| 1. |
|
|
| 2. |
- Asplund, Kenneth, et al.
(författare)
-
Facial Expressions of Patients With Dementia : A Comparison of Two Methods of Interpretation
- 1995
-
Ingår i: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 7:4, s. 527-534
-
Tidskriftsartikel (refereegranskat)abstract
- Two methods of interpreting the videotaped facial expressions of four patients with severe dementia of the Alzheimer type were compared. Interpretations of facial expressions performed by means of unstructured naturalistic judgements revealed episodes when the four patients exhibited anger, disgust, happiness, sadness, and surprise. When these episodes were assessed by use of modified version of the Facial Action Coding System, there was, in total, 48% agreement between the two methods. The highest agreement, 98%, occurred for happiness shown by one patient. It was concluded that more emotions could be judged by means of the unstructured naturalistic method, which is based on an awareness of the total situation that facilitates imputing meaning into the patients' cues. It is a difficult task to find a balance between imputing too much meaning into the severely demented patients' sparse and unclear cues and ignoring the possibility that there is some meaning to be interpreted.
|
|
| 3. |
- Fagerberg, Ingegerd
(författare)
-
Nursing students' narrated, lived experiences of caring, education and the transition into nursing, focusing on care of the elderly
- 1998
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this longitudinal research project was to elucidate and reach an understanding of influencing aspects on nursing students' choice of future work area as newly graduated nurses. The influencing aspects should be affiliated with the three-year education, the students' transition into nursing and the care of the elderly. The first study (I) concerned the amount of projected education in gerontology and geriatrics in 30 colleges of nursing and health, and the result showed a variety between colleges. Newly admitted nursing students in three colleges responded to a questionnaire. A majority of the students preferred to work in the emergency care, rather than elder care, after graduation. Phenomenological analyses of one interview theme, after one year (II), gave two phenomena; patients' helplessness and identification/nonidentification of the individual patient. Phenomenological hermeneutic analyses were carried out on all interviews and diaries provided from the three years (III-V). The findings (III) show that the rneaning of caring for elderly patients was a process from naive caring via deeper relationships with patients to an organizational perspective. The transition into nursing (IV) meant for the students a process from a natural interest in caring to the perspective of an RN, where co-operation with team members had a strong influence. The students' experiences of theoretical and clinical elder care were not positive, which meant that their reluctance to work there was reinforced (V). Content analyses about students' reasoning regarding two fictitious elderly patient cases (Vl) showed a development in reasoning in a more acute oriented case but not in a case with a confused elderly patient. Conclusions drawn imply that both the theoretical and the clinical education in gerontology and geriatrics need to be strengthened.
|
|
| 4. |
- Hellzén, Ove, et al.
(författare)
-
From optimism to pessimism : A case study of a psychiatric patient
- 1998
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 7:4, s. 360-370
-
Tidskriftsartikel (refereegranskat)abstract
- This article focuses on the results of a single case study which illuminates an understanding of phases in nursing care for a patient in a psychiatric setting in Sweden. The focus of this study is a fifty year old man who showed progressive deterioration from increased motor activity to oral, sexual, destructive and aggressive actions. The data collection using five methods occurred during a 21 months period. Results of the content analyses processes identified four distinct but indiscreet phases of the patient’s complex condition. The medical and nursing care was categorised in three approaches: optimistic, strategic and resigned. The results raise the question whether there is action that is without any meaning as an expression of the patient´s wishes, thoughts and feelings. It seems clear that the patient in this study felt really angry and in despair. However, during moments of lucidity, he also indicated that he felt this was not an authentic expression of his "real" self. His experience was that of a splintered world.
|
|
| 5. |
- Hellzén, Ove, et al.
(författare)
-
Unwillingness to be violated : Carers' experiences of caring for a person acting in a disturbing manner. An interview study
- 1999
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 8:6, s. 653-662
-
Tidskriftsartikel (refereegranskat)abstract
- Carers working in psychiatric care are sometimes exposed to insane, unpredictable and violent actions. In rare cases a patient appears to be resistant to all forms of pharmacological treatment. · Fifteen carers (4 RNs, 11 ENs) on a psychiatric ward in Sweden were interviewed about their experiences when caring for a person who acted in a disturbing manner. Narrative interviews were conducted and interpreted using a method inspired by Ricoeur. · Four themes were formulated which describe the carers’ uncertainty about the future, their inability to interpret the patient’s disturbing behaviour and their own overall feeling of meaninglessness. · Carers believed that the patient had power and ruled the ward, which led to them feeling they were subjugated victims. Interviews also revealed the carers’ recognition of forbidden feelings and actions and own unknown negative sides. · These results were interpreted and reflected on in the light of an ethical framework in order to achieve a deeper understanding of the text. · This paper shows that an ethical perspective is important when searching for the meaning of caring for patients acting in a disturbing manner. The study raises the question: ‘Is it possible to establish good when evil has dominion?
|
|
| 6. |
- Normann, Hans Ketil, et al.
