| 1. |
- Thurang, Anna, et al.
(författare)
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Women's experiences of caring when in treatment for alcohol dependency
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 24:4, s. 700-706
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Tidskriftsartikel (refereegranskat)abstract
- Despite the fact of increased levels of alcohol dependency in women and gender differences in how the disease affects men and women, the research on alcohol dependency continues to have a dominating perspective on men. The meaning of the phenomenon of caring in formal care for women with alcohol dependency is not well known. Thus, formal caregivers may find it problematic to know what is caring for women with alcohol dependency. The aim of the study was to illuminate the meaning of caring in formal care for women with alcohol dependency, as narrated by the women. The study was performed using a phenomenological-hermeneutic method. Data were collected in ten in-depth interviews with alcohol-dependent women. The themes presented are availability, being a patient and being a learner. The findings reveal that the women with alcohol dependency receiving a mandate from formal care, experience the relation between them and their caregiver as a mutual transformation. Within the mutual transformation, the participants experienced being respected as a responsible human being which renders possibilities for the women with alcohol dependency to continue in formal care even when the struggle against the disease became hard. Continual meetings with the caregiver allowed the women to gain structure in their daily life as well as allowing the women and their caregivers to develop mutual transformation, which both relieved the women's suffering and increased their experience of being involved in the care process.
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| 2. |
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| 3. |
- Asp, Margareta, 1958-, et al.
(författare)
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Begreppsutveckling på livsvärldsfenomenologisk grund
- 2012. - 1
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Ingår i: Vårdvetenskapliga begrepp i teori och praktik. - Lund. - 9789144071046 ; , s. 65-77
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Bokkapitel (populärvet., debatt m.m.)abstract
- I kapitlet presenteras en modell för att utveckla begrepp på livsvärldsfenomenologisk grund. Det förs en argumentation föratt denna kunskapsteoretiska grund stämmer överens med antaganden om vad som karaktäriserar en människa liksom hälsorelaterade fenomen som patienter erfar och vårdare reflekterar över.
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| 4. |
- Breitholtz, Agneta, et al.
(författare)
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Carers’ ambivalence in conflict situations with older persons
- 2013
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 20:2, s. 226-237
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study was to illuminate the meaning of professional carers’ experiences in caring situations when a conflict of interest arises with the older person receiving care. The findings reveal the complexity of the carers’ ambivalence when facing a conflict of interest, weighing between the older persons’ right to self-determination and external demands. The carers are alone in their ambivalence and the conclusion is that they need help and support to be more present in the encounter. The implication for this study is a person-centred practice, and to focus on people as interdependent on support carers to maintain older people’s right to self-determination in the relationship.
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| 5. |
- Breitholtz, Agneta, et al.
(författare)
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Living with Uncertainty : Older Persons’ Lived Experience of Making Independent Decisions over Time
- 2013
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Ingår i: Nursing Research and Practice. - : Hindawi Publishing Corporation. - 2090-1429 .- 2090-1437. ; 2013
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to illuminate the meaning of older persons’ independent decision making concerning their daily care. Autonomy when in care is highly valued in the western world. However, research shows that autonomy can give rise to problematic issues. The complexity of independence and dependence for older people when living at home with help has also been highlighted. In Sweden, older people are increasingly expected to live at home with help from municipal home care services, and study into this aspect of care is limited. This study is a part of an ongoing project and has a qualitative life world perspective. Audiotaped narrative interviews were conducted and analysed using a phenomenological hermeneutic method. Findings revealed a main theme: “living with uncertainty as to how to relate one’s own independence and dependence with regard to oneself, and others.” This involves a constant process of relating to one’s independence controlled by others or oneself, and adjusting one’s independence and dependence with regard to oneself and others. The conclusion is that professional carers need to acknowledge the changing vulnerability of dependent older persons over time. The implication is a relational approach to autonomy beyond the traditional individualistic approach.
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| 6. |
- Breitholtz, Agneta, et al.
