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- Falk, Hanna, 1977, et al.
(författare)
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A sense of home in residential care
- 2012
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 27:4, s. 999-1009
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Tidskriftsartikel (refereegranskat)abstract
- Moving into a residential care facility requires a great deal of adjustment to an environment and lifestyle entirely different from that of one's previous life. Attachment to place is believed to help create a sense of home and maintain self-identity, supporting successful adjustment to contingencies of ageing. The purpose of this study was to deepen our understanding of processes and strategies by which older people create a sense of home in residential care. Our findings show that a sense of home in residential care involves strategies related to three dimensions of the environment – attachment to place, to space and attachment beyond the institution – and that the circumstances under which older people manage or fail in creating attachment, consist of psychosocial processes involving both individual and shared attitudes and beliefs. Assuming that attachment is important to human existence regardless of age, attention must be paid to optimize the circumstances under which attachment is created in residential care, and how nursing interventions can help speed up this process due to the frail and vulnerable state of most older residents.
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| 2. |
- Henoch, Ingela, 1956, et al.
(författare)
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Nursing students' experiences of being involved in a clinical research project.
- 2014
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Ingår i: Sigma Theta Tau International Honor Society’s 2nd European Regional Conference i Göteborg, Sverige, 2014-06-16 – 06-18..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Nursing education can positively affect nurses' attitudes toward nursing research, resulting in better patient outcomes. Experiential learning theory was the basis for this study. Making use of the students' experiences, observations and reflections in training related to nursing research could facilitate the students' use of a deep learning approach and thus contribute to a better understanding of nursing research and evidence-based practice. Aim: To explore nursing students' experiences of involvement in clinical research, their approach to learning and their interest in nursing research. Design/methods: This was a cross-sectional study in which 126 nursing students were invited to be involved as data collectors in a research project as part of their training in research methodology in second year of nurse education. The data collection concerned to help patients to complete a symptom assessment form in a structured interview. The students completed an evaluation form and the Revised Study Process Questionnaire, exploring deep and surface level of approach to learning. The questionnaires were analyzed quantitatively and one open-ended question was analyzed qualitatively. Results: On the whole, the students were happy to be involved in the data collection although a minority felt uncertain and exposed. Students with a deeper approach to learning felt that their involvement had increased their interest in nursing research and their interest and knowledge of symptom assessment and they stated that data collection should be a regular feature of the course. Conclusions: Participation as data collectors in research has the potential to increase interest in nursing research among students with higher levels of deep learning. Further studies are needed to examine ways to increase interest in research among students with lower levels of deep learning.
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| 3. |
- Henoch, Ingela, 1956, et al.
(författare)
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Nursing students' experiences of involvement in clinical research : An exploratory study
- 2014
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Ingår i: Nurse Education in Practice. - : Churchill Livingstone. - 1471-5953 .- 1873-5223. ; 14:2, s. 188-194
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Tidskriftsartikel (refereegranskat)abstract
- Background Nursing education can positively affect nurses' attitudes toward nursing research, resulting in better patient outcomes. Experiential learning theory was the basis for this study. Objectives To explore nursing students' experiences of involvement in clinical research, their approach to learning and their interest in nursing research. Design Cross-sectional. Methods One hundred and twenty-six nursing students were invited to be involved as data collectors in a research project as part of their training in research methodology. The students completed an evaluation form and the Revised Study Process Questionnaire. The questionnaires were analyzed quantitatively and one open-ended question was analyzed qualitatively. Results On the whole, the students were happy to be involved in the data collection although a minority felt uncertain and exposed. Students with a deeper approach to learning felt that their involvement had increased their interest in nursing research and they stated that data collection should be a regular feature of the course. Conclusions Participation as data collectors in research has the potential to increase interest in nursing research among students with higher levels of deep learning. Further studies are needed to examine ways to increase interest in research among students with lower levels of deep learning.
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| 4. |
- Henoch, Ingela, 1956, et al.
(författare)
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Symptom Distress Profiles in Hospitalized Patients in Sweden: A Cross-Sectional Study.
