| 1. |
- Dahlborg Lyckhage, Elisabeth, 1956-, et al.
(författare)
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Living in Liminality : Being Simultaneously Visible and Invisible: Caregivers' Narratives of Palliative Care
- 2013
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Ingår i: Journal of Social Work in End-of-Life & Palliative Care. - : Routledge. - 1552-4256 .- 1552-4264. ; 9:4, s. 272-288
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Tidskriftsartikel (refereegranskat)abstract
- Palliative care is an integral part of care and takes place in many settings—including the home, special accommodations, and hospitals. However, research shows that palliative care often ends with a death in the hospital due to the heavy burden on the primary caregiver. This study explores the meaning of being the primary caregiver of a close one who is terminally ill and is based on qualitative interviews with six primary caregivers of a terminally ill individual at home. The findings are discussed in the light of the theoretical concepts of liminality, lived body, and power. A potential impending risk exists of being abandoned when one is the primary caregiver to a close one who is terminally ill. This situation calls for professional caregivers to take responsibility and to respond to these, often unspoken, needs. This is particularly important concerning bodily care and the medical treatment regimen. In addition, when friends and relatives are absent, there is an ethical demand on professional caregivers to compensate for this lack and to compensate for this need. Palliative home care demands care that is person-centered—including the individual’s history, family and loved ones, and individual strengths and weaknesses.
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| 2. |
- Engwall, Marie, et al.
(författare)
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Let there be light and darkness : findings from a prestudy concerning cycled light in the intensive care unit environment.
- 2014
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Ingår i: Critical Care Nursing Quarterly. - : Wolters Kluwer Health Lippincott Williams & Wilkins. - 0887-9303 .- 1550-5111. ; 37:3, s. 273-298
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Tidskriftsartikel (refereegranskat)abstract
- The present study reports findings concerning light in an intensive care unit setting presented from 3 aspects, giving a wide view. The first part is a systematic review of intervention studies concerning cycled light compared with dim light/noncycled light. The findings showed that cycled light may be beneficial to preterm infant health. Second, a lighting intervention in the intensive care unit is presented, comparing and assessing experience of this lighting environment with that of an ordinary room. Significant differences were shown in hedonic tone, favoring the intervention environment. In the third part, measured illuminance, luminance, and irradiance values achieved in the lighting intervention room and ordinary room lighting are reported.
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| 3. |
- Eriksson, Thomas, et al.
(författare)
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Hermeneutiska observationsstudier : från ett metodologiskt perspektiv.
- 2013
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Konferensbidrag (refereegranskat)abstract
- Sedan några år har det varit en pågående diskussion om hur observationer kan användas i den vårdvetenskapliga forskningen, när det gäller att samla in kvalitativa forskningsdata och att tolka dessa data med hjälp av hermeneutik. Syftet med denna artikel var att reflektera, argumentera och bidra med ett innehåll i en pågående diskurs som rör utveckling av hermeneutisk tolkning av observationer som vetenskaplig metod via ett exempel genomfört inom intensivvård. I den hermeneutiska observationsstudie som används för att belysa metoden ligger forskningens fokus på att fånga det vårdande i besöken av patienter som vårdas på intensivvårdsavdelning. Den främsta anledningen till varför det finns ett behov av att utveckla och använda observation som datainsamling i det kliniska fältet är behovet av att få insikt i och synliggöra vad vårdandets innersta kärna kan innebära. Men det innefattar även kunskapsbildning om det som innebär att kunna se och vittna om vad som händer.
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| 4. |
- Eriksson, Thomas, et al.
(författare)
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The experiences of patients and their families of visiting during whilst in an intensive care unit : A hermeneutic interview study
- 2011
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 27:2, s. 60-67
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. Method The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. Findings Patients’ narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives’ narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. Conclusion The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there – a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.
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| 5. |
- Eriksson, Thomas, 1959-, et al.
(författare)
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The experiences of patients and their families of visiting whilst in an intensive care unit - a hermeneutic interview study
- 2011
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 27:2, s. 60-66
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of this study was to interpret and understand the meanings of the lived experiences of visiting of patients in an ICU and their families. Method The research design was hermeneutic, based on interviews. This study includes 12 interviews with seven patients and five relatives who had been in an ICU. The interview text was interpreted in a Gadamerian manner as different plays with actors and plots. Findings Patients’ narratives could be divided into two parts; recall of real life and unreal life experiences, the unreal being more common. Relatives’ narratives are described as being on stage and being backstage, i.e. in the room with the patient and outside it. Conclusion The final interpretation elucidated the experience of visiting as the sudden shift between being present in real life vs. being present in the real life of unreality. It was a process whereby the patient and the family build a new understanding of life that creates a new form of interplay within the family. The pre-critical illness life is no longer there – a new life has begun. To support patients and their families in this process of change a family-centred care perspective is necessary.
