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Sökning: WFRF:(Strandberg Gunilla)

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1.
  • Strandberg, Gunilla, 1957-, et al. (författare)
  • Struggling to be/show oneself valuable and worthy to get care : One aspect of the meaning of being dependent on care--a study of one patient, his wife and two of his professional nurses
  • 2002
  • Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 16:1, s. 43-51
  • Tidskriftsartikel (refereegranskat)abstract
    • Dependency on care has commonly been described negatively and as a problem that needs to be addressed. From a larger data material, interviews with an old, hospitalized man with a chronic disease, his wife and two of his professional nurses was selected to study. The aim was to illuminate the meaning of being dependent on care, when it appears "negative". A phenomenological-hermeneutic approach was used to interpret the material. The interpretation shows that dependency on care is reluctantly shown although it is expected to be expressed and/or respected as it is shown. This makes dependency on care camouflaged and the space to be dependent is limited. The meaning of being dependent on care is understood as a two-dimensional struggle for existence. One dimension of the struggle is about to be/show oneself worthy to get care, as dependency on care holds a fear to be abandoned. The other dimension of the struggle is about to be/show oneself valuable as a human being, as identity is built upon being able to manage oneself and be strong. The interpretation if reflected on can open up possibilities to improve the quality of life for patients who are dependent on care.
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2.
  • Viglund, Kerstin, 1958- (författare)
  • Inner strength among old people : a resource for experience of health, despite disease and adversities
  • 2013
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background Inner strength has been described as an important phenomenon in association with disease management, health, and ageing. To increase the knowledge of the phenomenon of inner strength, a meta-theoretical analysis was performed which resulted in a model of Inner Strength where inner strength comprises four interrelated and interacting dimensions; connectedness, creativity, flexibility, and firmness. The model was used in this thesis as a theoretical framework.Aim The overall purpose of this thesis was to develop and validate an inner strength scale, describe inner strength among an older population, and elucidate its significance for experience of health, despite disease and adversities.Methods The studies had quantitative approaches with cross-sectional designs (I-III) and a qualitative approach with narrative interviews (IV). Studies I-IV was part of the GErontological Regional DAtabase (GERDA) Botnia project. In study I, the participants (n = 391, 19-90 years old) were mostly from northern Sweden. In studies II and III, the participants (n = 6119, 65, 70, 75 and 80 years old) were from Sweden and Finland, and in study IV the participants (n = 12, 67-82 years old) were from Västerbotten County. Data was analysed using principal component analysis and confirmatory factor analysis (CFA), various statistics, structural equation modelling, and qualitative content analysis.Results In study I, the Inner Strength Scale (ISS) was developed and psychometrically tested. An initial 63-item ISS was reduced to a final 20-item ISS. A four-factor solution based on the four dimensions of inner strength was supported, explaining 51% of the variance, and the CFA showed satisfactory goodness-of-fit. In study II, ISS scores in relation to age, gender and culture showed the highest mean ISS score among the 65-year-olds, with a decrease in mean score for every subsequent age (70, 75, and 80 years). Women had slightly higher mean ISS scores than men, and there were minor differences between the regions in Sweden and Finland. In study III, a hypothesis was proposed and subsequently supported in the results where inner strength was found to partially mediate in the relationship between disease and self-rated health. The bias-corrected bootstrap, estimating the mediating indirect effect was significant and the test of goodness-of-fit was satisfactory. In study IV, from the narratives of inner strength it was found that inner strength comprised feelings of being connected and finding life worth living. Having faith in oneself and one’s possibilities and facing and taking an active part in the situation were also expressed. Finally, coming back and finding ways to go forward in life were found to be essential aspects of inner strength.Conclusions The newly developed ISS is a reliable and valid instrument that captures a broad perspective of inner strength. Basic data about inner strength in a large population of old people in Sweden and Finland is provided, showing the highest mean ISS score among the 65-year-olds. Inner strength among old people is a resource for experience of health, despite disease and adversities. This thesis contributes to increase knowledge of the phenomenon of inner strength and provide evidence for the importance of inner strength for old people’s wellbeing. Increased knowledge of the four dimensions of inner strength; connectedness, creativity, flexibility and firmness, is proposed to serve as an aid for health care professionals in their efforts to identify where the need of support is greatest and to find interventions that promotes and strengthen inner strength.
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3.
  • Brännström, Margareta, et al. (författare)
  • Being a close relative of a person with severe, chronic heart failure in palliative advanced home care : a comfort but also a strain
  • 2007
  • Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 21:3, s. 338-344
  • Tidskriftsartikel (refereegranskat)abstract
    • Within previous research on family care of terminally ill people, studies have only rarely been carried out concerning heart failure care. This study aims to illuminate meanings of being a close relative of a person with severe, chronic heart failure (CHF) in palliative advanced home care (PAHC). Narrative interviews were conducted with three close relatives, tape-recorded, transcribed verbatim and a phenomenological-hermeneutic method was used to interpret the text. Meanings of being a close relative is to follow the life-threatening ups and downs, the person with CHF is going through. This means being on primary call, always on standby to mediate security and pleasure. In the deepest downs it is also to call for the back-up call i.e. the PAHC team, trusting their ability to show up on time to alleviate in the worst downs i.e. ease suffering. This study reveals that to be the close relative that the ill person is dependent on 24 hours a day is both a comfort and a strain.
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4.
  • Brännström, Margareta, et al. (författare)
  • Being a palliative nurse for persons with severe congestive heart failure in advanced homecare.
  • 2005
  • Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 4:4, s. 314-323
  • Tidskriftsartikel (refereegranskat)abstract
    • Advanced homecare for persons with congestive heart failure is a ‘new’ challenge for palliative nurses. The aim of this study is to illuminate the meaning of being a palliative nurse for persons with severe congestive heart failure in advanced homecare. Narrative interviews with 11 nurses were conducted, tape-recorded, and transcribed verbatim. A phenomenological-hermeneutic method was used to interpret the text. One meaning of being a palliative nurse is being firmly rooted and guided by the values of palliative culture. Being adaptable to the patient's way of life carries great weight. On one hand nurses live out this value, facilitating for the patients to live their everydaylife as good as possible. Being a facilitator is revealed as difficult, challenging, but overall positive. On the other hand nurses get into a tight corner when values of palliative culture clash and do not correspond with the nurses interpretation of what is good for the person with congestive heart failure. Being in such a tight corner is revealed as frustrating and giving rise to feelings of inadequacy. Thus, it seems important to reflect critical on the values of palliative culture.
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5.
