| 1. |
- Elf, Marie, 1962-, et al.
(författare)
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The importance of context : a qualitative study exploring healthcare practitioners' experiences of working with patients at home after a stroke
- 2023
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Stroke significantly impacts individuals, leading to the need for long-lasting rehabilitation and adaptation to environmental demands. Rehabilitation after stroke is increasingly performed in patients' homes, and it is argued that rehabilitation in this context is more person-centred and positively impacts client outcomes. However, the role of environmental factors in this process is largely unknown. The aim of this study was to explore how multidisciplinary healthcare practitioners working with rehabilitation in the home after stroke consider possibilities and challenges in the environment and how environmental factors are documented in patients' records.METHODS: Eight multidisciplinary healthcare practitioners working with home-based rehabilitation after stroke participated in two semistructured focus group sessions. Thematic analysis was used to analyse the transcripts of recorded focus group discussions. Data were also collected from patient history records (N = 14) to identify interventions to increase patients' opportunities to participate in activities inside and outside the home. These records were analysed using life-space mobility as a conceptual framework.RESULTS: The analysis generated four overarching themes concerning possibilities and challenges in the environment: (1) the image of rehabilitation conflicts with place, (2) the person in the home reveals individual needs and capabilities, (3) environmental characteristics influence the rehabilitation practice, and (4) the person is integrated within a social context. The patient record analysis showed that most patients were discharged from hospital to home within four days. Assessments at the hospital mainly focused on basic activities of daily living, such as the patient's self-care and walking ability. Also at home, the assessments and actions primarily focused on basic activities with little focus on participation in meaningful activities performed in different life situations outside the home.CONCLUSIONS: Our research suggests that one way to improve practice is to include the environment in the rehabilitation and consider the person´s life space. Interventions should focus on supporting out-of-home mobility and activities as part of person-centred stroke rehabilitation. This must be supported by clear documentation in the patient records to strengthen clinical practice as well as the communication between stakeholders.
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| 2. |
- Ganda Mall, John-Peter, 1988-, et al.
(författare)
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Are self-reported gastrointestinal symptoms among older adults associated with increased intestinal permeability and psychological distress?
- 2018
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite the substantial number of older adults suffering from gastrointestinal (GI) symptoms little is known regarding the character of these complaints and whether they are associated with an altered intestinal barrier function and psychological distress. Our aim was to explore the relationship between self-reported gut health, intestinal permeability and psychological distress among older adults.METHODS: Three study populations were included: 1) older adults with GI symptoms (n = 24), 2) a group of older adults representing the general elderly population in Sweden (n = 22) and 3) senior orienteering athletes as a potential model of healthy ageing (n = 27). Questionnaire data on gut-health, psychological distress and level of physical activity were collected. Intestinal permeability was measured by quantifying zonulin in plasma. The level of systemic and local inflammation was monitored by measuring C-reactive protein (CRP), hydrogen peroxide in plasma and calprotectin in stool samples. The relationship between biomarkers and questionnaire data in the different study populations was illustrated using a Principal Component Analysis (PCA).RESULTS: Older adults with GI symptoms displayed significantly higher levels of both zonulin and psychological distress than both general older adults and senior orienteering athletes. The PCA analysis revealed a separation between senior orienteering athletes and older adults with GI symptoms and showed an association between GI symptoms, psychological distress and zonulin.CONCLUSIONS: Older adults with GI symptoms express increased plasma levels of zonulin, which might reflect an augmented intestinal permeability. In addition, this group suffer from higher psychological distress compared to general older adults and senior orienteering athletes. This relationship was further confirmed by a PCA plot, which illustrated an association between GI symptoms, psychological distress and intestinal permeability.
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| 3. |
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| 4. |
- Haseli, Arezoo, et al.
