| 1. |
- Anderzén-Carlsson, Agneta, 1966-
(författare)
-
Children with cancer : focusing on their fear and on how their fear is handled
- 2007
-
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.
|
|
| 2. |
- Anderzén-Carlsson, Agneta, et al.
(författare)
-
Children's fear as experienced by the parents of children with cancer
- 2007
-
Ingår i: Journal of Pediatric Nursing. - Amsterdam : Elsevier. - 0882-5963 .- 1532-8449. ; 22:3, s. 233-244
-
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.
|
|
| 3. |
- Anderzén-Carlsson, Agneta, 1966-, et al.
(författare)
-
Dealing with fear : from the perspective of adolescent girls with cancer
- 2012
-
Ingår i: European Journal of Oncology Nursing. - Oxon, United Kingdom : Elsevier. - 1462-3889 .- 1532-2122. ; 16:3, s. 286-292
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Previously fears in adolescents with cancer has been identified in relation to medical procedures, death, altered appearance and as having an overall influence on life, but to our knowledge young people's perspectives on dealing with fear have not been previously investigated.Purpose: To examine adolescents' perspectives on dealing with cancer related fear.Methods and sample: Six girls participated in qualitative interviews focussing on their fear and and how they dealt with it. Data were analysed by means of qualitative content analysis.Results: The results revealed two perspectives. First, the adolescents' own personal battle with fear. Second, they reported that they were not alone with their fear, as they shared it with significant others. An environment characterized by emotional presence helped them to deal with their fear, as well as prevented it from occurring.Conclusions: There is a need for staff and parents to be vigilant to the adolescents' need to feel cared for and allow them the opportunity to deal with their own fear, as at times they want to manage in their own way. Young patients have resources to cope with their fears and therefore should not be viewed as victims, but as young people with a great amount of competence, who benefit from a supportive environment.
|
|
| 4. |
- Anderzén-Carlsson, Agneta, 1966-, et al.
(författare)
-
Embodied suffering : experiences of fear in adolescent girls with cancer
- 2008
-
Ingår i: Journal of Child Health Care. - London : Sage. - 1367-4935 .- 1741-2889. ; 12:2, s. 129-143
-
Tidskriftsartikel (refereegranskat)abstract
- Previously, fear in adolescents with cancer has been sparsely described from an emic perspective. The aim of this study was to illuminate fear in adolescents with personal experience of cancer. The participants were six adolescent girls between the age of 14 and 16 years who were no longer under active treatment for cancer but still went for regular check-ups. Open interviews were conducted. Data were analysed according to the phenomenological hermeneutic method. In the result one main theme was identified: `an embodied fear — a threat to the personal self'. This theme was built up by three separate but intertwined themes: `experiencing fear related to the physical body', `experiencing existential fear' and `experiencing fear related to the social self'. In the comprehensive understanding the fear was interpreted from youth cultural aspects as well as a holistic perspective. The importance of professionals taking the whole person and their situation into account when meeting the fear is underlined.
|
|
| 5. |
- Anderzén-Carlsson, Agneta, 1966-, et al.
(författare)
-
Fear in children with cancer : observations at an outpatient visit
- 2008
-
Ingår i: Journal of Child Health Care. - London : Sage. - 1367-4935 .- 1741-2889. ; 12:3, s. 191-208
-
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.
|
|
| 6. |
- Anderzén-Carlsson, Agneta, et al.
(författare)
-
How physicians and nurses handle fear in children with cancer
- 2007
-
Ingår i: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 22:1, s. 71-80
-
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
|
|
| 7. |
|
|
| 8. |
- Dahlqvist, Vera, et al.
(författare)
-
Development of the perceptions of conscience questionnaire.
- 2007
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 14:2, s. 181-193
-
Tidskriftsartikel (refereegranskat)abstract
- Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses' assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers.
|
|
| 9. |
- Fläckman, Birgitta, et al.
(författare)
-
Unmet expectations : why nursing home staff leave care work
- 2008
-
Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 3:1, s. 55-62
-
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.
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
- Forslund, Kerstin, et al.