(författare)
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Older people’s dependence on caregivers’ help in their own homes and their lived experiences of their opportunity to make independent decisions
- 2013
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Ingår i: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 8:2, s. 139-148
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate the meaning of older people’s dependence on caregivers’ help, and of their opportunity to make independent decisions.Background. Throughout the world, the older population is growing, and in Sweden, the system of care for older people is currently undergoing change. Older people in the need of care are expected to live at home for as long as possible.Design.A qualitative and life world approach was used.Methods. Audio-taped interviews were conducted with twelve older persons living at home, dependent on daily municipal home help service. A phenomenological hermeneutic method was utilised to disclose the meanings of lived experiences.Finding. The findings revealed three themes : being facilitated to make one’s own decisions, being hindered from making one’s own decisions, struggling for vs. resigning oneself to losing the opportunity to make one’s own decisions.The comprehensive understanding revealed that as older people become more dependent on caregivers’ help, their opportunity to self-determine is challenged and this is stressful for them.Conclusion. The older persons assess their opportunity to self-determine differently, depending on who they are as a person. The caregivers need an awareness of this, and further research is needed to gain knowledge and understanding of how caregivers can improve the way they support and enhance older people’s opportunity to decide for themselves.Implications for practice. The findings revealed older persons need to exercise more self-determination and caregivers’ need for knowledge to enable this. Further, it indicates a move towards a person-centred approach to focus on persons as individuals and see them as interdependent. The findings contribute to improvements in similar contexts worldwide.
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| 7. |
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| 8. |
- Elmqvist, Carina, 1964-
(författare)
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Akut omhändertagande : i mötet mellan patienter, närstående och olika professioner på skadeplats och på akutmottagning
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To describe and develop understanding of the patient’s first encounter with the involved persons at the scene of an accident and at the emergency department; with a special focus on describing the meaning of emergency care of patients in these caring contexts. Method: The thesis uses a reflective lifeworld research (RLR) approach founded on phenomenological philosophy. The purpose with this approach is to describe the essential meaning and the variations of a phenomenon. Interviews with a lifeworld perspective were used for data collection and analyzed according to the RLR approach for searching for the essence of the phenomenon. The four essences in the studies (I-IV) establish a general structure for the phenomenon.Findings: Emergency care is characterized by an organisation, whose goal and resources are focused on life-saving, and that encounters a human being with needs of emergency care as well as existential support. The responsibility in emergency care means an intertwining of doing and being. The one who is in charge takes responsibility for performing or “doing” medical actions, and by “being” close and present in the situation the patient can at the same time feel an existential support. The responsibility for the injured or ill body is handed over to a chain of persons with more and more specialized competence and resources. This hand-over entails a relief for all involved but fails in one link in the chain, namely to explicitly hand back the responsibility to the patient. When the patient’s condition allows the distance to be larger the responsibility pales and the existential support decreases. A gap between doing and being arises where the patient is left to regain control and independence. The intertwining of doing and being, which appears as soon as the one in charge is close and present to the patient, facilitates the hand-over to the patient who in a natural way is able to receive the responsibility with possibilities to be able to conclude the encounter.Conclusions: A new understanding of emergency care appears which entails more than just life support measures. Emergency care includes different ways of communication in order to hand over the responsibility and complete the care chain back to the patient in a safe way. The results highlight the importance of empowering patients with a confirming, communicative contact throughout the whole caring process in order for them to retain their identity. There are also implications for educating students and personnel in inter-professional communication and work. In order to assist the intertwining between doing and being there are needs for the development of supportive structures for inter-professional reflection, which in turn would improve the interaction between patients and professionals in their encounter.
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| 9. |
- Engström, Gabriella, 1965-, et al.
(författare)
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Attitudes Towards Older People among Swedish Health Care Students and Health Care Professionals Working in Elder Care
- 2011
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Ingår i: Nursing Reports. - : Frontiers Media SA. - 2039-4403. ; 1:1, s. e2-
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Tidskriftsartikel (refereegranskat)abstract
- The proportion of older people in the general population has increased and will continue to increase during the coming decade. Therefore, a positive attitude towards older people is important. The aim of the study was to gain knowledge about attitudes towards older people among health care students and health care staff in Swedish elder care settings. The study includes a convenience sample of 928 respondents comprised of health care students and three groups of professional caregivers [registered nurses (RNs) with university degrees, certified nursing assistants (CNAs), nurses] in a variety of health care settings in Sweden. The participants completed the Kogan’s Old People (KOPS) Scale with 17 positive (OP+) and 17 negative (OP–) statements. The statements score ranged from 17 to 85 respectively. A significant (P<0.05) difference in both positive and negative scores was observed among the three professional caregiver groups. RNs had the highest positive score (OP+:64) as well as the lowest negative score (OP–:36). Health care students in semester one had the most unfavourable attitude toward older people (OP–:41) while students in semester two had the most favourable attitude toward older people (OP+:62). RNs reported both a higher positive score as well as lower negative score compared to nurses without an academic degree and CNAs. In addition, we found that progression in one’s health care education contributes to reduce unfavourable attitudes toward older people. Health care professionals need to have the right skills to manage a more demanding role in the future in order to offer effective services for older people. A skilled workforce of health professionals is therefore very necessary.
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| 10. |
- Engström, Gabriella, et al.
