| 1. |
- Andreassen Devik, Siri, et al.
(författare)
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Nurses’ experiences of compassion when giving palliative care at home
- 2020
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 27:1, s. 194-205
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Tidskriftsartikel (refereegranskat)abstract
- Background: Compassion is seen as a core professional value in nursing and as essential in the effort of relieving suffering and promoting well-being in palliative care patients. Despite the advances in modern healthcare systems, there is a growing clinical and scientific concern that the value of compassion in palliative care is being less emphasised.Objective: This study aimed to explore nurses’ experiences of compassion when caring for palliative patients in home nursing care. Design and participants: A secondary qualitative analysis inspired by hermeneutic circling was performed on narrative interviews with 10 registered nurses recruited from municipal home nursing care facilities in Mid-Norway. Ethical considerations: The Norwegian Social Science Data Services granted permission for the study (No. 34299) and the re-use of the data.Findings: The compassionate experience was illuminated by one overarching theme: valuing caring interactions as positive, negative or neutral, which entailed three themes: (1) perceiving the patient’s plea, (2) interpreting feelings and (3) reasoning about accountability and action, with subsequent subthemes.Discussion: In contrast to most studies on compassion, our results highlight that a lack of compassion entails experiences of both negative and neutral content.Conclusion: The phenomenon of neutral caring interactions and lack of compassion demands further explorations from both a patient – and a nurse perspective.
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| 2. |
- Dahlkvist, Eva, et al.
(författare)
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First-Line Managers’ Leadership Behavior Profiles and Use of Gardens in Residential Care Facilities: An Interview Study
- 2023
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Ingår i: Journal of Aging and Environment. - : Taylor & Francis. - 2689-2618 .- 2689-2626. ; 37:1, s. 65-84
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Tidskriftsartikel (refereegranskat)abstract
- This study explored first-line managers’ leadership behavior profiles regarding their goals for utilizing the garden at residential care facilities for older people. Semi-structured interviews were conducted with a convenience sample of first-line managers (n = 12) in Sweden. Data were analyzed using deductive content analysis theoretically guided by the Three-dimensional Leadership Model. The results showed that the main leadership behavior profiles were related to the dimensions structure, relation and change. The managers emphasized workplace regulations and goals. They allowed staff to make decisions and encouraged them to see problems and opportunities.
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| 3. |
- Eivergård, Kristina, et al.
(författare)
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Disciplined into Good Conduct : Gender Constructions of Users in a Municipal Psychiatric Context in Sweden
- 2021
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 30:15-16, s. 2258-2269
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To examine how gendered discursive norms and notions of masculinity and femininity were (re)produced in professional conversations about users of long-term municipality psychiatric care. Focus is on the staff's use of language in relation to gender constructions.BACKGROUND: Psychiatric care in Sweden has undergone tremendous changes in recent decades from custodian care in large hospitals to a care mainly located in a municipal context. People who need psychiatric care services often live in supporting houses. In municipal psychiatric care, staff conduct weekly professional meetings to discuss daily matters and the users' needs. Official reports of the Swedish government have shown that staff in municipal care services treat disabled women and men differently. Studies exploring gender in relation to users of long-term psychiatric care in municipalities have problematised the care and how staff, through language, construct users' gender. Therefore, language used by staff is a central tool for ascribing different gender identities of users.DESIGN: The content of speech derived from audio recordings were analysed using Foucauldian discursive analysis. The COREQ checklist was used in this article.RESULTS: The results indicate that by relying on gender discourses, staff create a conditional care related to how the users should demonstrate good conduct. In line with that, an overall discourse was created: Disciplined into good conduct. It was underpinned by three discourses inherent therein: The unreliable drinker and the confession, Threatened dignity, Doing different femininities.CONCLUSION: The community psychiatric context generates a discourse of conduct in which staff, via spoken language (re)produces gendered patterns and power imbalances as a means to manage daily work routines. Such practices of care, in which constant, nearly panoptic, control despite the intention to promote autonomy, urgently require problematising current definitions of good conduct and normality.