(författare)
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Midwifery students’ experiences : Violations of dignity during childbirth
- 2023
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 31:2-3, s. 296-310
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe principle of human dignity is woven into the ethical principles of the midwifery profession, noted as both an obligation and a human right.Research ObjectivesThe aim of this study is to explore the experiences of midwifery students regarding threats to women's dignity during childbirth.Research DesignThis is a qualitative study with explorative design. Participants and Research Context: The research was carried out in 2022 at Kermanshah University of Medical Sciences, involving 32 midwifery students in individual interviews that lasted between 30 and 90 minutes. These participants aged 21 to 28 years, with an average age of 23.5 years, provided their perspectives on the matter.ResultsFour key themes described the threats to women?s dignity during childbirth: 1) professional incompetence, 2) abuse of power imbalance, 3) caring only for physical and not mental health, and 4) structural issues within the healthcare system. Professional incompetence was characterized by outdated practices and lack of adherence to evidence-based medicine. Abuse of power imbalance was demonstrated in instances where the authoritative position of healthcare providers was misused, thereby disrupting the respectful care that women are entitled to receive. The disproportionate emphasis on physical health over mental health was evidenced by the disregard for mothers' psychological well-being during childbirth. Lastly, systemic structural issues emerged as significant impediments, revealing the need for system-wide changes. Ethical considerations: This study was approved by the Ethics Committee of the Research Deputy at Kermanshah University. Participation was voluntary and the confidentiality were maintained.ConclusionThe findings underscore the role that unprofessional behavior, ethical lapses in medical practices, and systemic challenges play in undermining maternal dignity during childbirth. These threats necessitate urgent attention and must be adequately addressed in policy development and program implementation to safeguard the dignity of mothers during childbirth.
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| 5. |
- Platts, Loretta G., et al.
(författare)
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Having a Post-Retirement Job : Improvisation And Containing Commitments
- 2021
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Ingår i: Innovation in Aging. - Oxford : Oxford University Press. - 2399-5300. ; 5:Supplement_1, s. 414-414
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Tidskriftsartikel (refereegranskat)abstract
- This qualitative paper focuses on individuals who work after pensionable age, a distinctive period in the late career when workers are supported by the known and reliable income of a pension. Using constant comparative analysis, we analyzed interviews from a purposive sample of 25 Swedish people in their late sixties and early seventies. We examined conditions for being in paid work in terms of enabling factors (self-employment, shift work, shortage occupation), improvisation, and the role of chance. The interviews revealed that post-retirement workers took charge of the aspects of work that mattered most to them, evading the disciplinary aspects of work by controlling scheduling and limiting the duration of their commitment. These constrained commitments had knock-on effects of improving psychosocial working conditions. Women and immigrants—groups facing low pensions—experienced the greatest financial consequences of being unable to work in their retirement years in order to supplement their pension income.
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| 6. |
- Platts, Loretta G., et al.
(författare)
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The nature of paid work in the retirement years
- 2023
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Ingår i: Ageing & Society. - Bimingham : Cambridge University Press. - 0144-686X .- 1469-1779. ; 43:6, s. 1310-1332
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Tidskriftsartikel (refereegranskat)abstract
- Ever more people are in paid work following the age of state pension availability, and yet the experience of working in this phase of the late career has been little studied. We interviewed a purposive sample of 25 Swedish people in their mid- to late sixties and early seventies, many of whom were or had recently been working while claiming an old-age pension. The data were analysed with constant comparative analysis in which we described and refined categories through the writing of analytic memos and diagramming. We observed that paid work took place within a particular material, normative and emotional landscape: a stable and secure pension income decommodifying these workers from the labour market, a social norm of a retired lifestyle and a looming sense of contraction of the future. This landscape made paid work in these years distinctive: characterised by immediate intrinsic rewards and processes of containing and reaffirming commitments to jobs. The oldest workers were able to craft assertively the temporal flexibility of their jobs in order to protect the autonomy and freedom that retirement represented and retain favoured job characteristics. Employed on short-term (hourly) contracts or self-employed, participants continually reassessed their decision to work. Participation in paid work in the retirement years is a distinctive second stage in the late career which blends the second and third ages.