- 2014
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Ingår i: Research in nursing & health. - : Wiley. - 1098-240X .- 0160-6891. ; 37:6
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Tidskriftsartikel (refereegranskat)abstract
- Symptom distress profiles of patients with a variety of diagnoses at two hospitals in Sweden were examined using a point-prevalence cross-sectional survey design. The sample included 710 patients present on internal medicine, surgery, geriatric, and oncology acute care hospital wards of each hospital on a single day. Symptom distress data were collected via structured interviews using a 0-10 numeric rating scale (NRS). Fatigue was the most prevalent symptom, experienced by 76.2% of the patients, followed by pain (65.2%) and sleeping difficulties (52.8%). Symptoms were fairly distressing (median NRS 5-6). Patients experiencing high distress from fatigue and pain were more likely to be female, living alone, and to have more symptoms. Latent class analysis revealed three symptom distress profiles that differed with respect to the degree of distress and number of symptoms. The profiles were not substantially differentiated by diagnoses. Symptom distress needs to be assessed and treated on an individual basis, rather than predicting distress levels based on diagnosis alone. © 2014 Wiley Periodicals, Inc.
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| 5. |
- Henoch, Ingela, 1956, et al.
(författare)
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Symptom distress profiles in hospitalized patients in Sweden—a point prevalence survey
- 2014
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Ingår i: Quality of life research. 21st Annual Conference of the International Society for Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Context: Troublesome symptoms are the most common reason for seeking hospital care. Since many patients report multiple symptoms concurrently, symptom research needs to study symptom clusters. There are two conceptual approaches to symptom cluster research: (a) the identification of symptom clusters by investigating associations among different symptom reports; (b) the identification of subgroups of patients that reflect different symptom profiles. Symptom clusters and symptom profiles have been examined in patients with cancer. However, no studies have examined symptom profiles based on patients' self-reported symptom distress in heterogeneous groups of hospitalised patients. Objective: To examine symptom distress profiles of hospitalised patients. Method: Symptom distress data were collected at two hospitals in Sweden via point prevalence surveys using numeric rating scales (NRS) of pain, dyspnoea, fatigue, sleeping difficulties, loss of appetite, depression and anxiety. Patients were grouped according to symptom experience using two approaches: (a) classification of patients with high versus low pain and fatigue distress scores; (b) classification based on a latent class analysis of symptom profiles. Results: In the 710 patients, fatigue (76.2%) and pain (65.3%) were the most prevalent symptoms (median NRS 5 to 6). The group of patients experiencing high fatigue and pain distress were to a greater extent female, living alone and diagnosed with musculoskeletal diseases, and had a higher number of symptoms than the low pain and fatigue group. The latent class analysis revealed three latent classes that differed in ratings and symptom distress profiles. People in the low symptom distress class (LSDC) reported less distress on average than people in medium (MSDC) and high symptom distress classes (HSDC). Compared to LSDC, people in HSDC were more likely to be female and live alone. Latent class membership, reflective of different symptom distress profiles, was not substantially explained by different diagnoses. Conclusions: The majority of patients admitted to hospital experience symptom distress at a level that requires symptom management. Symptom distress is a subjective illness experience and needs to be treated as such, irrespective of diagnosis. Although symptom distress was analysed with two different approaches, the most distressed patients were women who were living alone.
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| 6. |
- Browall, Maria, et al.
(författare)
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Patients' experience of important factors in the healthcare environment in oncology care
- 2013
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Ingår i: International Journal of Qualitative Studies on Health and Well-Being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background and objective. The aim of this study was to describe what factors of the healthcare environment are perceived as being important to patients in oncology care. Setting and participants. The sample was 11 patients with different cancer diagnoses in an oncology ward at a university hospital in west Sweden. Results. Analysis of the patients' perceptions of the environment indicated a complex entity comprising several aspects. These came together in a structure consisting of three main categories: safety, partnership with the staff, and physical space. The care environment is perceived as a complex entity, made up of several physical and psychosocial aspects, where the physical factors are subordinated by the psychosocial factors. It is clearly demonstrated that the patients' primary desire was a psychosocial environment where they were seen as a unique person; the patients wanted opportunities for good encounters with staff, fellow patients, and family members, supported by a good physical environment; and the patients valued highly a place to withdraw and rest. Conclusions. This study presents those attributes that are valued by cancer patients as crucial and important for the support of their well-being and functioning. The results show that physical aspects were subordinate to psychosocial factors, which emerged strongly as being the most important in a caring environment.