(författare)
-
Acute chest pain emergencies : spouses' prehospital experiences
- 2008
-
Ingår i: International emergency nursing. - : Elsevier BV. - 1878-013X .- 1755-599X. ; 16:4, s. 233-240
-
Tidskriftsartikel (refereegranskat)abstract
- The call to the Emergency Medical Dispatch Centre is often a person's first contact with the health-care system in cases of acute illness or injury and acute chest pain is a common reason for calling. The aim was to illuminate how spouses to persons with acute chest pain experienced the alarm situation, the emergency call and the prehospital emergency care. Interviews were conducted with nineteen spouses. A phenomenological-hermeneutic approach was used for the analyses. The themes responsibility and uneasiness emerged as well as an overall theme of aloneness. Being a spouse to a person in need of acute medical and nursing assistance was interpreted as "Being responsible and trying to preserve life" and "Being able to manage the uneasiness and having trust in an uncertain situation." When their partners' life was at risk the spouses were in an escalating spiral of worry, uncertainty, stress, fear of loss, feeling of loneliness and desperation. They had to manage emotional distress and felt compelled to act to preserve life, a challenging situation.
|
|
| 13. |
- Forslund, Kerstin, 1953-
(författare)
-
Challenges in prehospital emergency care : patient, spouse and personnel perspectives
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Prehospital emergency care (PEC) with the emergency call to the Emergency Medical Dispatch (EMD) centre is an essential part of the health-care system. It is important to obtain knowledge about the links in the PEC chain from the perspectives of those providing the service and those receiving it. The overall aim of this thesis was to describe the challenges surrounding PEC based on the experiences of patients, spouses and personnel. A qualitative descriptive design was used in the five papers included. The data analysis methods were phenomenological-hermeneutics (I–III), qualitative content analysis (IV–V) and descriptive statistics (V). Interviews with thirteen patients who had called the EMD-centre due to acute chest pain (I) revealed a general satisfaction with PEC. They were aware of the number to call in an emergency but were uncertain when to call. The potentially life threatening emergency situation was marked by vulnerability and dependency and was fraught with pain, fear and a sense of aloneness. An overall theme of aloneness emerged from the interviews with nineteen spouses who had placed an emergency call for their husband or wife that was experiencing acute chest pain (II). The challenges in being a spouse to a person in need of PEC were associated with: “Being responsible and trying to preserve life” and “Being able to manage the uneasiness and feel trust in an uncertain situation”. The spouses were in an escalating spiral of aloneness, worry, uncertainty, stress, fear of loss and desperation. Interviews with sixteen emergency operators dealt with situations they considered difficult to deal with and their reflections on how they managed such situations (III). Uncertainty, communication difficulties and insufficient resources characterized those situations. Skills, knowledge, experience, as well as personal qualities such as sensitivity, self-insight, empathy and intuition were regarded as important when handling them. Interviews with four nurses and fifteen emergency operators related to their experiences of working together for two years at an EMD-centre were conducted after the nurses were added to the EMD-centre to increase medical and nursing competence (IV). Initial frustration and scepticism changed to positive experiences with improved cooperation and service. The nurses voiced difficulties dealing with the more medically urgent calls and the emergency operators with the more complicated and diffuse medical cases. A total of 336 questionnaires related to alarms involving acute chest pain and given the highest priority by the emergency operator were collected in a study aimed at describing the ambulance personnel’s perceptions of the quality of the information received from the EMD-centre (V). The ambulance personnel perceived most of the information such as patient assessment, condition, history, preparedness and in particular pain status to be of high quality. In summary: In PEC there is many interdependent complexities that present demands and challenges to the actors involved (I–V). In general those who received emergency assistance from PEC were satisfied, but the margins between success and failure are small. Risks for errors exist throughout the PEC chain and time poses a challenge. Understanding is crucial for all involved, and the same situation can be experienced differently. Challenges inherent in PEC are the communication problems, unpredictability and uniqueness along with daring to be in the acute situation and dealing with a sense of aloneness, uncertainty and dependency. The personnel that do not have the ability to see the person they are helping are even more challenged. Important attributes for PEC personnel are caring attitudes, personal skills, experiences and professional knowledge. PEC personnel have the authority and power to act and make decisions, in which responsibility, sensitivity, and human dignity must be addressed. Lives are saved with PEC despite all the challenges and possibilities for error, such as those that exist between the different actors. It is vital that the PEC chain is as strong as possible.
|
|
| 14. |
- Forslund, Kerstin, et al.
