| 1. |
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| 2. |
- Bergius, Berit, 1949, et al.
(författare)
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Matematiklyftet har prövats ut
- 2013
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Ingår i: Nämnaren. - 0348-2723. ; :2013:2, s. 14-17
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- I höst startar huvudomgången av den stora satsningen "Matematiklyftet". Under läsåret 2012-2013 har modellen prövats av 316 lärare och 31 handledare på 33 grundskolor. Dessa har arbetat med modulerna inom området "Tal och tals användning". NCM har utvecklat innehållet i provomgångens moduler och har också följt arbetet på några skolor. Erfarenheterna från utprövningen är värdefulla för utvecklingen av Matematiklyftet.
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| 3. |
- Björk Brämberg, Elisabeth, et al.
(författare)
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Interpreters in Cross-Cultural Interviews: A Three-Way Coconstruction of Data
- 2013
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Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 23:2, s. 241-247
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Tidskriftsartikel (refereegranskat)abstract
- Our focus in this article is research interviews that involve two languages. We present an epistemological and methodological analysis of the meaning of qualitative interviewing with an interpreter. The results of the analysis show that such interviewing is not simply exchanging words between two languages, but means understanding, grasping the essential meanings of the spoken words, which requires an interpreter to bridge the different horizons of understanding. Consequently, a research interview including an interpreter means a three-way coconstruction of data. We suggest that interpreters be thoroughly introduced into the research process and research interview technique, that they take part in the preparations for the interview event, and evaluate the translation process with the researcher and informant after the interview.
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| 4. |
- Björk Brämberg, Elisabeth, et al.
(författare)
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Patient participation : A qualitative study of immigrant women and their experiences
- 2010
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa Healthcare. - 1748-2623 .- 1748-2631. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Patient participation in healthcare is a neglected area of interest in the rather extensive amount of research on immigrant so-called Selma patients in Swedish health care as well as worldwide. The aim is to explore the phenomenon ‘‘patient participation’’ in the context of the Swedish health care from the perspective of immigrants non-fluent in Swedish. A phenomenological lifeworld approach was chosen. Data were collected from patients within a municipal home care setting in Sweden. Eight women agreed to participate. In seven interviews, an interpreter was necessary for the translation of the interview. Five authorized interpreters were used. Data were analysed in accordance to a descriptive phenomenological method for caring research. The analysis led to an essence of the phenomenon with three constituents, ‘‘to experience participation,’’ ‘‘to refrain from participation,’’ and ‘‘to be deprived of participation.’’ Patient participation from the perspective of immigrant women means that patients are involved and active in their own health and caring processes. For these women, it is particularly important to have the opportunity to express themselves. Patient participation presupposes professional caregivers who act in a way that increases the patients’ opportunities to take part. A skilled interpreter is often necessary in order to enable the patient participation.
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| 5. |
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| 6. |
- Boström, Elisabeth Almer, 1983, et al.
(författare)
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Resistin and insulin/insulin-like growth factor signaling in rheumatoid arthritis.
- 2011
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Ingår i: Arthritis and rheumatism. - : Wiley. - 1529-0131 .- 0004-3591. ; 63:10, s. 2894-904
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Tidskriftsartikel (refereegranskat)abstract
- Human resistin has proinflammatory properties that activate NF-κB-dependent pathways, whereas its murine counterpart is associated with insulin resistance. The aim of this study was to examine potential cross-talk between resistin and insulin/insulin-like growth factor (IGF) signaling in rheumatoid arthritis (RA).
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| 7. |
- Bremer, Anders, 1957-, et al.
