging to a Context : A Nurse-Led Lifestyle Intervention for Adult Persons with ADHD
- 2021
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 42:3, s. 216-226
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Tidskriftsartikel (refereegranskat)abstract
- Living with attention deficit hyperactivity disorder (ADHD) and mental illness involves an increased risk of lifestyle-related diseases. Although there are several ways to provide support to adult persons with ADHD, there is a lack of non-medical strategies for this purpose. This study explore how adult persons with ADHD with mental illness experienced taking part in a nurse-led lifestyle intervention. Fifteen participants participated in a 52-week lifestyle intervention. The analysis revealed two main categories; Building trusting relationships and Health together. This nurse-led lifestyle intervention could be an alternative or complement to current approaches to promoting health in adults with ADHD.
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| 8. |
- Kristiansen, Lisbeth, et al.
(författare)
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Urinary incontinence and newly invented pad technique: patients', close relatives' and nursing staff's experiences and beliefs
- 2011
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Ingår i: International Journal of Urological Nursing. - 1749-7701 .- 1749-771X. ; 5:1, s. 21-30
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Tidskriftsartikel (refereegranskat)abstract
- Urinary incontinence (UI) is a major public health issue and considered to be undertreated, costly and often lead to suffering for patients. Close relatives involved in caring for sufferers describe UI as a complicated problem. For older patients, close relatives and staff, it is important with high absorption UI pads in order to have an undisturbed nightly rest and to prevent bedsores. The aim was twofold: to understand older persons', close relatives' and nursing staff's views and experiences of UI, and their experience of using a particular UI pad system with an alarm. A qualitative design with individual and focus-group interviews was used to describe 6 patients', 14 close relatives' and 22 staff's experience of UI. These were analysed by using qualitative manifest analysis. The findings were divided into four categories. The patients expressed that they, due to UI, regarded themselves as burdens to others. The patients, the relatives and some staff experienced UI as a natural consequence of ageing. The UI pad system appeared to be a functional incontinence aid during the night, but more research is needed to develop the product and to find new fields of applications. From all perspectives, it appears that nursing cannot be replaced by technology, though the UI pad system can be a very useful complement in UI nursing care. Complementary use of the UI pad system might lead to a more economically effective and safe use of the existing nursing resources.
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| 9. |
- Larsson Gerdin, Anna
(författare)
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Experiences of care encounters in Swedish home care setting: perspectives from older persons and home care nurses
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The Swedish healthcare organisation for older persons has shifted its focus towards home care. Receiving care at home offers comfort and security, allowing older persons to remain in familiar surroundings. The care encounter in home care is the core of everyday care practice. However, what happens during these care encounters is often unknown due to its private nature and is sparsely researched. Aim: The overall aim of this doctoral thesis was to explore, describe, and gain a deeper understanding of the lived experiences of care encounters in home care, as perceived by older persons and home care nurses, to generate knowledge for nursing practice. Method: The design is qualitative, and data has been collected through interviews at both descriptive (I, III) and in-depth narrative levels (II, IV). Participants were purposefully sampled to ensure a diverse range of perspectives and experiences relevant to the research aim. The interview text has been analysed through Qualitative content analysis (I, III), Hermeneutic interpretation (II), and Phenomenological hermeneutic interpretation (IV). Findings: While older persons appreciated the convenience of receiving care at home, the findings revealed challenges such as nursing routines conflicting with everyday life routines (I, II), unclear communication, and being dependent on support (I). Although receiving vital support, older persons strove to uphold independence (II) but were subordinate to their home care nurses which posed a challenge in this regard (I, II). Home care nurses encountered a wide range of patient needs, which spanned from medical requirements to emotional support (III). Each of their patients brought unique challenges and circumstances, necessitating home care nurses to flexibly adjust their approaches (IV). However, they struggled with balancing their expectations and desires related to the quality and extent of care they intended to provide to their patients, against what was realistically achievable given the constraints of time, legislative requirements, and organisational demands (III, IV). Conclusion: An examination of the findings alongside the overall aim of this doctoral thesis, relevant literature, and Kari Martinsen’s philosophy of caring, reveal the complexity of care encounters in this context. For example, the quality of these care encounters varies based on the assigned home care nurse, affecting the equality and effectiveness of care. Older persons lacked involvement in their care decisions, impacting the person-centred approach. Dependency on home care nurses complicates matters, as it can lead to a loss of autonomy and dignity. Additionally, tight schedules limit home care nurses’ time with each of their patients, reducing opportunities for meaningful interactions. The unique nature of care at home blurs personal and professional boundaries. Providing relational, moral, and practical care enhances dignity and empowerment for older persons. Effective implementation of this approach requires adequate time and resources for home care nurses.