(författare)
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Attitudes towards older people among Swedish health care students and health care professionals working in elder care
- 2011
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Ingår i: Nursing Reports. - : MDPI AG. - 2039-4403 .- 2039-439X. ; 1:1
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Tidskriftsartikel (refereegranskat)abstract
- The proportion of older people in the general population has increased and will continue to increase during the coming decade. Therefore, a positive attitude towards older people is important. The aim of the study was to gain knowledge about attitudes towards older people among health care students and health care staff in Swedish elder care settings. The study includes a convenience sample of 928 respondents comprised of health care students and three groups of professional caregivers [registered nurses (RNs) with university degrees, certified nursing assistants (CNAs), nurses] in a variety of health care settings in Sweden. The participants completed the Kogan’s Old People (KOPS) Scale with 17 positive (OP+) and 17 negative (OP–) statements. The statements score ranged from 17 to 85 respectively. A significant (P<0.05) difference in both positive and negative scores was observed among the three professional caregiver groups. RNs had the highest positive score (OP+:64) as well as the lowest negative score (OP–:36). Health care students in semester one had the most unfavourable attitude toward older people (OP–:41) while students in semester two had the most favourable attitude toward older people (OP+:62). RNs reported both a higher positive score as well as lower negative score compared to nurses without an academic degree and CNAs. In addition, we found that progression in one’s health care education contributes to reduce unfavourable attitudes toward older people. Health care professionals need to have the right skills to manage a more demanding role in the future in order to offer effective services for older people. A skilled workforce of health professionals is therefore very necessary.
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| 11. |
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| 12. |
- Fagerberg, Ingegerd, 1950-, et al.
(författare)
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Care of the old : A matter of ethics, organization and relationships
- 2012
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- The world stands on the threshold of a demographic revolution called global ageing. According to the World Health Organization (WHO), the population aged 60 and over is expected to increase from today's 650 million to an estimated 2 billion by 2050. Alongside demographic changes, dramatic changes can also be observed in older people's services. The shift has resulted in reduced government spending on caring for ill and frail older people in health care. Today, many governments have developed strategies to keep older people living well in their private home for as long as possible and have replaced long-term care institutions with residential homes. The aim of this study was to illuminate the meaning of caring for older people as experienced by health care students and professionals working in this field. Interviews were carried out with 17 women and one man, aged 21-65 years; six were Registered Nurses (RN), six were Enrolled Nurses (EN) and six were nursing students. The interviews were analyzed with a phenomenological hermeneutical approach and provided three themes and eight sub-themes: Ethical moral self with sub-themes "meeting the needs of the old", "pliability towards the old", and "difficulties in meeting aggressiveness"; Organizational and co-workers ethical moral actions with sub-themes, "co-workers who are offensive", and "supportive and non-supportive leaders": The relation with the old persons and their relatives with sub-themes "fellowship and closeness in the relation", "uncertainty and fear in the relation", and, "demands from the older persons' close relatives".
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| 13. |
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| 14. |
- Fagerberg, Ingegerd
(författare)
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Förvirringstillstånd
- 2010
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Ingår i: Höftfraktur hos äldre. - Stockholm : Liber förlag. - 9789147093397 ; , s. 157-165
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 15. |
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| 16. |
- Fagerberg, Ingegerd, 1950-, et al.
(författare)
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Hästen och hunden i människovården
- 2014
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Ingår i: Vårdmiljöns betydelse. - Lund : Studentlitteratur AB. - 9789144102573 ; , s. 255-274
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 17. |
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| 18. |
- Fagerberg, Ingegerd, et al.
(författare)
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Robotdjur i demensvården - i vems intresse?
- 2014
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Ingår i: Hästen, hunden och den mänskliga hälsan. - Stockholm : Ersta Sköndal högskola. - 9789138326534 ; , s. 151-164
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 19. |
- Gustafsson, Christine, 1967-, et al.
(författare)
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Dependency in autonomous caring : – night nurses’ working conditions for caring in nursing
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 24:2, s. 312-320
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Tidskriftsartikel (refereegranskat)abstract
- Few research studies have focused on nurses' working conditions for caring provided at night, and these studies have mainly described nurses' work in hospital settings, not in a municipal, social-care context. In Swedish municipal care, nurses have responsibility for hundreds of older people in need of care. This working condition compromises caring encounters; instead the nurses' caring is mainly mediated through care staff (or relatives). In considering that caring based on caring encounters is fundamental to ethical nursing practice questions leads to the aim: to explore Swedish municipal night nurses' experiences of their working conditions for caring in nursing. All municipal night-duty nurses (n = 7) in a medium-sized community in Sweden participated in interviews, while six of them also wrote diaries. Thematic content analysis has been used in analysing the data. The findings revealed that the nurses experienced their working conditions for caring in nursing in the themes of Dependency in the Organisation and Other Staff, Vocational Responsibility, Deficiency in Conditions for Caring and Autonomous Caring. The findings illustrate privileged, as well as, poor working conditions for caring in nursing. The nurses' role as consultants emerge as their main function. The consultant function implies that nurses do not participate in ordinary bed-side caring, which makes it easier for them to find time for caring in situations that arise when nurses' skills, expertise and authority are called upon. Conversely the consultancy function entails short-term solution of complex caring problems, which can signify deficient caring due to prevailing working conditions. The findings also point to nurses' possible problems in fulfilling their own and vocational demands for ethics in the practice of caring in nursing related to existing working conditions.
