| 1. |
- Boman, Åse, 1957-, et al.
(författare)
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Conceptions of Diabetes and Diabetes Care in Young People With Minority Backgrounds.
- 2015
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Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 25:1, s. 5-15
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Tidskriftsartikel (refereegranskat)abstract
- Adolescents with type 1 diabetes (T1DM) need stable self-care routines for good metabolic control to minimize future cardiovascular health complications. These routines are demanding, and might be particularly challenging in underprivileged groups. The aim of this study was to gain in-depth knowledge on the experience of adolescents with T1DM and a non-Swedish background regarding factors that might influence their ability to take care of themselves; in particular, factors that might influence diabetes management routines, their social situation, and the support they receive from caregivers. We interviewed 12 adolescents with T1DM and minority backgrounds. The results indicated resources and constraints in the adolescents' social context and in the health care organization. The adolescents developed conceptions that helped to explain and excuse their self-care failures, and their successes. These findings highlight the importance of integrating T1DM as part of the individual's personal prerequisites. We discuss implications for the organization of diabetes care for adolescents.
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| 2. |
- Boman, Åse, 1957-, et al.
(författare)
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Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background
- 2017
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Ingår i: Sage Open medicine. - : SAGE Publications. - 2050-3121 .- 2050-3121. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: The pediatric diabetes team aims to support health, quality of life, and normal growth and development among adolescents with type 1 diabetes mellitus. Adolescents with an immigrant background have been found less successful in self-care. Previous research indicated that adolescents who had integrated the disease as a part of their self-image reasoned differently about their self-care to those who had not. Objective: The aim of this study was to identify elements in the patient–pediatrician consultations that might influence such integration of the disease among adolescents with type 1 diabetes mellitus. Methods: A total of 12 pediatrician–adolescent consultations were video-recorded and analyzed. The adolescents all had an immigrant background. Results: Integration of the disease appeared enabled when responsibility was shared; when hope, autonomy, and emotions were confirmed; and when the pediatrician asked probing questions. Letting objective data dominate the adolescent’s experiences, using risk as a motivator, neutralizing emotions in relation to having diabetes, and confirming forgetfulness, may instead inhibit disease integration. Conclusion: An extended person-centered approach with focus on the adolescent’s experiences of everyday life with a chronic disease and less attention on physical parameters in the pediatrician–adolescent consultations may increase integration of the disease.
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| 3. |
- Boman, Åse, 1957-
(författare)
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Learning by supporting others : experienced parents' development process when supporting other parents with a child with Type 1 diabetes
- 2018
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 27:5-6, s. E1171-E1178
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: This study's purpose was to describe and analyze coach-parents' development process when supporting parents of children recently diagnosed with Type 1 Diabetes Mellitus (T1DM).BACKGROUND: It has been found repeatedly that providing social support for families with a child diagnosed with T1DM promotes health and wellbeing for both the child and the parents. Less explored are the processes experienced by those who provide this support. However, research has found that acting as a provider of social support promotes personal development, strengthens communication skills, and increases self-confidence.METHODS: The study design was based on Constructivist Grounded Theory and data were collected, through Repeated Focus Group Discussions, from eight coach-parents at a Swedish hospital from 2012-2015.RESULTS: The core category in the data was identified as a learning process where coach-parents emphasized their own learning in the dyad supporter - supported, and in the interaction with other parents in the Repeated Focus Group Discussions. The coach-parents' motivation for participation was a wish to learn more and to help other parents in a life-changing situation. They also pointed out hindrances and their frustration when unable to provide support.CONCLUSIONS: This study leads to the conclusion that people who provide support benefit from doing so. Encountering people with similar experiences in a supportive situation promotes a reciprocal learning process, based on the supporter's wish to help people in a situation they recognize. A further conclusion is that social support is not only essential initially, but is also important over a longer period and that it follows various life stages.RELEVANCE TO CLINICAL PRACTICE: Setting up repeated focus group discussions might be a relevant and effective tool for pediatric diabetes nurses to use in promoting health and wellbeing for both families with a newly diagnosed child and experienced families. This article is protected by copyright. All rights reserved.
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| 4. |
- Boman, Åse, 1957-, et al.
(författare)
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Salutogen omvårdnad
- 2015. - 1. uppl.
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Ingår i: Salutogenes. - Stockholm : Liber. - 9789147111336 ; , s. 191-208
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 5. |
- Dahlborg Lyckhage, Elisabeth, 1974-, et al.
