| 1. |
- Blomgren Mannerheim, Ann, et al.
(författare)
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Parents’ experiences of caring responsibility for their adult child with schizophrenia
- 2016
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Ingår i: Schizophrenia Research and Treatment. - : Hindawi Limited. - 2090-2085 .- 2090-2093.
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Tidskriftsartikel (refereegranskat)abstract
- As a consequence of the latest psychiatry-related reform in Sweden and its implementation, relatives and family members have taken over from the formal healthcare system significant responsibility for the care of persons with a mental disability and illness. The aim of this study was to systematically describe and analyze the experiences of parents' informal care responsibility. The questions were, what are the experiences around parents' informal care activities and responsibilities and how do parents construct and manage their caring responsibility and with what consequences? Semistructured in-depth interviews were conducted (16 hours of recorded material) with eight parents who were all members of the Interest Association for Schizophrenia (Intresseforeningen for Schizofreni (IFS)) in Sweden. A mixed hermeneutic deductive and inductive method was used for the interpretation of the material. The parents endow their informal caring responsibility with meaning of being a good, responsible, and accountable parent with respect to their social context and social relationships as well as with respect to the psychiatric care representatives. In this tense situation, parents compromise between elements of struggle, cooperation, avoidance, and adaption in their interaction with the world outside, meaning the world beyond the care provision for their child, as well as with the world inside themselves.
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| 2. |
- Hellström Muhli, Ulla, et al.
(författare)
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Patient-Involvement in Consultation for Atrial-Fibrillation : The Cardiologists’ Perspective
- 2019
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald Group Publishing Limited. - 0952-6862 .- 1758-6542. ; 32:4, s. 765-776
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose was to analyse the accounts of Swedish cardiologists concerning patient involvement in consultations for atrial fibrillation (AF). The questions were: (i) how cardiologists handle and provide scope for patient involvement in medical consultations regarding AF treatment and (ii) how cardiologists describe their familiarity with shared decision-making.Design/Methodology/Approach: A descriptive study was designed. Ten (n=10) interviews with cardiologists at four Swedish hospitals were held and a qualitative content analysis was performed on the collected data.Findings: The analysis shows cardiologists´ accounts of (i) persuasive practice, (ii) protective practice, (iii) professional role, and (iv) medical craftsmanship when it comes to patient involvement and shared decision-making.Conclusions: - The term “shared decision-making” implies a concept of not only making one decision but also ensuring that it is finalised with a satisfactory agreement between both parties involved, the patient as well as the cardiologist. - In order for the idea of patient involvement to be fulfilled, the two parties involved must have equal power, which can never actually be guaranteed.Practical implications: Cardiologists should prioritise patient involvement and participation in decision-making regarding AF treatment decisions in consultations when trying to meet the request of patient involvement.Originality/value: Theoretically, we have learned that the patient involvement and shared decision-making requires the ability to see patients as active participants in the medical consultation process.
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| 3. |
- Hellström Muhli, Ulla, et al.
(författare)
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Patient participation, authority and understanding : A case study of communication patterns in a geriatric consultation
- 2015
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Ingår i: Journal of Applied Linguistics and Professional Practice. - Sheffield (UK) : Equinox Publishing. - 2040-3658 .- 2040-3666. ; 12:3, s. 336-353
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective is to examine communication patterns in the discourse that emerges between a female geriatric patient and a pharmacist in the context of using an inhaler. This analysis is done in order to understand the communicative components of consultation interaction that support the patient learning and demonstrating understanding of medical information.Methods: This article is a qualitative case study from a project that video recorded forty (N=40) clinical consultations. The actual case was selected as a representative example of the use of material and visual information resources during a clinical consultation between a patient and a pharmacist in a geriatric setting.Results: The patient’s understanding of the clinician’s medical advice did not result simply from repeating the clinician’s demonstration. Rather, the patient’s discussion and manipulation of the inhaler produced a communication pattern that increased the patient’s authority over topics and forms of expression.Conclusion: A combination of verbal, visual and tactile activities oriented to visual and material information resources, produced pattterns of interaction that enhanced the patient’s participation, authority and understanding of medical information.Practice implications: Many consultations can incorporate elder patients’ use of various visual and material information resources to improve their participation in treatment decisions.