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| 6. |
- Eriksson, Thomas, et al.
(författare)
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The Nordic Association for Intensive Care Nursing Research (NOFI)
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Nordic nursing studies have a strong tradition within the qualitative approach. This approach has been applied to explore the lived experience of critical illness and intensive care therapy from the perspectives of the patient and the patient’s family. In 2003, the Nordic Association for Intensive Care Nursing Research (NOFI) was established by nursing scholars from Denmark, Norway, and Sweden. The purpose of NOFI was to encourage research in intensive care nursing in the Nordic countries, to establish a network of intensive care nursing scholars, to exchange research experience and research outcomes among the Nordic research communities, and to increase the visibility of research in intensive care nursing in the Nordic countries. Although the focus was on nursing research, an interdisciplinary approach has also been encouraged with joint research and conference activities. NOFI have arranged biannual conferences for members and other individuals interested in the activities of the network. The venue has rotated among the tree Nordic countries, and the themes of the meetings have been: Intensive Care Unit (ICU) environment and acoustics, relatives of ICU-patients, ways of knowing, sedation, ethics, patient diaries, multimodal interventions, research designs, ICU-delirium, psychometrics, burns, and mechanical ventilation. Other activities have been presentations of newly completed PhD-studies in the Nordic countries. Since 2006, nursing scholars from the three Scandinavian countries have collaborated on a study of diaries written for ICU patients (patient diaries). The three countries share common values, culture and language, which has facilitated the exchange of ideas among the Nordic nurses. Intensive care nursing is a young domain of research. We still need to encourage more scholars within this area to increase our knowledge base, improve the ICU-experience and formalize rehabilitation of post-ICU patients. Intensive care is a collaborative practice and future research should reflect the interdisciplinary aspect of the field.
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| 7. |
- Eriksson, Thomas, et al.
(författare)
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The visiting situation in an ICU : an observational hermeneutic study –oral presentation
- 2011
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Konferensbidrag (refereegranskat)abstract
- Aim: The aim was to interpret the interplay between critically ill patients and their next of kin in an ICU to understand the visiting situation. Method: A hermeneutic research design with non-participant observation was chosen as the data collection method. Ten observations of 10 patients and 24 loved ones over a 20 hour period were conducted. The text describing the observations of the interplay was interpreted in accordance with Gadamer. Data were analysed by considering the text as a play with scenes, actors and plots. Results: The interpretation of the scenes revealed two themes describing the patient’s interplay and six themes describing the next of kin’s interplay. The understanding of the plot concerns people who had entered a situation where normal everyday life was disconnected. The path from health to illness was a totally unfamiliar environment and perception of life, where the body constituted a new and unknown world. As a result of the fact that the patients were unable to use their bodies in the usual way, which sends different signals to their loved ones, who in turn have difficulty deciding how to respond. Both parties become trapped or locked out by their own bodies. Conclusion: A hindrance to the interplay could be the room, which was designed for medical and technical use and thus did not promote healing. The professionals were crucial for interpreting the signals from both patients and next of kin, as well as for finding caring strategies, such as physical contact, that promote interplay, which in turn create a caring and healing atmosphere.
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| 8. |
- Eriksson, Thomas, et al.
(författare)
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Visits in an intensive care unit : an observational hermeneutic study
- 2010
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Ingår i: Intensive & Critical Care Nursing. - : Churchill Livingstone. - 0964-3397 .- 1532-4036. ; 26:1, s. 51-57
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim was to interpret the interplay between critically ill patients and their next of kin in an ICU and to disclose a deeper understanding of the visiting situation. Method A hermeneutic research design with non-participant observation was chosen as the data collection method. Ten observations of 10 patients and 24 loved ones over a 20-h period were conducted. The text describing the observations of the interplay was interpreted in accordance with Gadamer's thoughts. Data were analysed by considering the text as a play with scenes, actors and plots. Findings Due to their medical condition the patients were unable to use their bodies in the usual way, which sends different signals to their loved ones, who in turn have difficulty deciding how to respond. Both parties become, in a manner of speaking, trapped or locked out by their own bodies. Conclusion The physical environment became a hindrance to the interplay as it was designed for medical and technical use and thus did not promote healing. The professionals are important for interpreting the signals from both patients and next of kin, as well as for finding caring strategies, such as physical contact that promote interplay, which in turn strengthens connectedness.
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| 9. |
- Johansson, K., et al.