(författare)
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Health care systems in transition: Equality, access and health literacy in three Scandinavian welfare states. : “The Emperor’s new clothes”: discourse analysis on how the patient is constructed in the new Swedish Patient Act
- 2017
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Konferensbidrag (refereegranskat)abstract
- The Swedish welfare debate increasingly focuses on market liberal notions and its healthcare perspective aims for more patient-centered care. This article examines the new Swedish Patient Act describing and analyzing how the patient is constructed in government documents. This study takes a Foucauldian discourse analysis approach following Willig’s analysis guide. The act contains an entitlement discourse for patients and a requirement discourse for healthcare personnel. These two discourses are governed by a values-based healthcare discourse. Neo-liberal ideology, in the form of New Public Management discourse, focusing on the value of efficiency and competition, is given a hegemonic position as laws and regulations are used to strengthen it. The new Swedish Patient Act seems to further strengthen this development. The Act underlines the increased entitlement for patients, but it is not legally binding as it offers patients only indirect entitlement to influence and control their care. To safeguard the patient’s entitlement under the Patient Act, healthcare personnel should be made aware of the contents of the Act, so that they can contribute to the creation of systems and working methods that facilitate respect of the Act’s provisions in daily healthcare work.
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| 6. |
- Dahlborg Lyckhage, Elisabeth, 1974-, et al.
(författare)
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"The Emperor's new clothes" : discourse analysis on how the patient is constructed in the new Swedish Patient Act.
- 2017
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Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 24:2
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Tidskriftsartikel (refereegranskat)abstract
- The Swedish welfare debate increasingly focuses on market liberal notions and its healthcare perspective aims for more patient-centered care. This article examines the new Swedish Patient Act describing and analyzing how the patient is constructed in government documents. This study takes a Foucauldian discourse analysis approach following Willig's analysis guide. The act contains an entitlement discourse for patients and a requirement discourse for healthcare personnel. These two discourses are governed by a values-based healthcare discourse. Neo-liberal ideology, in the form of New Public Management discourse, focusing on the value of efficiency and competition, is given a hegemonic position as laws and regulations are used to strengthen it. The new Swedish Patient Act seems to further strengthen this development. The Act underlines the increased entitlement for patients, but it is not legally binding as it offers patients only indirect entitlement to influence and control their care. To safeguard the patient's entitlement under the Patient Act, healthcare personnel should be made aware of the contents of the Act, so that they can contribute to the creation of systems and working methods that facilitate respect of the Act's provisions in daily healthcare work.
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| 7. |
- Johnsson, Anette, 1963-, et al.
(författare)
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Striving to establish a care relationship -Mission possible or impossible? : Triad encounters between patients, relatives and nurses
- 2019
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Ingår i: Health Expectations. - : Wiley. - 1369-6513 .- 1369-7625. ; 22:6, s. 1304-1313
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: When patients, relatives and nurses meet, they form a triad that can ensure a good care relationship. However, hospital environments are often stressful and limited time can negatively affect the care relationship, thus decreasing patient satisfaction.OBJECTIVE: To explain the care relationship in triad encounters between patients, relatives and nurses at a department of medicine for older people.DESIGN: A qualitative explorative study with an ethnographic approach guided by a sociocultural perspective.METHOD: Participatory observations and informal field conversations with patients, relatives and nurses were carried out from October 2015-September 2016 and analysed together with field notes using ethnographic analysis.RESULT: The result identifies a process where patients, relatives and nurses use different strategies for navigating before, during and after a triad encounter. The process is based on the following categories: orienting in time and space, contributing to a care relationship and forming a new point of view.CONCLUSION: The result indicates that nurses, who are aware of the process and understand how to navigate between the different perspectives in triad encounters, can acknowledge both the patient's and relatives' stories, thus facilitating their ability to understand the information provided, ensure a quality care relationship and strengthen the patient's position in the health-care setting, therefore making the mission to establish a care relationship possible.
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| 8. |
- Johnsson, Anette, 1963-, et al.