  • Brännström, Margareta, 1957- (författare)
  • Ett liv i berg och dalbana : innebörder av att leva med svår kronisk hjärtsvikt i palliativ avancerad hemsjukvård utifrån patienters, närståendes och sjuksköterskors berättelser
  • 2007
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall purpose of this thesis is to illuminate meanings of living with severe chronic heart failure (CHF) in palliative advanced home care (PAHC) as disclosed through patients’, close relatives’ and nurses’ narratives. This thesis comprises four papers that illuminate the phenomenon from various perspectives and with different focus. In paper I four patients with severe CHF in PAHC were interviewed. In paper II three of their close relatives were interviewed. In paper III one man and his wife in PAHC were interviewed at 3-5 month intervals over a 4.5-years period. In paper IV 11 nurses in PAHC were interviewed. In all papers narrative interviews were conducted and the text was interpreted using a phenomenological-hermeneutic method. The result shows that meanings of living with severe CHF in PAHC is to be ‘knocking on death’s door’ yet surviving. This means never knowing what to expect of tomorrow as one suffers from a complex array of unpredictable, interwoven symptoms. The course of the illness forces sufferer to ride a symbolical ‘roller coaster’, an ongoing oscillation between ‘ups and downs’. Being offered a safety belt in the ‘roller coaster’ by the PAHC team means feelings of safety (I). Meanings of being a close relative of a person with severe CHF in PAHC is to be following the life- threatening ups and downs that the ill person goes through. It is like being a fellow passenger on the ‘roller coaster’ ride that is their loved one’s disease, with burdensome responsibility for easing the ‘downs’ and supporting the ‘ups’. This means being on primary call, always on standby to mediate security and pleasure. In the deepest downs it is also to call for the back-up call i.e. the PAHC team (II). Meanings of living the ‘ups and downs’ over time is being captive in a roller-coaster ride, side by side, with the ‘ups and downs’ caused by the illness. Living close to death is inescapable when recurrent periods of deepest ‘downs’ force one to face that one’s life together is coming to an end. The relationship between the spouses is severely tested but seems to withstand the strain and meaning is found in togetherness in life. Sharing the safety belt on the ‘roller coaster’, offered by the PAHC team, evokes feelings of security. However, the safety belt is adjusted to the man with severe CHF leaving the wife partly without comfort and at times uncertain, especially in the deepest ‘downs’ (III). Meanings of being a palliative nurse for patients with severe CHF in PAHC is being firmly rooted and guided by the values of palliative culture. Being a facilitator for the patient with CHF to live his/her everydaylife in the best way possible is difficult, challenging but overall positive. The nurses get into a tight corner when palliative culture values clash and do not correspond to nurses’ interpretation of what is good for the patient with severe CHF. There is a limit to nurses’ pliability to patients’ and close relatives’ will, as they are strongly convinced that resuscitation is not an option. Nurses have already made up their mind about that they do not perform heart- lung resuscitation (IV). The comprehensive understanding is that meanings of living with severe CHF in PAHC is being captive in a ‘roller-coaster’ life with varying periods between unpredictable improvement and deterioration of the body, for the rest of life. Living with the unpredictable, deteriorated body means to oscillate between enduring the suffering in ‘downs’ and enjoying life in ‘ups’ (I-III). Living with death so close over and over again i.e. being in a limit situation evokes feelings of uncertainty (I-IV) and confidence (I-III). Being positive dependent on PAHC facilitates a life as normal as possible in togetherness at home (I-IV). The comprehensive understanding of the four papers (I-IV) are discussed in the light of a theoretical framework from the German psychiatrist and philosopher Karl Jaspers thoughts about limit situation, the Danish philosopher K.E Lögstrup thoughts about the ethical demand, palliative theories and relevant empirical studies.
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6.
  • Brännström, Margareta, et al. (författare)
  • Living with severe chronic heart failure in palliative advanced home care.
  • 2006
  • Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 5:4, s. 295-302
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Living with severe chronic heart failure (CHF) in palliative care has been little studied. AIM: The aim of this study is to illuminate meaning of living with severe CHF in palliative advanced home care through patients' narratives. METHODS: Narrative interviews were conducted with 4 patients, tape-recorded and transcribed verbatim. A phenomenological-hermeneutic method was used to interpret the text. RESULTS: Meaning of living with severe CHF in palliative advanced home care emerged as 'knocking on death's door' although surviving. The course of the illness forces one to live a 'roller coaster life,' with an ongoing oscillation between ups and downs. Making it through the downs breeds a kind of confidence in one's ability to survive and the will to live is strong. Being offered a safety belt in the 'roller coaster' by the palliative advanced home care team evokes feelings of security. CONCLUSIONS: Meaning of living with severe CHF in palliative advanced home care is on one hand, being aware of one's imminent death, on the other hand, making it through the downs i.e. surviving life-threatening conditions, breed confidence in also surviving the current down. Being constructively dependent on palliative advanced home care facilitates everyday life at home.
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7.
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8.
  • Brännström, Margareta, et al. (författare)
  • Patients' experiences of being informed about having an abdominal aortic aneurysm : a follow-up case study five years after screening
  • 2009
  • Ingår i: Journal of Vascular Nursing. - : Elsevier BV. - 1062-0303 .- 1532-6578. ; 27:3, s. 70-4
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to describe patients' experiences 5 years after being informed about having an abdominal aortic aneurysm (AAA), at screening, in a subgroup of patients who suffered a decrease in quality of life (QoL) 12 months after screening. Of 6 patients with a decreased QoL 12 months after AAA screening, one had died, one declined to participate and one suffered cognitive problems and was therefore excluded. The remaining 3 patients (all men, aged 79-80 years) were interviewed in their homes. The interviews were analysed using thematic content analysis. The result shows that the patients have feelings of security about offered professional care, despite awareness of having an AAA. These feelings include having a relationship of trust with the surgeon; having trust in screening, follow-up checks and the possible treatment for their AAAs; and having awareness of the severity of the disease. Furthermore, the patients experience having an AAA to be symbolically 'like a drop in the ocean.' This means having no physical problems related to AAA, and having more difficulties with other diseases or problems in life overshadows the awareness about the AAA. An observed reduction in QoL among subjects with screening-detected AAA was mainly explained by other diseases or problems that overshadow the AAA. However, the low number of participants indicates a need for extended studies on this topic.
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9.
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10.
  • Burström, Marianne, et al. (författare)
  • Life experiences of security and insecurity among women with chronic heart failure
  • 2012
  • Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 68:4, s. 816-825
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim. This paper is a report of a study illuminating womens experiences of living with chronic heart failure with a focus on feelings of security and insecurity. Background. To be secure is a basic human need. Although feelings of being insecure has been found to be a common problem among people who live with chronic heart failure few qualitative studies, particularly among women, have been carried out in the field. Method. Eight women took part in focus group interviews during 2006. The data were analysed using qualitative content analysis. Findings. The womens feelings of security include acceptance of the past, everyday life and the future, trusting the self and the body despite the disease, not having to deal with dependency alone, and faith in care and treatment. The womens feelings of insecurity include feeling guilty for being sick and incapacitated, fear of living with a frail and failing body, anxiety about growing dependence on others, loneliness and death and lack of faith in care and treatment. Conclusion. The outlook on the past, the present and the view about the future, can be fundamental for the quality of life, and the sense of security and insecurity among women living with chronic heart failure. To support a sense of security it seems essential that nursing staff attempt to understand the womens outlook on life and their personal interpretations of living with chronic heart failure. This can be crucial for enhancing feelings of security in daily life for these women.
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11.
  • Burström, Marianne, et al. (författare)
  • Manliga patienter med hjärtsvikt och deras erfarenheter av att vara trygga och otrygga
  • 2007
  • Ingår i: Vård i Norden. - København : Sjuksköterskornas samarbete i Norden. - 0107-4083 .- 1890-4238. ; 3:27, s. 24-28
  • Tidskriftsartikel (refereegranskat)abstract
    • To be safe is a basic human need. Although feelings of being unsafe has been identified as a common problem among persons who live with heart failure there are few qualitative studies focusing on the problem. The aim of this study was to describe what it means to be safe or unsafe for men with heart failure. Seven men with heart failure, functional class NYHA II-III, were interviewed in focus groups. The interviews were analysed with content analysis. Threat of sudden death was described as both a source of safety and unsafety, and living with a fear of drowning in their own body fluid was seen as a source of unsafety for the men. In meetings with caregivers and relatives it was of importance to be received as a unique and valuable person. The confidence to the heart specialist was almost supernatural and the specialist nurse was spoken about as valuable for the feeling of being safe. In conclusion, to be seen with respect by physicians and nurses who have good ability to listen to the men's experience of living with heart failure can probably increase the men's feelings of safety. Further, it is important that physicians and nurses have good knowledge about heart failure.
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12.
  • 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.
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13.
  • Ericson-Lidman, Eva, et al. (författare)
  • Being closely connected to health care providers experiencing burnout : putting one's life on hold to help.
  • 2010
  • Ingår i: Journal of Family Nursing. - : SAGE Publications. - 1074-8407 .- 1552-549X. ; 16:1, s. 101-123
  • Tidskriftsartikel (refereegranskat)abstract
    • Being closely connected to a person experiencing illness may be a trying experience.This study aimed to illuminate meanings of being closely connected to health care providers experiencing burnout. Ten interviews were conducted with five people closely connected (i.e., family members or supportive friends) to health care providers recovering from burnout. The interviews were tape-recorded and transcribed verbatim, and the resulting text was interpreted using a phenomenological-hermeneutic method. One consequence of being closely connected to health care providers experiencing burnout is putting one's life on hold to help. In facing an almost unmanageable burden, those closely connected revealed their own suffering, emphasizing their need for support. Health care professionals need to be aware that those who are closely connected to a person experiencing burnout may lack knowledge about burnout and its related challenges. It is to be hoped such knowledge would allow significant others to better support the person experiencing burnout and promote their own health.
