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1.
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2.
  • Bolmsjö, Ingrid, et al. (författare)
  • The use of drama to support reflection and understanding of the residents' situation in dementia care : a pilot study
  • 2014
  • Ingår i: International Journal of Older People Nursing. - : Blackwell Munksgaard. - 1748-3735 .- 1748-3743. ; 9:3, s. 183-191
  • Tidskriftsartikel (refereegranskat)abstract
    • Background.  One key aspect of person-centredness is striving to understand both the patients' experiences and behaviours from their perspective. These aspects are precisely those that staff in dementia care highlight as causing them most difficulty because the people in their care have major problems expressing themselves. There is thus a need to develop a method to help the staff to achieve interpretation through reflection.Aim.  The aim of this study was to explore the use of drama as a tool to support reflection among staff working in the residential care of people with dementia.Design.  A qualitative evaluation of a programme consisting of three drama sessions with staff working in residential care (n = 10 nurse assistants).Methods.  Data comprised observations and tape recordings of the sessions, the researchers' reflections after each session and a focus-group interview with the participants. The texts were analysed using qualitative content analysis.Results.  The analysis showed that: (i) the exercises stimulate reflection about daily caring practice; (ii) the participants must receive extensive information about the purpose of the sessions; (iii) the research team must secure the defined frames and conditions and have practical knowledge about caring for people with dementia and (iv) the management needs to be stable, committed and supportive.Conclusion.  Drama seems to be a valid tool to aid reflection, but several adjustments are needed concerning both the content of the sessions and the methodology. When designing a larger intervention study, it would be preferable to the sessions to be combined with staff support to effect changes in care provision resulting from their increased awareness of the residents' situation and experience.Implications for practice.  Our results showed that drama can be a means to enhance reflection among staff in residential care for people with dementia. Further research is however needed concerning the effects for the staff's situation and nursing care quality.
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3.
  • Bolmsjö, Ingrid, et al. (författare)
  • The use of drama to support reflection and understanding of the residents' situation in dementia care : a pilot study.
  • 2012
  • Ingår i: International Journal of Older People Nursing. - : Blackwell Munksgaard. - 1748-3735 .- 1748-3743. ; 9:3, s. 183-191
  • Tidskriftsartikel (refereegranskat)abstract
    • The use of drama to support reflection and understanding of the residents' situation in dementia care: a pilot study. International Journal of Older People Nursing doi: 10.1111/j.1748-3743.2012.00333.x Background.  One key aspect of person-centredness is striving to understand both the patients' experiences and behaviours from their perspective. These aspects are precisely those that staff in dementia care highlight as causing them most difficulty because the people in their care have major problems expressing themselves. There is thus a need to develop a method to help the staff to achieve interpretation through reflection. Aim.  The aim of this study was to explore the use of drama as a tool to support reflection among staff working in the residential care of people with dementia. Design.  A qualitative evaluation of a programme consisting of three drama sessions with staff working in residential care (n = 10 nurse assistants). Methods.  Data comprised observations and tape recordings of the sessions, the researchers' reflections after each session and a focus-group interview with the participants. The texts were analysed using qualitative content analysis. Results.  The analysis showed that: (i) the exercises stimulate reflection about daily caring practice; (ii) the participants must receive extensive information about the purpose of the sessions; (iii) the research team must secure the defined frames and conditions and have practical knowledge about caring for people with dementia and (iv) the management needs to be stable, committed and supportive. Conclusion.  Drama seems to be a valid tool to aid reflection, but several adjustments are needed concerning both the content of the sessions and the methodology. When designing a larger intervention study, it would be preferable to the sessions to be combined with staff support to effect changes in care provision resulting from their increased awareness of the residents' situation and experience. Implications for practice.  Our results showed that drama can be a means to enhance reflection among staff in residential care for people with dementia. Further research is however needed concerning the effects for the staff's situation and nursing care quality.
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4.
  • Brorson, Hanna, et al. (författare)
  • Pain Relief at the End of Life: Nurses' Experiences Regarding End-of-Life Pain Relief in Patients with Dementia.
  • 2013
  • Ingår i: Pain Management Nursing. - : Elsevier BV. - 1532-8635 .- 1524-9042.