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| 20. |
- Gustafsson, Christine, 1967-, et al.
(författare)
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Supportive leadership in Swedish community night nursing
- 2010
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Ingår i: Journal of Nursing Management. - : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 18:7, s. 822-831
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of the present study was to examine the support night nurses’ give to staff in community night nursing.Background Studies have shown that support given to staff is one of night registered nurses’ (RNs’) experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described.Methods All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations.Results The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership.Conclusions Out of ‘concern for the staff’ the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs’ awareness that by giving support to staff this affects the staffs’ caring for older people.Implications for nursing management The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.The aim of the present study was to examine the support night nurses give to staff in community night nursing. Studies have shown that support given to staff is one of night registered nurses (RNs) experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described.All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations. The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership.Conclusions Out of concern for the staff the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs awareness that by giving support to staff this affects the staffs caring for older people. Implications for nursing management The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.
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| 21. |
- Holmberg, Mats, 1976-, et al.
(författare)
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The encounter with the unknown : Nurses lived experiences of their responsibility for the care of the patient in the Swedish ambulance service
- 2010
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 5:2, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Registered nurses (RNs) have, according to the Swedish National Board of Health and Welfare, the overall responsibility for the medical care in the ambulance care setting. Bringing RNs into the ambulance service are judged, according to earlier studies, to lead to a degree of professionalism with a higher quality of medical care. Implicitly in earlier studies, the work in the ambulance service involves interpersonal skills. The aim of this study was to describe RNs' experiences of being responsible for the care of the patient in the Swedish ambulance service. A reflective lifeworld approach within the perspective of caring science was used. Five RNs with at least five years experience from care in the ambulance care setting were interviewed. The findings show that the essence of the phenomenon is to prepare and create conditions for care and to accomplish care close to the patient. Three meaning constituents emerged in the descriptions: prepare and create conditions for the nursing care, to be there for the patient and significant others and create comfort for the patient and significant others. The responsibility is a complex phenomenon, with a caring perspective, emerging from the encounter with the unique human being.
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| 22. |
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| 23. |
- Holmberg, Mats, 1976-, et al.
(författare)
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To surrender in dependence of another : The relationship with the ambulance clinicians as experienced by patients.
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 28:3, s. 544-551
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Tidskriftsartikel (refereegranskat)abstract
- Historically, the ambulance care has focused on acute transports and medical treatment, although ambulance care has also been reported as complex, encompassing more than just medical treatment and transports. Previous studies, on ambulance clinicians, have pointed out the importance of interpersonal caring activities complementary to the medical treatment. Those activities can be understood as taking part in the relationship between patients and ambulance clinicians, earlier described as essential and a core component of care. The aim of this study was to elucidate the meaning of the relationship with the ambulance clinicians as experienced by patients. Twenty ambulance patients were interviewed in the study. The interviews were transcribed verbatim and analysed with a phenomenological hermeneutical method to grasp meanings in the patients' experiences. The regional ethical committee approved the study. In the result emerged one main theme: To surrender in dependence of another. The main theme includes four themes: Being in the hands of another, Being in a caring temporary presence, Being important while involved and Being powerless while insignificant, and the themes comprise eleven subthemes. The main theme meant to have no other option than to surrender and to put their life into the hand of another. This surrender also meant to adapt to the clinicians' views even if not shared. This is experienced as excessive care. Summarised, the patients' experiences were both positive and negative and the findings provide a complex understanding of the relationship between the patient and the ambulance clinicians. Overall, the relationship embraces the whole person without reducing the patient to be a recipient of an objectified ambulance care.
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| 24. |
- Jöhnemark, Birgitta, et al.