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| 10. |
- Lundahl, Maja-Klara, et al.
(författare)
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Nurse's perspectives on care provided for patients with gamma-hydroxybutyric acid and gamma-butyrolactone abuse
- 2014
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 23:17-18, s. 2589-2598
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives To describe registered nurses' views and experiences providing care for gamma-hydroxybutyric acid and gamma-butyrolactone abuse inpatients in a psychiatric unit.Background Gamma-hydroxybutyric acid and gamma-butyrolactone are illegal drugs with potentially fatal outcomes that are entering wider use in Scandinavia. Gamma-hydroxybutyric acid-dependent persons with withdrawal symptoms often require forceful withdrawal treatment provided in psychiatric units.Design A qualitative study with a purposive sample including interviews from registered nurses.Methods Data were collected from interviews with 15 registered nurses working in specialised dependency units in psychiatric wards. The data collected were analysed through a descriptive, qualitative analysis.Results The registered nurses' narratives revealed four main areas of convergence: feelings of anxiety and despair, preparation for unpredictable and precarious situations, striving for good relationship and striving to optimise and develop nursing care. The interviews revealed that registered nurses reflect on and discuss their feelings about their patients' situations with colleagues; prepare themselves for potential aggressiveness and unpredictable situations; improve their care through conscious attitude adjustment and relationship-forming behaviours; and strive to increase their personal knowledge, maintain a hopeful outlook and exhibit a positive approach. These themes were found in all nine categories and sixteen subcategories.Discussion The findings based on the registered nurses' narratives indicated that the registered nurses experienced their work situation when caring for these patients to be very complex and demanding.Conclusion The study revealed that registered nurses worked extensively to craft their approach and attitude towards their patients. It is clear that registered nurses use themselves as tools or instruments for the creation of good relationships, thus providing the best care possible.Relevance to clinical practice Registered nurses should be given more education, clearer guidelines and better guidance to assist them in facing such challenging and often problematic situations. One-on-one shadowing provides the possibility to create and develop relationship.
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| 11. |
- Rönngren, Ylva, et al.
(författare)
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Educational nurse-led lifestyle intervention for persons with mental illness.
- 2018
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Ingår i: International Journal of Mental Health Nursing. - : Wiley-Blackwell. - 1445-8330 .- 1447-0349. ; 27:3, s. 1022-1031
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Tidskriftsartikel (refereegranskat)abstract
- Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention.
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| 12. |
- Rönngren, Ylva, et al.
(författare)
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Initiating and Maintaining a Lifestyle Program Directed at Persons Living with Severe Mental Illness in a Municipality Care Setting
- 2024
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 45:7, s. 706-714
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Tidskriftsartikel (refereegranskat)abstract
- Lifestyle programs are effective in improving the health of persons living with severe mental illness. However, the implementation of these programs and making them a sustainable part of daily care remain challenging. This qualitative descriptive study aimed to describe how staff worked with and experienced a lifestyle program in a municipality mental health care setting over time. The program intended to support persons living with severe mental illness to overcome health challenges. Data was collected at three time points spanning 7?years. The staff motivated the participants with SMI with severe mental illness to take part in the program, prepared them, and gave them individualized lifestyle support. A key factor of the program?s implementation was the staff?s interest and engagement in lifestyle questions. According to the staff it was apparent that small efforts such as running the present program could give synergic health effects such as improved mental- and social health. This study shows that it is feasible to conduct this lifestyle program in ordinary care without considerable resources. However, support from management is crucial, as well as the development of guidelines and routines of the work with lifestyle questions.