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients with dementia receive suboptimal palliative care, and this patient group is at risk to have pain at the end of life. Because communicative impairments are common in this patient group, nurses play an important caregiver role in identifying, assessing, and relieving patients' pain. This study aimed to describe nurses' experiences regarding end-of-life pain relief in patients with dementia. This descriptive exploratory qualitative study was based on seven semistructured interviews. Burnard's content analysis inspired the data analysis. Two main categories were identified: (1) nurses' experience of difficulties concerning pain relief and (2) nurses' experience of resources concerning pain relief. Nurses experienced difficulties, such as feeling of powerlessness because of difficulties in obtaining adequate prescriptions for analgesics, ethical dilemmas, feeling of inadequacy because analgesia did not have the desired effect, and a feeling of not being able to connect with the patient. Factors, including knowledge about the patient, professional experience, utilization of pain assessment tools, interpersonal relationships, and interprofessional cooperation, served as resources and enabled end-of-life pain relief. The results of this study highlight the complexity of pain relief in patients with dementia at the end of life from a nursing perspective. The inability of patients with dementia to verbally communicate their pain makes them a vulnerable patient group, dependent on their caregivers. Knowing the life story of the patient, professional experience, teamwork based on good communication, and use of a pain assessment tool were reported by the nurses to improve pain relief at the end of life for patients with dementia.
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5.
  • Carlson, Elisabeth, et al. (författare)
  • Registered nurses' perceptions of their professional work in nursing homes and home-based care : A focus group study
  • 2014
  • Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 51:5, s. 761-767
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In Sweden, as well as in most industrialized countries, an increasing older population is expected to create a growing demand for health care staff. Previous studies have pointed to lack of proficient medical and nursing staff specialized in geriatric care, which poses serious threats to the care of a vulnerable population. At the same time, there are studies describing elderly care as a low-status career choice, attracting neither nurses nor student nurses. Judging from previous research it was deemed important to explore how nurses in elderly care perceive their work, thus possibly provide vital knowledge that can guide nurse educators and unit managers as a means to promote a career in elderly care. Objective: The aim of the present study was to illuminate how nurses, working in nursing homes and home-based care, perceived their professional work. Method: This was a qualitative study using focus groups. 30 registered nurses in seven focus groups were interviewed. The participants worked in nursing homes and home-based care for the elderly in rural areas and in a larger city in southern Sweden. The interviews were analyzed in line with the tradition of naturalistic inquiry. Results: Our findings illustrate how nurses working in elderly care perceived their professional work as holistic and respectful nursing with the older person at its centre. Three categories emerged during analysis: (1) establishing long-term relationships, (2) nursing beyond technical skills, and (3) balancing independence and a sense of loneliness. Conclusions: We suggest that nurse educators and nurse managers promote continuity and long term relationships with patients, as well as independence and the opportunity to provide holistic care as key aspects of elderly care. These key aspects can be used to attract and retain nurses to a much needed area as well as be used as positive examples that can influence values and attitudes towards a career in elderly care.
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7.
  • Holst-Hansson, Annette, et al. (författare)
  • The breath of life : womens' experiences of breathing adapted radiation therapy
  • 2013
  • Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 17:3, s. 354-359
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose To describe and analyze how women with breast cancer experience breathing adapted radiation therapy (BART) and to explore how women manage daily radiation therapy. Method Individual interviews were conducted with 20 women treated with BART for breast cancer concerning their perception of radiation therapy. The transcribed interviews were analyzed using qualitative content analysis. Results ‘The breath of life’ was the overall theme, as the women experienced the breathing as a way in which to influence their treatment and thus their survival. ‘Participating in one's treatment, for good or ill’, was the main category with four subcategories, ‘Knowing one has done something good’, ‘Getting an extra bonus – healthwise’, ‘The experience of being in control’ and ‘Being in a high-technology environment’. The breathing technique became the strategy by which they could manage their treatment and gave them a sense of participation which led to a feeling of being in control. The women also felt that breathing benefited their health both mentally and physically. The high-technology environment was experienced as both hopeful and frightening. Conclusion Survival or increasing the chances of survival, are of ultimate importance for a woman with breast cancer. BART requires commitment from the women, which was perceived as offering them an opportunity to participate in their own treatment, for their survival. Increasing the women's possibilities to participate in their treatment benefits their health and welfare during an otherwise turbulent time and allow the rehabilitation process to start during treatment.
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8.