(författare)
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Balancing Between Closeness and Distance : Emergency medical services personnel’s experiences of caring for families at out-of-hospital cardiac arrests and deaths
- 2012
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Ingår i: Prehospital and Disaster Medicine. - Cambridge : Cambridge University Press. - 1049-023X .- 1945-1938. ; 27:1, s. 42-52
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Out-of-hospital cardiac arrest (OHCA) is a lethal health problem thataffects between 236,000 and 325,000 people in the United States each year. As resuscitationattempts are unsuccessful in 70-98% of OHCA cases, Emergency Medical Services(EMS) personnel often face the needs of bereaved family members.Problem: Decisions to continue or terminate resuscitation at OHCA are influenced byfactors other than patient clinical characteristics, such as EMS personnel’s knowledge,attitudes, and beliefs regarding family emotional preparedness. However, there is littleresearch exploring how EMS personnel care for bereaved family members, or how theyare affected by family dynamics and the emotional contexts. The aim of this study is toanalyze EMS personnel’s experiences of caring for families when patients suffer cardiacarrest and sudden death.Methods: The study is based on a hermeneutic lifeworld approach. Qualitative interviewswere conducted with 10 EMS personnel from an EMS agency in southern Sweden.Results: The EMS personnel interviewed felt responsible for both patient care and familycare, and sometimes failed to prioritize these responsibilities as a result of their ownperceptions, feelings and reactions. Moving from patient care to family care implied amovement from well-structured guidance to a situational response, where the personnelwere forced to balance between interpretive reasoning and a more direct emotionalresponse, at their own discretion. With such affective responses in decision-making, thepersonnel risked erroneous conclusions and care relationships with elements of dishonesty,misguided benevolence and false hopes. The ability to recognize and respond to people’sexistential questions and needs was essential. It was dependent on the EMS personnel’sbalance between closeness and distance, and on their courage in facing the emotionalexpressions of the families, as well as the personnel’s own vulnerability. The presence offamily members placed great demands on mobility (moving from patient care to familycare) in the decision-making process, invoking a need for ethical competence.Conclusion: Ethical caring competence is needed in the care of bereaved family membersto avoid additional suffering. Opportunities to reflect on these situations within a frameworkof care ethics, continuous moral education, and clinical ethics training are needed.Support in dealing with personal discomfort and clear guidelines on family support couldbenefit EMS personnel.Bremer A, Dahlberg K, Sandman
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| 8. |
- Bremer, Anders, 1957-
(författare)
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Vid existensens gräns : Etiskt vårdande och professionellt ansvar vid hjärtstopp utanför sjukhus
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To describe and interpret patients’, family members’ and ambulance personnel’s experiences with regard to survival, attendance, and caring at cardiac arrests and deaths, and to analyze ethical conflicts that arise in relation to families and how the personnel’s ethical competence can affect caring and the ability to handle ethical problems.Method: The three interview studies were guided by a reflective lifeworld approach grounded in phenomenology and analyzed by searching for the essence of the phenomenon in two studies and by attaining a main interpretation in one study. In the fourth study, the general approach was supplemented by “reflective equilibrium” that guided the ethical analysis.Results: The survivors are striving towards a good life by means of efforts to reach meaning and coherence, facing existential fear and insecurity as well as gratitude and the joy of life. Family members lose everyday control through feelings of unreality, inadequacy and overwhelming responsibility. Ambulance personnel’s care mediates hope and despair until the announcement of survival or death. After the event, family members risk involuntary loneliness and anxiety about the future. For the ambulance personnel, caring for families involves a need for mobility in decision making, forcing the personnel to balance their own perceptions, feelings and reactions against interpretative reasoning. To base decision making on emotional reactions creates the risk of erroneous conclusions and a care relationship with elements of dishonesty, misdirected benevolence and false hopes. Identification with family members can promote recognition of and response to their existential needs, but also frustrate meeting family members emotions’ and handling one’s own vulnerability and inadequacy. It was found that futile cardiopulmonary resuscitation, administered to patients for the benefit of family members, is not an acceptable moral practice, due both to norms of not deliberately treating persons as mere means and to norms of taking care of families.Conclusions: Ethical conflicts exist when it comes to conveying realistic hope, relief from guilt, participation, responsibility for decision making, and fairness in the professional role. Ambulance personnel need support to enhance ethical caring competence and to deal with personal discomfort, as well as clear guidelines on family support.