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| 4. |
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| 5. |
- Siouta, Eleni, et al.
(författare)
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Cardiologists' experiences and perceptions of patient involvement and communication related to shared decision-making regarding atrial fibrillation treatment
- 2017
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Ingår i: Communication & Medicine. - : Equinox Publishing. - 1612-1783 .- 1613-3625. ; 14:1, s. 39-50
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To feel involved in decisions about atrial fibrillation (AF) treatment, patients need supportive communication from cardiologists. Shedding light on cardiologists’ perceptions of patient involvement in AF care settings is thus of importance. We examine (1) how cardiologists describe patient involvement and communication related to shared decisionmaking regarding AF treatment, and (2) their perceptions of efforts to involve patients in the treatment decisions. Methods: Ten cardiologists were interviewed in four Swedish hospitals. A qualitative content analysis was performed on the interview data. Results: Cardiologists’ perceptions of patient involvement in treatment decisions are framed in terms of (1) ideology, (2) experience, and (3) responsibility. Conclusion: By taking into account patients’ feelings in the consultations, and by actively encouraging patients to be involved, the cardiologists contributed to patient involvement. Practice Implications: One key to improving compliance with legislation aimed at increasing patient involvement in treatment decisions could lie in paying attention to physician–patient communication and the conditions for patient involvement in decision-making about treatment.
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| 6. |
- Siouta, Eleni
(författare)
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Communication in Patient Involvement in Decision making : Examples from consultations on atrial fibrillation
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- AbstractBackground: Further knowledge is needed regarding communication that occurs in practice between patients with atrial fibrillation (AF) and health professionals in consultations to understand the issue of patient involvement in treatment decisions.Overall aim: The overall aim of this thesis is to contribute knowledge on communication between patients and health professionals (cardiology nurses and cardiologists), focussing on how they create involvement in decision making in consultations.Specific aims: (1) To describe (i) the topics that patients with AF discuss with cardiology nurses and cardiologists; (ii) the use of discursive space in consultations between these participants; and (iii) the frequency at which patients, cardiology nurses, and cardiologists introduce identified topics. (2) To describe the different types of resistance by patients to treatment with warfarin and how cardiologists respond to such resistance. (3) To examine how patients describe involvement and communication in decision making regarding treatment in consultations with cardiology nurses and cardiologists. (4) To examine how cardiologists describe their views on patient involvement in AF treatment decisions, their perceptions regarding efforts to involve patients, and how they handle decisions.Methods: A qualitative design was used. In study I, the sample consisted of 23 videotaped consultations between patients with AF and cardiology nurses and cardiologists at six nurse-led cardiology outpatient clinics. Content analysis was used to obtain a description of topics that were discussed. The patterns of dominance for the various topics and participants were examined. In study II, the sample consisted of 11 videotaped consultations between patients with AF and cardiologists. Conversation analysis was used to describe interactions concerning resistance to treatment with warfarin. In study III, 22 patients with AF were interviewed directly after their consultations with cardiology nurses and cardiologists. Content analysis was used for the resulting data. In study IV, 10 cardiologists were interviewed in cardiology clinics at four Swedish hospitals and qualitative content analysis was used.Findings: In study I, a medically driven agenda dominated the patient-driven agenda. However, when the patients initiated conversations about their life with AF (the topic that received the least amount of space on the agenda), involvement was created. In study II, the patients’ resistance could be viewed as a source of knowledge about patients’ real-life situations and what motivates them. In study III, despite not being actively involved in the decision-making process, the patients experienced a sense of involvement when they felt understood and were listened to. In study IV, by taking into account the patients’ feelings in the consultations, and by actively encouraging the patients to be involved, the cardiologists contributed to patient involvement.Conclusions: Patients, cardiology nurses, and cardiologists create involvement in decision making in consultations as communicative projects. Patients strive for space and create involvement by showing resistance to the decisions suggested by health professionals. However, involvement is not only an issue about obtaining space in the consultations, but is also associated with obtaining clarification, building confidence, feeling understood, trusting cardiology nurses and cardiologists, and having confidence in receiving consistent care within an established relationship. On a theoretical level, this thesis sheds light on the interaction between the concepts of communication, involvement, and decision making.