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| 13. |
- Rönngren, Ylva, et al.
(författare)
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LIFEHOPE.EU – Lifestyle & Healthy Outcome in Physical Education : Development of a lifestyle intervention program for people with severe mental illness: Physical activity, dietary changes, and cognitive adaptation training
- 2014
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 21:10, s. 924-930
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Tidskriftsartikel (refereegranskat)abstract
- People with severe mental illness (SMIs) are more prone to physicalillnesses, increased mortality and cognitive impairments, all of whichnegatively influence their daily lives. Physical activity (PHYS)programmes have helped alleviate SMI. LIFEHOPE is an ongoing researchproject with the purpose of developing a sustainable lifestyleintervention for physical and mental health. PHYS/cognitive adaptationtraining (CAT) is a newly created lifestyle intervention that providesgroup education and is based on CAT. It provides individualized supportfor PHYS and dietary change in a natural nursing environment. The aim ofthis study was to obtain further knowledge for developing a sustainablelifestyle programme by exploring psychiatric clients' experiences withPHYS and lifestyle habits, which we did by interviewing a localreference group, community mental healthcare users and community mentalhealthcare workers. Then, we developed a lifestyle programme for peoplewith SMI using information obtained from these focus group interviews.Our results suggest that there is a need for support and education, aswell as active interventions, in carrying out PHYS and dietary changesamong people with SMIs, and the PHYS/CAT may be a useful strategy.
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| 14. |
- Rönngren, Ylva, et al.
(författare)
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Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting
- 2018
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Ingår i: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 27:1, s. 390-399
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Tidskriftsartikel (refereegranskat)abstract
- Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16-25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting.
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| 15. |
- Rönngren, Ylva, et al.
(författare)
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Perspectives of a tailored lifestyle program for people with severe mental illness receiving housing support
- 2018
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Ingår i: Perspectives in psychiatric care. - : John Wiley & Sons. - 0031-5990 .- 1744-6163. ; 54:2, s. 309-316
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of the present study was to describe the acceptability of the lifestyle program PHYS/CAT and to get information about the tools used for assessment of functional exercise capacity, cognitive performance, and self-health-related quality of life.DESIGN AND METHODS: The findings are based on focus groups and the researchers' experiences of conducting the program as well as using the assessment tools.FINDINGS: The acceptability of the program and the assessment tools was mainly satisfactory.PRACTICE IMPLICATIONS: The program with relational, educational, and supportive dimensions may be a promising tool to be integrated into daily nursing care.
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| 16. |
- Rönngren, Ylva
(författare)
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Supporting healthy lifestyle habits in persons with mental disorders : The development of a nurse-led lifestyle intervention
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Persons with mental disorders have an increased risk of developing health problems. One reason for this is poor lifestyle habit support. The aim of this thesis was to develop and evaluate a nurse-led lifestyle intervention for persons with mental disorders. Two versions of the intervention were conducted in the municipality (versions I, II) and one in a primary healthcare setting (version III). The educational elements of the intervention were led by nurses and practically executed by nursing staff (study II and III). In study IV education was both led and executed in practice by nurses. Data were collected through focus groups, individual interviews, and measurements. Study I, a qualitative development study, showed that, when motivating for lifestyle changes, it was important to structure daily life and provide emotional support. Loneliness, lack of knowledge and support, and general resources were identified as barriers to lifestyle changes. Version I contained health education for nursing staff and individual lifestyle habit support to persons with mental disorders, which included physical exercises and cognitive support. Study II was a qualitative acceptability study of the intervention (version I) and its assessment tools. The intervention with its relational, educational, and supportive dimensions and the assessment tools was promising. In Study III (version II), a quantitative pilot study, persons with mental disorders received health education together with the nursing staff. The intervention provided improvements to various degrees in health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference. Study IV (version III), a qualitative study, included health education and individual lifestyle habit support for young adults with mental illness. The young adults experienced challenges including psychiatric symptoms, loneliness, and a lack of social understanding. The thesis results showed that the core components of the intervention with interpersonal relationships, where nursing staff played an important role, and further components such as health education and health discussions, in addition to cognitive support, worked well together to support lifestyle habit changes. Those components already exist and may therefore be easy to implement into daily nursing practice in different housing conditions and with individuals of different ages and needs for mental health care support. Group education was a way not only to develop new health strategies but also to establish social relationships. The intervention may also be modified to work with other groups of persons who need more explicit lifestyle habit support. However, to better determine the efficacy and sustainability of the intervention, larger studies over a longer time should be conducted.