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14.
  • Ericson-Lidman, Eva, et al. (författare)
  • Burnout : co-workers' perceptions of signs preceding workmates' burnout
  • 2007
  • Ingår i: Journal of Advanced Nursing. - : Wiley-Blackwell Publishing Inc.. - 0309-2402 .- 1365-2648. ; 60:2, s. 199-208
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: This paper is a report of a study to describe co‐workers’ perceptions of signs preceding workmates’ burnout.Background: Burnout engenders emotional and economic suffering, both individual and societal. It is therefore important to learn to recognize early signs to prevent burnout and co‐workers, who have opportunities to recognize such signs, are valuable resources in this context.Method: Fifteen interviews were conducted with nursing and medical staff in Sweden who had worked with a person who developed burnout. The interviews took place in 2004 and were analysed using a thematic content analysis. The narratives were obtained when co‐workers already knew that their workmates were on sick leave because of burnout or had left their employment after sick leave because of burnout.Findings: The findings show that co‐workers retrospectively recalled a multiplicity of signs. They perceived that the people concerned were struggling to manage alone, showing self‐sacrifice, struggling to achieve unattainable goals, becoming distanced and isolated, and showing signs of falling apart.Conclusions: Some of the signs preceding workmates’ burnout may be difficult to interpret as signs of burnout, because they may be regarded as qualities which are to some extent encouraged in the prevailing culture. The findings provide a complex picture of these signs that will hopefully increase our awareness of and ability to recognize such signs to facilitate the possibilities of our helping in time. The sub‐themes and themes in the present study may also serve as a basis for supervisors involved in supporting clinical staff.
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15.
  • Ericson-Lidman, Eva, et al. (författare)
  • Care providers learning to deal with troubled conscience through participatory action research
  • 2013
  • Ingår i: Action Research. - : Sage Publications. - 1476-7503 .- 1741-2617. ; 11:4, s. 386-402
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to identify a process to assist care providers in dealing constructively with their troubled conscience generated by a difficult situation in elderly care relating to spitting behaviour. Our idea was, with help from participatory action research (PAR), that sharing and reflecting with others upon the voice of conscience, may support care providers to find ways to deal constructively with troubled conscience. Care providers in municipal elderly care participated in intervention sessions over one year, and with support from PAR, they were able to learn to ease the burden of a troubled conscience. They dealt with their troubled conscience constructively by sharing their thoughts and feelings, and gaining more knowledge about behavioural symptoms. They were trying to take relevant measures when caring for the resident, and perceiving the behaviour as unintentional. In this study PAR contributes with increased understanding of the necessity to listen to one's conscience and of the possibility of using conscience as a driving force, to develop clinical practice. This contribution of PAR may in the long run increase quality of care and work-related health.
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16.
  • Ericson-Lidman, Eva, et al. (författare)
  • Care providers' troubled conscience related to an implementation of a time management system in residential care for older people : a participatory action research study
  • 2020
  • Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 34:3, s. 745-753
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Care providers in residential care for older people often refer to time shortage, a problem that may generate troubled conscience.Aim: The aim of the study was to describe a PAR process to assist care providers in municipal residential care for older people to constructively deal with their troubled conscience related to an implemented time management system.Method: This intervention study was carried out with 14 care providers and their manager in residential care for older people with the support of participatory action research (PAR). The recorded PAR sessions were transcribed and compiled with inspiration from content analysis.Ethical considerations: The participants were given oral and written information and gave their written informed consent.Findings: The PAR process was found to empower the participants to form their own structure of the practical professional planning, adapted to the residents needs and to their daily work. In this process, participants used their troubled conscience as a driving force and as an asset.Conclusion: Instead of launching change without any deeper information, it is important to carefully prepare, involve and inform those who are going to execute the change. Meeting places should be arranged wherein care providers have the opportunity to share and reflect on challenging situations that can generate troubled conscience, especially when comprehensive changes in their work are going to be implemented.
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17.
  • Ericson-Lidman, Eva, et al. (författare)
  • Change agents’ experiences of implementing a new organizational culture in residential care for older people : a qualitative study
  • 2021
  • Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 41:3, s. 149-157
  • Tidskriftsartikel (refereegranskat)abstract
    • Culture change in organizations may affect employees and change agents are often a forgotten resource; their perspective is often overlooked in research. The aim of the study was to illuminate experiences of being a change agent in order to improve residential care of older people. Interviews were performed with 15 change agents who participated in a large culture transformation in residential care for older people. The study followed COREQ guidelines and content analysis was used to interpret the text. The analysis revealed that the change agents felt chosen when they accepted the challenge to become a change agent, but they also felt that transferring the message to co-workers was demanding. Conflicting demands about measuring care and aggravating circumstances to implement change were described. The results indicate that change agents benefit from preparation for the role itself as they have a great responsibility on their shoulders. In making the process more successful, all co-workers should be involved in the change process from the beginning.
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18.
  • Ericson-Lidman, Eva, et al. (författare)
  • Dealing with troubled conscience in municipal care of older people
  • 2013
  • Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 20:3, s. 300-311
  • Tidskriftsartikel (refereegranskat)abstract
    • Troubled conscience may jeopardize the health of health-care personnel and, hence, the quality of care provided. Learning more about how personnel deal with their troubled conscience therefore seems important. The aim of this study was to describe personnel's experiences of how they deal with troubled conscience generated in their daily work in municipal care of older people. Interviews were conducted with 20 care providers and analysed with a thematic content analysis. The findings show that in order to deal with troubled conscience, personnel dialogued with themselves and with others. They took measures in a direction they perceived to be correct, and they expressed a need for distancing and re-energizing. It is of importance to share situations that generate troubled conscience in order to find ways to deal with them. Reconsidering one's ways of dealing with troubled conscience may give care providers an opportunity to reach consensus within themselves.
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19.
  • Ericson-Lidman, Eva, et al. (författare)
  • Healthcare personnel's experiences of situations in municipal elderly care that generate troubled conscience
  • 2013
  • Ingår i: Scandinavian Journal of Caring Sciences. - Hoboken, NJ, USA : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 27:2, s. 215-223
  • Tidskriftsartikel (refereegranskat)abstract
    • Healthcare personnel may perceive troubled conscience when feeling inadequate and powerless. It is important to further explore healthcare personnel's descriptions of situations in daily work, which generate troubled conscience to increase the awareness of such situations. This study aimed to describe health care personnel's experiences of situations in municipal elderly care that generate troubled conscience. In this qualitative study, interviews were conducted with Registered and Enrolled nurses and nursing assistants (n = 20) working in municipal elderly care. The interviews were tape-recorded, transcribed verbatim and analysed with content analysis. Situations that generated troubled conscience was (i) Being caught between different demands, comprising being forced to prioritize between different residents' needs, being torn between residents'-/relatives'-/and co-workers' needs and expectations' and between work and private life, (ii) Being torn away from residents to other 'must do's', comprising stealing time from residents' to do housekeeping chore' and to 'obey' rules and recommendations, (iii) Feeling unable to relieve suffering, comprising falling short when striving to help, lacking knowledge, advice and support and time to ease residents' suffering and finally, (iv) Being part of providing care that is or feels wrong, comprising providing poor care and/or witnessing co-workers providing poor care, and being forced to give care that feels wrong. These findings identify important factors that generate stress of conscience (stress caused by troubled conscience), including difficulties with balancing priorities and following rules and recommendations that seem contrary to best care, and the need for interdisciplinary teamwork. Findings point to that sharing what conscience tells in the work team opens up possibilities for healthcare personnel to constructively deal with troubled conscience. Intervention studies are needed to explore whether such measures contribute to relieve the burden of troubled conscience and increase possibilities to provide high quality care.
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20.
