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| 2. |
- Engström, Åsa, et al.
(författare)
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Close relatives in intensive care from the perspective of critical care nurses
- 2007
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:9, s. 1651-1659
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim was to describe critical care nurses’ experiences of close relatives within intensive care.Background. There is a lack of research describing critical care nurses' experiences of the significance of close relatives in intensive care. Knowledge in this area will support critical care nurses to develop good nursing care for the critically ill person and their close relatives.Design and method. The design of the study was qualitative. Data collection was carried out through focus group discussions with 24 critical care nurses in four focus groups during spring 2004. The data were subjected to qualitative thematic content analysis.Results. The focus groups discussions showed that the presence of close relatives was taken for granted by critical care nurses and it was frustrating if the critically ill person did not have any. Information from close relatives made it possible for critical care nurses to create individual care for the critically ill person. They supported close relatives by giving them information, being near and trying to establish good relations with them. Close relatives were important. Critical care nurses lacked forums for reflection and discussion about the care given.Relevance to clinical practice. This study indicates that close relatives are a prerequisite for critical care nurses to give good nursing care to meet the needs of the critically ill person. A communication based on mutual understanding is necessary if critical care nurses are to be able to support close relatives. Dealing constantly with situations that were ethically difficult without any chance to reflect was an obstacle for critical care nurses to improve their work with close relatives.
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| 3. |
- Engström, Åsa, et al.
(författare)
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Experiences of a follow-up visit to an ICU
- 2008
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Ingår i: 3rd EfCCNa Congress and the 27th Aniarti congress. - : European federation of Critical Care Nursing associations.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Engström, Åsa, et al.
(författare)
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Re-visiting the ICU. Experiences of follow-up visits to an ICU after discharge : A qualitative study
- 2008
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 24:4, s. 233-241
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to describe how people who have been critically ill, and their close relatives experience a post-discharge, follow-up visit to the intensive care unit (ICU) that provided the care. There is a lack of studies from such a standpoint. The study design is qualitative. A total of 18 adults participated; nine had been critically ill and nine were close relatives, all made a post-discharge follow-up visit to an ICU in the northern part of Sweden. The study data was collected through personal interviews, conducted after the follow-up visit, using a narrative approach. The data were then subjected to qualitative thematic content analysis which resulted in four themes: receiving strength from returning together; making sense of the critical-illness experience; feeling grateful to have survived and the possibility of improving the care. People who had been critically ill and close relatives felt that returning together was valuable. Meeting the staff, with whom participants felt they had developed a relationship, made it possible for them to express their gratitude for the treatment and nursing care received, and to suggest improvements. The interviews revealed that the follow-up visit was seen as an important way of learning what had happened and why during the period of critical illness. © 2008 Elsevier Ltd. All rights reserved.
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| 5. |
- Engström, Åsa, et al.
(författare)
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Receiving power through confirmation : The meaning of close relatives for people who have been critically ill
- 2007
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 59:6, s. 569-576
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper is a report of a study to elucidate the meaning of close relatives for people who have been critically ill and received care in an intensive care unit. Background. Falling critically ill can bring about a difficult change in life. In previous reports such events are described as frightening experiences, and close relatives are described as an important source of support in this difficult situation. Method. A purposive sample of 10 adults, eight men and two women, narrated how they experienced their close relatives during and after the time they were critically ill. The data were collected in 2004. The interview texts were transcribed and interpreted using a phenomenological hermeneutic approach influenced by the philosophy of Ricoeur. Findings. One major theme was identified, experiencing confirmation, with six sub-themes: receiving explanations; a feeling of being understood; a feeling of safety; gaining strength and will-power; having possibilities and realizing their value. Close relatives served as tools for the person who was ill, facilitating better communication and an increased ability to do various things. Simultaneously, feelings of dependence on the close relatives were expressed. There were descriptions of loneliness and fear in the absence of close relatives and, in order to feel safe, the participants wanted their close relatives to stay near them. Conclusion. Close relatives are vital, as they are the ill person's motivation to stay alive and to continue the struggle. Their presence is of great importance for the ill person and must be facilitated by staff. © 2007 The Authors.