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| 7. |
- Siouta, Eleni, et al.
(författare)
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Communicative constructions of person-centred and non-person-centred caring in nurse-led consultations
- 2019
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 40, s. 10-21
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Tidskriftsartikel (refereegranskat)abstract
- AbstractPurposeNursing is theorised to be a component of person-centred care. Communicative constructions of person-centred caring are a topic that needs to be studied in consultations. The study aimed to explore how person-centred caring and non-person- centred caring are verbally constructed in consultations between patients and nurse.MethodThis study was qualitative using audio-recorded observations from consultations with advanced nurse practitioners in nurse-led chemotherapy clinics from four hospitals in the UK through purposive sampling. Discourse analysis was used to identify communicative patterns in 45 non-participant observations of nurse consultations.ResultsThe dominant discourse was a non-person-centred oriented discourse framed by the biomedical model. It was also possible to identify fragments of an alternative discourse—a person-oriented discourse localising health problems within the patient's personal and sociocultural context.ConclusionsThe prominent use of a non-person-oriented discourse focusing on the medical/technical aspects of a patient's assessment/evaluation in consultations may make it difficult for patients to raise questions and concerns from their daily lives during consultations. However, fragments of a person-oriented discourse show that it is possible for nurses to allow a person-centred approach to the consultation. The pedagogical implications have to do with raising nurses' awareness of the role of evaluative language in enhancing person-centred communication with patients in clinical interactions.
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| 8. |
- Siouta, Eleni, et al.
(författare)
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Patients' experiences of communication and involvement in decision-making about atrial fibrillation treatment in consultations with nurses and physicians
- 2016
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Ingår i: Scandinavian Journal of Caring Sciences. - Chichester : Wiley. - 0283-9318 .- 1471-6712. ; 30:3, s. 535-546
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Tidskriftsartikel (refereegranskat)abstract
- Background: Insights in consultations across patient interactions with physicians and nurses are of vital importance for strengthening the patients' involvement in the treatment decision-making process. The experience of involvement and communication in decision-making from the patients' perspective has been sparsely explored.Objective: To examine how patients describe involvement in and communication about decision-making regarding treatment in consultations with nurses and physicians.Method: Twenty-two patients with atrial fibrillation (AF), aged 37-90 years, were interviewed directly after their consultations with nurses and physicians in outpatient AF clinics in six Swedish hospitals.Results: In consultations with nurses, the patients felt involved when obtaining clarifications about AF as a disease and its treatment and when preparing for and building up confidence in decision-making. In consultations with physicians, the patients felt involved when they could cooperate in decision-making, when acquiring knowledge, and when they felt that they were being understood. One shared category was found in consultations with both nurses and physicians, and the patients felt involved when they had a sense of trust and felt secure during and between consultations.Conclusions: Patients with AF stated that they would need to acquire knowledge and build up confidence and ability in order to be effectively involved in the decision-making about treatment. Despite not being actively involved in decision-making, patients felt involved through experiencing supportive and confirming communication.Practice implications: Attention must be given to the relationship with the patient to create the conditions for patient involvement in the consultation. This can be achieved through supportive communication attempting to create a feeling of clarity and building confidence. This will support involvement in decision-making concerning AF treatment and feelings of being understood and of trust in physicians and/or nurses.
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