(författare)
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Swedish nursing students´attitudes towards older people and working in care of older people
- 2012
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Ingår i: Nordisk sygeplejeforskning. - Oslo : Universitetsforlaget. - 1892-2678 .- 1892-2686. ; 2:3, s. 210-221
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden the number of old people is increasing. Consequently, there will be a shortage of nurses working within the field of care for the old in the future. It can be a challenge to recruit new nurses, and especially clinical nurse specialized in gerontological care. The aim of the study was to gain knowledge about Swedish nursing students´ attitudes towards older people and towards work in the field of care for older people among a group of Swedish nursing students. The study included 490 nursing students at four universities in Sweden. The participants completed the Swedish version of the Kogan´s Old People Scale that measures attitudes towards older people and working within the field of care for older people. The result showed that students 31 years and older had the highest positive median score. Furthermore, significant differences in positive and negative scores were found related to education levels. Progression in the nursing students’ education contributes to more positive attitudes and less negative attitudes toward older people.
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| 25. |
- Kneck, Åsa, et al.
(författare)
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Learning to live with diabetes : integrating an illness or objectifying a disease
- 2012
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 68:11, s. 2486-2495
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This paper is a report of a study of illuminating the meaning of ‘learning to live with diabetes’ 3 years after being diagnosed.Background: A changed situation, for example, in relation to living with diabetes, raises a need to understand. How time for experience contributes to this learning process for people living with diabetes is not yet well understood. It would therefore seem valuable to ask people, who have had diabetes over a similar length of time, to narrate their experience in relation to daily life situations in order to understand better how learning is established.Design: The study has a qualitative design.Methods: A life world approach was used, with interviews being conducted with 13 people who had been diagnosed with diabetes 3 years earlier. Data were collected in 2007, and analyses were conducted using a phenomenological-hermeneutic method.Findings: How a person experiences the physical body was found to be crucial in the learning process. If the body with its signals is understood it can be a tool for experiencing and understanding the world and oneself. Feeling insecure about one’s own needs, and not trusting or understanding bodily signs, made participants dependent on others to make decisions for them.Conclusion: This study showed that duration of illness was ‘not’ of importance for the understanding of living with diabetes. Living with diabetes 3 years after being diagnosed meant to experience both an overall balance in one’s existence and a daily struggle.
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| 26. |
- Kneck, Åsa, 1973-
(författare)
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Learning to live with diabetes : as experiencing an expanding life world
- 2011
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Chronic illness, such as diabetes, results in a transition process involving a variety of changes in both bodily function and conditions for living, and requiring broad knowledge and understanding in order to meet new demands. The outcomes of a healthy transition are described as well-being and mastery, in contrast to vulnerability and dependency. Little is known about how time for experience contributes to the transition of living with a chronic illness. Aim: The overall aim of the thesis was to illuminate the transition of living with diabetes during the first three years after diagnosis, in order to reach an understanding of how better to create more person-centred care.Design: The study has a life world phenomenological approach with a longitudinal, descriptive and interpretive design. Thirteen participants were interviewed within two months after diagnosis and again after three years. A selected sample approach was used. For study I a qualitative inductive content analysis was used and for study II a phenomenological-hermeneutic method.Findings: In study I four themes were found; ‘taken over by a new reality,’ ‘the body plays a role in life’, ‘different ways of learning’ and ‘the health care service as a necessary partner’ and in study II one overall theme; Experience for understanding the individual meaning of freedom and control in living with diabetes and two themes ´Solving the life-puzzle – a delicate balance to create the desired life´ and ´The need for being in control of your own health´.Discussion: For a healthy transition when living with diabetes, the ability to interact with others in order to share their experiences was crucial and contributed towards participants understanding themselves and their life world. In order to be able to interact, participants had to understand their body as a subject, interlaced with the self and the life, the lived body. Being able to listen to the body and interpret body cues and circumstantial information also contributed to a healthy transition. When the body with diabetes was objectified, a struggle ensued where incompatible needs were experienced and contradictory information created insecurity. The person then preferred not to interact with others but to be dependent on advice and information from the health care service.Conclusion: This study showed that duration of illness was not of importance for the understanding of living with diabetes. Three years after being diagnosed, living with diabetes meant an experience both of overall balance in one’s existence and of a daily struggle. Health care personnel are open to the unique experience of the person living with diabetes as well as to where the person is in the transition. Patient education in a group setting, with the goal of sharing experiences in a learning process, will be meaningful only if the person has the ability to interact with others.
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| 27. |
- Kneck, Åsa, et al.