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| 7. |
- Isaksson, Ann-Kristin
(författare)
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Chronic sorrow and quality of life in patients with multiple sclerosis
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to increase our understanding and knowledge of patients’ experiences of living with multiple sclerosis (MS). A mixed-method design was used, including both qualitative and quantitative methods. Thirty-one immunologically treated MS patients were randomly selected and matched with patients without immunological treatment. Matching criteria were gender, impairment, time since diagnosis and age. One patient dropped out and therefore the final sample consisted of 61 patients. All 61 were interviewed (Studies I, III and IV) and completed the 36-item Short Form health survey questionnaire (SF-36), the Subjective estimation of Quality of Life questionnaire (SQoL), the Self-reported Impairment Check-list (SIC) (Study II) and the Montgomery–Asberg Depression Rating Scale questionnaire (MADRS) (Study III). The interviews were subjected to content analysis. Initial symptoms and being diagnosed with MS were described in terms of becoming vulnerable and remaining in that vulnerability long after the diagnosis. Eventually the patients were able to manage this emotional distress and acquired strength in their illness situation (Study I). In the matched analysis, 29 pairs of patients were included after internal drop-out. There were no statistically significant differences between the treatment and control groups. Concerning the total group of 61 patients, the self-reported impairment check-list showed that they had various problems of impairment, most evident in balance and walking. The score on health-related quality of life (SF-36) was reduced, disclosing a negative influence on vitality, physical role and function. However, subjective quality of life (SQoL) was not reduced, showing that the patients estimated their well-being to be quite unaffected (Study II). Thirty-eight of the 61 patients (62%) experienced chronic sorrow (Study III). The group were not depressed in general, only four having mild symptoms of depression, revealing that chronic sorrow is a particular form of emotional distress in MS. Chronic sorrow was experienced in terms of loss of hope, loss of control over the body and loss of integrity and dignity. When the patients could not adequately manage their sorrow and lacked support, they were struggling with their vulnerability. In the successful management of MS, losses and emotional distress are managed in such a way as to enhance personal growth, appreciation and trust in life. The theoretical model of chronic sorrow facilitated the sorting of the empirical data and the linking of these data to theory, showing the usefulness of the model (Study IV).
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| 8. |
- Jacobsson, Lars, et al.
(författare)
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Functioning and disability 6-15 years after traumatic brain injuries in northern Sweden
- 2009
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 120:6, s. 389-395
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Tidskriftsartikel (refereegranskat)abstract
- Objectives - To assess long-term functioning and disability after traumatic brain injury (TBI). Material and methods - Individuals (n = 88) in Norrbotten, northern Sweden, who had been transferred for neurosurgical care were assessed with internationally established TBI outcome measures 6-15 years post-injury. Results - There was an improvement in overall outcome from discharge from inpatient rehabilitation to follow-up. Many individuals had a high degree of motor and cognitive functioning, which enabled them to live independently in their own home without assistance, but there remained a disability related to community reintegration and social participation. This affected their productivity and to some degree their marital stability. The remaining disability and reduced productivity were related to the age at injury and the injury severity. Conclusions Our data showed that individuals with a TBI can achieve and maintain a high degree of functioning many years after the injury. Increasing age and a greater injury severity contributed to their long-term disability.
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| 9. |
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| 10. |
- Jumisko, Eija, et al.
(författare)
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Living with moderate or severe traumatic brain injury : The meaning of family members' experiences
- 2007
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Ingår i: Journal of Family Nursing. - : SAGE Publications. - 1074-8407 .- 1552-549X. ; 13:3, s. 353-369
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Tidskriftsartikel (refereegranskat)abstract
- Traumatic brain injury (TBI) has long-lasting consequences not only for the individual with the injury but also for family members. The aim of this study is to elucidate the meaning of family members' experiences of living with an individual with moderate or severe TBI. The data have been collected by means of qualitative research interviews with 8 family member participants. A phenomenological hermeneutic interpretation (Ricouer, 1976) of the data reveal that family members struggle with their own suffering while showing compassion for the injured person. Their willingness to assume care for the injured person is derived from their feeling of natural love and the ethical demand to be responsible for the other. Hope and natural love from close relatives, the afflicted person, and other family members give the family members strength. It is important that professionals pay more attention to the suffering of close relatives.
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