(författare)
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Moving between rooms - moving between life and death: nurses' experiences of caring for terminally ill patients in hospitals
- 2012
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 21:13-14, s. 2034-2043
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This study describes the meanings of generalist registered nurses experiences of caring for palliative care patients on general wards in hospitals. Background. Earlier research shows that work with patients in palliative care is demanding. More research concerning palliative care is undertaken in oncological care, in hospice and in home-care settings than in general wards. It is therefore important to examine the palliative care in the context of acute-care settings to discover more about this phenomenon, to understand the experiences of nurses in this situation and to develop patient care. Design. Qualitative, descriptive and interpretive study. Method. Eight registered nurses in two different hospitals in Sweden were interviewed. The patients on these wards suffered from surgical and medical conditions, i.e. both curative and palliative care were administered. The interviews were analysed using a phenomenological hermeneutical approach inspired by Ricoeurs philosophy. Results. The registered nurses experiences are presented as seven themes and a comprehensive, interpreted whole. This latter revealed the significance of contrasts, contradictions and movement between the material and psychological experiences of the room and nursing care in this care context. Conclusions. The registered nurses say that something momentous occurred during the care process and they showed a strong determination and commitment to being part of the ending of the patients life circle, despite the situation often being one of stress. Relevance to clinical practice. The findings highlight the need for various forms of support for the nurses to meet their need for new and updated knowledge and support in existential matters. This may promote a better quality of care and confirm the nurses in their caring practice. Moreover, there is a need to introduce the hospice philosophy into acute-care settings in hospitals.
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| 10. |
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| 11. |
- Johansson, Lotta, 1965, et al.
(författare)
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Meanings of Being Critically Ill in a Sound-Intensive ICU Patient Room : A Phenomenological Hermeneutical Study
- 2012
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Ingår i: Open Nursing Journal. - : Bentham Open. - 1874-4346. ; 6, s. 108-116
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate the meanings of being critically ill in a sound-intensive ICU patient room, as disclosed through patients’ narratives. Patient rooms in ICUs are filled with loud activity and studies have revealed sound levels comparable to those of a busy road above the patient’s head. There is a risk that the sound or noise is disturbing and at worst a major problem for the patient, but there is a lack of knowledge concerning the patients’ own experiences. Thirteen patients were asked to narrate their experiences of the sound environment in ICU patient rooms. The interviews were analyzed using a phenomenological- hermeneutical method inspired by the philosophy of Ricoeur. Six themes emerged from the analysis. Conclusion: The meanings of being a patient in a sound- intensive environment were interpreted as never knowing what to expect next regarding noise, but also of being situated in the middle of an uncontrollable barrage of noise, unable to take cover or disappear. This condition is not to be seen as static; for some patients there is movement and change over time. The meanings indicate that the unpredictable shifts between silence and disturbing sounds stress the critically ill patient and impede sleep and recovery. Our findings indicate the need to reduce disturbing and unexpected sounds and noise around critically ill patients in high-tech environments in order to facilitate wellbeing, sleep and recovery. Nurses have a vital role in developing such an environment.
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| 12. |
- Johansson, Lotta, 1965, et al.
(författare)
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The sound environment in an ICU patient room--A content analysis of sound levels and patient experiences
- 2012
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier Limited. - 0964-3397 .- 1532-4036. ; 28:5, s. 269-279
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Tidskriftsartikel (refereegranskat)abstract
- This study had two aims: first to describe, using both descriptive statistics and quantitative content analysis, the noise environment in an ICU patient room over one day, a patient's physical status during the same day and early signs of ICU delirium; second, to describe, using qualitative content analysis, patients' recall of the noise environment in the ICU patient room. The final study group comprised 13 patients. General patient health status data, ICU delirium observations and sound-level data were collected for each patient over a 24-hour period. Finally, interviews were conducted following discharge from the ICU. The sound levels in the patient room were higher than desirable and the LAF max levels exceed 55dB 70-90% of the time. Most patients remembered some sounds from their stay in the ICU and whilst many were aware of the sounds they were not disturbing to them. However, some also experienced feelings of fear related to sounds emanating from treatments and investigations of the patient beside them. In this small sample, no statistical connection between early signs of ICU delirium and high sound levels was seen, but more research will be needed to clarify whether or not a correlation does exist between these two factors.
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| 13. |
- Karlsson, Veronika, 1972, et al.
(författare)
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Patients' statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study
- 2012
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Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 19:3, s. 247-258
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Tidskriftsartikel (refereegranskat)abstract
- KARLSSON V, LINDAHL B and BERGBOM I. Nursing Inquiry 2012; 19: 247258 ?Patients statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study Prospective studies using video-recordings of patients during mechanical ventilator treatment (MVT) while conscious have not previously been published. The aim was to describe patients statements, communication and facial expressions during a video-recorded interview while undergoing MVT. Content analysis and hermeneutics inspired by the philosophy of Gadamer were used. The patients experienced almost constant difficulties in breathing and lost their voice. The most common types of communication techniques patients used were nodding or shaking the head. Their expressions were interpreted as stiffened facial expression, tense body position and feelings of sadness and sorrow. Nursing care for patients conscious during MVT is challenging as it creates new demands regarding the content of the care provided. In caring for patients undergoing MVT while conscious, establishing a caring relationship, making patients feel safe and helping them to communicate seem to be most important for alleviating discomfort and instilling hope.