(författare)
-
Attitudes of Registered Nurses towards patients with severe dementia
- 1999
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 8:4, s. 353-359
-
Tidskriftsartikel (refereegranskat)abstract
- Meeting the needs and wishes of people with severe dementia is difficult and demanding for carers, and a number of approaches can be used in encounters with dementia sufferers. The aim of this study was to explore how registered nurses in a northern Norwegian county thought about approaching people with severe dementia. A patient case was used as a vignette, followed by a questionnaire with 13 sets of statements, each set containing two alternative approaches (one reality orientation approach and one personhood focused approach). In 12 out of the 13 sets of statements the reality orientation alternative was usually chosen, but responses to the statement regarding the meaning of confusion tended more towards the personhood focused approach. RNs with more than the basic education and staff nurses working in a team nursing system, chose the personhood focused approach significantly more often than RNs with no post-basic education and nurses working in a primary nursing system. The article discusses how reflection on daily experiences can improve one's ability to reflect on one's own experiences and encourage a personhood focused approach. Working in a team means gaining opportunities to reflect together with coworkers, while working in a primary nursing care system might afford fewer such opportunities.
|
|
| 7. |
- Normann, H K, et al.
(författare)
-
Episodes of lucidity in people with severe dementia as narrated by formal carers
- 1998
-
Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 28:6, s. 1295-1300
-
Tidskriftsartikel (refereegranskat)abstract
- Twenty formal carers employed in three nursing homes narrated 92 episodes of lucidity (ELs) in people with severe dementia. Sixty-two episodes concerned speech, nine concerned actions and 21 episodes concerned both speech and actions. Most ELs were said to occur spontaneously when the patients were acting closely together with a carer who did not make demands on them and regarded them as valuable human beings whose behaviour was a meaningful expression of their experiences. The narrations showed characteristics that indicated trustworthiness and the episodes described in three separate nursing homes were very similar and resembled descriptions given in previous research reports as well as in relatives' reports. Further research seems necessary and the assumption that severe dementia implies the destruction of the self or personhood must be questioned.
|
|
| 8. |
- Pejlert, Anita, et al.
(författare)
-
Stories about living in a hospital ward as narrated by schizophrenic patients
- 1995
-
Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 2:5, s. 269-334
-
Tidskriftsartikel (refereegranskat)abstract
- Ten schizophrenic patients were interviewed about their own experiences of life in a hospital ward, of their care provider and of the care received. The interview texts were analysed using a phenomenological hermeneutic method. Fatigue, thinking about problems/inner activities, relations and longings for the pre-illness days were themes that occurred in the stories. Seven of the ten interviewees stated that they suffered from fatigue. They were preoccupied with an inner dialogue, trying to solve problems on their own. The patients were alone in their stories. The problems that the patients expressed with regard to relationships arose because they both longed for and feared contact with others, and they felt that they were not 'themselves' when they were with others. For developing care, the importance of learning more about the patients' experiences, especially regarding fatigue, is emphasized.
|
|
| 9. |
- Pejlert, Anita, et al.
(författare)
-
The meaning of caring for patients on a long-term psychiatric ward as narrated by formal care providers
- 1998
-
Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 5:4, s. 255-264
-
Tidskriftsartikel (refereegranskat)abstract
- Seventeen care providers were interviewed about their caring experiences on a hospital psychiatric ward. The interviews focused on the meaning of their work, including the care they provide and the nature of the patient as a person. The study was guided by a phenomenological hermeneutic perspective inspired by Ricoeur (1976). The analysis focused on context and form. Three themes illuminate the meaning of care provided. These themes are as follows; being in the midst of human storage, moving towards a human care of relations, and struggling with 'the old' and 'the new'. Experiencing work as being in the midst of a human storage reflects the historical and human situation of warehousing psychiatric patients. The care providers are experiencing a shift in their view of the patient and the meaning of their work, towards a more human care of relations. For these care providers, there is a struggle between the past, the present and the future. This struggle between 'the old' and 'the new' conveys a struggle between doing as a nurse, which dominates the past, and relating, which is, or needs to be, the current and future focus in psychiatric care. The shift in view distinguished itself by the care providers viewing the patient as being vulnerable and having problems with relations. The results have been interpreted and discussed in the light of a previously published interview study with the patients, carried out at the same time on the same ward. Attending to ingrained attitudes of the past and their influence on new approaches to care is essential to understanding not only changes in ways of doing nursing tasks, but also ways of relating.
|
|
| 10. |
- Pejlert, Anita, et al.
(författare)
-
Towards recovery : living in a home-like setting after the move from a hospital ward
- 1999
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 8:6, s. 663-674
-
Tidskriftsartikel (refereegranskat)abstract
- Six clients with a diagnosis of schizophrenia were interviewed about their experiences of their lives in a home-like setting, their key care provider and the care received. Their narratives of lived experiences in care were interpreted as living a process of health in the midst of severe mental illness, involving: 'becoming more', 'being disabled', 'comforting/conforming relationship', 'discomforting/unconfirming relationship' and 'caring about the caring relationship'. Fatigue and lack of strength influenced the lives of most clients considerably, and the stories were about problems and conflicts. Nevertheless, the clients seemed really to struggle to make communal life work, and there were experiences of increased competence and better self-confidence in most of the stories. On the whole care was described as good, and the process of health seemed to be supported by experiences of comfort and being confirmed in the client-care provider relationship.
|
|
| 11. |
- Wimo, A, et al.
(författare)
-
Patients with dementia in group living: experiences 4 years after admission
- 1995
-
Ingår i: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 7:1, s. 123-127
-
Tidskriftsartikel (refereegranskat)abstract
- Sixteen patients with dementia were studied 4 years after admission to group-living (GL) units, an intermediate level of dementia care. Of eight patients who were still alive, four lived in the GL units and four had been institutionalized. The eight patients who had died had spent 89% of their survival time in GL. Aggression was the most frequent cause of institutionalization.
|
|