  • Holst-Hansson, Annette, et al. (författare)
  • The breath of life : womens' experiences of breathing adapted radiation therapy
  • 2013
  • Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 17:3, s. 354-359
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To describe and analyze how women with breast cancer experience breathing adapted radiation therapy (BART) and to explore how women manage daily radiation therapy.Method: Individual interviews were conducted with 20 women treated with BART for breast cancer concerning their perception of radiation therapy. The transcribed interviews were analyzed using qualitative content analysis.Results: 'The breath of life' was the overall theme, as the women experienced the breathing as a way in which to influence their treatment and thus their survival. 'Participating in one's treatment, for good or ill', was the main category with four subcategories, 'Knowing one has done something good', 'Getting an extra bonus - healthwise', The experience of being in control' and 'Being in a high-technology environment'. The breathing technique became the strategy by which they could manage their treatment and gave them a sense of participation which led to a feeling of being in control. The women also felt that breathing benefited their health both mentally and physically. The high-technology environment was experienced as both hopeful and frightening.Conclusion: Survival or increasing the chances of survival, are of ultimate importance for a woman with breast cancer. BART requires commitment from the women, which was perceived as offering them an opportunity to participate in their own treatment, for their survival. Increasing the women's possibilities to participate in their treatment benefits their health and welfare during an otherwise turbulent time and allow the rehabilitation process to start during treatment.
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9.
  • Janzon, Ellis, et al. (författare)
  • Obesity in Somali migration women due to post migration dietary changes and decreasing self-esteem : a qualitative interview study on diet, knowledge ab out risk of heart disease, inactivity, body image and self-esteem
  • 2013
  • Ingår i: Journal of research in obesity. - : IBIMA Publishing. - 2333-3707. ; :142971
  • Tidskriftsartikel (refereegranskat)abstract
    • The last-decade incidence of myocardial infarction (MI) has diminished dramatically in most age groups but not in middle-aged women in Sweden. There has been a large influx of immigrants and it has been shown that immigrant wom en have a higher BMI and are less physically active than Swedish women. Thereby they have a higher risk for heart disease. The aim of the study was to examine post-migration diet ary changes, and knowledge about risks for heart diseases among Somali women. Furthermore, to examine the women’s perceptions of body image, self-esteem, and their knowledge about the positive effect of physical activity. The qualitative research method was used and eight Soma li women aged 40 years or more, who have lived in Sweden longer than ten years, were in terviewed with the help of a semi- structured questionnaire. The study revealed that S omali migrated women in Sweden had changed their diet and experienced weight increase. They reported low self-esteem and little motivation for physical activity. They understood t hat they had a higher risk for heart disease as compared to Swedish women and they had, in gener al, a preference for big body size. The women of this study are, in combination with other risk factors, at a high risk of myocardial infarction. They all revealed a general knowledge a bout the relationship between obesity and inactivity and enhanced risks for heart disease. Th ey had a preference for a larger female body image. They expressed low self-esteem, loneliness, and alienation from society. It is important to address the health issue among migrant Somali wo men in Sweden, but since this study had few informants, larger studies and more science is needed to further investigate the problem.
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10.
  • Kisch, Annika, et al. (författare)
  • Factors associated with changes in quality of life in patients undergoing allogeneic haematopoietic stem cell transplantation
  • 2012
  • Ingår i: European Journal of Cancer Care. - : Blackwell Munksgaard. - 0961-5423 .- 1365-2354. ; 21:6, s. 735-746
  • Tidskriftsartikel (refereegranskat)abstract
    • Factors associated with changes in quality of life in patients undergoing allogeneic haematopoietic stem cell transplantation It is well known that patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) experience changes in quality of life. We investigated factors associated with quality of life changes in adult HSCT patients. The Functional Assessment of Cancer Therapy - Bone Marrow Transplantation (FACT-BMT) scale, supplemented with the Functional Assessment of Chronic Illness Therapy - Spiritual Well-being (FACIT-Sp) subscale, was administered on three occasions, immediately before transplantation, 100 days and 12 months after transplantation. Analyses of nine selected factors were made where changes in quality of life were found. Seventy-five patients were included and 40 of these completed the study. Emotional well-being was found to improve between the baseline and 100 days, while all other dimensions deteriorated, including overall quality of life. Physical and social/family well-being deteriorated between the baseline and the 12-month follow-up, while emotional well-being improved. The main factors associated with deteriorating quality of life over time were found to be significant infections, female gender and transplantation with stem cells from a sibling donor. In our further studies we aim to focus on the relationships between patients and sibling donors in order to improve the care. Careful attention must be paid to continuous adequate information during the transplantation procedure.