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| 9. |
- Chow, Judy, 1954-
(författare)
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Vårdandets symfoni : Fenomenet vårdrelation i skenet av två världsbilder
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis 'The Symphony of Care' consists of four studies focusing on care relationships between patients and professional caregivers.Care relationships are central to the health process and a fundamental element in caregiving. The term care relationship is widely used in caring science but lacks a clear definition, which can create misunderstanding and can constitute an obstacle when attempting to optimize care relationships.The aim of this thesis is to describe the phenomenon of care relationships in order to add to the body of knowledge in caring science.The main research questions are:• What is a care relationship within the caring science field?• How can a care relationship be optimized to improve its caring function, in order to promote health?The ontological foundation of this thesis is caring science. Phenomenology and Lifeworld theory are used as its epistemological bases. Reflective Lifeworld Research is used as a methodological approach.The four studies were conducted in different contexts and cultures- the first two empirical studies were performed in China and the remaining two, a metasynthesis and a secondary analysis, were carried out in a Swedish context.The results show that care relationships are temporary intentional relationships between a person who needs help and a helper. The purpose of this relationship is to support the patient in his/her dynamic health process, which is unique for each person in different times and contexts. Care relationships are fragile because the patient is vulnerable and the demand on the helper is great. It is an inter-human relationship between equals, which can at the same time be an asymmetric relationship due to the professionalism with the caregiver and the vulnerability with the patient. A care relationship is not independent, but is affected by internal factors such as the two individuals' lifeworlds and external factors such as health policies, organization, economics, health culture and environment. To optimize the effectiveness of caring, the relationship and its surrounding need to be in harmony. The view of care relationships should be broadened to include the external resources in order to optimize their caring potential.
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| 10. |
- Dahlberg, Anna-Karin
(författare)
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Chemical Analysis of Organic Compounds in Footwear
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- In view of that chemical emission from point sources such as industries has decreased over the years; chemical emission from articles has been pointed out to be of increasing concern. Hence, it is important to get a better understanding of the chemical content in different types of articles. The aim of this study was to provide information regarding the organic chemical content in footwear by chemical analysis of materials sampled from three shoes from well known brands (Ecco, Nike and Vagabond). Materials from the outsole, midsole, upper and the lining were extracted by methanol and analysed with GC-MS and HPLC-MS/MS. Overall, 31 compounds were identified at levels of parts per million in the sampled materials. Both plasticizers, antioxidants, solvents, vulcanization agents, surfactants, flame retardants, oxidants and biocides were found. Among the compounds identified, 11 high production volume chemicals and six compounds classified as either toxic to aquatic organisms, carcinogenic or toxic for reproduction were found. Three of these compounds (diisobutyl phthalate, dibutyl phthalate and bis(2-etyhylhexyl)phthalate) are included on the candidate list for authorization within REACH. However, the levels were approximately 100-1000 times lower than the limit stated in the European chemical regulation (REACH), for which requirements are put on manufacturers and importers. As an attempt to model weathering and leaching in the environment, outsole material from each shoe was subjected to soaking extraction using synthetic brackish water. The water samples obtained were found to contain only a few organic chemicals at levels of parts per million. The number of compounds was less compared to when outsole material was extracted using methanol. Hence, not all organic compounds identified in the three outsoles seem to have potential to be released under environmental conditions through leaching. The water samples were also used to evaluate the toxicity of footwear outsoles. The toxicity tests were carried out at the Department of Applied Environmental Science (ITM) by Ellen Kahn as a part of her diploma work. Both larval development test and growth inhibition tests were performed using Nitocra spinipes and Ceramium tenuicorne. The toxic effects observed by Ellen Kahn could not be explained by the levels of organic compounds identified in the water samples. Instead inorganic compounds (e.g zinc) were pointed out as the probable cause. Even though the levels of organic chemicals identified in this study were found to be low, the great number of different chemicals identified in the sampled materials raises the question about the widespread use of chemicals in articles.
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| 11. |
- Dahlberg, Anna-Karin, et al.
