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| 2. |
- Hellzén, Ove, et al.
(författare)
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Being in a fragmented and isolated world : Iinterviews with carers working with a person with severely autistic disorder. An interview study
- 2002
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 37:4, s. 346-354
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To illuminate the meaning of being a carer for a person having a severe autistic disorder. Background: Carers working with people with severe autim are occasionally exposed to residents’ self-injurious behaviours and violent actions and at time residents appear resistant to all forms of treatment. Design/Method: A qualitative case study was conducted. Six Swedish carers (ENs), working at a special ward on a nursing home were interviewed about their lived experiences when caring for an individual having a severe autistic disorder. Narrative interviews were conducted and interpreted using a phenomenological-hermeneutic method inspired by Paul Ricoeur. Findings: Two themes were formulated which describe the carers’ reality and their dream of an ideal, which described carers’ experiences of being trapped in a segmented and isolated care reality and thier longing to achieve a sense of wholeness. The findings were interpreted and reflected on in the light of a framework inspired by the German philosopher Karl Jaspers in order to achieve a deeper understanding of the text. Concusions: In their desperation the carers used their empirical knowledge based on scientific knowledge, which could be understood as a substitute for their vision of a consolating wholeness. This paper shows that searching for a substitute to consolation seems to be an important aspect of the meaning of being a carer for a person with severe autistic disorder.
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| 7. |
- Norberg, Astrid, et al.
(författare)
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Reactions to music, touch and object presentation in the final stage of dementia : an exploratory study
- 2003
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Ingår i: International Journal of Nursing Studies. - 0020-7489 .- 1873-491X. ; 40:5, s. 473-479
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Tidskriftsartikel (refereegranskat)abstract
- Two patients in the final stage of dementia of Alzheimer type were stimulated with music, touch and object presentation during 12 consecutive days (16 trials per patient). Evaluations were made by direct observations, analysis of video-taped recordings and registrations of pulse and rate of respiration. Both patients reacted differently to music than to touch and object presentation.
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| 8. |
- Norbergh, Karl-Gustaf, et al.
(författare)
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A retrospective study of functional ability among people with dementia when admitted to group-dwelling
- 2001
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 19:1, s. 39-42
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Tidskriftsartikel (refereegranskat)abstract
- Objective - To describe functional ability among people with dementia when admitted to group-dwelling (GD) during different time periods, and the probability of their remaining in these units for the rest of their lives. Design - Retrospective study of functional ability and likelihood of staying in GD. Setting - Thirteen GD units in the Sundsvall region, Sweden. Subjects - One-hundered-and-forty-two demented people admitted to GD in the period 1986-1996. Main outcome measures - Ability to manage personal care and somatic and psychiatric status were measured with the use of a rating scale. Result - On comparing people over the years, a significant increase was found in the need of assistance to manage everyday life on admission to GD. The likelihood of living the rest of life in GD has increased over time. Conclusions - Increasing dependency and increasing probability óf remaining in GD may influence the intention of GD as a unique way of caring for people with dementia. It is crucial to consider these changes in order to to encourage the development of GD.
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| 9. |
- Norbergh, Karl-Gustaf, et al.
(författare)
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How patients´ with dementia spend their time in a psycho-geriatric unit
- 2001
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 15:3, s. 215-221
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents the findings of a work sampling study conducted at an assessment unit for patients with dementia at a university hospital in Nothern Sweden. The aim of the study was to describe the activity of the demented patients´day at apsycho-geriatric unit, and to investigate the correlation between the patients´ characteristics and time provided by nursing staff, in order to increase our knowledge of institutionalized demented patients situation. The sample consited of 24 patients with dementia. The activities of patients were monitored at 10-min interval between 7.00 a.m. and 9.10 p.m. In total, 2024 activities were recorded. The findings showed that being demented and placed in a psycho-geriatric unit is a life in solitude for most of the time. The variationin time patients spent in solitude could partly be explanied by their communication abilities. For patients with dementia, communication is essential for their well-being. It seems important to enhance our knowledge about the reasons, that influence the nursing staffs' perceptions of patients with dementia, to decrease their time in solitude.
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| 10. |
- Norbergh, Karl-Gustaf, et al.