(författare)
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Learning to live with illness : experiences of persons with recent diagnoses of diabetes mellitus
- 2011
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 25:3, s. 558-566
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Tidskriftsartikel (refereegranskat)abstract
- Background: The process of learning to live with an illness is complex. By better understanding the learning process for persons with diabetes in the early stage of the illness, the role of the health care can be shown.Aim: To reach an understanding of how learning to live with diabetes is experienced in the first 2 months after diagnosis.Method: A qualitative descriptive design was used, and interviews were conducted. Thirteen participants with a recent diagnosis of diabetes were included and asked to narrate about their experience of living with diabetes. Qualitative inductive content analysis was used.Findings: Four themes emerged: ‘taken over by a new reality’, ‘the body plays a role in life’, ‘different ways of learning’ and ‘the healthcare service as a necessary partner’.Conclusion: People with short-term experience of the illness gained knowledge through personal resources such as their own experience and self-reflection. The learning process includes an inner dialogue between the self, the body and the life. Participants were concerned with grasping a new reality and understanding a different self and body where lifestyle changes and uncertainty were present. When health care was accessible and sensitive to their needs, those with short-term experience of diabetes chose the staff as key players in the early stages of their life with diabetes.
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| 28. |
- Kneck, Åsa, et al.
(författare)
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Living with diabetes : development of learning patterns over a 3-year period
- 2014
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 9, s. 24375-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Learning involves acquiring new knowledge and skills, and changing our ways of thinking, acting, and feeling. Learning in relation to living with diabetes is a lifelong process where there is limited knowledge of how it is experienced and established over time. It was considered important to explore how learning was developed over time for persons living with diabetes. AIM: The aim of the study was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period. MATERIALS AND METHODS: A longitudinal qualitative descriptive design was used. Thirteen participants, with both type I and type II diabetes, were interviewed at three different occasions during a 3-year period. Qualitative content analysis was used in different steps in order to distinguish patterns. FINDINGS: Five main patterns of learning were identified. Two of the patterns (I and II) were characterized by gradually becoming comfortable living with diabetes, whereas for one pattern (IV) living with diabetes became gradually more difficult. For pattern V living with diabetes was making only a limited impact on life, whereas for Pattern III there was a constant management of obstacles related to illness. The different patterns in the present study showed common and different ways of learning and using different learning strategies at different timespans. CONCLUSION: The present study showed that duration of illness is not of importance for how far a person has come in his own learning process. A person-centered care is needed to meet the different and changing needs of persons living with diabetes in relation to learning to live with a lifelong illness.
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| 29. |
- Kydd, Angela, et al.
(författare)
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Attitudes of Nurses, and student nurses towards working with older people and to gerontological nursing as a carrer in Germany, Scotland, Slovenia, Sweden, Japan and the United States
- 2014
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Ingår i: International Journal of Nursing Education. ; 6:2, s. 183-190
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe attitudes towards caring for older people among nurses and student nurses in sixparticipating countries.Background: Working with older people has historically had a negative profile and with a global risein the numbers of older people and a global shortage of nurses, it is essential to recruit nurses intothis area. This study gathered data from six countries to explore nurses and student nurses attitudesto nursing older people and to gerontological nursing as a career.Method: A convenience sample of 1064 nursing students and 2585 nurses in six countries answeredthe Multifactorial Attitudes Questionnaire (MAQ) designed to elicit attitudes towards caring forolder people and to the esteem that comes with working in this field. The MAQ consists of sevenpositive and 13 negative statements and uses a Likert scale. A higher total score indicates a morepositive attitude.Results: Differences in attitudes among the six counties was observed for both nursing students andfor nurses (<.001). Nursing students in Scotland and USA had the highest mean scores and Sloveniaand Sweden were the countries with the lowest mean score. The highest score for nurses were reportedin Scotland and Sweden and lowest in Germany and Japan.Conclusion: From the findings, it is suggested that formal nursing education to students between 18- 29 years of age has high importance for positive attitudes towards working with older people.
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| 30. |
- Kydd, Angela, et al.
(författare)
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Attitudes towards caring for older people in Scotland, Sweden and the United States
- 2014
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Ingår i: Nursing Older People. - : RCNi. - 1472-0795 .- 2047-8941. ; 26:2, s. 33-40
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Tidskriftsartikel (refereegranskat)abstract
- Aim To explore the attitudes of nurses and nursing students in Scotland, Sweden and the US towards working with older people.Method This quantitative study used the 20-item Multifactorial Attitudes Questionnaire (MAQ) to elicit attitudes on ageism, resources, working environment, education and professional esteem. Researchers from each country distributed the questionnaires to nursing students and nurses, giving a convenience sample of 1,587 respondents. Data were entered on the Statistical Package for Social Sciences version 18 and merged into one large dataset.Results Scottish participants had the highest (positive) and Swedish participants the lowest mean MAQ score. The Kruskal-Wallis test showed significant differences in mean scores across the countries in 18 of the 20 statements, even when controlling for age and experience.Most participants gave positive responses, but agreed that negative attitudes towards working with older people pervade among peers due to working conditions, poor career prospects and a perceived lack of professional esteem.Conclusion Inspirational educators, excellent clinical placements and increasing the professional esteem of those working with older people are required to promote the specialty as an attractive career option.