(författare)
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Recovery discrepancies of OH-PBDEs and polybromophenols in human plasma and cat serum versus herring and long-tailed duck plasma
- 2014
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Ingår i: Chemosphere. - : Elsevier BV. - 0045-6535 .- 1879-1298. ; 94, s. 97-103
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Tidskriftsartikel (refereegranskat)abstract
- Hydroxylated polybrominated diphenyl ethers (OH-PBDEs) have been identified as metabolites of polybrominated diphenyl ethers (PBDEs) and/or as natural products. The OH-PBDEs and polybromophenols have come into focus over the last decade due to their abundance in biota and their potential adverse health effects. The present recovery study aims to validate a commonly used method (published by Hovander et al. 2000) for OH-PBDE analysis in human plasma. Further, the authors intended to determine the method's applicability to serum/plasma matrices from other species than humans. The investigated matrices were human plasma, cat serum, herring- and long-tailed duck plasma. The recovery study included nine OH-PBDEs, four polybromophenols and three methoxylated PBDEs (MeO-PBDEs). Five replicates of each matrix were spiked with these compounds at two dose levels; a low dose (0.5 ng) and a high dose (5 ng) and were cleaned up according to the Hovander method. The recovery of OH-PBDEs and polybromophenols in human plasma and cat serum were high and reproducible at both dose levels whereas the recovery for herring and long-tailed duck plasma were low and insufficient with great variability amongst OH-PBDE congeners at both dose levels. Our data show that the method can be fully applied to matrices like human plasma and cat serum but not for herring and long-tailed duck plasma without further method development. Hence care needs to be taken when applying the method onto other blood matrices without validation since the present study have demonstrated that the recoveries may differ amongst OH-PBDE congeners and specie.
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| 12. |
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| 13. |
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| 14. |
- Dahlberg, Matz, et al.
(författare)
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Ethnic Diversity and Preferences for Redistribution
- 2012
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Ingår i: Journal of Political Economy. - : University of Chicago Press. - 0022-3808 .- 1537-534X. ; 120:1, s. 41-76
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Tidskriftsartikel (refereegranskat)abstract
- This paper investigates the causal link between the ethnic diversity in a society and its inhabitants' preferences for redistribution. We exploit exogenous variation in immigrant shares stemming from a nationwide program placing refugees in municipalities throughout Sweden during 1985-94 and match data on refugee placement to panel survey data on inhabitants of the receiving municipalities. We find significant, negative effects of increased immigration on the support for redistribution. The effect is especially pronounced among high-income earners. We also establish that estimates from earlier studies failing to identify causal effects are likely to be positively biased (i.e., less negative).
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| 15. |
- Dahlberg, Matz, et al.
(författare)
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Ethnic Diversity and Preferences for Redistribution : Reply
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- In a comment to Dahlberg, Edmark and Lundqvist (2012), Nekby and Pettersson-Lidbom (2012) argue (i) that the refugee placement program should be measured with contracted rather than actually placed refugees, and claim that the correlation between the two measures is insignificant and close to zero; (ii) that instead of using the rotating individual panel, we should have used the full cross-sections in combination with municipality fixed effects; and (iii) that immigrants should be dened based on country of birth rather than citizenship.In this response, we discuss why we (i) do not agree that contracted refugees is the preferred measure, and we show that the correlation between the two measures is highly significant and large; (ii) do not agree that the full cross-sections can be used; and (iii) do agree that defining immigrants according to country of birth is preferred. In a re-analysis, the conclusion from Dahlberg, Edmark and Lundqvist (2012) that ethnic diversity has a statistically and economically significant negative effect on preferences for redistribution is only marginally affected.
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| 16. |
- Dahlberg, Matz, et al.
(författare)
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Ethnic Diversity and Preferences for Redistribution
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- In recent decades, the immigration of workers and refugees to Europe has increased substantially, and the composition of the population in many countries has consequently become much more heterogeneous in terms of ethnic background. If people exhibit in-group bias in the sense of being more altruistic to one's own kind, such increased heterogeneity will lead to reduced support for redistribution among natives. This paper exploits a nationwide program placing refugees in municipalities throughout Sweden during the period 1985 - 94 to isolate exogenous variation in immigrant shares. We match data on refugee placement to panel survey data on inhabitants of the receiving municipalities to estimate the causal effects of increased immigrant shares on preferences for redistribution. The results show that a larger immigrant population leads to less support for redistribution in the form of preferred social bene t levels. This reduction in support is especially pronounced for respondents with high income and wealth. We also establish that OLS estimators that do not properly deal with endogeneity problems - as in earlier studies - are likely to yield positively biased (i.e., less negative) eects of ethnic heterogeneity on preferences for redistribution.
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| 17. |
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| 18. |
- Hörberg, Ulrica, 1968-, et al.
