| 1. |
- Björklund, Margereth, 1950-, et al.
(author)
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Health promoting contacts as encountered by individuals with head and neck cancer
- 2009
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In: Journal of Nursing and Healthcare of Chronic Illness. - 1752-9816 .- 1752-9824. ; 1:3, s. 261-268
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Journal article (peer-reviewed)abstract
- Aim. To describe the characteristics of health promoting contacts with health professionals as encountered by individuals with head and neck cancer. Background. Head and neck cancer has a profound and chronic impact on the individual's everyday life, e.g. physical problems that hinder speaking, breathing, eating and drinking. Furthermore, fear and uncertainty can lead to long-term psychological and psychosocial problems. The National Institute of Public Health in Sweden advocates that all care contacts should improve the quality of the individual's health. Design. A qualitative descriptive and explorative design was used. Eight participants were interviewed in the year 2005 and a qualitative thematic content analysis of the data was performed. Findings. Health promoting contacts were defined as contacts where health care professionals contribute positively to the well-being of individual patients. Characteristics include being available, engaged, respectful and validating. Three themes were identified: being believed in one's illness story; having a working relationship with health professionals and receiving individualised, tailored care. Conclusions. Health promoting contacts were experienced mainly during the treatment phase, when patients had daily contact with specific, qualified health professionals. Although the interview questions focused on health promoting contacts, nearly half of the contacts were experienced as not health promoting. Feelings of abandonment were particularly manifested before and after treatment. The starting point for achieving health promoting contact lies in understanding the patient's lifeworld in relation to health, illness and suffering and focusing on the individual's personal strengths and health resources. Relevance to clinical practice. The findings highlighted the importance of ensuring that patient interests and concerns are core considerations in health care. The participants viewed continuing individualised, tailored care and access to ear, nose and throat healthcare professionals as highly important.
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| 2. |
- Björklund, Margereth, et al.
(author)
-
Health promoting contacts as encountered by individuals with head and neck cancer
- 2009
-
In: Journal of Nursing and Healthcare of Chronic Illness. - : Wiley. - 1752-9816 .- 1752-9824. ; 1:3, s. 261-268
-
Journal article (peer-reviewed)abstract
- Aim. To describe the characteristics of health promoting contacts with health professionals as encountered by individuals with head and neck cancer.Background. Head and neck cancer has a profound and chronic impact on the individual’s everyday life, e.g. physical problems that hinder speaking, breathing, eating and drinking. Furthermore, fear and uncertainty can lead to long-term psychological and psychosocial problems. The National Institute of Public Health in Sweden advocates that all care contacts should improve the quality of the individual’s health.Design. A qualitative descriptive and explorative design was used. Eight participants were interviewed in the year 2005 and a qualitative thematic content analysis of the data was performed.Findings. Health promoting contacts were defined as contacts where health care professionals contribute positively to the well-being of individual patients. Characteristics include being available, engaged, respectful and validating. Three themes were identified: being believed in one’s illness story; having a working relationship with health professionals and receiving individualised, tailored care.Conclusions. Health promoting contacts were experienced mainly during the treatment phase, when patients had daily contact with specific, qualified health professionals. Although the interview questions focused on health promoting contacts, nearly half of the contacts were experienced as not health promoting. Feelings of abandonment were particularly manifested before and after treatment. The starting point for achieving health promoting contact lies in understanding the patient’s lifeworld in relation to health, illness and suffering and focusing on the individual’s personal strengths and health resources.Relevance to clinical practice. The findings highlighted the importance of ensuring that patient interests and concerns are core considerations in health care. The participants viewed continuing individualised, tailored care and access to ear, nose and throat healthcare professionals as highly important.
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| 3. |
- Björklund, Margereth, 1950-, et al.