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| 14. |
- Lindahl, Berit, 1955, et al.
(författare)
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A meta-synthesis describing the relationships between patients, informal caregivers and health professionals in home-care settings
- 2011
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:3/4, s. 454-463
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Tidskriftsartikel (refereegranskat)abstract
- The present study describes, through a meta-synthesis, the relationship between patients, informal caregivers and health professionals involved in home care. Today, many people receive help from health care professionals in their homes with the consequence that, for many health care professionals, their working place is the patients' homes. Research that addresses the dynamics in the caring relationship in home care seems to be rare. A meta-synthesis is an integrated interpretation of qualitative research findings, which is more substantive than the results from each individual investigation. We performed a systematic literature search regarding studies published during the period 1992-2005, using the search terms home nursing, professional and home health care. The included studies described relations in a home care context, between health professionals and patients or relations between health professionals, patients and their informal caregivers published in the same study. The fi ; ndings showed that when professionals entered people's home, the private area changed. The study presents an interpretation of the changed meanings of home as the place and space for professional care. We described the meanings of the relationship in two main themes with subthemes. The main themes are 'being there' and 'home care as a co-creation'. The understanding of relationships in home care is seen as the development of a professional friendship. This concept is reflected on through the writings of Aristotle and Alberoni. To address these concerns, it is important that home care providers, recipients and their family members develop friendships. These friendships should be a part of any professional relationship. When health professionals enter patients' homes, they have to be aware of the risk of transgressing borders of privacy. In addition, devaluing patients' or their informal caregivers' knowledge and their opinions about the care is interpreted as an exercise of institutiona ; l power.
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| 15. |
- Lindahl, Berit, et al.
(författare)
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Att vårda på evidensbaserad grund
- 2010
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Ingår i: Att bli sjuksköterska - en introduktion till yrke och ämne. - : Lund: Studentlitteratur AB. - 9789144054117 ; , s. 181-204
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 16. |
- Lindahl, Berit, 1955, et al.
(författare)
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Being the Parent of a Ventilator-Assisted Child: Perceptions of the Family-Health Care Provider Relationship When Care Is Offered in the Family Home
- 2013
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Ingår i: Journal of Family Nursing. - : SAGE Publications. - 1074-8407 .- 1552-549X. ; 19:4, s. 489-508
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Tidskriftsartikel (refereegranskat)abstract
- The number of medically fragile children cared for at home is increasing; however, there are few studies about the professional support these families receive in their homes. The aim of the study was to understand the meanings that parents had about the support they received from health care professionals who offered care for their ventilator-assisted child in the family home. A phenomenological-hermeneutic method was used. Data included the narratives of five mother-father couples living in Sweden who were receiving professional support for their ventilator-assisted child. The findings indicate that receiving professional support meant being at risk of and/or exposed to the exercise of control over family privacy. The professional support system in the families' homes worked more by chance than by competent and sensible planning. In good cases, caring encounters were characterized by a mutual relationship where various occupational groups were embraced as a part of family life. The findings are discussed in light of compassionate care, exercise of power, and the importance of holistic educational programs. © The Author(s) 2013.
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| 17. |
- Lindahl, Berit, et al.
(författare)
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Caring and being cared for at home : a meta-synthesis describing the relationships between patients, informal caregivers and health professionals
- 2011
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Ltd.. - 0962-1067 .- 1365-2702. ; 20:3-4, s. 454-463
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The present study describes, through a meta-synthesis, the relationship between patients, informal caregivers and health professionals involved in home care. BACKGROUND: Today, many people receive help from health care professionals in their homes with the consequence that, for many health care professionals, their working place is the patients' homes. Research that addresses the dynamics in the caring relationship in home care seems to be rare. DESIGN: A meta-synthesis is an integrated interpretation of qualitative research findings, which is more substantive than the results from each individual investigation. METHOD: We performed a systematic literature search regarding studies published during the period 1992-2005, using the search terms home nursing, professional and home health care. The included studies described relations in a home care context, between health professionals and patients or relations between health professionals, patients and their informal caregivers published in the same study. RESULTS: The findings showed that when professionals entered people's home, the private area changed. The study presents an interpretation of the changed meanings of home as the place and space for professional care. We described the meanings of the relationship in two main themes with subthemes. The main themes are 'being there' and 'home care as a co-creation'. The understanding of relationships in home care is seen as the development of a professional friendship. This concept is reflected on through the writings of Aristotle and Alberoni. CONCLUSION: To address these concerns, it is important that home care providers, recipients and their family members develop friendships. These friendships should be a part of any professional relationship. RELEVANCE TO CLINICAL PRACTICE: When health professionals enter patients' homes, they have to be aware of the risk of transgressing borders of privacy. In addition, devaluing patients' or their informal caregivers' knowledge and their opinions about the care is interpreted as an exercise of institutional power.