(författare)
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Voices used by nurses when communicating with patients and relatives in a department of medicine for older people : An ethnographic study
- 2018
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 27:7-8, s. E1640-E1650
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe how nurses communicate with older patients and their relatives in a department of medicine for older people in western Sweden.BACKGROUND: Communication is an essential tool for nurses when working with older patients and their relatives but often patients and relatives experience shortcomings in the communication exchanges. They may not receive information or are not treated in a professional way. Good communication can facilitate the development of a positive meeting and improve the patient's health outcome.DESIGN: An ethnographic design informed by the sociocultural perspective was applied.METHOD: Forty participatory observations were conducted and analyzed during the period October 2015 to September 2016. The observations covered 135 hours of nurse-patient-relative interaction. Field notes were taken and 40 informal field conversations with nurses and 40 with patients and relatives were carried out. Semi-structured follow-up interviews were conducted with five nurses.RESULTS: In the result, it was found that nurses communicate with four different voices: a medical voice described as being incomplete, task-oriented and with a disease perspective; a nursing voice described as being confirmatory, process-oriented and with a holistic perspective; a pedagogical voice described as being contextualized, comprehension-oriented and with a learning perspective; and a power voice described as being distancing and excluding. The voices can be seen as context-dependent communication approaches. When nurses switch between the voices this indicates a shift in the orientation or situation.CONCLUSION: The results indicate that if nurses successfully combine the voices, while limiting the use of the power voice, the communication exchanges can become a more positive experience for all parties involved and a good nurse-patient-relative communication exchange can be achieved.RELEVANCE TO CLINICAL PRACTICE: Working for improved communication between nurses, patients and relatives is crucial for establishing a positive nurse-patient-relative relationship, which is a basis for improving patient care and healthcare outcomes. This article is protected by copyright. All rights reserved.
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| 9. |
- Johnsson, Anette, 1963-, et al.
(författare)
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What are they talking about? Content of the communication exchanges between nurses, patients and relatives in a department of medicine for older people : An ethnographic study
- 2018
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 27:7-8, s. E1651-E1659
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To explore and describe the content of the communication exchanges between nurses, patients and their relatives in a department of medicine for older people in western Sweden.BACKGROUND: Information, messages and knowledge are constantly being communicated between nurses, older patients and relatives in the healthcare sector. The quality of communication between them has a major influence on patient outcomes. A prerequisite for good care to be given and received is that there is mutual understanding between the parties involved.DESIGN: An ethnographic study was informed by a sociocultural perspective.METHOD: Data were collected through 40 participatory observations of meetings between nurses and older patients and/or relatives which covered 135 hours of nurse-patient-relative interaction, field notes, 40 field conversations with 24 nurses and 40 field conversations with patients (n=40) and relatives (n=26). Five semi-structured interviews were conducted with nurses. An ethnographic analysis was performed.RESULTS: The analysis identified three categories of content of the communication exchanges: medical content focusing on the patient's medical condition, personal content focusing on the patient's life story, and explanatory content focusing on the patient's health and nursing needs. The content is influenced by the situation and context.CONCLUSIONS: Nurses would benefit from more awareness and understanding of the importance of the communication content and of the value of asking the didactic questions (how, when, what and why) in order to improve the patients' and relatives' understanding of the information exchanges and to increase patient safety.RELEVANCE TO CLINICAL PRACTICE: Nurses can use the communication content to create conditions enabling them to obtain a holistic view of the patient's life history and to develop an appropriate person-centered care plan. This article is protected by copyright. All rights reserved.
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| 10. |
- Tengelin, Ellinor, 1982-, et al.
(författare)
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The struggle between ancient welfare thinking and prevailing health care policy in Scandinavian health care legislative documents
- 2019
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Ingår i: 25th Annual Qualitative Health Research (QHR) Conference. ; , s. 67-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Traditional welfare state systems in Scandinavia are challenged by new governance systems. Demands for efficiency and productivity in healthcare increase, raising questions about patients' positions and agency. This also implies ethical dilemmas for healthcare professionals. Comprehensively analysing the findings of previous discourse studies on how the patient is constructed in central policy texts, this study compares the position of the patient and the accompanying ideological struggles in Norway, Sweden, and Denmark. The purpose was to compare and discuss the findings of discursive constructions of patients in law and policy text from the three countries. We found an ideological struggle across the Scandinavian countries, operating at a political level, a legislative level and a healthcare level, with variation in how the new value-based patient care is constructed. We conclude that national governance systems still exert hegemonic power by strongly influencing patients' degree of choice and autonomy. The Scandinavian countries may all be heading towards a commercial healthcare market, despite their tradition of a welfare model of healthcare. Today, healthcare strategies move in the opposite direction, controlled by politicians' financial goals. The ideological struggle between welfare state governance and other governance systems, may exist also in other western countries in our globalized world.
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