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| 7. |
- Falk, Hanna, 1977, et al.
(författare)
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Frail Older Persons' Experiences of Interinstitutional Relocation
- 2011
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Ingår i: Geriatric Nursing. - : Elsevier BV. - 0197-4572 .- 1528-3984. ; 32:4, s. 245-256
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Tidskriftsartikel (refereegranskat)abstract
- This study examined the effects and experiences of an interinstitutional relocation on older persons' quality of life, wellbeing, and perceived person-centeredness. A pre-test/post-test mixed method design, with an equivalent reference group, was used to examine relationships between variables and to explore personal meaning. Results indicate a significantly larger deterioration in perceived person centeredness among those cognitively intact residents that moved compared to the non-movers. Interviews with moving residents revealed that the relocation was experienced as uncontrollable, un-affectable, and uncertain. However, no significant relocation effects were found from the proxy ratings of the cognitively impaired residents. Nursing interventions that involve, inform, and prepare older persons prior to interinstitutional relocation to enhance their sense of control of the move might minimize adverse relocation effects. Further research is needed on the effects of interinstitutional relocations, which procedures that should be used, as well as effects of preparatory interventions.
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| 8. |
- Falk, Hanna, 1977, et al.
(författare)
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Functional disability and ability 75-year-olds: a comparison of two Swedish cohorts born 30 years apart
- 2014
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 43:5, s. 636-641
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare the level of functional disability and involvement in leisure activities between two birth cohorts of Swedish 75-year-olds examined in 1976-77 and 2005-06. Design :Cohort comparison. Setting and Participants: Representative data from the general population in Gothenburg, Sweden, examined at age 75 in 1976–77 (N= 744), and in 2005–06 (N= 731) with comprehensive somatic and psychiatric examinations. Measurements: Activities of daily living (ADL); Instrumental activities of daily living (IADL); a battery of self-report measures, including involvement in leisure activities, satisfaction with home environment, social networks, and self-rated health. Results: Functional disability in ADL decreased between the cohorts (13.9% vs. 5.6%, p<.001). Functional disability in IADL also decreased between the cohorts (33.4% vs. 13.0%, p<.001). Combining ADL and IADL resulted in an overall decreased dependency, with the largest decrease seen in women (42.3% vs. 15.1%, p<.001). Involvement in leisure activities increased between the cohorts. For example, the proportion going on international and domestic holiday travels increased (44.6% vs. 72.8%, p<.001), and the proportion who independently drove their own car also increased (10.0% vs. 53.0%, p<.001). Conclusion: Later born cohorts of 75-year-olds are less dependent in activities of daily living and more engaged in leisure activities compared to earlier cohorts. Later born cohorts of 75-year-olds are thus better equipped to maintain a non-age related identity compared to earlier cohorts. Our findings might serve as a reason to adopt a more positive view to aging in a world with an increasing number of older people.
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| 9. |
- Falk, Hanna, 1977, et al.