(författare)
-
Experiences of adding nurses to increase medical competence at an emergency medical dispatch centre
- 2006
-
Ingår i: Accident and Emergency Nursing. - : Elsevier BV. - 0965-2302 .- 1532-9267. ; 14:4, s. 230-236
-
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.
|
|
| 15. |
- Forslund, Kerstin, et al.
(författare)
-
Patients with acute chest pain : experiences of emergency calls and pre-hospital care
- 2005
-
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.
|
|
| 16. |
- Forsner, Maria, 1954-, et al.
(författare)
-
The experience of being ill as narrated by hospitalized children aged 7-10 years with short-term illness.
- 2005
-
Ingår i: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 9:2, s. 153-165
-
Tidskriftsartikel (refereegranskat)abstract
- Children's illness has been investigated through the eyes of parents and nurses but the child's own perspective has been largely ignored. The aim of this study is to illuminate the 7-10-year-olds' experiences of being ill. Three girls and four boys were interviewed and narrated their experience about short-term illness. The data obtained was subjected to a thematic qualitative content analysis. The analysis suggests that the children combined reality and imagination and contrasts seemed to coexist such as being scared/confident, sad/cosy and hurt/having fun. They felt caught and tried to escape. The experience of illness as narrated by children can lead to a richer understanding and influence the way we care for paediatric patients.
|
|
| 17. |
- Glasberg, Ann-Louise, et al.
(författare)
-
Development and initial validation of the Stress of Conscience Questionnaire.
- 2006
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 13:6, s. 633-48
-
Tidskriftsartikel (refereegranskat)abstract
- Stress in health care is affected by moral factors. When people are prevented from doing 'good' they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach's alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: 'internal demands' and 'external demands and restrictions'. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts.
|
|
| 18. |
- Häggström, Elisabeth, et al.
(författare)
-
Relatives' struggle for an improved and more just care for older people in community care
- 2007
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:9, s. 1749-1757
-
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.
|
|
| 19. |
- Kaminsky, Elenor
(författare)
-
Telephone Nursing : Stakeholder views and understandings from a paediatric and a gender perspective
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- ‘First line healthcare’ is offered via telephone in many Western countries. The overall aim of this thesis is to describe Telephone Nursing (TN) from three viewpoints: telenurses, parents calling for their children, and operation managers. Four empirical studies were conducted. Telenurses described their work in five different ways: ‘Assess, refer and give advice to the caller’, ‘Support the caller’, ‘Strengthen the caller’, ‘Teach the caller’ and ‘Facilitate the caller’s learning’, which all constitute a TN ‘work map’. Authentic paediatric calls between parents and telenurses revealed that 73% of callers were mothers and children were aged between 5 days and 14.5 years. The top three contact reasons were ear and skin problems, and fever, with a median call length of 4.4 minutes. More than half of the calls resulted in referrals and 48% received self-care advice. The likelihood of fathers being given referrals as a result of their call was almost twice as high as that for mothers, while mothers were almost twice as likely to receive self-care advice as fathers. Parents described their degree of worry and trust that influenced their decisions whether to contact SHD or not. Their calls were carefully prepared, and the parent calling often depended on family routine. Parents reported to follow recommendations. Most relied upon their own intuition if further worried, but some indicated they would never seek healthcare unless it was recommended. Operation managers described four main goals of TN work: ‘create feelings of trust’, ‘achieve patient safety’, ‘assess, refer and give advice’, and ‘teach the caller’. Equitable healthcare was regarded as important, whereas health promotion was not considered as part of the goals.Conclusion: The studied TN viewpoints present concordance and discrepancies. Paediatric health calls appear mostly to be a woman-to-woman activity. Telenurses’ increased gender competence might increase TN safety. For that matter, telenurses’ collaboration with parents and making parents aware of holding the ultimate responsibility for their child’s condition is important. Goals of TN work and their relationship with healthcare obligations such as equitable healthcare and health promotion need further clarification. The viewpoints described in this thesis may contribute to the development of TN.
|
|
| 20. |
- Kihlgren, Annica Larsson, 1957-, et al.