  • Ericson-Lidman, Eva, et al. (författare)
  • Learning to deal constructively with troubled conscience related to care providers' perceptions of deficient teamwork in residential care of older people : a participatory action research study
  • 2015
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:2, s. 215-224
  • Tidskriftsartikel (refereegranskat)abstract
    • Conscience can be perceived as an asset that helps care providers to provide good care, but it can also be a burden that generates stress of conscience (stress related to a troubled conscience). Participatory action research (PAR) has been shown to be successful in supporting care providers in residential care of older people to learn to deal with their troubled conscience in challenging and demanding care situations. The aim of the study was to describe an intervention process to assist care providers in residential care of older people to constructively deal with their troubled conscience related to perceptions of deficient teamwork. The study design was grounded in PAR. Nine enrolled nurses (ENs), two nursing aids (NAs), one Registered Nurse (RN) and their manager participated in 12 PAR sessions. All sessions were tape-recorded, and a domain analysis of the transcriptions was performed. Findings show that a PAR-based intervention can support care providers to understand, handle and take measures against deficient teamwork. Using troubled conscience as a driving force can increase the opportunities to improve quality of care in residential care for older people. During the PAR process, participants raised their awareness of the need to view the team in a wider sense and that the manager and the Registered Nurse should also be members of the team to improve team outcome. To improve clinical practice, we suggest that teams in residential care of older people should be enabled to share and reflect on challenging situations that generate troubled conscience. However, as shown in this study, care providers might need support in order to facilitate and promote sharing and reflecting on what their conscience tells them.
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21.
  • Ericson-Lidman, Eva, et al. (författare)
  • Learning to Deal Constructively With Troubled Conscience Related to Care Providers' Perceptions of Not Providing Sufficient Activities for Residents
  • 2015
  • Ingår i: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 24:2, s. 221-227
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to illuminate an intervention process to assist care providers in municipal care of older people to constructively deal with their troubled conscience generated from their perceived shortcomings about not providing sufficient activities for residents. The study design was grounded in participatory action research. Twelve care providers and their manager participated in intervention sessions. Content analysis was used to analyze the transcriptions. By sharing their experiences with each other, care providers became aware of, and confirmed in one another, what types of activities were meaningful for residents and actions were taken to provide such activities. The importance of being attentive and relying on residents' responses, that is, providing person-centered activities, was found to be satisfying to residents and eased the care providers' troubled conscience. An enlightened conscience can be an important asset, which may prevent ill-health and improve quality of care.
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22.
  • Ericson-Lidman, Eva, et al. (författare)
  • Meanings of being a change agent in implementing a new organisational culture in home care services : a phenomenological hermeneutic study
  • 2023
  • Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Culture change is common in healthcare organisations worldwide today, and change agents are key persons in the process of change. It is therefore of vital importance to deepen the knowledge about change agents’ experiences. The aim of the study was to illuminate meanings of being a change agent to improve home care services. Ten change agents were interviewed individually using open-ended questions. The interviews were analysed with phenomenological hermeneutics. The design of the study followed the COREQ guidelines. Three themes were revealed in the analysis: ‘Being confirmed by the opportunity to make quality improvements’; ‘Pushing oneself to transfer the message’; and ‘Being strengthened by achievements but wishing for better conditions’. In order to prepare co-workers, change agents need training before their mission begins and during the change process.
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23.
  • Ericson-Lidman, Eva, et al. (författare)
  • Meanings of being a female co-worker to a person developing burnout
  • 2007
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell Publishing Inc.. - 0283-9318 .- 1471-6712. ; 21:2, s. 155-162
  • Tidskriftsartikel (refereegranskat)abstract
    • Burnout is dramatically increasing in many industrialised countries. Burnout is mainly studied from the perspective of the burnout person although it has been confirmed to affect co-workers as well. This study aimed to illuminate meanings of being a female co-worker to a person developing burnout. Fifteen interviews with nursing and medical staff were performed, tape-recorded and transcribed verbatim and a phenomenological-hermeneutic method was used to interpret the text. One meaning of being a female co-worker is struggling, on the one hand to understand and help the person developing burnout and on the other hand to manage their work and survive oneself. This means to be torn between helping the workmate and managing their work. Co-workers are filled with contradictory feelings, from deep concern to aversion and when the workmate finally goes on sick leave, co-workers' feelings of shortcomings and failure emerge, along with troubled conscience. This study reveals a picture of the difficulties of being a female co-worker to a person developing burnout that it is crucial to be aware of.
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24.
  • Ericson-Lidman, Eva, et al. (författare)
  • Meanings of being a supervisor for care providers suffering from burnout : from initial signs to recuperation
  • 2009
  • Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 17:3, s. 366-375
  • Tidskriftsartikel (refereegranskat)abstract
    • To illuminate meanings of being a supervisor for care providers suffering from burnout: from initial signs to recuperation. Background Supervisors in health care, i.e. supervisors with first-line responsibilities for a work unit, are exposed to heavy demands, especially in times of downsizing and restructuring of the healthcare system. When care providers show signs of developing burnout, these demands are even greater. Methods Interviews with 12 supervisors in health care were interpreted using a phenomenological-hermeneutic method. Results Being a supervisor when someone in the work team shows signs of burnout means struggling to help them to continue working. In this predicament and being responsible for the unit, the supervisors are torn between focusing on relations and on production. When the care provider reports sick, they are left with feelings of hopelessness and self-blame. Conclusions and implications for nursing management Supervisors face almost unmanageable strain, caught between conflicting demands. It seems important that supervisors are offered opportunities to share their feelings about this predicament as well as gaining increased knowledge about burnout. This is important if the supervisors are to give proper support, but it will also help to turn supervisory failure into development and to protect the health of the supervisors.
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25.
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26.
  • Ericson-Lidman, Eva, et al. (författare)
  • Relatives' perceptions of residents' life in a municipal care facility for older people with a focus on quality of life and care environment
  • 2015
  • Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 10:3, s. 160-169
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Relatives' perceptions of their older loved one's living conditions at residential care facilities are poorly described in interviews. Older persons often find it difficult to make their voices heard and an alternative is to ask a relative who knows the person well to express their views.AIM: This study aimed to describe relatives' perceptions of residents' life in a municipal care facility for older people with a focus on quality of life and care environment.DESIGN: A qualitative study design was used. Data were collected through nine interviews with six relatives of older people living in a residential care facility.METHODS: The interviews were recorded, transcribed and analysed using content analysis.RESULTS: The analysis resulted in three main themes and eight subthemes. The main themes were: Residents' life/quality of life is perceived to be in the hands of the care providers, Residents' disabilities and lack of stimulation are perceived to threaten their quality of life, and The secure climate in the residence is perceived to be coloured by Death's waiting room.CONCLUSIONS: The study emphasizes the importance of cocreating a constructive dependency and to take on the challenge of creating a feeling of at-homeness for each resident. It is important to be aware that what relatives perceive as monotony and passivity may be a problem for some residents, but not for all.IMPLICATIONS FOR PRACTICE: This study highlights the need to create a powerful partnership between relatives, care providers and residents to enhance the quality of life for residents. Every single meeting is important and makes a difference for the resident. Care providers might need to support relatives to understand that the last phase of life might be about focusing inwardly and reflecting on one's whole life as a way to end it.
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27.