(författare)
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To be strategically struggling against resignation : The lived experience of being cared for in forensic psychiatric care
- 2012
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 33:11, s. 743-751
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Tidskriftsartikel (refereegranskat)abstract
- To be referred to care in forensic psychiatric services can be seen as one of the most comprehensive encroachments society can impose upon a person's life, as it entails a limitation of the individual's freedom with no time limit. This study focuses upon patients' experiences of their life situation in forensic psychiatric wards. Using a Reflective Lifeworld Research approach founded in phenomenology, we analysed 11 qualitative interviews with patients cared for on a maximum security unit in a Swedish forensic psychiatric service. Results show how forensic psychiatric care can be non-caring with only moments of good care, from the patient's perspective. By using different strategies, the patients attempt to adapt to the demands of the caregivers in order to gain privileges. At the same time the patients are lacking meaningful and close relationships and long to get away from the system of forensic care. Being cared for entails struggling against an approaching overwhelming sense of resignation.
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| 19. |
- Legradi, Jessica, et al.
(författare)
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Disruption of oxidative phosphorylation (OXPHOS) by hydroxylated polybrominated diphenyl ethers (OH-PBDEs) present in the marine environment
- 2014
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Ingår i: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 48:24, s. 14703-14711
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Tidskriftsartikel (refereegranskat)abstract
- Hydroxylated polybrominated diphenyl ethers (OH-PBDEs) are of growing concern, as they have been detected in both humans and wildlife and have been shown to be toxic. Recent studies have indicated that OH-PBDEs can be more toxic than PBDEs, partly due to their ability to disrupt oxidative phosphorylation (OXPHOS), an essential process in energy metabolism. In this study, we determined the OXPHOS disruption potential of 18 OH-PBDE congeners reported in marine wildlife using two in vitro bioassays, namely the classic rat mitochondrial respiration assay, and a mitochrondrial membrane potential assay using zebrafish PAC2 cells. Single OH-PBDE congeners as well as mixtures were tested to study potential additive or synergistic effects. An environmental mixture composed of seven OH-PBDE congeners mimicking the concentrations reported in Baltic blue mussels were also studied. We report that all OH-PBDEs tested were able to disrupt OXPHOS via either protonophoric uncoupling and/or inhibition of the electron transport chain. Additionally we show that OH-PBDEs tested in combinations as found in the environment have the potential to disrupt OXPHOS. Importantly, mixtures of OH-PBDEs may show very strong synergistic effects, stressing the importance of further research on the in vivo impacts of these compounds in the environment
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| 20. |
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Matematikundervisning i praktiken
- 2014
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Denna bok behandlar undervisning i matematik och vänder sig främst till dig som undervisar i årskurserna 4-9, och till dig som går en lärarutbildning med denna inriktning. Texterna behandlar undervisning både ur forsknings- och praktikperspektiv . Boken är tänkt att kunna användas både enskilt och tillsammans med andra.
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| 21. |
- Ozolins, Lise-Lotte, 1960-
(författare)
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Beröringens fenomenologi i vårdsammanhang
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis explores the phenomenon of touch and describes its meaning in the healthcare context. Caring science theory based on a lifeworld approach forms the theoretical perspective of the dissertation and consequently the patient perspective is guiding the research. The ontological, epistemological and methodological framework of the thesis is phenomenology.The overall aim was to describe the phenomenon of touch in the healthcare context. Touch showed to be a phenomenon with several diverse aspects being differentially explicit in different contexts. Four empirical studies were therefore conducted in different contexts. Further, a synthesis of the empirical results was carried out to show the invariant meanings and structure of the phenomenon. Furthermore, a philosophical illumination of the results was carried out to further deepen and expand the understanding of touch related to healthcare. The phenomenon of touch is described as a complex caring movement, as an interplay between lived bodies forming a foundation to understand health, suffering, well-being, and care. The results show how touch has the power to both alleviate the patients’ suffering and to experience joy and deep connectedness, as well as how touch can frighten and cause or worsen suffering. In order to take advantage of the caring potential, the person who touches must be fully present in all senses of the word. Caring touch of different kinds can never be reduced to a “method”. It is much more than a mechanical and static act or a treatment. Moreover, touch that is objectifying may be understood as an obstacle or detrimental for the caring relationship and well-being since it lacks the necessary pliable interpersonal room. Such touch creates distance and alienation rather than closeness, trust and togetherness. If the potential of touch for caring is to be used and the threat of non-caring warded off, then the intentionality of touch must be balanced visavi the existential vulnerability of the individual. Therefore carers need to be open and attentive to the lifeworld of the patients to enhance their health-processes and avoid hurting them.