(author)
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Health promotion and empowerment from the perspective of individuals living with head and neck cancer
- 2008
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In: European Journal of Oncology Nursing. - 1462-3889 .- 1532-2122. ; 12:1, s. 26-34
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Journal article (peer-reviewed)abstract
- The aim of this study was to shed light on health promotion from the perspective of individuals living with head and neck cancer. Eight informants were interviewed and latent content analysis was used. Individuals living with head and neck cancer experienced many problems that had a negative impact on their health. One overarching main theme was demonstrated; the ability to regain control and empower oneself. Three themes emerged: (1) Being enabled by dialogue with one's inner self, including three sub-themes: transformed and improved self-esteem, recognising and embracing existentiality, and increased self-determination. (2) Being enabled by means of contact with a social network, including two sub-themes: emotional support and practical support. (3) Being enabled by means of contact with and a passion for the environment, including two sub-themes: nature, hobbies and activities. Empowerment, the goal of health promotion, was understood as an ongoing process, and the ability to promote health varied and was dependent on internal and external enabling of acting and doing. The interpretation of this ongoing process demonstrates interplay assisted by a dialogue with one's inner self, contact with a social network and a passion for the environment. Altogether, these findings may inspire nurses and other health care professionals to support the individual's empowerment process and pose non-pathology-oriented questions such as "what improves your health?" or "what makes you feel good?"
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| 4. |
- Björklund, Margereth, et al.
(author)
-
Health promotion and empowerment from the perspective of individuals living with head and neck cancer
- 2008
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In: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 12:1, s. 26-34
-
Journal article (peer-reviewed)abstract
- The aim of this study was to shed light on health promotion from the perspective of individuals living with head and neck cancer. Eight informants were interviewed and latent content analysis was used. Individuals living with head and neck cancer experienced many problems that had a negative impact on their health. One overarching main theme was demonstrated; the ability to regain control and empower oneself. Three themes emerged: (1) Being enabled by dialogue with one's inner self, including three sub-themes: transformed and improved self-esteem, recognising and embracing existentiality, and increased self-determination. (2) Being enabled by means of contact with a social network, including two sub-themes: emotional support and practical support. (3) Being enabled by means of contact with and a passion for the environment, including two sub-themes: nature, hobbies and activities. Empowerment, the goal of health promotion, was understood as an ongoing process, and the ability to promote health varied and was dependent on internal and external enabling of acting and doing. The interpretation of this ongoing process demonstrates interplay assisted by a dialogue with one's inner self, contact with a social network and a passion for the environment. Altogether, these findings may inspire nurses and other health care professionals to support the individual's empowerment process and pose non-pathology-oriented questions such as "what improves your health?" or "what makes you feel good?"
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| 5. |
- Björklund, Margereth, 1950-, et al.
(author)
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Living with head and neck cancer : a profile of captivity
- 2010
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In: Journal of Nursing and Healthcare of Chronic Illness. - 1752-9816 .- 1752-9824. ; 2:1, s. 22-31
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Journal article (peer-reviewed)abstract
- Aim. To illuminate what it means to live with head and neck cancer.Background. Patients could experience head and neck cancer as more emotionally traumatic than other cancers because of visible disfigurement and its life-threatening impact on vital functions. This long-term illness often leads to lifestyle changes such as to physical function, work and everyday tasks, interpersonal relationships and social functioning.Design. This study used a qualitative and explorative longitudinal and prospective design with semi-structured interviews and open-ended questions. Twenty-one interviews were conducted with six participants with newly diagnosed or newly recurrent head and neck cancer. The analysis was descriptive and interpretive.Findings. The participants were living 'in captivity' in the sense that their symptoms were constant reminders of the disease. Our findings also revealed existential loneliness and spiritual growth, as interpreted within six themes: altered sense of affiliation; hostage of health care; locked up in a broken body, but with a free spirit; confined in a rogue body, forced dependency on others, and caught up in a permanent illness trajectory.Conclusions. Living with head and neck cancer involves emotional and existential vulnerability. The participants and their next of kin experienced insufficient support from health services and inadequate coordination between phases of their lengthy illness trajectory. These findings call for changes in oncological rehabilitation and management. Patient care must take a holistic view of everyone involved, centring on the individual and the promotion of health. A care coordinator could navigate between the individual patient needs and appropriate health services, hopefully with results that lessen the individual's emotional and existential confinement.