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| 18. |
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| 19. |
- Lindahl, Berit, 1955
(författare)
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Experiences of exclusion when living on a ventilator: reflections based on the application of Julia Kristeva's philosophy to caring science
- 2011
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Ingår i: NURSING PHILOSOPHY. - : Wiley-Blackwell Publishing Ltd.. - 1466-7681 .- 1466-769X. ; 12:1, s. 12-21
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: The research presented in this work represents reflections in the light of Julia Kristeva's philosophy concerning empirical data drawn from research describing the everyday life of people dependent on ventilators. It also presents a qualitative and narrative methodological approach from a person-centred perspective. Most research on home ventilator treatment is biomedical. There are a few published studies describing the situation of people living at home on a ventilator but no previous publications have used the thoughts in Kristeva's philosophy applied to this topic from a caring science perspective. The paper also addresses what a life at home on a ventilator may be like and will hopefully add some new aspects to the discussion of philosophical issues in nursing and the very essence of care. Kristeva's philosophy embraces phenomena such as language, abjection, body, and love, allowing her writings to make a fruitful contribution to nursing philosophy in that they strengthen, expand, and deepen a caring perspective. Moreover, her writings about revolt having the power to create hope add an interesting aspect to the work of earlier philosophers and nursing theorists.
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| 20. |
- Lindahl, Berit, 1955, et al.
(författare)
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Family Members' Experiences of Everyday Life When a Child Is Dependent on a Ventilator: A Metasynthesis Study
- 2011
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Ingår i: JOURNAL OF FAMILY NURSING. - : Sage Publications, Inc.. - 1074-8407 .- 1552-549X. ; 17:2, s. 241-269
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Tidskriftsartikel (refereegranskat)abstract
- Children using mechanical ventilation for survival represent a small, but growing, vulnerable population in society. The aim of this study was to describe the existing qualitative research that examined family members’ experiences when a child is dependent on ventilator at home. A metasynthesis is an interpretative integration of qualitative research findings based on a systematic literature search. Twelve original research reports focusing on the life situation of ventilator- and technology-dependent children and their families published between 1998 and 2006 were selected as data. Themes from the metasynthesis included experiences of the ill child, siblings, and parents and the meaning of space and place. These findings provide an understanding of the family members’ experiences when a child is dependent on a ventilator for survival. Recommendations for future research with this population of families include a greater focus on professional support systems and family strengths and the use of longitudinal research methods using observation and interviews.
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| 21. |
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| 22. |
- Lindahl, Berit, 1955
(författare)
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Patients' suggestions about how to make life at home easier when dependent on ventilator treatment - a secondary analysis
- 2010
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Ingår i: SCANDINAVIAN JOURNAL OF CARING SCIENCES. - : Wiley-Blackwell Publishing Ltd.. - 0283-9318 .- 1471-6712. ; 24:4, s. 684-692
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Tidskriftsartikel (refereegranskat)abstract
- Background: While quantitative research has provided valuable information, studies presenting patients’ experiences have been lacking in the field of knowledge of home mechanical ventilation. The aim of this study was, therefore, to present patient views and suggestions about how to improve home ventilator care and treatment. Method: Data in the present study comprise 35 qualitative research interviews collected for a primary project carried out in the years 2002–2005 and now analysed using qualitative content analysis, the most established method for secondary analysis. Results: The results are presented as six categories: the start-up process, to attach to oneself and the ventilator, to experience home as a shelter, to seek knowledge and understanding, to build up confidence in technology and the need to have people to relate to and depend on. The article presents a brief summary of patients’ ideas and requests to healthcare providers and manufacturers involved in home ventilator treatment. Conclusions: The patients’ perspectives and experiences include much useful knowledge of interest for nursing and medical professional practices. More attention needs to be given to these experiences in both home ventilator treatment and research. It is also of great importance for nurses and researchers to encourage manufacturers to develop beautiful and user-friendly design in their products, suitable for ‘home use’ and not just in hospitals.