(författare)
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Older Patients' Experiences of Heart Failure-An Integrative Literature Review
- 2013
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Ingår i: Journal of Nursing Scholarship. - : Wiley. - 1527-6546. ; 45:3
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Several literature reviews have been published summarizing objective knowledge about older patients with heart failure (HF). Although of vital importance to the treatment and diagnosis of HF, these reviews fail to explicate and summarize older patients' subjective and lived experience of the condition, which restrains us from providing a complete picture of the illness trajectory. The purpose of this integrative review was to explore and summarize the current literature examining self-reported symptoms, illness experience, and self-care management in older patients with HF. DESIGN AND METHODS: Combinations of search terms related to illness experience, symptoms, and self-care management in HF were used to search three electronic databases. Inclusion criteria were empirical studies, published in English between 2001 and 2011, in populations of older patients (>/= 75 years) investigated in relation to a self-reported subjective experience of HF. The search initially yielded 279 results; 23 qualitative and qualitative studies met the inclusion criteria. FINDINGS AND CONCLUSIONS: Older patients with HF have poor health-related quality of life compared with controls and experience severe and frequent symptoms of fatigue and dyspnea that limit several aspects of their life, making them dependent on others for survival. The variety of ways in which older patients cope with these consequences is determined by how they understand their illness, with the majority showing poor health literacy in relation to HF. Neither self-management nor symptom monitoring is ideal in older patients with HF, although person-centered interventions such as motivational interviewing show promising results in improving self-efficacy in this age group. Studies examining older patients' personal experiences of HF and the relationships between symptoms, situational antecedents, and social ties will fill a gap in the literature. CLINICAL RELEVANCE: Older patients have special care needs caused by their HF and other chronic conditions, coupled with those of great age. When symptoms of HF exacerbate, older patients are predominantly admitted to geriatric care rather than cardiac care units, implying restricted access to specialized treatment. Little is still known about the basis for self-care abilities from both healthcare provider and patient perspectives.
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| 10. |
- Falk, Hanna, 1977
(författare)
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There is no escape from getting old - Older persons' experiences of environmental change in residential care
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A life of quality in residential care has to be finely balanced against the characteristics of institutionalization. Highly desirable aspects of person-hood, such as dignity, privacy, and eligibility, are bound up with satisfying and supportive living arrangements. The overall aim of this thesis was to achieve a comprehensive understanding of how environmental changes affect frail older persons’ perceptions of quality of life, wellbeing, and care atmosphere, and how people create attachment and self-identity in residential care facilities. A secondary aim was to psychometrically evaluate a Swedish translation of a quality of life instrument, specifically for dementia. This thesis combines quantitative (I), qualitative (IV), and mixed method designs (II and III) to explore meaning, gain understanding, examine relationship between variables, as well as outcome effects. Paper I (n=169), used a cross-sectional design to psychometrically evaluate a Swedish translation of the Quality of Life in Late-Stage Dementia (QUALID) Scale. Paper II (n=131), used a sequential mixed method design to follow a refurbishment aimed at enhancing the supportiveness of the physical environment. Paper III (n=155), used a concurrent mixed method design to follow an inter-institutional relocation. Paper IV (n=25), used a grounded theory method to gain an understanding of the various ways in which older persons create attachment in residential care, and to discover a plausible variety of real-life contingencies that affect this creation process. The findings suggest that the Swedish translation of the QUALID provide reliable and valid information about quality of life in older persons with late-stage dementia. That interior design features alone may have little importance to the care climate, and that the disruption caused by the refurbishment had negative effects on the wellbeing and quality of life of frail older persons. That inter-institutional relocation has adverse effects for those able to self-report and describe their experiences and that there is a lack of preparatory programs aimed at minimizing the adverse effects of relocation. The findings also show that frail older persons who are able to create a sense of home in the residential care facility, and thereby improve their sense of wellbeing and belonging, are those who create an attachment to the place, the space, or to someplace beyond the institution. The results provide added insight on the complex and transactional relationship between frail older persons and their living environment in residential care facilities. There is a need for further research into how a homely atmosphere can be created in institutional contexts in order to avoid oversimplification in which a physical environment with an aesthetic appearance of a home becomes the general standard for good residential care. This work also expands existing knowledge regarding quality of life in late-stage dementia, and the methodological difficulties that surrounds measurement. Altogether, the results in this thesis might improve the lives of frail older persons in residential care by acknowledging the fundamental human need for a home. A home is more than a physical environment, and the present thesis challenge us to learn from the inside about life in residential care, which is a prerequisite for wise and supportive interventions aimed to improve the wellbeing and quality of life in old age.
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