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| 6. |
- Björklund, Margereth, 1950-, et al.
(author)
-
Living with head and neck cancer : a profile of captivity
- 2010
-
In: Journal of Nursing and Healthcare of Chronic Illness. - : Wiley. - 1752-9816 .- 1752-9824. ; 2:1, s. 22-31
-
Journal article (peer-reviewed)abstract
- Aim. To illuminate what it means to live with head and neck cancer.Background. Patients could experience head and neck cancer as more emotionally traumatic than other cancers because of visible disfigurement and its life-threatening impact on vital functions. This long-term illness often leads to lifestyle changes such as to physical function, work and everyday tasks, interpersonal relationships and social functioning.Design. This study used a qualitative and explorative longitudinal and prospective design with semi-structured interviews and open-ended questions. Twenty-one interviews were conducted with six participants with newly diagnosed or newly recurrent head and neck cancer. The analysis was descriptive and interpretive.Findings. The participants were living 'in captivity' in the sense that their symptoms were constant reminders of the disease. Our findings also revealed existential loneliness and spiritual growth, as interpreted within six themes: altered sense of affiliation; hostage of health care; locked up in a broken body, but with a free spirit; confined in a rogue body, forced dependency on others, and caught up in a permanent illness trajectory.Conclusions. Living with head and neck cancer involves emotional and existential vulnerability. The participants and their next of kin experienced insufficient support from health services and inadequate coordination between phases of their lengthy illness trajectory. These findings call for changes in oncological rehabilitation and management. Patient care must take a holistic view of everyone involved, centring on the individual and the promotion of health. A care coordinator could navigate between the individual patient needs and appropriate health services, hopefully with results that lessen the individual's emotional and existential confinement.
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| 7. |
- Hasson, Henna, et al.
(author)
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Significance of scientific evidence in organizing care processes
- 2016
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In: Journal of Health Organisation & Management. - 1477-7266 .- 1758-7247. ; 30:4, s. 597-612
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Journal article (peer-reviewed)abstract
- Purpose – The purpose of this paper is to analyze how staff and managers in health and social care organizations use scientific evidence when making decisions about the organization of care practices. Design/methodology/approach – Document analysis and repeated interviews (2008-2010) with staff (n=39) and managers (n=26) in health and social care organizations. The respondents were involved in a randomized controlled study about testing a continuum of care model for older people. Findings – Scientific evidence had no practical function in the social care organization, while it was a prioritized source of information in the health care organization. This meant that the decision making regarding care practices was different in these organizations. Social care tended to rely on ad hoc practice-based information and political decisions when organizing care, while health care to some extent also relied in an unreflected manner on the scientific knowledge. Originality/value – The study illustrates several difficulties that might occur when managers and staff try to consider scientific evidence when making complicated decisions about care practices.
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| 8. |
- Heikkilä, Kristiina, et al.
(author)
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Culturally congruent care for older people: Finnish care in Sweden
- 2007
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In: Scandinavian Journal of Caring Science. ; 21, s. 354-361
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Journal article (peer-reviewed)abstract
- An increasing number of older people belong to minority and immigrant groups. This calls for new models on the subject of how to provide culturally adjusted care for these populations. The aim of this study is to describe how culturally congruency is used in care for older Finnish immigrants in order to promote their well-being. The study was conducted with an ethnographic design, based on participant observations and interviews among residents, staff and visitors in the Finnish Home in Sweden. In the core of the cultural congruency is the use of the Finnish language, and the fact that both residents and staff have Finnish backgrounds. In addition to this, Finnish customs and celebrations, popular culture and topics of discussion, are actively used in order to create a common ground for communication and shared understanding of the individual person. Cultural congruency, based on the residents' mother language, shared athnic background with staff, and shared customs creates a common ground for communication and an understanding. This enables caring relationships, which, in turn, increases the residents' well-being.
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| 9. |
- Hörder, Helena M, et al.