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| 23. |
- Lindahl, Berit
(författare)
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Patients’ suggestions on how to make life easier at home when being dependent on ventilator treatment : A secondary analysis
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell Publishing Ltd.. - 0283-9318 .- 1471-6712. ; 24:4, s. 684-892
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Tidskriftsartikel (refereegranskat)abstract
- Background: While quantitative research has provided valuable information, studies presenting patients’ experiences have been lacking in the field of knowledge of home mechanical ventilation. The aim of this study was, therefore, to present patient views and suggestions about how to improve home ventilator care and treatment. Method: Data in the present study comprise 35 qualitative research interviews collected for a primary project carried out in the years 2002–2005 and now analysed using qualitative content analysis, the most established method for secondary analysis. Results: The results are presented as six categories: the start-up process, to attach to oneself and the ventilator, to experience home as a shelter, to seek knowledge and understanding, to build up confidence in technology and the need to have people to relate to and depend on. The article presents a brief summary of patients’ ideas and requests to healthcare providers and manufacturers involved in home ventilator treatment. Conclusions: The patients’ perspectives and experiences include much useful knowledge of interest for nursing and medical professional practices. More attention needs to be given to these experiences in both home ventilator treatment and research. It is also of great importance for nurses and researchers to encourage manufacturers to develop beautiful and user-friendly design in their products, suitable for ‘home use’ and not just in hospitals.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Mattsson, Janet
(författare)
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Uncovering pain and caring for children in the pediatric intensive care unit : nurses’ clinical approach and parent’s perspective
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The thesis has a standpoint in a synthesis of caring science and educationscience from a clinical perspective. Children in a Pediatric Intensive Care Unit (PICU) are in an exposed position, dependent on nurses to acknowledge their needs. The alleviation of children’s pain has been investigated from various perspectives, but undertreated pain remains a problem in the PICU. There is a preponderance of empirical evidence pointing toward the role of nurses in uncovering children’s pain and suffering. How nurses interpret the child’s expressions and judge the clinical situation influences their actions in the clinical care. In a PICU, the basis for nurses’ concerns and interpretation of what is meaningful in the nursing care situation are formed by professional concern, workplace culture, traditions, habits, and workplace structures. This influences how parents interpret the meaning of care as well. Patricia Benner’s theory on clinical judgment forms a reference framework for this thesis. The assumption is that children need to be approached from a holistic perspective in the caring situation in order to acknowledge their caring needs. A nurse’s clinical education and insights allow for the possibility to enhance the quality of care for children and parents in the PICU.Aim: To uncover clinical concerns, from caring and learning perspectives, in caring for children in the Pediatric Intensive Care Unit (PICU) from nurses and parents perspective.Methods: Qualitative methods were used in all studies to unfold and explore the phenomena in the nurses’ and parents’ everyday clinical life world. In Papers I and II, a phenomenographic method was adopted. In Papers III and IV, an interpretive phenomenological approach was adopted.Findings: Nurses that have a holistic view of the child and approach the child from a multidimensional perspective, with a focus on the individual child and his/her caring needs, develop a clinical “connoisseurship” and meet the parents’ expectations of the meaning of care. The nurses express that it is only when they focus on the child that subtle signs of pain are revealed. The meaning of nursing care, in the ideal case, is a holistic care where all aspects are integrated and the child as a person has first priority.Conclusion: The meaning of caring and children’s needs must become elucidated to improve the cultural influence of what can be seen as good nursing care within the PICU.
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| 28. |
- Olausson, Sepideh, et al.
(författare)
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A phenomenological study of being cared for in a critical care setting : The meanings of the patient room as a place of care.
- 2013
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Ingår i: Intensive & Critical Care Nursing. - : Churchill Livingstone. - 0964-3397 .- 1532-4036. ; 29:4, s. 234-243
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Tidskriftsartikel (refereegranskat)abstract
- Summary Previous research highlights the impact of care and treatment in ICUs on the patient recovery process and wellbeing. However, little is known about how the interior design in the ICU settings may affect patients’ wellbeing. Objective The aim of this study is, by using a lifeworld perspective, to reveal the meanings of the ICU settings as a place of care. Design Nine patients from three ICUs in Sweden participated. Data were collected using photo-voice methodology and were analysed using a reflective lifeworld phenomenological approach. Results The ICU setting as a place of care for critically ill patients is a complex and multidimensional phenomenon. The place is constituted of patients, staff and technical equipment. The struggle for life and occurrences taking place there determine how the room is perceived. The tone and touch of caring together with interior design are fundamental for the room as lived. The room is experienced in various moods; a place of vulnerability, a place inbetween, a place of trust and security, a life-affirming place, a place of tenderness and care and an embodied place. Conclusion Promoting patients’ well-being and satisfaction of care involves integrating a good design and a caring attitude and paying attention to patients’ needs.
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| 29. |
- Olausson, Sepideh, et al.
(författare)
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Giving voice to loved ones : Using photo-voice as a data collection method in ICU
- 2011
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Konferensbidrag (refereegranskat)abstract
- The Intensive Care Unit (ICU) is a place of care for the most critically ill patients. The ICU rooms are considered to be one of the most complicated rooms to design. Providing successful intensive care requires that human, technologies and spatial resources are integrated in a rigorous way. Research shows that being a patient or next-of-kin in ICU is a traumatic experience not only because of the illness but also because of one’s human existence is threatened. Literature suggests that the presence of next-of-kin and the design of ICU affect the patients’ recovery and wellbeing.
