| 1. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(författare)
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Comprehensive geriatric assessment of frail older people: ideals and reality
- 2018
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Ingår i: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 32:6, s. 728-734
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Tidskriftsartikel (refereegranskat)abstract
- We explored different professionals’ views on and experiences of comprehensive geriatric assessment (CGA) of frail older people. Forty-six professionals working in hospitals, primary care, or municipal health and social care participated in 10 focus groups. Professional groups comprised of occupational therapists, physiotherapists, nurses, physicians, and social workers. Participants shared an ideal image of how the CGA of frail elderly people should be conducted. Experience-based competence was more often used as an assessment tool than standardized tests. The ideal image contrasted with reality, listening to the needs expressed, with the person’s problems, needs, and priorities in the foreground, as described by the categories: a need that can be met; different perspectives on needs; needs can be hidden; and needs assessment is affected by the collaboration around the person, by the context, and by the dialogue. The health and social care professionals’ first priority is to make a person-centred tailor-made comprehensive geriatric assessment and not be bound to instruments. Clear guidelines need to be developed, stating which profession assesses what, when and how in order to ensure that person-centred needs are assessed including structures and procedures for how communication and collaboration within the team as well as between the organizations are achieved in order to perform a good person-centred CGA.
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| 2. |
- Alnervik, Karin, 1958-, et al.
(författare)
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Barn och vårdnadshavares minnen av deltagande i pedagogisk dokumentation
- 2018
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Ingår i: Nordisk Barnehageforskning. - : OsloMet – storbyuniversitetet. - 1890-9167. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Syftet med artikeln är att bidra till kunskapandet om pedagogisk dokumentation med specifikt fokus på dokumentationens betydelse ur ett demokratiperspektiv. Trots många studier kring pedagogisk dokumentation finns det få studier som explicit utgår ifrån barn och vårdnadshavares perspektiv. I artikeln analyseras barns och vårdnadshavares samtal utifrån minnesbilder, vilka framträder i fokusgruppssamtal, från förskoletiden i relation till pedagogiskt dokumentationsarbete. Resultatet visar att den pedagogiska dokumentationspraktiken bidrog till skapandet av en praktikgemenskap på förskolan vilket i sin tur möjliggjorde en demokratisk undervisning.
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| 3. |
- Bångsbo, Angela, 1968, et al.
(författare)
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Collaboration in discharge planning in relation to an implicit framework
- 2017
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Ingår i: Applied Nursing Research. - : Elsevier BV. - 0897-1897 .- 1532-8201. ; 36, s. 57-62
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of our study was to explore healthcare and social care professionals’ experiences of preconditions for interorganizational and interprofessional collaboration to support frail elderly patients in discharge planning conferences. Background: At the time for hospital discharge, healthcare and social care professionals have to balance safe care, need for continuity of care, and elderly patients’ own expectations with economical demands. Therefore, collaboration interorganizationally and interprofessionally is essential, since deficiencies are risks to patient safety. Methods: Four focus groups, which consisted of 30 participants—occupational therapists, social workers, physiotherapists, and nurses from hospital, primary care, municipal health, and social welfare—were held. Results: The tacit framing of normative and contextual aspects that influenced discharge conferences’ outcomes, such as around decision-making about post-discharge activities, was identified as a main category in the results, comprised of the following four categories: (1) Different perceptions of prioritizing the elderly patients’ involvement in practice; (2) Choice of method for information transferal affecting collaboration; (3) The limited timeframe affecting assessments and choice of actions; (4) Underlying professional hierarchies. Conclusions: Overall, we found professional hierarchies and organizational administrative demands on efficiency reduced collaboration interorganizationally and between healthcare and social care professionals. Based on our findings, it is our opinion further development is needed both locally at hospitals and at a systemic level in Sweden.
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| 4. |
- Friberg, Febe, 1950, et al.