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| 4. |
- Eivergård, Kristina
(författare)
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Språkets makt : en studie av vårdpersonals tal om psykiatriska patienter och brukare
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this dissertation was to critically examine, based on three selected psychiatric care environments, how healthcare staff talk about patients and users with a focus on how notions of gender are produced and reproduced during rounds and in reportings.Reportings and rounds are daily activities in almost all healthcare practices. It takes place three to four times a day and is ideally aimed at creating continuity and alignment in the care. In psychiatric contexts, the reportings and rounds constitute important tools in assessing which approach and treatment are most appropriate. Studies on verbal reporting have mainly been carried out in somatic care and have been focused on the reportings’ content, type, cost and time required. Research also suggests that healthcare staff find it difficult to move away from a strictly medical perspective and that reporting and rounds take place in a ritualized way where the staff are socialized into what is valid information to pass on. The reportings can also serve as a way for healthcare staff to support each other in their work. The research also applies in psychiatric care contexts where different power structures also become apparent in the use of language. However, how psychiatric care staff talk about patients and users in reportings and on rounds based from a gender perspective has not been studied to any great extent.The dissertation is based on four sub-studies, all with qualitative research design. The empirical material in all sub-studies consisted of sound recordings from rounds and reports in three different psychiatric care contexts; general psychiatry, forensic psychiatry and municipal psychiatry. In sub-study I and II, content analysis was employed and in sub-study III and IV, discourse analysis was employed. Sub-study I showed how the healthcare staff used everyday words and concepts in both reports as in the rounds. The words and concepts formed the basis for assessing the patient's behaviour and mental condition and decisions about nursing and treatment. Sub-study II showed that the language discourse of the healthcare staff reproduced a gender order in which the female patients were expected to behave according to feminine norms in order to be acceptable as women and, as patients. In sub-study III, the statements studied showed a family oriented caring practice and how power techniques in terms of discursive norms around masculinity contributed to the subordination of men cared for in. The results also revealed how the healthcare staff reproduced a heteronormativity gender order through the language used. In sub-study IV, the statements showed a discourse of care where various techniques of power such as intimacy and confession were used to persuade the users to behave according to feminine or masculine norms. The statements also showed a heteronormative and heterosexual order in which the paradox between the need for support and maintaining one's dignity was clarified.The conclusion of the sub-studies together was that the reports and rounds was a scene for which everyday words and concepts were used to describe and assess patients and users. These everyday words and concepts reproduced power orders in which different disciplining power techniques were displayed. The language also reproduced a heteronormative gender order in which notions of femininity and masculinity participated in the assessments of patients and users´ mental states. Because the patients were not involved in the conversations about themselves, healthcare staff were given the possibility to describe and position the patients and users in ways that they themselves were not aware of. In order to create opportunities to break with stereotypical gender patterns as well as patterns of dominance and subordination in psychiatric nursing and care, students, as well as healthcare staff, should work with awareness and critical reflection on discursive norms and how language constructs the patient and user.
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| 5. |
- Eivergård, Kristina, et al.
(författare)
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Subordinated masculinities : A critical inquiry into the reproduction of gender norms in forensic psychiatric care.
- 2020
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 29:21-22, s. 4227-4238
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender.BACKGROUND: During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms.DESIGN: Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used.RESULTS: While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family-oriented care. The overarching discourse, which we labelled subordinated masculinities, was supported by three other discourses: being unable to take responsibility, being drug-addicted and performing masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms.CONCLUSION: The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients´ responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them.RELEVANCE TO CLINICAL PRACTICE: Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care.
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| 6. |
- Eivergård, Kristina, et al.
(författare)
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Subordinated masculinities : a critical inquiry into reproduction of gender norms in handovers and rounds in a forensic psychiatric care
- 2020
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 29:21-22, s. 4227-4238
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender.Background: During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms.Design: Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used.Results: While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family‐oriented care. The overarching discourse, which we labelled subordinated masculinities, was supported by three other discourses: being unable to take responsibility, being drug‐addicted and performing masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms.Conclusion: The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients' responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them.Relevance to clinical practice: Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care.