  • Ericson-Lidman, Eva, 1960- (författare)
  • The complicated struggle to be a support : meanings of being a co-worker, supervisor and closely connected to a person developing burnout
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of this thesis is to illuminate meanings of being a co-worker, supervisor and closely connected to a person developing burnout, and to describe perceptions of signs preceding burnout. The thesis comprises four papers and is based on qualitative data. In papers I and II, the data material consisted of interviews with 15 female coworkers of a person developing burnout, in paper III, interviews with 12 supervisors to care providers suffering from burnout, and in paper IV, interviews on two occasions with 5 people closely connected to a person developing burnout. Thematic content analysis (I) and phenomenological-hermeneutic method (II, III, IV) was used to analyse/interpret the interview text. The findings show that the coworkers retrospectively recalled different signs preceding their workmate’s burnout. They describe that their workmate was struggling to manage alone and was showing self-sacrifice. Co-workers also describe that their workmates were struggling to achieve unattainable goals and were becoming distanced and isolated. Finally, the co-workers describe that their workmates were showing signs of falling apart (I). Meanings of being a female co-worker to a person developing burnout are struggling, on the one hand to understand and help the person with symptoms of burnout, and on the other to manage one’s own work. This burdensome situation means that the co-workers are filled with contradictory and frustrating feelings and when the workmate is finally sick-listed, troubled conscience arise in the coworkers (II). Meanings of being a supervisor for care providers suffering from burnout are struggling to help the care provider continue to work, but being responsible for the unit, the supervisors are forced to ensure that the work is carried out. As the situation proceeds, supervisors are trapped in a predicament, unable to help and feeling inadequate. When the care provider is sick-listed, feelings of self-blame arise. When the time comes for rehabilitation the supervisors are once again caught between conflicting demands in a seemingly impossible mission (III). Meanings of being closely connected to a person suffering from burnout are putting one’s life on hold in order to help the person, striving to stand by to the person developing burnout, regardless of one’s own needs. Those closely connected are saving the face of the person developing burnout in order to protect them from stress. As the situation proceeds, those closely connected carry the burden alone in this strained situation and sometimes they are treated with disrespect by the person developing burnout, a situation which reveals their own suffering. Striving to find recuperation engenders troubled conscience. This situation reveals a huge need for support for those closely connected to a person developing burnout (IV). The comprehensive understanding is that meanings of being a co-worker, supervisor and closely connected to a person developing burnout are, on the one hand, a complicated struggle to support the person and on the other to shoulder a heavy burden. They try to do everything they can to help and support the person developing burnout (II-IV), these attempts, however, do not seem to reach through (I-IV). Co-workers describe signs that something is the matter (I), but they (co-workers, supervisors and those closely connected) do not understand what is happening (IIIV). This burdensome situation is full of conflict for those involved, torn between the complicated struggle to support the person developing burnout and to manage this burdensome situation. Faced with their own shortcomings, troubled conscience arises. The comprehensive understanding of the four papers (I-IV) are discussed and reflected on with the help of social support theories and the ideas of the Danish philosopher Lögstrup’s thoughts about the ethical demand.
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28.
  • Ericson-Lidman, Eva, et al. (författare)
  • Troubled conscience related to deficiencies in providing individualised meal schedule in residential care for older people : a participatory action research study
  • 2015
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:4, s. 688-696
  • Tidskriftsartikel (refereegranskat)abstract
    • Food and mealtimes should be adapted to the older person's individual needs and desires, a fact that is often ignored in favour of a functional mealtime organisation. This study was grounded in participatory action research (PAR), and the aim of the study was to illuminate a PAR process to assist care providers in constructively dealing with their troubled conscience generated from perceived shortcomings in providing an individualised meal schedule in residential care for older people. Care providers and their manager participated in twelve PAR sessions. The participants' troubled conscience was eased by reflecting on and sharing their thoughts about their perception of a lack of individualised meal schedule and a lack of opportunities for meaningful interventions. The researchers in PAR became the bridge between the care providers and the management that was needed to improve individualised mealtime schedule. This study pinpoints how difficult it can be to make small changes in a rigid organisation that is run by a management that does not have the hands-on knowledge about the daily care provided by the organisation. This study points to the need of creating communication arenas wherein all personnel involved in care for older people, at all organisational levels, together meet to create a good care for older people. However, the care providers have been provided with tools, uncomplicated to use, to continue to let their voices being heard.
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29.
  • Ericson-Lidman, Eva, et al. (författare)
  • Using a developed participatory action research process in practice to help care providers deal with troubled conscience in residential care of older people
  • 2018
  • Ingår i: Action Research. - London : Sage Publications. - 1476-7503 .- 1741-2617. ; 16:2, s. 190-206
  • Tidskriftsartikel (refereegranskat)abstract
    • Stress of conscience seriously influence the quality of care and the wellbeing of the care providers in care for older people. It is therefore of great importance to take measures to address, and relieve but preferably prevent stress related to troubled conscience. In our participatory action research studies, we have used troubled conscience as a driving force to relieve care providers’ burden and to increase quality of care. The aim with this paper is to present our experiences of using a further developed participatory action research process in practice to deal with care providers’ troubled conscience in residential care for older people. The contribution to participatory action research practice in our studies is a support to the participatory action research process through using a modified model of problem processing, an approach which we found fruitful. In the paper, we describe our experiences and discuss them in relation to relevant literature and theory. Our experiences are that in participatory action research it is crucial to build a trusting relationship and striving to create a fruitful dialogue between the researchers and the participants. In our studies, we found that participatory action research is an easy approach to adapt as a problem-solving process in clinical practice and in nursing research.
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30.
  • 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.
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31.
  • Gustafsson, Gabriella, 1951- (författare)
  • Att bli eller inte bli utbränd : ett komplext fenomen bland vårdpersonal på samma arbetsplatser
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The thesis comprises four papers. The overall aim was to illuminate meanings of becoming and being burnt out respectively not becoming or being burnt out. The papers deal with two groups of healthcare personnel, one group on sick leave due to medically assessed burnout (n=20) and one group who showed no indications of burnout (n=20) from the same workplaces at psychiatric (n=7) and elderly (n=7) care units. A further aim was to describe personality traits and to elucidate perceptions of conscience (PCQ), stress of conscience (SCQ), moral sensitivity (MSQ-R), social support (SocIS) and resilience (RS) among the people in these two groups. Papers I and II are based on the text of narrative interviews interpreted using a phenomenological-hermeneutic method. Papers III and IV are based on data, pertaining to the same participants as in Papers I and II, derived from the following questionnaires; Cattell’s Sixteen Personality Factors Questionnaire (16PF) (III), ‘Perception of Conscience’ (PCQ), ‘Stress of Conscience’ (SCQ), ‘Moral Sensitivity Revised’ (MSQ-R), ‘Social Interactions Scale’ (SocIS) and ‘Resilience Scale’ (RS) (IV). Conventional statistical methods and Partial Least Square Regression (PLSR) were used to analyse the data (III, IV). In Paper I the aim was to illuminate meanings of becoming and being burnt out as narrated by healthcare personnel. The results show that meanings of becoming and being burnt out is to be torn between what one wants to manage and what one can actually manage. It is as if one’s ideals become more like demands for, regardless of the circumstances, one must be and show that one is capable and independent. It also means being dissatisfied with oneself for not living up to one’s own ideals as well as being disappointed in other people for not providing the confirmation one strives for. Feelings that one is a victim of circumstances emerge. Becoming and being burnt out leads to a futile struggle to live up to one’s ideals and when failing to unite one’s ideal picture with one’s reality one finally reaches an overwhelming feebleness. In Paper II the aim was to illuminate meanings of not becoming or being burnt out at workplaces where others developed burnout, as narrated by healthcare personnel. The results show that meanings of not becoming or being burnt out are to be rooted in an outlook on life which perceives its many-sidedness of prosperity, adversity, strength and weakness in oneself and others. An openness towards the circumstances of life emerges. Being able to judge the possibilities of influencing things, as well as being able to let go of injustice and look after oneself with a clear conscience are revealed as meanings of not becoming and being burnt out. In Paper III the aim was to describe personality traits among burnt out and non-burnt out healthcare personnel from the same workplaces. The results show, that the people in the burnt out group had lower scores regarding emotional stability and higher scores regarding anxiety than the people in the non-burnt out group but the results also showed a wide variation of personality traits within the groups. The most important indicators for belonging to the burnt out group were openness to changes and anxiety, and for belonging to the non-burnt out group, emotional stability, liveliness, privateness and tension. In Paper IV the aims were to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among burnt out and non-burnt out healthcare personnel from the same workplaces. The results show that higher levels of stress of conscience and moral sensitivity, a perception of conscience as a burden, having to deaden one’s conscience in order to keep working in healthcare and perceiving a lack of support from those around them characterize the burnt out group. Those in the non-burnt out group are characterised by lower levels of stress of conscience, an out-look on life with a forbearing attitude, a perception of conscience as an asset, an ability to deal with one’s conscience in a constructive way and a perception of receiving support from those around them. The comprehensive understanding from the four papers (I-IV) is discussed in light of a theoretical framework derived from Emmy van Deurzens thoughts about the four life worlds: the natural world (the physical world), the public world (the social world), the private world (the psychological world) and the ideal world (the spiritual world). The result can be summarized in terms of the human condition in life and demonstrates the essential importance of reconciling the vita activa (the active life of labor, work and action), the vita contemplativa (thinking, willing and judging) and not least the vita regenerativa (rest and recovery) in order to avoid being burned out.