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| 17. |
- Stenman, Tove, 1975-, et al.
(författare)
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“Daring to deal with the difficult and unexpected” registered nurses’ confidential conversations with patients with palliative care needs : a qualitative interview study
- 2023
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Ingår i: BMC Palliative Care. - : Springer Nature. - 1472-684X. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn palliative care, registered nurses provide advanced nursing care to relieve patients’ symptoms and increase their quality of life based on physical, mental, social and existential dimensions. Conversations, often about existential issues, are an important part of nursing and can affect quality of life positively. Confidential conversations between patients and nurses occur naturally while other nursing activities are being performed. Despite their great importance for palliative care these are rarely described.AimTo gain a deeper understanding of how nurses in palliative care experience and describe confidential conversations with patients.MethodSecondary analysis of data from 17 open-ended face-to-face interviews with registered nurses in palliative care was conducted. Qualitative content analysis using an inductive approach was used to gain a deeper understanding and analyse the latent content.ResultsThe confidential conversation was considered an important part of palliative care and is the nurse’s responsibility. This responsibility was described as complex and placed various demands on the nurses, both personal and professional. A prerequisite for the conversation was the interpersonal relationship. The conversation allowed the patient to process important matters not previously addressed or put into words. It had no predetermined content, was unplanned and entirely on the patient’s terms. For nurses the conversation could be experienced both as draining and a source of power and strength. The nurses also described safeguarding the patient through the conversation.ConclusionNurses’ confidential conversations with patients are essential in palliative care and must be highlighted more to increase the quality of palliative care. The confidential conversations often have an existential content and are challenging for the nurses. Therefore, nurses need time, knowledge, and supervision to increase their conversation skills.
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| 18. |
- Stenman, Tove, 1975-, et al.