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| 30. |
- Olausson, Sepideh
(författare)
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Intensivvårdsrummets betydelse för vårdande och välbefinnande : patienters närståendes och vårdpersonalens erfarenheter
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of the thesis was to illuminate the meanings of intensive care units’ patient rooms as a place of care for critically ill patients and their loved ones. Moreover, it was aimed to develop photovoice as a data collection method for research in ICU context. Methods and materials: Data has been collected using photovoice methodology in combination with research interviews for all three empirical studies. In total 37 people participated. Nine patients, fourteen loved ones and fourteen nurses from three ICU settings. Study I examined the perspective of loved ones, for this purpose a phenomenological hermeneutic method rooted in the philosophy of Ricoeur was chosen. Study II and III examined patients’ respectively nurses’ perspective. Both studies are phenomenologically orientated guided by a reflective lifeworld approach rooted in continental philosophy. Study IV is a theoretical paper focusing on employing photovoice as a data collection method in ICU context. Main findings: The tone and touch of caring is vital for how ICU patient room is materialized for patients. The interior design and furnishing has a great impact on the wellbeing of the loved ones and also the support they can offer the critically ill patient. One major finding is that the ICU patient room is a taken for granted place for health care providers and the impact of it upon caring, patients’ and loved ones wellbeing is not reflected over. It also seems unclear who is responsible for the environment of ICU once it has been built. The environment of ICU affects nurses’ ability to care for the patients and their family in a genuine way and to promote their wellbeing during a fragile time in life. Conclusions: There is an urgent need to translate research findings into clinical practice in order to improve the environment of ICU patient rooms. There is also need of further research and policies for transforming the hostile environment of the patient rooms to a healing environment more conductive to people’s recovering process.
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| 31. |
- Olausson, Sepideh, et al.
(författare)
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Patient safety in relation to the design of the patient room
- 2011
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Konferensbidrag (refereegranskat)abstract
- he demographic changes in Western countries, with an aging population and medical and technological progresses, have meant an increased demand on treating multi-morbid patients in intensive care units (Rashid, 2006). Intensive care room is the core of all activities in providing care for the most critically ill patients. According to European Society of intensive Care Medicine, providing a safe and high quality care requires an integration of human, technological and spatial recourses. The patient rooms in ICU are usually crowded places, characterized by high prevalence of stressors such as high levels of sound and strong lighting and constant activity with a negative effect on the patients’ recovery process. Previous research indicates that the design of patient rooms in ICU can be one of the causes of developing ICU delirium (Dubois, Bergeron, Dumont, Dial och Skrobik 2001). Furthermore, it is highlighted that there is an increase risk of medical errors in ICU environment due to high levels of sound (Christensen, 2002). Patient safety means preventing suffering or damages of any kind, caused by the health care provider or due to milieu related factors. The design and interior of ICU can have an impact on the patient safety and treatment outcomes. The presentation will focus on how design and interior of ICU rooms can meet the demands of patient safety.
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| 32. |
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| 33. |
- Olausson, Sepideh, et al.
(författare)
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Photo-Voice as a Data Collection Method in ICU
- 2011
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Konferensbidrag (refereegranskat)abstract
- The demographic changes in Western countries, with an aging population and medical and technological progresses, have meant an increased demand on treating multi-morbid patients in intensive care units (Rashid, 2006). Intensive care room is the core of all activities in providing care for the most critically ill patients. According to European Society of intensive Care Medicine, providing a safe and high quality care requires an integration of human, technological and spatial recourses. The patient rooms in ICU are usually crowded places, characterized by high prevalence of stressors such as high levels of sound and strong lighting and constant activity with a negative effect on the patients’ recovery process. Previous research indicates that the design of patient rooms in ICU can be one of the causes of developing ICU delirium (Dubois, Bergeron, Dumont, Dial och Skrobik 2001). Furthermore, it is highlighted that there is an increase risk of medical errors in ICU environment due to high levels of sound (Christensen, 2002). Patient safety means preventing suffering or damages of any kind, caused by the health care provider or due to milieu related factors. The design and interior of ICU can have an impact on the patient safety and treatment outcomes. The presentation will focus on how design and interior of ICU rooms can meet the demands of patient safety.
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| 34. |
- Olausson, Sepideh, et al.
(författare)
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The ICU patient room : Views and meanings as experienced by the next of kin
- 2011
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Konferensbidrag (refereegranskat)abstract
- Intensive care unit, ICU, is considered to be one the most complicated area for care of critically ill patients. The rooms in ICU are small and narrow and the high tech environment believes to affect patients and next-of-kin wellbeing. Previous research reveals that a large number of patients suffer from unreal experiences, often very traumatic during their stay in ICU. Unpleasant memories and risk of developing post traumatic stress after discharge from ICU is rather common. In this context next-of-kin play an important and crucial role for supporting the patient though the process of illness and recovery. Next-of-kin in ICU are considered to be a lifeline for patients. Furthermore, the design and interiors of ICU affect the interplay between the patient and the next-of-kin.
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| 35. |
- Olausson, Sepideh, et al.