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| 22. |
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| 23. |
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| 24. |
- Petersson, Bengt-Olof, 1948-
(författare)
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Handledning för vårdare - ett lärande möte utifrån patientens värld
- 2010
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The present research study is a supervision project which was carried out between 2004-2006. The overall aim of the research was to investigate how caring science supervision can support carers in integrating caring science and can contribute to a constructive way of integrating caring science knowledge with praxis.The research project consisted of supervision given to groups of carers in two different contexts where a caring science model for supervision was tested and developed.The experience of how carers integrate caring science knowledge through supervision has been studied by interviewing carers. Seven were interviewed in the first study about how they experienced their own learning process by participating in group supervision. The second study focused on how the supervisor’s selection of different supervision methods can support the carers’ development and understanding for the patient’s lifeworld.The interviews were analysed with the help of a reflective lifeworld approach. The results from the seven interviews consisted of a description of the essence and seven constituents. The results show that knowledge about caring, from the carers’ point of view, is an attitude that is taken for granted. With this as a starting point the carers listen and read what has happened to the patient in different situations. In the supervision session the carer and the supervisor have worked out a critical caring science investigation of the patient’s situation and developed new strategies for the patient’s caring. The interviewed carers point out the importance of a free zone, a learning room in supervision, where they can reflect and, in a constructive dialogue with each other, work with the patient’s situation together with the supervisor.In the second research study the supervisor’s selection of methods in supervision is in focus. The aim of using these different methods was to support the development of knowledge grounded in caring science. The supervision methods support the carers in the reflection process and stimulate them to develop good skills in the relationship with the patient. The results also show, in two ways, how important the supervisor’s role is for the supervision process. Firstly in terms of being able to see and understand what the focus is in the carer’s narrative of the patient’s situation. Secondly how the selection of an appropriate method can support the carers’ understanding of what obstacles there can be and which possibilities there can be for the caring of the patients. This work in the supervision process demands that supervisors are aware of how the group process can be integrated with the learning process.Keywords: caring science, phenomenology, lifeworld, reflection, dialogue, supervision, supervision methods.
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| 25. |
- Ranheim, Albertine, 1960-, et al.
(författare)
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Expanded awareness as a way to meet the challenges in care that is economically driven and focused on illness- a nordic perspective
- 2012
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Ingår i: Aporia. - 1918-1345. ; 4:4, s. 20--24
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden as well as in many other countries, nursing and caring science exist in a health care context that is characterised by increasing reliance on the economics of diagnoses and measureable symptoms. This presents a challenge for caring science to defend person - and lifeworld-centred care. Nursing as a caring science must make clear its position in modern health care. The objective of this paper is to show how health oriented nursing, grounded in caring science, advocates expanded nursing care. The paper revisits the relationship between nursing and caring science, specifically the insights from new caring science research that emphasises carers’ capacity for expanded awareness. In addition, the ever-present question of evidence is addressed.
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| 26. |
- Rydeman, IngBritt, et al.
(författare)
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Being in-between and lost in the discharge process : An excursus of two empirical studies of older persons', their relatives', and care professionals' experience
- 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, s. Article ID: 19678-
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Tidskriftsartikel (refereegranskat)abstract
- The discharge process (DP) is full of well-known risks, and a comprehensive and well-executed DP is especially important for older people with multiple health problems and continuing care needs, as well as for their relatives. Few studies focus on the experiences with the DP by older people in need of home care nursing and their relatives. Therefore, the aim was to deepen the understanding of the DP as a phenomenon described by older people, their relatives, and care professionals. The method is an excursus of the findings of two previously published research studies. By using the Reflective Lifeworld Research approach, the empirical findings were further interpreted with lifeworld theory. The results describe the essential meaning of the phenomenon of DP in relation to healthcare needs. The illness and the DP can be viewed as a course of action where the familiar becomes unfamiliar for older people and their relatives, entailing an insecure future existence characterized by the experience of being in-between. The DP is marked by bodily and existential needs. The older persons and their relatives are lost in the hospital context and trying to influence life and adapt to life circumstances, while being relentlessly dependent on care professionals. Care professionals work from both an organizational and a medical approach. Disharmony and disagreement seem to arise easily among the professionals regarding the planning negatively affecting the patients and their relatives. More efforts are needed in the DP to empower older people and their relatives to go on with their life at home. The caring practice needs to more clearly meet and address the individual needs of older people and their relatives and their understanding of their illness. It needs to give them lifeworld and life goals to alleviate their suffering and to help them adjust to their new situation.