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| 7. |
- Qaderi, Kowsar, et al.
(författare)
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Changes in screening, diagnosis, management, and outcomes of gestational diabetes during the COVID-19 pandemic : A systematic review
- 2024
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Ingår i: Heliyon. - 2405-8440. ; 10:11, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy, and it can lead to complications for the mother and the infant/fetus. This was especially evident during the COVID-19 pandemic. Therefore, the present systematic review aimed to describe the changes in screening, diagnosis, management, and outcomes of gestational diabetes during the COVID-19 pandemic.Methods: The systematic review was conducted from December 2019 until January 1, 2022. To find articles related to the purpose of the study, PubMed, Scopus, Web of Science, and WHO were searched using relevant and validated keywords using MeSH/Emtree.Results: In total, 675 entries were ascertained from the database inquiry, and 17 scholarly works were deemed suitable for inclusion in the final review. The salient conclusions derived from this review were as follows: (a) During the COVID-19 pandemic, there was a significant decrease in the use of OGTTs and a rise in the use of HbA1c assays for both GDM screening and diagnosing. (b) A predominant number of physicians incorporated some variation of telemedicine to remotely supervise and conduct follow-up evaluations of patients with GDM. Various strategies are presented for the provision of prenatal care to women afflicted with GDM, such as concentrating on high-risk demographics, the initiation of lifestyle modifications at early stages, and the implementation of remote patient monitoring techniques. The ’single test procedure’ is identified as the most suitable for the preliminary screening of GDM. The OGTT should be assigned clinical precedence in patients at high risk during the ongoing COVID-19 pandemic. Additionally, Medical Nutrition Therapy (MNT) was established as the primary management strategy, and the most influential determinant of the transition from dietary adjustments to pharmacotherapy was the Fasting Blood Glucose (FBG) levels during the second trimester.Conclusion: Suggested strategies for GDM screening and management during the pandemic integrated into routine antenatal care, emphasized the importance of remote diabetes education and technology utilization during health emergencies.
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| 8. |
- Qaderi, Kowsar, et al.
(författare)
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Changes in sexual activities, function, and satisfaction during the COVID-19 pandemic era: a systematic review and meta-analysis
- 2023
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Ingår i: Sexual Medicine. - : Oxford University Press (OUP). - 2050-1161. ; 11:2
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Forskningsöversikt (refereegranskat)abstract
- Introduction: Little is known about the impact of the coronavirus on sexual behavior, function, and satisfaction.Aim: The aim of the present study was to systematically review people’s sexual function and behaviors and their changes in sexual activities during the COVID-19 pandemic.Methods: Comprehensive searches in PubMed, Web of Science, and Scopus were conducted with keywords in accordance with MeSH terms: COVID-19, SARS-CoV-2, coronavirus, sexual health, sexual function, sexual dysfunctions, sexuality, sexual orientation, sexual activities, and premarital sex. Two reviewers independently assessed full-text articles according to predefined criteria: original design, English studies, and investigating either the general population or sexual minorities.Results: Risk of bias in the studies was assessed by the Newcastle-Ottawa Scale, and data were pooled via random effects meta-analyses. We utilized the standardized mean difference to evaluate the effects of the COVID-19 pandemic on sexual activity, functioning, and satisfaction. We included 19 studies in the analysis and 11 studies in the meta-analysis, with a sample size of 12 350. To investigate sexual activity changes, a sample size of 8838 was entered into the subgroup analysis, which showed a significant decrease in both genders (5821 women, P < .033; 3017 men, P < .008). A subgroup meta-analysis showed that the sexual function of men and women during the COVID-19 pandemic significantly declined (3974 women, P < .001; 1427 men, P < .001). Sexual desire and arousal decreased in both genders, though mainly in women. In investigating sexual satisfaction changes during the COVID-19 pandemic, a meta-analysis with a sample size of 2711 showed a significant decrease (P < .001). The most indicative changes in sexual behaviors during the pandemic were the increase in masturbating and usage of sex toys. Greater COVID-19 knowledge was associated with lower masturbation, oral sex, and vaginal sex. The more protective behaviors were associated with less hugging, kissing, cuddling, genital touching, watching porn with a partner, and vaginal sex.Conclusion: The COVID-19 pandemic led to increased challenges and changes for individuals’ sexual behaviors. Efforts for preventive strategies should therefore be concentrated between pandemics, while ensuring that there is information available to the population during a pandemic for help in times of psychological distress or crisis.