(författare)
-
Caring for older patients at an emergency department : emergency nurses' reasoning.
- 2005
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 14:5, s. 601-8
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to use the experiences of emergency nurses to illuminate what constitutes good nursing care for patients 75 years or older transferred to emergency departments.BACKGROUND: Emergency departments have a medical technical character and the number of visits there increases dramatically as people age. Older patients require increased healthcare services in terms of nursing care, interventions and hospitalizations due to an increased complexity of their problems. For these reasons it is important to study what good nursing care of the older patients consists of at an emergency department from the emergency nurses' point of view.METHOD: Ten emergency nurses from a university hospital emergency department in Sweden were interviewed. A thematic content analysis was performed.RESULTS: The study showed that it was necessary to be knowledgeable, to be understanding of the older patients' situation and to take responsibility for them in order to be able to provide good nursing care. The emergency nurses shifted focus from describing the central aspect of good nursing care to describing what hinders the provision of it. Their experience was that prioritizing medical procedures, everyday tasks and routines threatens good nursing care of older patients in emergency departments. The emergency nurses held that the older patient is often sent to an emergency department where the level of care is not appropriate to their needs.CONCLUSIONS: The result can be seen as a challenge for the organization and the nurses in the future; to prioritize differently, thereby maintaining a balance between good nursing and medical/technical tasks when treating older patients.RELEVANCE TO CLINICAL PRACTICE: The present day healthcare system is not organized to appropriately meet the needs of the older patients. Nurses themselves hold they can better serve the older patient. By sharing their experiences, both can be accomplished.
|
|
| 21. |
- Lindblad, Britt-Marie
(författare)
-
Att vara förälder till barn med funktionsnedsättning : erfarenheter av stöd och av att vara professionell stödjare.
- 2005
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Avhandlingens övergripande syfte är att tolka och beskriva innebörder av stöd, utifrån att vara förälder till barn med funktionsnedsättning och att vara professionella stödjare. Datainsamling har skett i form av berättande intervjuer med 39 föräldrar (23 mödrar och 16 fäder) och 9 professionella (7 kvinnor, 2 män) från olika verksamheter. Samtliga intervjuer har analyserats med hjälp av fenomenologisk hermeneutisk metod. Innebörder av att vara förälder till barn med funktionsnedsättning (studie I) har tolkats som en medvetenhet om viktiga värden i livet. Barnet har ett inneboende värde som en unik person och föräldrarna strävar efter att göra sitt bästa för barnet. Denna strävan innebär att konfrontera oro, osäkerhet och rädsla i vården av barnet och andra personers nedvärdering av barnet. I föräldrarnas strävan att tillmötesgå barnets olika behov, ingår också att anpassa egna behov efter barnets. Den fördjupade förståelsen av studiens resultat är, att det handlar om en strävan att möjliggöra för barnet att leva ett gott liv. Innebörder av att få stöd av professionella (studie II) har tolkats som att föräldrar och barn blir bekräftade som värdefulla personer och att föräldrarna uppnår trygghet och kompetens i föräldraskapet och får ett hopp för barnets framtid. Erfarenheter av att inte få stöd, medför en kamp mot de professionella, för att kräva det stöd som föräldrarna anser att de och barnet behöver. Innebörder av att vara professionell stödjare (studie III), består av att ha personlig filosofi, som är integrerat i sättet att vara och handla som stödjare. Det innebär att vara trygg i hoppet om att det alltid går att göra något för att hjälpa, genom att söka unika lösningar i den aktuella situationen. Tillit till föräldrar som partners och att få deras tillit, samt att möjliggöra för föräldrarna att uppnå kompetens och trygghet i vården av sina barn är andra innebörder. Detta har tolkats som en frihet från att vara bunden av byråkrati och prestige och en möjlighet att vara äkta, följa sin filosofi och att vara i samklang med barn och föräldrar. Innebörder av informellt stöd (studie IV) har tolkats som en livsberikande gemenskap, där barnet, innefattas i kärleksfulla relationer med närstående och har en naturlig plats i samhället. Att som föräldrar kunna dela glädje, oro och sorg med andra personer och att få möjlighet att uppleva lättnad och spontanitet i det dagliga livet, är andra innebörder av informellt stöd. Helhetsförståelsen av de fyra studierna är, att stöd av professionella i sin tur är ett stöd i föräldrars etiska förpliktelse i deras strävan att möjliggöra för barnet att leva ett gott liv. Informellt stöd betyder att föräldrar och barn är inneslutna i trofasta och berikande relationer med andra.
|
|
| 22. |
- Skovdahl, Kirsti, 1964-, et al.