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| 27. |
- Stranneheim, Henrik, et al.
(författare)
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Rapid pulsed whole genome sequencing for comprehensive acute diagnostics of inborn errors of metabolism
- 2014
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Ingår i: BMC Genomics. - : Springer Science and Business Media LLC. - 1471-2164. ; 15, s. 1090-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Massively parallel DNA sequencing (MPS) has the potential to revolutionize diagnostics, in particular for monogenic disorders. Inborn errors of metabolism (IEM) constitute a large group of monogenic disorders with highly variable clinical presentation, often with acute, nonspecific initial symptoms. In many cases irreversible damage can be reduced by initiation of specific treatment, provided that a correct molecular diagnosis can be rapidly obtained. MPS thus has the potential to significantly improve both diagnostics and outcome for affected patients in this highly specialized area of medicine. Results: We have developed a conceptually novel approach for acute MPS, by analysing pulsed whole genome sequence data in real time, using automated analysis combined with data reduction and parallelization. We applied this novel methodology to an in-house developed customized work flow enabling clinical-grade analysis of all IEM with a known genetic basis, represented by a database containing 474 disease genes which is continuously updated. As proof-of-concept, two patients were retrospectively analysed in whom diagnostics had previously been performed by conventional methods. The correct disease-causing mutations were identified and presented to the clinical team after 15 and 18 hours from start of sequencing, respectively. With this information available, correct treatment would have been possible significantly sooner, likely improving outcome. Conclusions: We have adapted MPS to fit into the dynamic, multidisciplinary work-flow of acute metabolic medicine. As the extent of irreversible damage in patients with IEM often correlates with timing and accuracy of management in early, critical disease stages, our novel methodology is predicted to improve patient outcome. All procedures have been designed such that they can be implemented in any technical setting and to any genetic disease area. The strategy conforms to international guidelines for clinical MPS, as only validated disease genes are investigated and as clinical specialists take responsibility for translation of results. As follow-up in patients without any known IEM, filters can be lifted and the full genome investigated, after genetic counselling and informed consent.
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| 28. |
- Summer Meranius, Martina, 1971-
(författare)
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"Era delar är min helhet" : En studie om att vara äldre och multisjuk
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis is to describe what it means to be old and live with multimorbidity. An additional aim is to examine and describe the contextual meaning of the phenomenon in ordinary housing and nursing homes, and a third aim is to deepen our understanding of the situation for old people who also are ill. The thesis uses a caring science perspective and a reflective lifeworld approach founded on phenomenological philosophy. This approach searches for and describes the meaning of a phenomenon, its variations and its essential meaning structure. Interviews were used for data collection and data were analyzed for meaning, searching for the essence of the phenomenon. The findings are presented in two empirical studies and one philosophical excursion. The empirical studies have been further thematized with the essential meanings from the empirical studies. The philosophical excursion is the result of a more profound understanding of the thematized meanings.The essential meaning of being old and living with multimorbidity in ordinary housing is described as a struggle to maintain identity in a life situation that changes. Multimorbidity and aging pose existential barriers at the same time as the possibility of living an independent life and being oneself is hindered. Ordinary housing is experienced as a place where the old can be themselves, and a place that is associated with independence. On the other hand, multimorbidity threatens the possibility of continuing to live in their private homes, as does the failure of others to meet the old as individuals.The essential meaning of being old and living with multimorbidity in nursing homes is described as striving for independence which brings with it a zest for life and a feeling of security. The older’s degree of independence can change due to the fragile health situation, and is characterized by the experience of not being a burden for the busy caregivers and relatives. Independence can change to insecurity, vulnerability and helplessness.The themes of essential meaning that have been extracted from the empirical studies suggest that the experiences of frailty and loneliness differ more between those living in ordinary housing and in nursing homes than the experiences of trust and independence differ.The philosophical excursion illuminates how older people with multimorbidity experience their lives as an ability to manage their daily lives and not merely an absence of disease symptoms. A person is “just” sick, independently of the objective quantity of diseases s/he may suffer from. Health and wellbeing occur from the ability to live in existential coherence, which is encouraged when the older people are allowed to retain their habits, the ability to be oneself, individual’s life story and by social relationships, as well as by continuity among the caregivers.