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| 9. |
- Rasoal, Dara, et al.
(författare)
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Balancing different expectations in ethically difficult situations while providing community home health care services : A focused ethnographic approach
- 2018
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Ingår i: BMC Geriatrics. - : BioMed Central Ltd.. - 1471-2318. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The general opinion in society is that everyone has the right to live in their own home as long as possible. Provision of community home health care services is therefore increasingly common. Healthcare personnel encounter ethically difficult situations when providing care, but few studies describe such situations in the context of community home health care services. Method: This study has a qualitative descriptive design, using focused ethnography. Data from 21 days of fieldwork (in total 123 h) consisting of non-participant observations (n = 122), memos and informal interviews with registered nurses (n = 8), and nurse assistants (n = 4). The transcribed texts were analyzed with interpretive content analysis. Results: The inductive analyses revealed two categories: 1) difficulties in balancing different requirements, expectations and needs, and 2) use of coping strategies. The results demonstrate that there are different values and expectations that influence each other in a complex manner. The personnel dealt with these situations by generating strategies of coaxing the patients and finding a space to deliberate and share difficult emotions with their colleagues. Conclusions: This study reveals that complex ethically difficult situations emerged in the context of community home health care services, and healthcare personnel were forced to find a balance regarding the different demands, expectations, values and needs that influence the care provided.
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| 10. |
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| 11. |
- Rasoal, Dara, 1980-, et al.
(författare)
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Clinical Ethics Support for Healthcare Personnel : An Integrative Literature Review
- 2017
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Ingår i: HEC Forum. - Dordrecht, Netherlands : Springer. - 0956-2737 .- 1572-8498. ; 29:4, s. 313-346
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Forskningsöversikt (refereegranskat)abstract
- This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different coun-tries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a ‘‘bot-tom-up’’ perspective might give healthcare personnel opportunities to think and reflect more than a ‘‘top-down’’ perspective. A ‘‘bottom-up’’ approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a ‘‘top-down’’ approach risks removing such moral responsibility.
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| 12. |
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| 13. |
- Rasoal, Dara, PhD, Senior Lecturer, 1980-
(författare)
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Coaxing as a Strategy to Deal with Ethical Issues in Community Home Care : An Ethnographic Study
- 2020
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Ingår i: Journal of community health research. - : Knowledge E. - 2322-5688 .- 2345-2609. ; 9:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The provision of home health care services increases as a desirable option in western society. Previous studies indicate that health care professionals encounter ethically difficult situations when providing home care services. There is a lack of studies describing ethically difficult situations through observation. This study aimed to explore ethical issues experienced by healthcare staff when providing community home care services.Methods: Qualitative design, using the ethnographical approach. Data gathered as fieldwork in terms of memos, non-participant observation and informal interview with registered nurses (n=8), and nurse-assistants (n=4) during three weeks (in total 148 hours, 7am -5pm) .Results: The result generated two main categories: 1) To balance stakeholders‟ requirements, and, 2) Strategy to deal with ethical issues. Coxing was used as a strategy to deal with ethically difficult situations in patient care. The results showed that the complexity of the ethical issues is often related to personal values and organisational impact. The staff experienced need for a structured approach to assist them in identifying, analysing, and resolving ethical issues that arise in clinical practice. Health care organisations, personnel and patients are disagreed about values and choices that could lead to the best course of actions.Conclusion: This study reveals that the ethically difficult situations in the context of community home care services are complex and are influencing the provision of care. The personnel enforced to find a balance between different expectations and from different stakeholders. To deal with these situations coaxing was used as a strategy for managing ethical issues.Keywords: Homecare nursing, Healthcare professional, Ethics
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| 14. |
- Rasoal, Dara, PhD, Senior Lecturer, 1980-
(författare)
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Concept Clarification of Moral Case Deliberation
- 2018
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 8, s. 390-403