(författare)
-
Tactile stimulation associated with nursing care to individuals with dementia showing aggressive or restless tendencies : an intervention study in dementia care
- 2007
-
Ingår i: International Journal of Older People Nursing. - Oxford : Blackwell Publishing. - 1748-3735 .- 1748-3743. ; 2, s. 1-9
-
Tidskriftsartikel (refereegranskat)abstract
- Aim. This study aimed to describe from documentation both the caregivers' experiences of giving tactile stimulation to five people with moderate-to-severe dementia and who showed aggressive or restless tendencies, and the changes seen in them. Background. Clinical experiences indicate that tactile stimulation can contribute to a feeling of trust and confirmation as well as to improving communication, promoting relaxation and easing pain. There is, however, very little scientific documentation of the effects of touch massage for people with dementia. Design. From caregivers' documentation (28 weeks) of experiences, the giving of tactile stimulation to five randomly selected people with dementia showing aggressive or restless tendencies and the subsequent changes noticed. Method. The documentation was analysed by using qualitative content analysis. Results. All residents displayed signs of positive feelings and relaxation. The caregivers stated that they felt able to interact with the residents in a more positive way and that they felt they had a warmer relationship with them. Conclusion. Tactile stimulation can be seen as a valuable way to communicating non-verbally, of giving feedback, confirmation, consolation or a feeling of being valuable and taken care of. Relevance to clinical practice. Tactile stimulation has to be administered with respect and care, and given from a relational ethics perspective. Otherwise, there is a risk that tactile stimulation will be used merely as a technique instead of as a part of an effort to achieve optimal good, warm nursing care.
|
|
| 23. |
- Sørlie, Venke, et al.
(författare)
-
Meeting ethical challenges in acute care work as narrated by enrolled nurses.
- 2004
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 11:2, s. 179-88
-
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.
|
|
| 24. |
- Sørlie, Venke, et al.
(författare)
-
Meeting ethical challenges in acute nursing care as narrated by registered nurses
- 2005
-
Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 12:2, s. 133-42
-
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.
|
|
| 25. |
|
|
| 26. |
- Sörlie, Venke, et al.
(författare)
-
The meaning of being in ethically difficult care situationsin paediatric care as narrated by female Registered Nurses
- 2003
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 17:3, s. 285-292
-
Tidskriftsartikel (refereegranskat)abstract
- Studies among physicians and nurses in paediatric care reveal experiences of loneliness and lack of open dialogue. The aim of this study was to illuminate the meaning of female Registered Nurses’ lived experience of being in ethically difficult care situations in paediatric care. Twenty female Registered Nurses who had experienced being in ethically difficult care situations in paediatric care were interviewed as part of a comprehensive investigation into the narratives of male and female nurses and physicians about being in such situations. The transcribed interview texts were subjected to phenomenological-hermeneutic interpretation. The results showed that nurses appreciated social confirmation from their colleagues, patients and parents very much. This was a conditioned confirmation that was given when they performed the tasks expected from them. The nurses, however, felt that something was missing. They missed self-confirmation from their conscience. This gave them an identity problem. They were regarded as good care providers but at the same time, their conscience reminded them of not taking care of all the ‘uninteresting’ patients. This may be understood as ethics of memory where their conscience ‘set them a test’. The emotional pain nurses felt was about remembering the children they overlooked, about bad conscience and lack of self-confirmation . Nurses felt lonely because of the lack of open dialogue about ethically difficulties, for example, between colleagues and about their feeling that the wrong things were prioritized in the clinics. In this study, problems arose when nurses complied with the unspoken rules and routines without discussing the ethical challenges in their caring culture. The rules and the routines of the caring culture represented structural barriers for creating open dialogue and an ethically justifiable practice, called inauthentic existence, blindness related to our own inauthentic understanding, which focuses on the routines, rules, theories and systems. [ABSTRACT FROM AUTHOR]
|
|