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11.
  • Kisch, Annika, et al. (författare)
  • Having a sibling as donor : patients’ experiences immediately before allogeneic hematopoietic stem cell transplantation
  • 2014
  • Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 18:4, s. 436-442
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Allogeneic haematopoietic stem cell transplantation (HSCT) offers a potential cure for a variety of diseases but is also associated with significant risks. With HSCT the donor is either a relative, most often a sibling, or an unrelated registry donor. Purpose The aim was to explore patients’ experiences, immediately before transplantation, regarding having a sibling as donor. Method Ten adult patients with sibling donors were interviewed before admission for HSCT. The interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. Results The main theme Being in no man’s land is a metaphor for the patients’ complex situation with its mixture of emotions and thoughts prior to transplantation. The three subthemes Trust in the sibling donor, Concern about others and Loss of control cover the various experiences. The patient’s experiences are influenced by their personal situation and the quality of the relationship with the sibling donor. While patients feel secure in having a sibling donor, they are dependent for their survival on the cell donation and feel responsible for the donor’s safety during donation. These emotions intensify the patients’ sense of dependency and loss of control. Conclusions In caring for HSCT patients the nurses should be aware of the complexity of the patients’ situation and keep in mind that having a sibling donor might imply extra pressure, including a sense of responsibility. Caring for both patients and sibling donors optimally is a challenge, which needs further improvement and exploration.
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12.
  • Kisch, Annika, et al. (författare)
  • Potential adult sibling stem cell donors’ perceptions and opinions regarding an information and care model
  • 2013
  • Ingår i: Bone Marrow Transplantation. - : Nature Publishing Group. - 0268-3369 .- 1476-5365. ; 48:8, s. 1133-1137
  • Tidskriftsartikel (refereegranskat)abstract
    • The first international recommendations and guidelines for the care of sibling stem cell donors were established in 2010, and have not yet been evaluated. However, a model for information and care of adult potential sibling stem cell donors (the IC model) developed and introduced at the Skåne University Hospital, Lund, Sweden, in 2005 conforms closely to them. The IC model aims to protect the privacy of potential donors, support and respect their free choice, and identify quickly those unwilling or unable to donate and thus minimize delay in seeking alternative donors. To evaluate the IC model a questionnaire survey in 2010 gathered the perceptions and views on information provision; influences over decision making; and care provision under the IC model of 148 adult siblings informed about SCT donation, and asked to undergo HLA-typing since September 2005 at the hospital. The results suggest the IC model works well but highlights areas for improvement, such as in delivery of HLA typing results to non-matched siblings, and a need to further prevent complicating influence from health professionals and relatives on the decision to undergo HLA typing. Thus improved, the IC model could provide the groundwork for other SCT units seeking to implement the recommendations and guidelines.
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13.
  • Kisch, Annika, et al. (författare)
  • Potential adult sibling stem cell donors’ perceptions and opinions regarding an information and care model
  • 2013
  • Ingår i: Bone Marrow Transplantation. - : Nature Publishing Group. - 0268-3369 .- 1476-5365. ; 48:S2, s. S471-S472
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Background: The first international recommendations and guidelines for the care of sibling stem cell donors were established in 2010 and have not yet been evaluated. However, a model for information and care of adult potential sibling stem cell donors (the IC model) developed and introduced at Skåne University Hospital, Lund, Sweden, in 2005 conforms closely to them. The IC model aims to protect the privacy of potential donors, support and respect their free choice, and identify quickly those unwilling or unable to donate and thus minimize delay in seeking alternative donors. All contacts with potential sibling donors are handled by the SCT (Stem Cell Transplantation) team. If the sibling is unwilling or unable to donate, HLA (Human Leukocyte Antigen) typing is not performed and the patient is told only that there is no possible donor among the siblings. To protect the sibling donor’s privacy, the physician and nurse assigned to the donor are never those responsible for the patient.Objectives: The main aim of the present study was to evaluate the IC model by surveying adult potential sibling stem cell donors’ perceptions and views regarding the provision of information, staff and relatives’ influence over decision making, and the care provision by health professionals around the time of the decision whether to undergo HLA typing.Methods: A questionnaire survey containing 30 questions was performed in 2010 gathering the perceptions and views on information provision; influences over decision making; and care provision under the IC model of 148 adult siblings informed about SCT donation and asked to undergo HLA typing since September 2005 at the hospital. The questionnaire responses were analysed using descriptive statistical methods.Results: The results suggest the IC model works well but highlights areas for improvement, such as in delivery of HLA typing results to non-matched siblings and a need to further prevent complicating influence from health professionals and relatives on the decision to undergo HLA typing.Conclusion: The majority of the siblings was satisfied with the information and care provided, and found the aspects of information, care provision and support important. The IC model could provide the groundwork for other SCT units seeking to implement handling of potential adult sibling stem cell donors according to the international recommendations and guidelines published after the IC model was developed and introduced.