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health care professionals have encountered ethically difficult situations for decades in their clinical practice. Various clinical ethics support has been established in order to deal with these issues. Moral case deliberation is a new developed approach that deliberates over ethically difficult cases in clinical practice. However, there is lack of knowledge that describes the characteristics of the moral case deliberation and how this differs to related clinical ethics support where a concept analysis may clarify the differences. Aim: To analyse the concept of moral case deliberation and related concepts. Methods: Integrative literature review. Rodger’s evolutionary view of concept analysis has been used for clarification of the concept. Using specific keywords in the databases, searching for peer-reviewed academic paper published in English between 1995-2017 in the CINAHL, MEDLINE, Psych Info, Academic Search Elite and AMED. Results: Moral case deliberation (MCD) was defined as an approach with four specific characteristics: 1) Perspective sharing via dialogue, 2) training moral awareness, 3) moral emotional deliberation, and 4) moral support and joint learning. The presence of a facilitator who is trained in a specific method for the MCD reflection seemed to be important when stimulating the discussion from a patient perspective. Conclusions: Clarify the concept of moral case deliberation can be useful for healthcare professionals when choosing a facilitate-base reflection. Through a mutual dialogue and perspective sharing can MCD train staff members in moral awareness, create a space for emotions to be expressed and finally work as an platform for joint learning.
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| 15. |
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| 16. |
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| 17. |
- Rasoal, Dara, 1980-, et al.
(författare)
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‘It’s like sailing’ : experiences of the role as facilitator during moral case deliberation
- 2017
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Ingår i: Clinical Ethics. - United Kingdom : Royal Society of Medicine Press. - 1477-7509 .- 1758-101X. ; 12:3, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Moral case deliberation is one form of clinical ethics support, and there seems to be different ways of facilitating thedialogue. This paper aimed to explore the personal experiences of Swedish facilitators of their role in moral casedeliberations. Being a facilitator was understood through the metaphor of sailing: against the wind or with it. Therole was likened to a sailor’s set of skills: to promote security and well-being of the crew, to help crew navigate theirmoral reflections, to sail a course into the wind against homogeneity, to accommodate the crew’s needs and just sail withthe wind, and to steer towards a harbour with authority and expertise. Balancing the disparate roles of being accom-modative and challenging may create a free space for emotions and ideas, including self-reflection and consideration ofmoral demands. This research opens the question of whether all these skills can be taught through systematic training orwhether facilitators need to possess the characteristics of being therapeutic, pedagogical, provocative, sensitive andauthoritarian.
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| 18. |
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| 19. |
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| 20. |
- Rasoal, Dara, 1980-
(författare)
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Perspectives on clinical ethics support and ethically difficult situations : reflections and experiences
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Healthcare personnel encounter ethically difficult situations in their everyday work and clinical ethics support might be important to support healthcare personnel to deal with these situations. The overall aim of this thesis was to describe perspectives on clinical ethics support, experiences of being in ethically difficult situations and experiences of facilitating ethics reflection. Methods. Study I had a descriptive design in which research articles were reviewed (n=54). In study II audio-recorded moral case deliberation (n=70) in 10 Swedish workplaces in hospitals and community care were analysed. In study III interviews were conducted with facilitators (n=11) of moral case deliberation. Study IV used non-participant observation during three weeks as well as informal conversations with healthcare personnel (n=12) in community home healthcare. Results and conclusion. In study I, two perspectives emerged on clinical ethics support, a “Top-down” perspective, where an individual or a group of “experts” in ethics could recommend the best course of action and a “Bottom-up” perspective that allows healthcare personnel to manage ethically difficult situations through ethical reflections led by a facilitator. Studies II and IV showed how ethically difficult situations on different levels are often connected with emotions and uncertainties. Study III showed the role of the facilitator to be fundamental in creating a space for self-reflection among healthcare personnel. Study IV showed that healthcare personnel face complex demands and expectations from the healthcare organization regarding the provision of care as well as having to meet the needs of patients and their next-of-kin. To conclude, healthcare personnel needed to find a balance among demands and expectations in order to satisfy those stakeholders involved and they had to seek compromise. There is a need for clinical ethics support that helps healthcare personnel reflect individually and collectively on ethically difficult situations they encounter in their everyday clinical practice. From this standpoint, a “Bottom-up” perspective may reduce the risk of moral distress among healthcare personnel and promote care based on person-centred values.