(författare)
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Förtroliga samtal i palliativ vård - Personalens och patienters erfarenheter
- 2022
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: I palliativ omvårdnad identifierar, bedömer och bemöter sjuksköterskan fysisk, social, psykisk och existentiell hälsa för såväl patient som närstående samt planerar, genomför och utvärderar åtgärder. Samtal är en viktig omvårdnadshandling med syfte att förbättra patienternas livskvalitet och möjliggöra en värdig död. Samtalen om existentiella frågor har positiva effekter på livskvalitet och samtalet erbjuder existentiellt stöd i olika åldrar och sjukdomsgrupper vid obotlig sjukdom som exempelvis cancer, organsvikt, demenssjukdom. Det finns olika former av samtal i palliativ vård. Sjuksköterskans förtroliga samtal som ofta sker spontant vet vi lite om Det förtroliga samtalet finns inte heller explicit beskrivet som begrepp i vårdvetenskaplig forskning. Syfte: Att få en djupare förståelse för innebörden av förtroliga samtal i palliativ vård utifrån sjuksköterskors och patienters perspektiv. Metod: Kvalitativ ansats med sjuksköterskor och patienter som i intervjuer beskriver sina erfarenheter av förtroliga samtal. Resultat: Analys av insamlade data med sjuksköterskor pågår och beräknas avslutas hösten 2022. Rekrytering och insamling av data med patienter beräknas påbörjas hösten 2022. Preliminära resultat i delstudie I visar att samtalen är en viktig del i den palliativa omvårdanden och sjuksköterskans självklara ansvar. Såväl ansvaret som samtalet i sig beskrivs som komplext och ställer olika typer av krav på sjuksköterskan. I samtalet kan patienten med palliativ vårdbehov få möjlighet att bearbeta saker som inte tidigare bearbetats och sätta ord på det som behöver sättas ord på. Samtalet inte har något förutbestämt innehåll, sker ofta i anslutning till någon annan omvårdnadssituation och sker helt på patientens villkor då det är patienten somhåller i taktpinnen. Betydelse: Samtal är mycket viktig del av omvårdnaden, trots det upplever vårdpersonal av olika skälutmaningar i att genomföra samtal. Personalens vilja att hjälpa, lindra symtom och plågor samt att främja en värdig död är ofta en stark drivkraft. I förtroliga samtal med en sjuksköterska får patienter möjlighet att hantera sin situation, sin sjukdom, sina förluster, sitt beroende av hjälp och stöd samt sin livssituation vilket kan leda till ökad livskvalitet och känsla av oberoende och värdighet. Kontexten palliativ vård är viktig i det förtroliga samtalet, där livets sista tid, döendet och döden är närvarande. Studien med patienter kommer att ligga till grund för en digital interaktiv utbildningsintervention om existentiella samtal riktad till vårdpersonal. Det är centralt att medarbetare i teamet runt patienter med palliativ vårdbehov har kunskaper, förmåga och mod att initiera och samtala kring patienters existentiella tankar och funderingar vid obotlig sjukdom.
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| 19. |
- Stenman, Tove, 1975-, et al.
(författare)
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“Unless someone sees and hears you, how do you know you exist?” Meanings of confidential conversations – a hermeneutic study of the experiences of patients with palliative care needs
- 2024
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Ingår i: BMC Nursing. - : Springer Nature. - 1472-6955. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with palliative care needs live with the reality of limited time due to illness or age, eliciting emotional and existential responses. A failure to address their existential needs can lead to significant suffering. A person-centred approach is paramount to effectively address these needs, emphasising holistic care and effective communication. Although existing communication models focus on predefined frameworks, a need exists to explore more spontaneous and confidential conversations between patients and nurses. Confidential conversations have the potential to build therapeutic relationships and provide vital emotional support, highlighting the need for further research and integration into palliative care practice. This study aims to more deeply understand the meaning of confidential conversations for patients with palliative care needs. Methods: In-depth interviews were conducted with 10 patients in the context of specialised palliative care. A hermeneutic analysis was used to gain a deeper understanding of the meanings of the conversations. Results: The patients had varying experiences and wishes concerning confidential conversations. They strived for self-determination in finding confidants, seeking trust and comfort in their interactions with nurses. Trust was crucial for creating a safe space where patients could express themselves authentically. In shared belonging, confidential conversations with a nurse provided validation and relief from life’s challenges. Experiences of feeling unheard or rejected by a nurse could intensify loneliness, prompting individuals to withdraw and remain silent. Regardless of the motives behind their choices, it was crucial that patients felt respect and validation in their decisions. Their autonomy could thus be recognised, and they felt empowered to make decisions based on their unique preferences. Conclusions: Patients value trust and understanding, particularly in confidential conversations with nurses, which offer solace, validation and empowerment. However, indifference can increase patients’ suffering, fostering self-doubt and reluctance to engage further. To address this, health care can prioritise empathic communication skills, offer ongoing support to nurses, and promote continuity in care through investment in training and resources. Additionally, adopting a person-centred approach in confidential conversations is crucial, considering patients’ varying preferences.
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