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| 7. |
- Häggström, Elisabeth, et al.
(författare)
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Gävle, en äldrevänlig kommun? : Äldre personers erfarenheter av sin livssituation
- 2021
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Rapport (populärvet., debatt m.m.)abstract
- Ökningen av befolkningen 65 år och äldre har lett till ökat intresse för den äldre människans hälsa och sociala engagemang i samhället. Som en följd av detta har Gävle kommun sökt och antagits som medlem i WHO:s nätverk för äldrevänliga städer och samhällen 2019 med ambitionen att förbättra för de äldre kommuninvånarna utifrån WHO:s åtta utvecklingsområden, samhällsstöd med transporter och mobilitet, boende och bostäder, social delaktighet, god hälso- och sjukvård, utomhusmiljöer, parker och byggnader, respekt och social tillhörighet och möjliga utvecklingsområden. Syftet med denna forskningsstudie var att beskriva äldre personers erfarenheter av sin livssituation i Gävle kommun utifrån WHO:s åtta utvecklingsområden. Tretton äldre personer mellan 66 och 85 år deltog fördelat i tre fokusgruppsintervjuer. I Resultatet framkom sju teman som belyste deltagarnas erfarenheter; möjligheten att komma ut i samhället, hur boendet fungerade i vardagen, känslan av social tillhörighet och delaktighet, möjligheten att få stöd och service av hälso- och sjukvården, upplevelserna av att känna sig respekterade, möjligheten till att delta i olika aktiviteter samt hur de som kommuninvånare har möjlighet till medborgardeltagande. Slutsatsen av studien visar att de äldre kommuninvånarna är en grupp att räkna med när det handlar om framtidens äldrevänliga kommuner. Äldre personer vill vara delaktiga i och kunna påverka utvecklingen av de beslut som fattas i kommunen när det gäller frågor som rör äldre personer. Mot den bakgrunden ges förslag på åtgärder som kan förbättra Gävle kommuns intention till en äldrevänlig kommun där de äldre kommuninvånarna får möjlighet att vara delaktiga i kommunens fortsatta arbete.
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| 8. |
- Moe, Aud, et al.
(författare)
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Research utilization in municipality nursing practice in rural districts in Norway : a cross sectional quantitative questionnaire study
- 2020
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Ingår i: BMC Nursing. - : BMC. - 1472-6955. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Scientific knowledge and theory constitute part of the nurse’s competence and evidence-based nursing practice. To obtain and maintain these skills, nurses require access to research utilization. The aim of the present study was therefore to describe and compare nurses in nursing homes and home-based nursing care and their use of research knowledge in their practice in elderly care in Norwegian rural districts.Methods: The Research Utilization Questionnaire (RUQ) was employed in cross-sectional quantitative design. One hundred nurses were recruited from ten rural municipalities that participated in the study. Inclusion criteria for participating were registered nurses and employees working in the municipal elderly care service for 6 months or more.Results: Most participants were younger than 55 years old, worked in permanent jobs, and were educated more than 5 years ago. The result showed that nurses in nursing homes were significantly more positive compared to nurses in home-based nursing care when analyzing all three domains in the RUQ together, as well as for attitudes towards research when testing each domain separated. Overall, each item in the domains revealed opinions that were more positive for nurses in nursing homes. The regression analysis showed that attitudes towards research, as well as availability and support of research utilization predicted the use of research in daily practice.Conclusions: Positive attitudes, availability, and support for research utilization can contribute to greater use of research in nursing practice and improve the quality of service. Younger nurses’ knowledge about using research should be shared with senior colleagues, who possess much experience in practice. In collaboration, they can develop evidence-based practice by the implementation of research seen in the context of nurses’ experiences, user involvement, and person-centred practice. The i-PARIHS (Promoting Action on Research Implementation in Health Services) framework can be a useful tool in this implementation process.