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| 21. |
- Rasoal, Dara, PhD, Senior Lecturer, 1980-
(författare)
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Rätt och fel om svår etik inom vården
- 2017
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Rapport (populärvet., debatt m.m.)abstract
- Healthcare personnel encounter ethically difficult situations in their everyday work and clinical ethics support might be important to support healthcare personnel to deal with these situations. The overall aim of this thesis was to describe perspectives on clinical ethics support, experiences of being in ethically difficult situations and experiences of facilitating ethics reflection. Methods. Study I had a descriptive design in which research articles were reviewed (n=54). In study II audio-recorded moral case deliberation (n=70) in 10 Swedish workplaces in hospitals and community care were analysed. In study III interviews were conducted with facilitators (n=11) of moral case deliberation. Study IV used non-participant observation during three weeks as well as informal conversations with healthcare personnel (n=12) in community home healthcare. Results and conclusion. In study I, two perspectives emerged on clinical ethics support, a “Top-down” perspective, where an individual or a group of “experts” in ethics could recommend the best course of action and a “Bottom-up” perspective that allows healthcare personnel to manage ethically difficult situations through ethical reflections led by a facilitator. Studies II and IV showed how ethically difficult situations on different levels are often connected with emotions and uncertainties. Study III showed the role of the facilitator to be fundamental in creating a space for self-reflection among healthcare personnel. Study IV showed that healthcare personnel face complex demands and expectations from the healthcare organization regarding the provision of care as well as having to meet the needs of patients and their next-of-kin. To conclude, healthcare personnel needed to find a balance among demands and expectations in order to satisfy those stakeholders involved and they had to seek compromise. There is a need for clinical ethics support that helps healthcare personnel reflect individually and collectively on ethically difficult situations they encounter in their everyday clinical practice. From this standpoint, a “Bottom-up” perspective may reduce the risk of moral distress among healthcare personnel and promote care based on person-centred values
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| 22. |
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| 23. |
- Rasoal, Dara, PhD, Senior Lecturer, 1980-
(författare)
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Towards International PhD Standards
- 2013
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Ingår i: Organisation of PhD Education in Biomedicine and Health Sciences in the European System, 8th Orpheus Conference, Towards International PhD Standards, Prague, Czech Republic, April 25 – 27 2013, Programme, Abstracts.
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Konferensbidrag (refereegranskat)
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| 24. |
- Rasoal, Dara, PhD, Senior Lecturer, 1980-, et al.
(författare)
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Unethical abuse of women’s medical right during the childbirth : Risk factors and consequences
- 2022
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Ingår i: 3rd Scientific Conference on Women’s Health, Erbil, Sept 1-2, 2022.