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| 31. |
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| 32. |
- Martinsson, Gunilla, et al.
(författare)
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Being altruistically egoistic : Nursing aides’ experiences of caring for older persons with mental disorders
- 2011
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 6:4, s. 7530-
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Tidskriftsartikel (refereegranskat)abstract
- Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given
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| 33. |
- Martinsson, Gunilla, et al.
(författare)
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Mental disorders affect older persons in Sweden : a register-based study
- 2011
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 26:3, s. 277-283
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The study aimed to estimate the prevalence of mental disorders based on pharmaceutical use among the old (age >/= 65) in Sweden for the years 2006-2008. METHODS: Data on the mental health of older persons were approximated on the basis of recommended prescriptions for pharmaceuticals, gathered from the Swedish Register on Prescribed Pharmaceuticals (SRPP). Each disorder (ICD-10, F20-F42, and F60-F61) was analyzed to identify associated recommended pharmaceuticals. Anatomical Therapeutic Chemical Classification codes were applied. The data covered 188 024 individuals who received 2 013 079 prescriptions for pharmaceuticals for mental disorders during a 3-year period. Persons with pharmaceuticals for dementia disorders were excluded from the calculations of the prevalence of mental disorders. RESULTS: The prevalence of mental disorders among the old in Sweden, measured on the basis of pharmaceutical use, was 6.6% in 2006, 2007, and 2008, respectively. Men constituted one-third of cases and women two-thirds. Prevalence was lowest in the age group 65-69 and increased subsequently with age. CONCLUSIONS: This fundamental register-based study included a great number of older persons and shows that mental disorders affect every fifteenth older person in Sweden. The prevalence of mental disorders increases with increasing age. The results highlight the extent of mental disorders among older persons, which is important to know when planning care for these patients. This study, by investigating a large population, provides a solid basis for general planning as well as for future mental disorder research.
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| 34. |
- Martinsson, Gunilla, et al.
(författare)
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Specialist prescribing of psychotropic drugs to older persons in Sweden : a register-based study of 188 024 older persons
- 2012
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Ingår i: BMC Psychiatry. - 1471-244X. ; 12:197
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe situation for older persons with mental disorders other than dementia disorders has scarcely been studied. The older population is increasing worldwide and along with this increase the prevalence of mental disorders will also rise. The treatment of older persons with mental disorders entails complex challenges, with drugs constituting the major medical treatment. Knowledge of geriatric psychiatry is essential for providing older persons with appropriate treatment and care. This study aimed to evaluate the prescription of drugs for mental disorders to older persons (>=65) in Sweden, focused on the medical specialties of the prescribing physicians.MethodsData concerning drug treatment for older persons from 2006 to 2008 was gathered from the Swedish Prescribed Drug Register. Mental disorders, defined as affective, psychotic and anxiety disorders (ICD-10 F20-42) were evaluated in order to identify associated drugs. Included was a total of 188 024 older individuals, who collectively filled 2 013 079 prescriptions for the treatment of mental disorders. Descriptive analyses were performed, including frequency distribution and 95% CI. The competence of the prescribers was analyzed by subdividing them into five groups: geriatricians, psychiatrists, general practitioners (GPs), other specialists, and physicians without specialist education.ResultsGPs represented the main prescribers, whereas geriatricians and psychiatrists rarely prescribed drugs to older persons. Benzodiazepines and tricyclic antidepressants were the most commonly prescribed drugs. Women were prescribed drugs from geriatricians and psychiatrists to a greater extent than men.ConclusionsThis study examined the prescription of psychotropic drugs to older persons. Physicians specialized in older persons' disorders and mental health were rarely the prescribers of these drugs. Contrary to clinical guidelines, benzodiazepines and tricyclic antidepressants were commonly prescribed to older persons, emphasizing the need for continuous examination of pharmaceutical treatment for older persons. The results indicate a future need of more specialists in geriatrics and psychiatry.
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| 35. |
- Martinsson, Gunilla, et al.