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32.
  • Gustafsson, Gabriella, et al. (författare)
  • Burnout and perceptions of conscience among health care personnel : a pilot study.
  • 2010
  • Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 17:1, s. 23-38
  • Tidskriftsartikel (refereegranskat)abstract
    • Although organizational and situational factors have been found to predict burnout, not everyone employed at the same workplace develops it, suggesting that becoming burnt out is a complex, multifaceted phenomenon. The aim of this study was to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among two groups of health care personnel from the same workplaces, one group on sick leave owing to medically assessed burnout (n = 20) and one group who showed no indications of burnout (n = 20). The results showed that higher levels of stress of conscience, a perception of conscience as a burden, having to deaden one's conscience in order to keep working in health care and perceiving a lack of support characterized the burnout group. Lower levels of stress of conscience, looking on life with forbearance, a perception of conscience as an asset and perceiving support from organizations and those around them (social support) characterized the non-burnout group.
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33.
  • Gustafsson, Gabriella, 1951-, et al. (författare)
  • Meanings of becoming and being burnout : phenomenological-hermeneutic interpretation of female healthcare personnel's narratives
  • 2008
  • Ingår i: Scandinavian Journal of Caring Sciences. - Umeå : Institutione för omvårdnad. - 0283-9318 .- 1471-6712. ; 22:4, s. 520-528
  • Tidskriftsartikel (refereegranskat)abstract
    • The incidence of burnout has increased in many industrialized countries. Burnout is mainly studied among people still at work and with quantitative methods. The present study aimed to illuminate the meanings of becoming and being burnout as narrated by healthcare personnel on sick leave because of symptoms of burnout. Interviews with 20 female healthcare personnel were performed, tape-recorded and transcribed verbatim and a phenomenological-hermeneutic method was used to interpret the text. The result shows that the meanings of becoming and being burnout are to be torn between what one wants to be and what one manages. It is as one's ideals have become more like demands and no matter the circumstances, one must be and show oneself as being capable and independent. It is also to be dissatisfied with oneself for not living up to one's ideals as well as disappointed with other people for not giving the confirmation one strives for. Feelings of being a victim of circumstances emerge. Thus, becoming and being burnout is leading a futile struggle to live up to one's ideal, failing to unite one's ideal picture with one's reality and experiencing an overwhelming feebleness. This is interpreted in the light of Buber's philosophy as well as relevant empirical studies about burnout. One conclusion is that it seems important to reflect on as well as discuss between one another about our everyday reality; what are reasonable vs. unreasonable demands. Hopefully, such reflections will increase our tolerance of ourselves and others and our insightfulness of what is possible to achieve in work as well as in private life. This study is ethically approved.
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34.
  • Gustafsson, Gabriella, 1951-, et al. (författare)
  • Meanings of staying healthy in a context where others developed burnout : phenomenological-hermeneutic interpretation of healthcare personnel's narratives
  • 2009
  • Ingår i: Scandinavian Journal of Caring Sciences. - Umeå : Institutionen för omvårdnad. - 0283-9318 .- 1471-6712. ; 23:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Burnout has become a major problem in many industrialized countries, but not everyone at the same work place develops burnout. The present paper aimed to illuminate meanings of staying healthy in a context where others developed burnout as narrated by healthcare personnel. Interviews were conducted with 20 healthcare personnel and were interpreted using a phenomenological-hermeneutic method. The result shows that the meanings of staying healthy are to be rooted in an outlook on life perceiving its many-sidedness and the strengths and weaknesses of oneself and others with forbearance. One is striving to shoulder responsibility for oneself and for others and is also receptive towards the circumstances of life, striving to judge the possibilities of being and acting in order to attempt to influence things in what is believed to be the right direction. Being able to let go of injustice and look after oneself with a clear conscience is also revealed as meanings of staying healthy. In conclusion, forbearance with life's many-sidedness seems to pervade one's experiences, judgements and actions in life when dealing with one's reality, and thus, it is interpreted as essential for staying healthy in a context where others developed burnout. This study is ethically approved.
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35.
  • Gustafsson, Gabriella, et al. (författare)
  • Personality traits among burnt out and non-burnt out health-care personnel at the same workplaces : a pilot study
  • 2009
  • Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 18:5, s. 336-348
  • Tidskriftsartikel (refereegranskat)abstract
    • Stress-related illnesses, such as burnout, have increased over the last decade, but not everyone at the same workplace develops burnout, suggesting that individual factors may contribute to this phenomenon. The aim of this study was to describe patterns of personality traits among two groups of health-care personnel from the same workplaces, one group on sick leave due to medically-assessed burnout, and one group with no indication of burnout, respectively. Fourteen psychiatric- (n = 7) and elderly (n = 7)-care units, located in one specific area in a municipality in northern Sweden, participated in this questionnaire-based study. The participants (n = 40), on sick leave due to medically-assessed burnout (n = 20), and those with no indication of burnout (n = 20), respectively, completed Cattell's 16 Personality Factors Questionnaire between February and December 2004. Conventional statistical methods and partial least square regression were used to analyze data. The results showed that the burnout group had lower scores regarding emotional stability and higher scores regarding anxiety than the non-burnout group, but the results also showed a wide variation of personality traits within groups. The most important indicators for belonging to the burnout group were 'openness to changes' and 'anxiety', and for belonging to the non-burnout group, 'emotional stability', 'liveliness', 'privateness' (i.e. forthright or discreet), and 'tension'. The result indicates complex interactions between personality traits and the context in which the individual lives. It seems to be important to increase our awareness of when personality traits may constitute opportunities versus risks in dealing with one's existing circumstances.
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36.
  • Johan, Åhlin, et al. (författare)
  • Care providers’ narrated experiences of working in private non-profit residential care for older people during downsizing and reorganisation, focusing on troubled conscience
  • 2017
  • Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 37:4, s. 177-185
  • Tidskriftsartikel (refereegranskat)abstract
    • Knowledge about care providers’ experiences of working in residential care of older people during times of downsizing and reorganisation is scarce, and it is not known whether/how their conscience is influenced by such changes. The aim was to describe care providers’ experiences of working in private residential care for older people during downsizing and reorganisation, focusing on troubled conscience. This study adopted a qualitative descriptive design based on interviews with seven care providers. A qualitative content analysis was used. The overall understanding was revealed as perceiving oneself as pinioned in between current circumstances to provide care and what one’s conscience conveyed. Care providers perceived: deteriorating working conditions as exhausting, downsizing and reorganisation as triggering one’s conscience when collaborating, troubled conscience when downsizing and reorganisation decrease the quality of care, and good management as crucial during downsizing and reorganisation. The results highlight that adequate communication strategies, well-functioning leadership and opportunities to know together and share what one’s conscience tells are aspects that need consideration.
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37.
  • Jonsén, Elisabeth, et al. (författare)
  • Psychometric properties of the Swedish version of the Purpose in Life scale
  • 2009
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Blackwell Publishing. - 0283-9318 .- 1471-6712. ; 24:1, s. 41-48
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to test the theoretical assumptions beyond the Purpose in Life (PIL) scale, and to elucidate the underlying structure of the Swedish version of the PIL. The PIL, originally created by Crumbaugh and Maholick, is a 20-item scale of the Lickert type with possible scores ranges from 20 to 140, the higher score, the stronger PIL. The analysis was based on 449 participants, 62% of whom were women, from five different samples, ranging from 19 to 103 years old. An exploratory factor analysis restricted to three factors was performed. The factors were labelled meaning in existence, freedom to create meaning in daily life, and will to find meaning in future challenges. These factors reflected the three dimensions described by Frankl. Cronbach's alpha coefficient for the total scale was 0.83 and varied between 0.54 and 0.83 in the three factors. We concluded that the Swedish version of the PIL scale seems to have construct validity and reliability. Our results give support to the fact that the PIL scale captures and confirms the theoretical assumptions of Frankl's existential theory. We consider the PIL scale to be both feasible and appropriate for use in nursing research.