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Konferensbidrag (refereegranskat)abstract
- Background: Obstetric violence (OV) is a widespread post antenatal phenomenon all around the globe and threatens the provision of respectful, dignified and autonomy-based childbirth for women. Previous research indicates that the consequence of OV is devastating for women’s human right, health, and childbirth experiences. Furthermore, previous studies have also highlighted the increased numbers of elective cesarean section because of fear to exposed to OV during childbirth. The aim of this study is to illuminate the risk factors associated with obstetric violence in the private and public financed hospital and the need of ethical aspects. Methods: Systematic reviews were performed and a comprehensive data extraction from 1996 to 2022 were conducted in databases PubMed, CINAHL and Web of science. Mesh terms and Cinahl headings used to identify the relevant literature based on the concept obstetric violence. In total 330 scientific articles were analyzed, condensed, and generated the results.Discussion/Conclusion: Preliminary results shows that risk factors that is associated with the prevalence of obstetric violence is more likely to appear in the public financed hospital compare with private. This includes the lack of resources, staff/shortage/work overload, organizational and medical hierarchy (culture of abuse), women’s socioeconomical backgrounds and education, social status and family support, age, physical appearance, patients’ advocacy, lack of legal protection and patient organization, lack of ethical guidelines and principles. The result also indicates a great need for ethical reflection groups among healthcare providers in both private and public financed hospital delivery unit. Consequences: Women who are exposed to OV are more likely to develop postnatal depression and anxiety. This could have a huge impact on women’s’ lactation and care for the infant (difficulty bonding). Distrust to the healthcare system (ethical and legal aspects) could lead to choices such as home birth which means higher risks and complications for women’s health in terms of infections, hypertension, bleeding, newborn injuries, or death. Future studies need to focus on the hypothesis: - Obstetric violence could have negative impact on pro-natalist society with lower childbirth rate consequently.- Postpartum depression could enhance the risk for trigger a shaken baby syndrome.
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| 25. |
- Rasoal, Dara, 1980-, et al.
(författare)
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What healthcare teams find ethically difficult : Captured in 70 moral case deliberations
- 2016
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Ingår i: Nursing Ethics. - London, United Kingdom : Sage Publications. - 0969-7330 .- 1477-0989. ; 23:8, s. 825-837
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ethically difficult situations are frequently encountered by healthcare professionals. Moral case deliberation is one form of clinical ethics support, which has the goal to support staff to manage ethical difficulties. However, little is known which difficult situations healthcare teams need to discuss.Aim: To explore which kinds of ethically difficult situations interprofessional healthcare teams raise during moral case deliberation.Research design: A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedish workplaces. A descriptive, qualitative approach was applied, using thematic content analysis.Ethical considerations: An advisory statement specifying no objections to the study was provided from an Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moral case deliberation.Findings: Three themes emerged: powerlessness over managing difficult interactions with patients and next-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over care decisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or manage patient's/next-of-kin's emotional needs or emotional outbursts and discouragement over motivating patients not taking responsibility for themselves. They could be uncertain over the patient's autonomy, who should have power over life and death, disclosing the truth or how much power next-of-kin should have.Discussion: The findings suggest that the nature of the ethically difficult situations brought to moral case deliberations contained more relational-oriented ethics than principle-based ethics, were permeated by emotions and the uncertainties were pervaded by power aspects between stakeholders.Conclusion: MCD can be useful in understanding the connection between ethical issues and emotions from a team perspective.
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| 26. |
- Rasoal, Dara, PhD, Senior Lecturer, 1980-
(författare)
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Which ethical problems arise in Moral Case Deliberation concerning patients whose voices are impaired?
- 2014
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Ingår i: International Conference of Clinical Ethics Consultation.
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Konferensbidrag (refereegranskat)abstract
- Background: Ethically difficult situations are frequently encountered by healthcare professionals. Moralcase deliberation is one form of clinical ethics support, which has the goal to support staff to manageethical difficulties. However, little is known which difficult situations healthcare teams need to discuss.Aim: To explore which kinds of ethically difficult situations interprofessional healthcare teams raise duringmoral case deliberation.Research design: A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedishworkplaces. A descriptive, qualitative approach was applied, using thematic content analysis.Ethical considerations: An advisory statement specifying no objections to the study was provided froman Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moralcase deliberation.Findings: Three themes emerged: powerlessness over managing difficult interactions with patients andnext-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over caredecisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or managepatient’s/next-of-kin’s emotional needs or emotional outbursts and discouragement over motivatingpatients not taking responsibility for themselves. They could be uncertain over the patient’sautonomy, who should have power over life and death, disclosing the truth or how much power nextof-kin should have.Discussion: The findings suggest that the nature of the ethically difficult situations brought to moral casedeliberations contained more relational-oriented ethics than principle-based ethics, were permeated byemotions and the uncertainties were pervaded by power aspects between stakeholders.Conclusion: MCD can be useful in understanding the connection between ethical issues and emotionsfrom a team perspective.