(författare)
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The relationship between organisational climate and the content of daily life for people with dementia living in group-dwelling
- 2002
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 11:2, s. 237-246
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Tidskriftsartikel (refereegranskat)abstract
- One factor influencing the outcome of care may be nursing staff's experience of the organizational work climate. The aim of the study was to investigate how people with dementia spend their time in group-dwelling units (GD) with either a creative or less creative organizational climate. 2. For the study, two GD units assessed as having a creative organizational climate and two units assessed as having a less creative climate were selected. Eighteen residents living in the units assessed as creative and 20 residents living in the units assessed as less creative participated in the study. 3. For measuring the organizational climate the Creative Climate Questionnaire was used. Observations of residents' activities were classified according to the Patient Activity Classification. For measuring residents' functional ability the Multi-Dimensional Dementia Assessment Scale was used. Their cognitive capacity was measured with the Mini Mental State Examination. 4. Residents living in the units assessed as having a creative organizational climate spent 45.2% of the time with nursing staff, while those in the less creative climate spent 25.6% (P < 0.001). Time spent with fellow residents in the creative climate was 13.9% and in the less creative climate 31.3% (P < 0.001). There was no significant difference between the units according time spent with relatives and time spent alone. 5. Since the purpose of GD is to offer care adapted to the abilities and psychosocial needs of people suffering from dementia, a less creative climate can be a threat to the aims of GD. In order to maintain these, it is important for managers to be aware of the work climate and its impact on care for people with dementia.
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| 11. |
- Normann, Hans Ketil, et al.
(författare)
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Confirmation and lucidity during conversations with a woman with severe dementia
- 2002
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 39:4, s. 370-376
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Tidskriftsartikel (refereegranskat)abstract
- Rationale. Patients with severe dementia sometimes surprise the care providers because they seem to be much more aware of their situation and function much more adequately than usual. Such episodes are labelled 'episodes of lucidity' (ELs). The aim of this study was to describe the characteristics of the particular conversations with a woman with severe dementia when ELs occurred as compared with conversations when she was not lucid.Methodological design. A woman with a probable diagnosis of Alzheimer's disease (AD) was selected. Her Mini Mental State Examination (MMSE) was estimated as 3. The first author met the woman for 4 hours five times over a period of 2 weeks.Research methods. The conversations were tape-recorded and transcribed verbatim. The text was divided into 278 content units and analysed.Findings. Lucidity is promoted by supporting the patient in various ways, that is sharing the patient's view, repeating and reformulating the patient's utterance, reinforcing the patient by using positive utterances, not emphasizing errors and supporting the patient's language in various ways, and avoiding making demands. The relation between the patient and her conversation partner during ELs is characterized by confirmation and communion.Conclusions. This case study indicates that a supportive attitude in conversation with the patient with severe dementia promotes lucidity. A supportive attitude includes the avoidance on the part of the conversational partner making demands on the patient, confirming the patient as an important, unique and valuable person and creating communion. The connection between supporting and avoiding demands and lucidity/nonlucidity during conversation needs further study.
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| 12. |
- Pejlert, Anita, et al.
(författare)
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From a psychiatric ward to a home-like setting : the meaning of caring as narrated by nurses
- 2000
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 9:5, s. 689-700
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Tidskriftsartikel (refereegranskat)abstract
- This study presents interviews with nurses 1 and 2 years after they moved to a home-like setting, compared with results from interviews with nurses before their move. A phenomenological hermeneutic perspective inspired by Ricoeur guided the study. The interviews focused on the meaning of their work, including their view of the client as a person and the care they provide. The meaning of caring was interpreted in terms of the following themes: 'being free and entrusted with the task of caring makes a difference'; 'sharing the activities of everyday life is a natural way of being together'; 'providing a warm, open and supportive eating atmosphere', 'sharing the client's everyday world with compassion and love, glimpsing possibilities'; and 'dealing with limiting circumstances in care, the lack of "homeliness"'. Findings suggest a transformation in the view of care that reveals itself in increased closeness in the client-carer relationship and a change in values. The narratives revealed a caring atmosphere, valuing the client as well as the carer. The same questions guided all interviews, allowing developments to be followed. The carer and the interviewer thus became increasingly familiar with the situation on each interview occasion and the possibility that this has influenced the study must be taken into consideration. However, the similarity between nurses' narratives validated their trustworthiness.
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| 13. |
- Ragneskog, Hans, et al.