(author)
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Home as a health promotion setting for older adults
- 2014
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:Suppl 15, s. 36-40
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Journal article (peer-reviewed)abstract
- Background: The number and the proportion of older persons is growing in the Nordic Countries. The growth in the older population has a clear impact on the care system for older persons. One trend is to prioritise home care instead of care in institutions. Another trend is to emphasise preventive and health promotion care. As official guidelines in the Nordic countries state that home is the best place to grow old, it is essential that older persons keep their health and functional capacity in order to be able to live at home for as long as possible. As current policy emphasises living at home, home care, preventive work and health promotion it becomes essential to study the home as a health promotion setting. Objective: The aim of this study was to reach a new understanding of home as a health promotion setting for older persons. Study design: The method used was a literature reflection and analysis with a hermeneutical approach. Results: The results show that with increasing age the home environment becomes a crucial determinant for independence. The home environment supports the self as people age; it has associations with the past, can provide proximity to family, and a sense of being a part of neighbourhood life. Conclusions: Only by taking into consideration the meaning of home and the resources of the individual older person can home function as a true health promoting setting. If health personnel focus solely on risk prevention, they can neglect the perspectives of the older person, resulting in dis-empowerment not health promotion.
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| 10. |
- Juthberg, Christina, 1966-
(author)
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Samvetsstress hos vårdpersonal i den kommunala äldreomsorgens särskilda boenden
- 2008
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis is to describe perception of conscience, stress of conscience (stress related to troubled conscience) and burnout, to explore their relationships and to illuminate meanings of the lived experience of troubled conscience in one’s work among registered nurses (RNs) and nurse assistants (NAs) in municipal residential care for the elderly. The thesis comprises four studies; studies I-III are based on questionnaire data from 50 RNs and 96 NAs and study IV is based on interview data from 6 RNs and 6 NAs selected from the participants in the questionnaire study. Questionnaire data was analysed with multivariate statistics (I-III). Narrative interviews were interpreted with a phenomenological hermeneutic method (IV). Study I showed two relationships explaining a noteworthy amount of the shared variance by themselves (25.6% and 17.8%). One relationship was shown between having to deaden one’s conscience in order to keep working in healthcare and stress of conscience related to external demands which was interpreted as having to deaden one’s conscience in order to be able to collaborate with co-workers. The other relationship was shown between having to deaden one’s conscience in order to keep working in healthcare and stress of conscience related to internal demands which was interpreted as having to deaden one’s conscience in order to be able to feel like a good healthcare professional. Study II showed a relationship between stress of conscience and burnout (43.6% explained variance) indicating that experiences of shortcomings and of being exposed to contradictory demands are strongly related to burnout. The relationship between perceptions of conscience and burnout (33.9% explained variance) indicated that having to deaden one’s conscience in order to keep working in healthcare is strongly related to burnout. Study III showed that both RNs and NAs perceived conscience mainly as an asset and a guide and not as a burden in their work. Lack of time and high demands of work influencing home life were the situations related to the highest stress of conscience for both RNs and NAs. The predictive pattern for RNs was interpreted as RNs showing sensitivity to expectations and demands and NAs using their conscience as a guide in their work. Study IV showed that meanings of the RNs’ lived experience of troubled conscience in their work are of being trapped in feelings of powerlessness and a sense of being inadequate. They feel they are failing to live up to expectations from residents and their families, colleagues and themselves because of feelings of powerlessness, cowardice and incompetence. Meanings of NAs’ lived experience of troubled conscience in their work are a sense of being hindered in providing the level of care they would like to provide because of pre-determined conditions and by feelings of being inadequate. They are betraying the residents and themselves by accepting perceived inadequate working conditions and through their own perceived sense of cowardice and negligence. The conclusion of these studies is that stress of conscience is related to burnout among RNs and NAs in municipal residential care for the elderly. Experiences of inadequacy, powerlessness and feelings of being hindered are shown in situations where they have troubled conscience. When the norms of others and/or the pre-determined conditions do not correspond to their own values and norms it may result in the feeling that they cannot perceive themselves as good healthcare professionals.
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