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38.
  • Lundman, Berit, et al. (författare)
  • Development and psychometric properties of the Inner Strength Scale
  • 2011
  • Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 48:10, s. 1266-1274
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Four dimensions of inner strength were previously identified in a meta-theoretical analysis: firmness, creativity, connectedness, and flexibility.OBJECTIVE: The aim of this study was to develop an Inner Strength Scale (ISS) based on those four dimensions and to evaluate its psychometric properties.METHOD: An initial version of ISS was distributed for validation purpose with the Rosenberg Self-Esteem Scale, the resilience scale, and the sense of Coherence Scale. A convenience sample of 391 adults, aged 19-90 years participated. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were used in the process of exploring, evaluating, and reducing the 63-item ISS to the 20-item ISS. Cronbach's alpha and test-retest were used to measure reliability.RESULTS: CFA showed satisfactory goodness-of-fit for the 20-item ISS. The analysis supported a fourfactor solution explaining 51% of the variance. Cronbach's alpha on the 20-item ISS was 0.86, and the test-retest showed stability over time (r=0.79).CONCLUSION: The ISS was found to be a valid and reliable instrument for capturing a multifaceted understanding of inner strength. Further tests of psychometric properties of the ISS will be performed in forthcoming studies.
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39.
  • Lundman, Berit, et al. (författare)
  • Fatigue in elderly with chronic heart failure : an under-recognized symptom
  • 2009
  • Ingår i: Aging Health. - : Future Medicine Ltd. - 1745-509X .- 1745-5103. ; 5:5, s. 619-624
  • Tidskriftsartikel (refereegranskat)abstract
    • In this secondary analysis of interviews with people with chronic heart failure, we examine living with fatigue in terms of obstacles and opportunities on personal, systemic and societal levels. On a personal level, people report that their bodies force them to rest, and to give in to and make space in their lives for fatigue. The need for rest is strong, but resting and inactivity are also regarded as dangerous. The healthcare system provides assistance through home care and technical equipment. However, society imposes obstacles, such as a lack of services in the immediate surroundings that prevent living well. In conclusion, people with chronic heart failure can manage their lives on a personal level by means of selection, optimization and compensation, and the healthcare system can provide further support; however, on a societal level there is lack of resources for those suffering from fatigue due to chronic heart failure.
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40.
  • Lundman, Berit, et al. (författare)
  • Inner strength-A theoretical analysis of salutogenic concepts.
  • 2010
  • Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 47:2, s. 251-260
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Theoretical and empirical overlaps between the concepts of resilience, sense of coherence, hardiness, purpose in life, and self-transcendence have earlier been described as some kind of inner strength, but no studies have been found that focus on what attributes these concepts have in common. OBJECTIVES: The objective of this study was to perform a theoretical analysis of the concepts of resilience, sense of coherence, hardiness, purpose in life, and self-transcendence, in order to identify their core dimensions in an attempt to get an overarching understanding of inner strength. PRINT METHOD: An analysis inspired by the procedure of meta-theory construction was performed. The main questions underlying the development of the concepts, the major paradigms and the most prominent assumptions, the critical attributes and the characteristics of the various concepts were identified. RESULTS: The analysis resulted in the identification of four core dimensions of inner strength and the understanding that inner strength relies on the interaction of these dimensions: connectedness, firmness, flexibility, and creativity. These dimensions were validated through comparison with the original descriptions of the concepts. CONCLUSION: An overarching understanding of inner strength is that it means both to stand steady, to be firm, with both feet on the ground and to be connected to; family, friends, society, nature and spiritual dimensions and to be able to transcend. Having inner strength is to be creative and stretchable, which is to believe in own possibilities to act and to make choices and influence life's trajectory in a perceived meaningful direction. Inner strength is to shoulder responsibility for oneself and others, to endure and deal with difficulties and adversities. This knowledge about inner strength will raise the awareness of the concept and, in turn, hopefully increase our potential to support people's inner strength.
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41.
  • Lundman, Berit, et al. (författare)
  • Inner strength in relation to functional status, disease, living arrangements, and social relationships among people aged 85 years and older
  • 2012
  • Ingår i: Geriatric Nursing. - : Elsevier BV. - 0197-4572 .- 1528-3984. ; 33:3, s. 167-176
  • Tidskriftsartikel (refereegranskat)abstract
    • Inner strength is described as an important resource that promotes well-being. We used data from a sample of 185 people in the Umeå 85+ cohort study to relate inner strength and its attributes to objective health variables. The Resilience, Sense of Coherence, Purpose in Life, and Self-Transcendence scales were used to assess aspects of inner strength, and strong correlations between the scales were found. Prevalence of heart failure, chronic obstructive pulmonary disorder, osteoporosis, or diagnosed depression was associated with low inner strength. Significant relationships were also found between high inner strength and various measures of social relationships. Participants with a higher degree of inner strength had better physical health and more satisfying social relationships. The promotion of inner strength should be a major aim of geriatric nursing.
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42.
  • Lundman, Berit, et al. (författare)
  • Psychometric properties of the Swedish version of the Resilience Scale
  • 2007
  • Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 21:2, s. 229-237
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate resilience in relation to age and gender, and to elucidate the underlying structure of the Swedish version of the Resilience Scale (RS). The RS, originally created by Wagnild and Young is a 25 items scale of Lickert type with possible scores ranges from 25 to 175, the higher the score, the stronger resilience. A standardized procedure was used for translation. The analysis was based on 1719 participants, 1248 women and 471 men, from eight different samples, aged from 19 to 103 years. We found that the participants estimated their resilience as relatively high. There was a significant relationship between age and resilience, for every year RS score increased with 0.134 units. There was no relation between gender and resilience. From a factor analyses five factors emerged, equanimity, meaningfulness, perseverance, existential aloneness and self-reliance reflecting the five dimensions described by Wagnild and Young.
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43.
  • Lundman, Berit, et al. (författare)
  • Sense of coherence (SOC) related to health and mortality among the very old : The Umeå 85+ study
  • 2010
  • Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 51, s. 329-332
  • Tidskriftsartikel (refereegranskat)abstract
    • We describe associations between sense of coherence (SOC) and sense of well-being, diseases, physical function and the predictive value of SOC on depression and mortality. The study included 190 participants, aged 85-103 years. Linear correlation analysis was used for relationships between SOC scores and continuous variables. The effects of SOC score on 1- and 4-year mortality, as well as on depression at the 5-year follow-up, were investigated using Cox regression models. The mean SOC score was 71.8+/-10.2 (+/-S.D.). SOC score was positively related to well-being (p
  •  
44.
  • Lövheim, Hugo, et al. (författare)
  • Changes in sense of coherence in old age : a 5-year follow-up of the Umeå 85+ study
  • 2013
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 27:1, s. 13-19
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: This study aims to describe the changes in sense of coherence (SOC) over time and relate these changes to negative life events among very old people. Design: Prospective and longitudinal study. Subjects:  190 old women and men participated, of whom 56 could be included in the 5-year follow-up. Methods: The mean SOC score from the first and second data collection were compared using a paired sample t-test. The relationship between the index of negative life events and the changes on SOC score between the two data collections was investigate using linear regression. Main outcome measures: Antonovsky's SOC scale and an index of negative life events including severe physical and mental diseases, various losses as losses of spouses, cognitive and functional ability. Result:  For the whole group of subjects (n = 56), the SOC scores was higher (70.1 vs. 73.7, p = 0.029) at the second point measure. The most common negative life events at follow-up were loss of independence in activities in daily living and decrease in cognitive function. A significant correlation between the index of negative life events and changes in SOC over 5 years was found (p = 0.025). The more negative life events, the more decrease in SOC. Conclusion: We concluded that there is a risk of decreased SOC and thereby quality of life when negative life events accumulate among very old people. Nursing interventions might play an important role for maintaining and perhaps strengthening SOC among old people exposed to negative life events.
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45.