(författare)
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Individualized music played for agitated patients with dementia: Analysis of video-recorded sessions
- 2001
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Ingår i: International Journal of Nursing Practice. - 1322-7114 .- 1440-172X. ; 7:3, s. 146-155
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Tidskriftsartikel (refereegranskat)abstract
- Many nursing home patients with dementia suffer from symptoms of agitation (e.g. anxiety, shouting, irritability). This study investigated whether individualized music could be used as a nursing intervention to reduce such symptoms in four patients with severe dementia. The patients were video-recorded during four sessions in four periods, including a control period without music, two periods where individualized music was played, and one period where classical music was played. The recordings were analysed by systematic observations and the Facial Action Coding System. Two patients became calmer during some of the individualized music sessions; one patient remained sitting in her armchair longer, and the other patient stopped shouting. For the two patients who were most affected by dementia, the noticeable effect of music was minimal. If the nursing staff succeed in discovering the music preferences of an individual, individualized music may be an effective nursing intervention to mitigate anxiety and agitation for some patients.
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| 14. |
- Sjöling, Mats, et al.
(författare)
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The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management.
- 2003
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Ingår i: Patient Education and Counseling. - 0738-3991 .- 1873-5134. ; 51:2, s. 169-176
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Tidskriftsartikel (refereegranskat)abstract
- The primary objective of this study was to test whether specific information given prior to surgery can help patients obtain better pain relief after total knee arthroplasty (TKA). Secondary objectives were to study the impact of preoperative information on state and trait anxiety, satisfaction with pain management and satisfaction with nursing care. The study was an intervention study with two groups of equal size (n ¼ 30). The intervention group was given specific information while the control group received routine information. Pain assessments were made preoperatively and every 3 h for the first three postoperative days, using the visual analogue scale (VAS). The results of this study suggest that information does influence the experience of pain after surgery and related psychological factors. The postoperative pain declined more rapidly for patients in the treatment group, the degree of preoperative state anxiety was lower and they were more satisfied with the postoperative pain management.
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| 16. |
- Storli, Sissel, et al.
(författare)
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Intensivpasienternas erfaringer
- 2004
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Ingår i: Norsk Tidskrift for Sykepleieforskning. - 1501-4754. ; 6:3, s. 22-37
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Tidskriftsartikel (refereegranskat)
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| 17. |
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| 18. |
- Wester, Kenneth, et al.
(författare)
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Zinc-based fixative improves preservation of genomic DNA and proteins in histoprocessing of human tissues.
- 2003
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Ingår i: Lab Invest. - 0023-6837. ; 83:6, s. 889-99
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Tidskriftsartikel (refereegranskat)abstract
- Advantageous preservation of histology and detailed cellular morphology has rendered neutral buffered formalin (NBF) the most widely used fixative in clinical pathology. Despite excellent morphology for routine diagnostics, a major drawback of NBF fixation is its detrimental effect on DNA and RNA quality. In addition to complicating analysis of genes and transcripts in complex tissues, NBF denatures proteins and thereby hampers immunohistochemical visualization of certain antigens. In the present study, we evaluated a zinc-based fixative (ZBF) regarding its effects on tissue morphology, quality of genomic DNA, and preservation of protein immunoreactivity in a broad spectrum of tissues. Four different modes of fixation were analyzed: ZBF-paraffin embedding, NBF-paraffin embedding, ZBF-fixation prior to snap-freezing, and immediate snap-freezing. Laser-assisted microdissection, allowing retrieval of a defined number of cells for PCR, was used to study DNA quality. Genomic DNA was analyzed using primers for beta2-microglobulin and the transferrin receptor. Immunohistochemistry was performed using nine antibodies. Tissue microarray blocks were used for analysis of morphology and immunoreactivity. Only slight impairment of morphologic qualities was found after ZBF-paraffin embedding, whereas ZBF prior to freezing resulted in a more crisp morphology compared with routine cryosections. A significantly higher DNA yield was observed in samples isolated from ZBF-paraffin-embedded tissues compared with NBF-paraffin-embedded tissues. Both yield and quality of DNA was comparable in frozen tissues irrespective to prior ZBF fixation. Immunoreactivity in paraffin-embedded tissue was superior in ZBF-fixated tissue compared with NBF-fixated for a majority of tested antibodies. Furthermore, for seven out of nine antibodies, antigen retrieval pretreatment proved unnecessary in ZBF-fixated tissue. Thus, despite a slight impairment of morphology, ZBF preserves protein structures well. We conclude that ZBF is superior to NBF for analysis of DNA and protein expression. Fixation of tissues in ZBF may also be an alternative strategy to freeze storage of tissue specimens, eg, in future bio-banks.
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