(författare)
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Communicating bodily changes : Physicians' ways of enabling patient understanding in gastrointestinal cancer consultations
- 2015
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Ingår i: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; 13:03, s. 661-671
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore how physicians communicatively enable patients' understanding of bodily changes in gastrointestinal cancer care consultations.Method: Two datasets were used. The first consisted of transcribed video-recorded palliative care consultations with three oncologists and six patients diagnosed with advanced gastrointestinal cancer, in the context of outpatient palliative care. The second dataset was audio-recorded transcriptions from diagnostic consultations with six surgeons and seven patients diagnosed with colorectal cancer, in the context of cancer surgery. An inductively driven and iterative analysis of interaction was performed, guided by Wetherell et al. (2001).Results: Two overarching communicative strategies were identified: (1) “visualizing strategies,” with the dimensions: visible strategies (visualizing with what you actually or potentially can see), sensory strategies (visualizing with what is possible to feel), and imaginative strategies; and (2) “contrasting strategies,” with the dimensions: contrasting subjective experiences and contrasting between the patient and other people.Significance of results: The visualizing and contrasting communicative strategies form parts of physicians' tacit and experience-based knowledge. The strategies employed by physicians reveal clear potentials to enable patients' understanding and sense making of bodily changes. However, these strategies need to be explicated and problematized as parts of both consultation practice and basic medical education. By means of increased awareness, physicians can more easily identify turning points in patients' levels of understanding, thereby enriching ordinary medical consultations with reflected pedagogical strategies and skills in how to dialogue in a person-centered manner.
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| 5. |
- Håland, Kristin, 1965, et al.
(författare)
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Fathers’ experiences of being in change during pregnancy and early parenthood in a context of intimate partner violence
- 2016
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Intimate partner violence (IPV) is a large public health problem with far-reaching consequences for those involved. The aim of this study was to explore fathers’ experiences of change during pregnancy and early parenthood in the context of IPV. Methods: The methodological approach in this interview study was hermeneutics, based on a lifeworld perspective. Ten men, who had subjected their partners to violence during the childbearing period, and had become fathers within the previous 6 years, participated. Results: The analysis revealed four themes: beginning to acknowledge that you are inflicting violence, receiving confirmation that you are more than just a perpetrator of violence, becoming aware of the child, and the desire to receive support in the process of learning how to become a father. Levinas’ concept “the face of the other” is used to interpret the findings. Conclusion: This study contributes to a more nuanced and expanded picture of IPV. It shows that men who inflict violence want to be and learn how to be fathers. We need more knowledge about how to stop violent acts and support these men in the process of fatherhood.
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| 6. |
- Lidén, Eva, 1955, et al.
(författare)
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Combining garden therapy and supported employment - a method for preparing women on long-term sick leave for working life
- 2016
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 30:2, s. 411-8
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Tidskriftsartikel (refereegranskat)abstract
- © 2015 Nordic College of Caring Science. Women are overrepresented among the group people suffering from long-term illness. In addition to their illness, suffering long-term sick leave leads to economical restraints as well social distress. There are gaps in our understanding of the challenges these women face. There is also lack of knowledge about how these challenges can be effectively addressed in rehabilitation. This deficiency is problematic from an ethical, justice and a caring perspective. In this study, changes in health-related quality of life (HRQoL) among women on long-term sick leave were investigated during and after participating in a rehabilitation programme combining two validated methods, Garden Therapy and Supported Employment (SE). The study also discusses difficulties in realising research related to vulnerable under-privileged people. From a population of 329 women who had reported their interest to participate, 245 were randomised to the programme. Of these 144 accepted participation in the research project and of these 123 women accepted to answer the SF-36 questionnaire. The participants were between 21 and 62 years with poor physical and mental health. They had received public financial support from <1 year to >10 years. The SF-36 measurement was carried out at baseline, after completion of Garden Therapy and after completion of SE. The results are based on data of respondents who participated at all the three occasions (n = 52). When comparing HRQoL baseline with the following occasions, the participants' General Health (GH), Vitality (VT), Social Functioning (SF) and mental health had improved significantly. The Four Leaf Clover (FLC) programme could be an appropriate method for reducing socially induced suffering. However, to conduct intervention studies where vulnerable persons are involved, it is off vital importance to consider whether the participants have the strength to complete the intervention.
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| 7. |
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| 8. |
- Lidén, Eva, 1955, et al.