  • Manasatchakun, Pornpun (författare)
  • Understanding healthy aging in Isan-Thai culture
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The older population in Thailand is growing, and the number of older people who suffer from health problems is increasing as well. The health situation of the older population challenges healthcare providers to care for older people. Healthy aging is key to promoting the health of older people and sustaining their well-being. However, little is known about healthy aging in Thailand, especially in northeastern Thailand, or the Isan region, where the number of older people is increasing. Thus, this thesis aims to understand the factors associated with perceived health and healthy aging and how older people and their relatives in the Isan region conceptualize healthy aging. This thesis also focuses on how community nurses experience the meaning and promotion of healthy aging in this region.This thesis includes four studies. The first is a quantitative cross-sectional study with 453 participants aged 60 years or older. The second and third studies are qualitative with a phenomenographic approach that is based on lifeworld theory. Participants in the second and third studies include 17 older people and 14 relatives who are responsible for caring for older people, respectively. The fourth study is a qualitative study that involves focus group interviews with 36 community nurses who work with older people in the Isan region.The findings of the first study show a variance (24.3%) in perceived health and healthy aging based on residential area, marital status and disability status. The meaning of healthy aging, which was derived from the second, third and fourth studies, was divided into three domains: being interconnected; being able to do something good and feeling strong; and thinking beyond the capacity and functions of body and mind. The promotion of healthy aging was described as “providing health assessments”, “sharing knowledge”, and “having limited resources”.The findings of the first study revealed the key factors that will help healthcare providers promote healthy aging. The findings of the second, third and fourth studies revealed that older people, their children and grandchildren, and community nurses attach different meanings to healthy aging. The finding regarding promotion of healthy aging emphasizes that the person-centredness should be integrated in practice when promoting healthy aging. The results of this thesis will be useful to policymakers, who can apply this enhanced understanding of healthy aging to develop healthcare practices that promote healthy aging. 
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46.
  • Nazari, Shima, et al. (författare)
  • Perceptions and stress of conscience in relation to burnout among nursing staff in older people care settings : a cross sectional study
  • 2023
  • Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Considering cultural influences, it is important to study the perceptions and stress of conscience in different contexts. This study aimed to investigate the association between perceptions of conscience, stress of conscience, and burnout among nursing staff working in older people care settings in Tehran.Methods: This was a descriptive, cross-sectional study. A total of 161 participants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire, and Oldenburg Burnout Inventory, 2019. All nursing staff working at the 20 contacted nursing homes agreed to participate in the study. The descriptive and inferential analysis was conducted through SPSS, using T-tests and one-way between-groups analysis of variance, Chi-square and t-tests, Cohen's d (d), Eta-squared (η2), and Phi coefficient (φ), Partial least squares regression (PLSR), jackknife approximate t-tests of the regression coefficients, and jackknife 95% confidence intervals of the regression coefficients.Results: The nursing staff perceived their conscience mainly as an authority, asset, and warning signal. Impact of workload on family life was the most common source of stress for the nursing staff. Dealing with incompatible demands, the impact of workload on family life, witnessing insulated patients, inability to meet one’s standards in providing care, and perception of conscience as a burden were strongly associated with the burnout.Conclusions: Perceiving conscience as a warning signal or authority may serve as a buffer against burnout among nursing staff. This study highlights the need for further exploration of perceptions of conscience in different cultural and social backgrounds.
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47.
  • Neumüller, Kristina, 1975- (författare)
  • Vattensjön och Vattenån : Samband mellan sjönamn och ånamn i Medelpad
  • 2007
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The main aim of this study of pairs of lake and river names in the northern Swedish province of Medelpad is to establish whether, as a rule, the lake name or the river name is (in formal terms) the primary name. The study also seeks to ascertain whether there are geographical variations in ‘name priority’ in this sense within the region studied, and whether there are any signs of the priority pattern having changed over time. An additional aim is to shed light on other aspects of the water feature names of Medelpad. The area covered by the study comprises five parishes. Two of them (Borgsjö and Haverö) are situated in the western part of Medelpad, the other three (Attmar, Njurunda and Tuna) in the south-east. In the hydronym pairs studied (just over 200 in all), the secondary names are most commonly formed by composition. In a few cases derivation may be involved instead, but here the element of uncertainty is quite large. Name pairs formed by composition have been affected by elliptical processes of various kinds, above all by reduction. The investigation of the name pairs shows that lake-name priority is more than ten times as common as river-name priority; this stock of names thus follows a pattern also found in more southerly parts of Sweden. The modern-day dominance of lake-name priority in Medelpad seems to be partly the result of a growing influence of this pattern in more recent times. The proportions of primary lake names and primary river names vary between the different parts of Medelpad studied; the further west one goes, the more common – or less uncommon – primary river names seem to become. The most important reasons for this difference probably have to do with the physical geography and settlement history of these areas.
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48.
  • Nyberg, Jonna, 1967-, et al. (författare)
  • How does driving license withdrawal affect subjective well-being? A Swedish comparative survey study of visual field loss
  • 2021
  • Ingår i: European Transport Research Review. - : Springer. - 1867-0717 .- 1866-8887. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Research has found strong relationships between access to transport, accessibility of activities, and subjective well-being (SWB), and society is said to be car dependent. Accordingly, this study investigates, in a Swedish context, whether and how withdrawal of a driving license for a private car due to visual field loss (VFL) affects SWB. A web survey was used for statistical comparisons of three respondent groups (n = 436): people with a driving license, people with a driving license and VFL, and people whose driving license was withdrawn due to VFL. The inclusion criterion for all participants was that they should have a diagnosis that could cause VFL. The no-license group had lower overall SWB than did respondents with driving licenses. The no-license group also perceived less access to transport means in order to live a life to be satisfied with than did the other groups. The most used transport means in the no-license group was getting a lift in a car, though this group had a strong desire to drive a car. Few respondents in the license groups wanted to use specific transport means to a greater extent, car driving being the most used transport means. Some inter-group differences were seen regarding how access to activities (measured by frequency of actual trips) affected SWB. This study found a significant negative effect of driving license withdrawal on SWB. However, the results imply that qualitative aspects other than the relationship between the frequencies of trips and activities might also affect SWB, and more research on this subject is needed.
  •  
49.
  • Stenlund, Anna-Lena, et al. (författare)
  • Intensive care nurses’ experiences of Covid-19 care : A practical and ethical challenge – a qualitative descriptive design
  • 2023
  • Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • The Covid-19 pandemic has generated new experiences of intensive care. It has entailed new working methods, treatment strategies,and ethical dilemmas. The aim of this study was to describe intensive care nurses’ experiences of Covid-19 care and itsethical challenges. Data collection consisted of 11 individual semi-structured interviews and a qualitative content analysis wasused. The COREQ checklist was followed. Three main themes emerged: to meet Covid-19 patients’ needs for specifically tailoredintensive care; to have a changed approach to the excluded relatives is unethical, but defensible; and to strive to protectethical values needs to be considered as good enough. In conclusion, ICU nurses shouldered a heavy burden in taking responsibilityfor the safety of these patients, continuously learning about new treatment strategies. Caring for Covid-19 patients was tostrive to make the best of the situation.
  •  
50.
  • Strandberg, Gunilla, 1957-, et al. (författare)
  • An exemplar of a positive perspective of being dependent on care
  • 2000
  • Ingår i: Scholarly inquiry for nursing practice. - 0889-7182. ; 14:4, s. 327-346; discussion 347-353
  • Tidskriftsartikel (refereegranskat)abstract
    • This article is part of an ongoing study which aims at disclosing the meaning of being dependent on care. From a larger data set derived from 10 patients, interviews with one severely ill patient, her daughter and two of her professional nurses were selected to illuminate a "positive" meaning of being dependent on care. The interviews were tape-recorded and transcribed verbatim and followed by interpretation of transcripts using a phenomenological-hermeneutic approach inspired by Paul Ricoeur's philosophy. The interpretation discloses the meaning of being dependent on care as balancing between being free and negotiating when receiving care. Whether or not dependency on care is negotiated about seems to be about how the power that lies in the existing differences in ability is used. When ability, that is, power, is used to compensate inability, the patient appears free to be dependent on care. Dependency on care is accepted for what it is, when it is. When dependency on care is negotiated about, the differences in ability, that is, power, risk setting limits for what dependency on care is to be. There is a risk that dependency on care will be limited within the frame of what is regarded as polite, appealing and pleasing.
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