(författare)
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Struggling for existence : - Life situation experiences of older persons with mental disorders
- 2012
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 7:Art. nr. 18422
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Tidskriftsartikel (refereegranskat)abstract
- Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons’ experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. ‘‘Struggling for existence’’ emerged as a main theme in the older persons’ narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care
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| 36. |
- Rytterström, Patrik, 1970-
(författare)
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Tradition och horisont : vårdkulturens betydelse för vårdens praxis
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main aim of this thesis was to illuminate and understand aspects of care culture as a meaning–making process that influences the care praxis. In health care there is increasing recognition of the impacts on organizational culture of health-related matters. Although the factors studied affect care and nursing care, there has been little research from a caring science perspective. Care culture is understood from a hermeneutic perspective as a meaning-making process related to tradition, horizon and “bildung”. These three concepts give care a meaning cohesion that helps caregivers to orient themselves and acquire a care praxis.Study I was an interview study with seventeen nurses working on different wards. Study II was a focus group study, and included three focus groups with 24 nurses and a secondary qualitative analysis of interviews from study I. Both studies I and II used a phenomenological-hermeneutic approach. Study III was a hermeneutic documentary analysis conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. Study III was a hermeneutic documentary analysis conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. Study IV was a case study involving 12 individual interviews and one focus group interview that included four participants. All participants were working at various levels in the municipal organization and were directly or indirectly connected to a mistreatment situation. This research also included a two-day field study and a document study. The individual interviews and focus group interviews were analyzed using a phenomenological hermeneutic approach.The findings show that care culture can be experienced as positive and enabling of good care but also as defective and an obstacle to good care. Three different care cultures were identified: a service, a social and a motherhood culture. All cultures showed traces of caring values, but from a caring theory perspective, none of them fully demonstrated understanding of the notion of existential caring revealed as the integration of freedom and vulnerability. By studying the underlying traditions and the caregivers’ horizon, the care culture can be illuminated and understood through its expression in praxis. From gaining a comprehensive understanding, a caring ideal could open up and reflect the care culture´s boundaries. This means that ideals can have different interpretations depending on the conditions the care praxis is based on. The gap between care theory and praxis can therefore be understood to mean that the care culture does not use Bildung as a process of alienation and appropriation, resulting in no transformation of the prevailing tradition.Care culture could be distinguished from three different perspectives. They are referred to in this thesis as the prevailing, the visionary and the critical perspective. Developing a hermeneutic concept of culture, understood as the care culture´s critical perspective, could serve as an opportunity for a reinterpretation of nursing theory´s meta-paradigm concept of environment.
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| 37. |
- Swall, Anna, 1977-, et al.
(författare)
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A therapy dog's impact on daytime activity and night-time sleep for older persons with Alzheimer's disease : a case study
- 2014
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Ingår i: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 2:4, s. 80-93
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Tidskriftsartikel (refereegranskat)abstract
- Background: Animal-Assisted Therapy using dogs have been described as having a calming effect, decrease sundowning and blood-pressure in persons with Alzheimer’s disease. The aim was to investigate how continuous and scheduled visits by a prescribed therapy dog affected daytime and night-time sleep for persons with Alzheimer’s disease.Methods: In this case study, registration of activity and sleep curves was conducted from five persons with moderate to severe Alzheimer’s disease living at a nursing home, over a period of 16 weeks using an Actiwatch. Data was analysed with descriptive statistics.Result: The study shows no clear pattern of effect on individual persons daytime activity and sleep when encounter with a therapy dog, but instead points to a great variety of possible different effects that brings an increased activity at different time points, for example during night-time sleep.Conclusions: Effects from the use of a Animal-Assisted Therapy with a dog in the care of persons with Alzheimer’s disease needs to be further investigated and analysed from a personcentred view including both daytime and nightime activities.
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| 38. |
- Thurang, Anna, 1968-, et al.
(författare)
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Womens experience of caring when in treatment for alcohol dependency
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 24:4, s. 700-706
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Tidskriftsartikel (refereegranskat)abstract
- Despite the fact of increased levels of alcohol dependency in women and gender differences in how the disease affects men and women, the research on alcohol dependency continues to have a dominating perspective on men. The meaning of the phenomenon of caring in formal care for women with alcohol dependency is not well known. Thus, formal caregivers may find it problematic to know what is caring for women with alcohol dependency. The aim of the study was to illuminate the meaning of caring in formal care for women with alcohol dependency, as narrated by the women. The study was performed using a phenomenological-hermeneutic method. Data were collected in ten in-depth interviews with alcohol-dependent women. The themes presented are availability, being a patient and being a learner. The findings reveal that the women with alcohol dependency receiving a mandate from formal care, experience the relation between them and their caregiver as a mutual transformation. Within the mutual transformation, the participants experienced being respected as a responsible human being which renders possibilities for the women with alcohol dependency to continue in formal care even when the struggle against the disease became hard. Continual meetings with the caregiver allowed the women to gain structure in their daily life as well as allowing the women and their caregivers to develop mutual transformation, which both relieved the women’s suffering and increased their experience of being involved in the care process
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| 39. |
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