(författare)
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The meaning of encounters with health professionals in primary health care as reported by patients with medically unexplained symptoms
- 2017
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Ingår i: Nordic Journal of Nursing Research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; 37:2, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- Medically unexplained symptoms (MUS) afflict up to 30% of patients who visit primary health care (PHC) services. The approach of health professionals is most important in encounters with these patients to accomplish a caring and effective treatment. The aim of the present study was to elucidate the meaning of patients’ lived experiences of encounters with PHC professionals when suffering from MUS. The study was based on ten narrative interviews with informants aged 24–61 years. Phenomenological hermeneutics was used as the method of analysis. Three themes emerged: Striving for understanding, Expecting to be taken seriously and Fear of being abandoned. The result can be seen as a call for health professionals to invite patients into an interpreting process to create a joint understanding of the patient’s body experiences and life situation. Thus the patient might also become reconciled with suffering and move on in life.
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| 9. |
- Lidén, Eva, 1955, et al.
(författare)
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The meaning of learning to live with medically unexplained symptoms as narrated by patients in primary care: A phenomenological-hermeneutic study
- 2015
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although research about medically unexplained symptoms (MUS) is extensive, problems still affect a large group of primary care patients. Most research seems to address the topic from a problem-oriented, medical perspective, and there is a lack of research addressing the topic from a perspective viewing the patient as a capable person with potential and resources to manage daily life. The aim of the present study is to describe and interpret the experiences of learning to live with MUS as narrated by patients in primary health-care settings. Methods: A phenomenological–hermeneutic method was used. Narrative interviews were performed with ten patients suffering from MUS aged 24–61 years. Data were analysed in three steps: naive reading, structural analysis, and comprehensive understanding. Findings: The findings revealed a learning process that is presented in two themes. The first, feeling that the symptoms overwhelm life, involved becoming restricted and dependent in daily life and losing the sense of self. The second, gaining insights and moving on, was based on subthemes describing the patients’ search for explanations, learning to take care of oneself, as well as learning to accept and becoming mindful. The findings were reflected against Antonovsky’s theory of sense of coherence and Kelly’s personal construct theory. Possibilities and obstacles, on an individual as well as a structural level, for promoting patients’ capacity and learning were illuminated. Conclusions: Patients suffering from MUS constantly engage in a reflective process involving reasoning about and interpretation of their symptoms. Their efforts to describe their symptoms to healthcare professionals are part of this reflection and search for meaning. The role of healthcare professionals in the interpretative process should be acknowledged as a conventional and necessary care activity.
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| 10. |
- Risa, Christina Furskog, et al.
(författare)
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Norwegian nurse-midwives' perspectives on the provision on antenatal diabetes care in an outpatient setting: A qualitative study
- 2015
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192. ; 28:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is limited research related to nurse-midwives’ accounts of their provision of antenatal diabetes care in hospital outpatient settings. This study explored the perspectives and experiences of eight Norwegian nurse-midwives regarding the provision of the midwifery aspect of an antenatal consultation as part of the diabetes specialist team. Methods: A qualitative descriptive study was used. Eight nurse-midwives aged between 37 and 58 years, representing four Norwegian hospital outpatient clinics, participated in individual interviews. Transcribed interviews were analysed in accordance with a qualitative thematic analysis. Results: Three main themes were developed: ‘‘Approaching the women as persons in order to frame strengths and normalcy’’, ‘‘Managing different tasks judiciously’’ and ‘‘Balancing conflicting values’’. Some of the barriers were found to be related to the organisation of care, such as short timeframes with a medical focus, which overshadowed or forced the normalcy aspects of childbearing into the background. Managing risk and evidence-based knowledge were demanding tasks to fulfil in a judicious way. Some midwives experienced ambiguity while being forced to prioritise medical factors over woman-focused care while running others’ errands, an act of balancing conflicting values. Conclusions: The contextual conditions related to the organisation present barriers for pregnant women to receive woman-focused care beyond the medical approach. The midwifery contribution in this care setting should be clearly recognised and defined so that women can capitalise on the different professionals and their expert competencies and contributions in this setting.
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