(författare)
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The ICU patient room : Views and meanings as experienced by the next of kin: A phenomenological hermeneutical study
- 2012
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Ingår i: Intensive & Critical Care Nursing. - : Churchill Livingstone, Elsevier. - 0964-3397 .- 1532-4036. ; 28:3, s. 176-184
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Tidskriftsartikel (refereegranskat)abstract
- The rooms in Intensive Care Units are considered as high-tech environments and believed to affect recovery process and wellbeing of patients. Moreover, the design and interiors affect the interplay between the patient and the next of kin. Objective The aim of this study was to describe and interpret the meanings of the intensive care patient room as experienced by next of kin. Design Next of kin (n = 14) from two different intensive care units participated. Data were collected through photo-voice and analysed using aphenomenological hermeneutical method. Results Three major themes emerged; dwelling in the room and time, becoming at home and extension of the room. The results show that the room is perceived as a lived and extended place and space. The design, interiors and furnishing in the patient room are fundamental in shaping the next of kin's experiences in the room and affect wellbeing. Conclusions How intensive care patient rooms are designed, the place given to next of kin and the way they are received in the room are decisive for the support given to the loved one. Simple interventions can make the patient room a more healing environment.
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| 36. |
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| 37. |
- Skyman, Eva, et al.
(författare)
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Notification card to alert for Methicillin-resistant Saphylococcus Aureus is stigmatizing from the patients' point of view
- 2014
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Ingår i: Scandinavian Journal of Infectious Diseases. Supplementum. - : Informa UK Limited. - 0300-8878 .- 0036-5548 .- 1651-1980. ; 46:6, s. 440-6
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Tidskriftsartikel (refereegranskat)abstract
- Scand J Infect Dis. 2014 Jun;46(6):440-6. doi: 10.3109/00365548.2014.896029. Epub 2014 Mar 26. Notification card to alert for methicillin-resistant Staphylococcus aureus is stigmatizing from the patient's point of view. Skyman E1, Bergbom I, Lindahl B, Larsson L, Lindqvist A, Thunberg Sjöström H, Ahrén C. Author information Abstract BACKGROUND: The importance of alerting health care systems of patients carrying multidrug-resistant bacteria (MRB) is highlighted in numerous guidelines. In the absence of electronic alert systems, notification cards are often recommended, but have rarely been evaluated. We evaluated patient experiences of receiving and using a methicillin-resistant Staphylococcus aureus (MRSA) notification card. METHODS: Two cohorts of patients given a card when identified for the first time as a carrier in 1999-2003 and 2008-2010, responded to questionnaires distributed in 2004 and 2011, respectively. The response rate in 2004 was 92 (38 females)/129 and in 2011 was 110 (55 females)/209. In addition, 63% and 49%, respectively, followed the encouragement to provide written comments to the questions. These were analysed using a qualitative method. RESULTS: The patients took responsibility not to infect others, reported high usage, and acknowledged the importance of the card to inform health care institutions about their carrier status, despite experiencing fear, disrespect, lack of knowledge, and unprofessional behaviour when presenting it to personnel. Alarmingly these stigmatizing experiences were more frequent in 2011. Professional behaviour was reported from the infectious disease clinic. A majority of the patients were unaware of how they had acquired MRSA. CONCLUSIONS: The MRSA notification card was felt to stigmatize the patient, which makes its use questionable. Other alert methods need to be developed. Most importantly, the study demonstrates the importance for these patients to meet staff educated about MRB. Thus, there is an urgent need to educate health care professionals at all levels.
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| 38. |
- Valsö, Åse, et al.
(författare)
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Begrensning av livsforlengende behandling til sederte intensivpatienter på respirator : hva er intensivsykepleierens rolle?
- 2013
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Ingår i: Vård i Norden. - : Sjuksköterskornas samarbete i Norden. - 0107-4083 .- 1890-4238. ; 33:4, s. 37-41
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Tidskriftsartikel (refereegranskat)abstract
- The aim: The aim was to illuminate ICU-nurses’ roles in the process of decision-making regarding limitation of life prolonging treatment to sedated patients on ventilators, and to get an insight to related knowledge of ethical and legal guidelines Method: Data consisted of qualitative semi-structured interviews analyzed via qualitative content analyses. Findings: The findings describe the nurses’ legally and ethical competences in relation to their caring role and insight into how the National Guideline is used. The ICU-nurses found decision-making difficult, but viewed their role as crucial through the whole withdrawal process. They took part indirectly in the decision-making concerning withdrawal as they are the ones who mediate their patient observations and next of kin’s wishes. Findings are presented in four categories: the ICU-nurses inclusion and participation in decision-making, deficient documentation, informing the next of kin and uncertainty about ethical and juridical perspectives. Conclusion: A multi-professional dialogue, knowledge about ethical and legal competencies, and content in the National Guideline, are seen as important help to the nurses as they are the ones who stay close to patients and the next of kin.
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