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| 27. |
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| 28. |
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| 29. |
- Rudman, Ann, et al.
(författare)
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Sjuksköterskor i frontlinjen av COVID-19 pandemin : vilka blev konsekvenserna? Teknisk rapport om enkät och datainsamling
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport summerar datainsamlingen som genomfördes av SCB (Statistiska centralbyrån) i projektet ”Sjuksköterskor i frontlinjen av COVID-19 pandemin: Vilka blev konsekvenserna?”. Projektet är finansierat av AFA försäkring (Diarienr 200311). I kapitel 1 beskrivs bakgrund till LUST (Longitudinell Undersökning om Sjuksköterskors Tillvaro) studien. I kapitel 2 beskrivs studien utifrån design, rekrytering och datainsamling. I kapitel 3 redovisas översikt över innehållet i enkäten som skickades ut studiedeltagarna. Projektet bedrivs på Högskolan Dalarna och inom ramen för Petter Gustavssons forskargrupp vid Karolinska Institutet.Sjuksköterskor har varit i frontlinjen av COVID-19-pandemin och de stressorer som de utsatts för i sitt arbete inom hälso- och sjukvården kan orsaka hälsoproblem. I föreliggande projekt har en nationell kartläggning av sjuksköterskors arbetssituation och hälsa under COVID-19 pandemin gjorts. Undersökningen är gjord utifrån de tre sjuksköterskekohorter som följts inom ramen för LUST-studien sedan 2002 (Gustavsson et al., 2013; Rudman, Hörberg, et al., 2020; Rudman et al., 2010). I LUST-studien har närmare 4500 sjuksköterskestudenter följts med uppföljande enkäter från deras utbildningstid 11 till 15 år efter examen. En uppföljande enkätundersökning genomfördes i september 2021 till januari 2022 vilket motsvarar 15 till 19 år efter examen. En speciellt anpassad enkät med relevans och aktualitet för arbetet under pandemin hade utvecklats gemensamt med forskare som har expertis gällande sjuksköterskor i olika verksamheter som belastats under COVID-19 pandemin. Enkäterna besvarades när pandemin pågått i ungefär ett år och nio månader.I samarbete med SCB har datainsamlingen genomförts som en postenkät med påminnelser och med möjlighet att besvara frågorna online. Svarsfrekvensen för enkätstudien blev 57% för hela undersökningen (för samtliga kohorter), vilket bedöms vara en hög svarsfrekvens med tanke på hur belastad sjuksköterskekåren har varit under COVID-19 pandemin.
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- Summer Meranius, Martina, 1971-, et al.
(författare)
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Paradoxes of person‐centred care : A discussion paper
- 2020
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 7:5, s. 1321-1329
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Forskningsöversikt (refereegranskat)abstract
- AIM: Previous research has mainly focused on the advantages of PCC and less on its disadvantages. Hence, there is a need to further explore the recent research regard-ing PCC from both sides. Therefore, the aim of this paper is to elucidate the advan-tages and disadvantages of PCC.DESIGN: Discussion paper.METHODS: We searched relevant literature published January 2000–March 2018 in PubMed, Medline, CHINAL, Scopus and Web of Science.RESULTS: The results showed that PCC can contribute to improved health and well-being, improved mutual interaction in relationships, improved cost-effectiveness and im-proved work environment, while the disadvantages can involve increased personal and financial costs, exclusion of certain groups, increased personal and financial costs, exclu-sion of staff's personhood and unfairness due to empathy. An analysis of the existing literature on PCC showed paradoxes, which call for further investigation.
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