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| 29. |
- Todres, L., et al.
(författare)
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"Caring for insiderness": Phenomenologically informed insights that can guide practice
- 2014
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Ingår i: International Journal of Qualitative Studies on Health and Well-Being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Understanding the "insider" perspective has been a pivotal strength of qualitative research. Further than this, within the more applied fields in which the human activity of "caring" takes place, such understanding of "what it is like" for people from within their lifeworlds has also been acknowledged as the foundational starting point in order for "care" to be caring. But we believe that more attention needs to be paid to this foundational generic phenomenon: what it means to understand the "insiderness" of another, but more importantly, how to act on this in caring ways. We call this human phenomenon "caring for insiderness." Drawing on existing phenomenological studies of marginal caring situations at the limits of caring capability, and through a process of phenomenologically oriented reflection, we interrogated some existential themes implicit in these publications that could lead to deeper insights for both theoretical and applied purposes. The paper provides direction for practices of caring by highlighting some dangers as well as some remedies along this path.
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| 30. |
- Wireklint Sundström, Birgitta, et al.
(författare)
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Being Prepared for the Unprepared : A Phenomenology Field Study of Swedish Prehospital Care
- 2012
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Ingår i: Journal of Emergency Nursing. - : Mosby, Inc.. - 0099-1767 .- 1527-2966. ; 38:6
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This paper presents a study of prehospital care with particular focus on how ambulance personnel prepare themselves for their everyday assignments. Methods: The caring science field study took a phenomenological approach, where data were analyzed for meaning. Two specialist ambulance nurses, three registered nurses, and six paramedics participated. Results: The previously known discrepancy between in-hospital care and prehospital care was further interpreted in this study. The pre-information from an emergency medical dispatch (EMD) center provides ambulance personnel with basic expectations as to what they will have to take care of. At the same time that they maintain their certainty and control, our major findings indicate that prehospital care in emergency medical service requires the personnel to be prepared for an open and flexible encounter with the patient; to be prepared for the unprepared, i.e., to be open and to avoid being governed by predetermined statements. Discussion: Our findings suggest that the outcomes of good prehospital care affect patient security. The seemingly time-consuming dialogue with the patient facilitates understanding and decision-making regarding the patient's medical needs, and it is comforting to the patient. The ambulance personnel need to be well prepared for this task and fully understand that the situation might differ considerably from the information provided by the EMD centers. All objective information is of great value in this care context, but ultimately it is the patient who provides reliable information about her/his own situation.
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| 31. |
- Wireklint Sundström, Birgitta, et al.
(författare)
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Caring assessment in the Swedish ambulance services relieves suffering and enables safe decisions
- 2011
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Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 19:3, s. 113-119
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Tidskriftsartikel (refereegranskat)abstract
- This study has a health care science approach and explores pre-hospital emergency care with emphasis on assessment. Health care science is focused on the patient with the general aim to describe care that strengthens and supports health. Assessment in the ambulance services has not been explored earlier from this perspective, despite the emphasis on ‘coming close’ to the acute suffering patient. The aim of the study is to describe and analyse assessment in caring situations. Data was collected by participant observations. The major findings point out the importance of professional carers’ recognition of the patient’s lifeworld as an essential part of assessment. The carers’ openness to the situation and to the patient’s suffering and needs vary from being of minor interest to complete focus of the assessment. It seems that assessments that focus solely on a patient’s medical condition can be an obstacle to a full understanding of the individual, and thereby the illness per se. A caring assessment based on an encounter and a dialogue between patient and carer, characterised by inviting the patient to participate, adds further dimensions to the objective data. Therefore, the inclusion of the patient perspective relieves suffering and enables more safe decisions.
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