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14.
  • Schaepe, Christiane, et al. (författare)
  • A Spider in the Web: Role of the Palliative Care Nurse Specialist in Uganda--An Ethnographic Field Study.
  • 2011
  • Ingår i: The American Journal of Hospice and Palliative Medicine. - : SAGE Publications. - 1938-2715 .- 1049-9091. ; 28:6, s. 403-411
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Palliative care is not a priority in developing countries. Hospice Africa Uganda (HAU), where nurses complete a course in clinical palliative care, is considered a model for other African countries. Aim: To explore the role of the palliative care nurse specialist (PCNS) in Uganda. METHODS: This ethnographic field study uses observations, interviews, and group interviews. Participants: In total, 20 participants are included in this study. Result: The role of the palliative care nurse specialist is multifaceted. Beyond prescribing drugs, their role is to deliver holistic care. They encounter numerous challenges in their work, but they also have the possibility to improve the quality of the patient's life.
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15.
  • Skogman, Katarina, et al. (författare)
  • Being in want of control : experiences of being on the road to, and making, a suicide attempt
  • 2012
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Co-Action. - 1748-2623 .- 1748-2631. ; 7
  • Tidskriftsartikel (refereegranskat)abstract
    • Attempted suicide is a risk factor for future suicidal behaviour, but understanding suicidality from the perspective of people who have experienced attempted suicide is limited. The aim of the study was to explore the lived experience of being suicidal and having made a suicide attempt, in order to identify possible implications for health care professionals. Semi-structured individual interviews were held with 10 persons shortly after they attempted suicide and were analysed through qualitative content analysis. The participants' experience of being suicidal and of having attempted suicide could be described as "Being on the road towards suicidal action", which culminated in an experience of either chaos or turned off emotions, "Making sense of the suicide attempt", and "Opening the door to possible life lines". An overall theme, "Being in want of control", captured their all-embracing lack of sense of control and was seen in relation to different aspects of oneself, overall life-situation, the immediate suicide attempt situation and in the outlook on the future. Being in want of control may be a relevant and general feature of being suicidal. People who have attempted suicide need more adequate help to break vicious circles before they reach a point of no return and enter an acute suicidal state of mind. Patients' experience-based knowledge is highly important to listen to and use clinically as well as theoretically when constructing suicide prevention programs.
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16.
  • Öhlen, Joakim, 1958-, et al. (författare)
  • Conceptual development of "at-homeness'' despite illness and disease : A review
  • 2014
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 9
  • Forskningsöversikt (refereegranskat)abstract
    • Only one empirical study, the one by Zingmark, Norberg and Sandman published in 1995, explicitly focuses on at-homeness, the feeling of being metaphorically at-home, as a particular aspect of wellness. However, other studies reveal aspects of at-homeness, but if or how such aspects of at-homeness are related to each other is unclear. For this reason, the aim was to review Scandinavian nursing research related to at-homeness in the context of wellness-illness in severe and long-term conditions in order to take a step towards conceptual clarification of "at-homeness.'' The review included interpretive studies related to severe and long-term illness conducted in Sweden: 10 original articles and 5 doctoral theses. "At-homeness'' was found to be a contextually related meaning of wellness despite illness and disease embedded in the continuum of being metaphorically at-home and metaphorically homeless. This was characterized by three interrelated aspects and four processes: being safe through expanding-limiting experiences of illness and time, being connected through reunifying-detaching ways of relating, and being centred through recognition-non-recognition of oneself in the experience and others giving-withdrawing a place for oneself. This conceptualization is to be regarded as a step in conceptual clarification. Further empirical investigation and theoretical development of "at-homeness'' are needed. The conceptualization will be a step of plausible significance for the evaluation of interventions aimed at enhancing wellness for people with severe long-term illness, such as the frail elderly, and people with chronic illness or palliative care needs.
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