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| 9. |
- Voraroon, Supaporn, 1977-, et al.
(författare)
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Participation in Shareholding Networks for the Care of Older People in Rural, Thailand
- 2021
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Ingår i: Psychology and Education. - 1553-6939. ; 58:2, s. 2587-2602
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Tidskriftsartikel (refereegranskat)abstract
- Given the lack of knowledge about rural-dwelling older adults’ experiences with health-promoting activities in shareholding network. The purpose of the study reported here was to explore older adults’ experiences with health promotion in shareholding network for the care of older people living in rural areas. Qualitative research methodology were used in-depth interviews and conducted with 15 older members of shareholding network in Thailand during 2017, and interview transcripts were subjected to content analysis guided by the World Health Organization’s theoretical framework for health promotion. Among the results, knowledge, fellowship and dignity were identified as general elements of health-promoting experiences, and activities organised by the shareholding network reflected the four categories of health-promoting elements proposed by the World Health Organization: empowerment to control health, participation in society, self-determination and shared responsibility. The results indicate that activities in the shareholding network contributed to the support provided by peer volunteers, which has potential to be an effective strategy for increasing activity among older adults, particularly ones who are inactive and socially disengaged. Conclusion, shareholding network for thecare of rural-living older people seem to promote a culture of volunteerism that holistically satisfies individual older person’s needs in the process of strengthening his or her self-care.
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| 10. |
- Voraroon, Supaporn, 1977-
(författare)
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Participation in shareholding networks for the care of older persons in rural Thailand : Older persons’ and relatives’ experiences
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to explore how older persons and family caregivers experience taking part in shareholding networks related to health promotion activities for older people in rural areas in Thailand. The thesis had a qualitative research design and is based on original articles (I-IV). Data were collected through paired interviews with older persons and their relatives (I), individual interviews with older persons (II), and by narrative interviews (III-IV). Qualitative data was analyzed with content analysis, phenomenological hermeneutics, and phenomenological philosophy. Study I showed that older persons and their family members experienced outsider status and disregard for older persons` individuality in the community, when participating in shareholding networks. The theme of outsider status described shortcomings in healthcare encounters and the theme of disregard described the lack of engagement of authorities and caregivers in older persons’ care. The concept of participation emerged as a framework for understanding interviewees’ experiences. Local authorities, older individuals, and their family members should engage in dialogue in order to support healthcare based on shared understanding. Study II identified four categories that reflected expressions of health promotion elements in shareholding networks activities: empowerment to control health, participation in society, self-determination, and shared responsibility. All of this can be seen as an important part of a health process. The results indicated that shareholding networks activities contributed to peer volunteering support that has potential to be an effective strategy for increasing activities in older adults, particularly among those who are inactive and socially disengage. Shareholding networks for the care of older people in rural areas seems to promote and preserve volunteerism that satisfies the individual old person's needs—from a holistic perspective—as a way to strengthen self-care. Study III found that older person’s lived experiences with participation in shareholding networks entailed both positive meaning and negative meaning. The participation could be understood as being satisfying, being valuable, being frustrating, and being boring. Study IV showed that participating in shareholding networks activities entails an always-present existence of aging intertwined with life. Its constituents further described the essential meaning of the phenomenon: “experience of improved self-management”, “feeling of increased self-esteem”, and “bridging the gap in the care of older people”. Participation in shareholding networks activities meant keeping contact with oneself and being able to have a life that corresponds to how one perceives oneself to be and must therefore be understood from a holistic perspective that satisfies the individual older person’s needs in the process of strengthening self-care. This thesis concluded that participants experienced benefits when they participated in shareholding networks for the care of older people in rural areas. Participation improved their health, increased their independence and their self-care ability, as well as strengthened their feelings of dignity. Health professionals should initiate a dialogue with shareholding participants to develop a cooperating model of care focusing on the participants` needs. Healthcare must be based on shared understandings and reflections on existential issues such as identity, trust, self-confidence and dignity.
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