| 1. |
- Norell Pejner, Margaretha Norell, 1958-, et al.
(author)
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Restoring Balance-A Woman's Expressions of Lived Experience of Everyday Life During a Period of Aging : A Case Study
- 2023
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In: Inquiry. - Rochester, NY : Sage Publications. - 0046-9580 .- 1945-7243. ; 60
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Journal article (peer-reviewed)abstract
- Bereaved older people face stressors from the changes in roles associated with the death of a spouse. To illustrate the lived experience of everyday life during a period of aging after a woman's loss of her spouse. One woman born in 1918 was followed between 74 and 80 years of age after her husband died. Data consisted of daily diary. The text from the diaries were analyzed with a phenomenological hermeneutical approach. Everyday life after becoming a widow is characterized by balancing between personal resources to manage everyday life and vulnerability. In health and social care, it is important to identify experiences of vulnerability because these are associated with poor health.
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| 2. |
- Etminani, Kobra, 1984-, et al.
(author)
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Improving Medication Adherence Through Adaptive Digital Interventions (iMedA) in Patients With Hypertension : Protocol for an Interrupted Time Series Study
- 2021
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In: JMIR Research Protocols. - Toronto : JMIR. - 1929-0748. ; 10:5
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Journal article (peer-reviewed)abstract
- Background: There is a strong need to improve medication adherence (MA) for individuals with hypertension in order to reduce long-term hospitalization costs. We believe this can be achieved through an artificial intelligence agent that helps the patient in understanding key individual adherence risk factors and designing an appropriate intervention plan. The incidence of hypertension in Sweden is estimated at approximately 27%. Although blood pressure control has increased in Sweden, barely half of the treated patients achieved adequate blood pressure levels. It is a major risk factor for coronary heart disease and stroke as well as heart failure. MA is a key factor for good clinical outcomes in persons with hypertension.Objective: The overall aim of this study is to design, develop, test, and evaluate an adaptive digital intervention called iMedA, delivered via a mobile app to improve MA, self-care management, and blood pressure control for persons with hypertension.Methods: The study design is an interrupted time series. We will collect data on a daily basis, 14 days before, during 6 months of delivering digital interventions through the mobile app, and 14 days after. The effect will be analyzed using segmented regression analysis. The participants will be recruited in Region Halland, Sweden. The design of the digital interventions follows the just-in-time adaptive intervention framework. The primary (distal) outcome is MA, and the secondary outcome is blood pressure. The design of the digital intervention is developed based on a needs assessment process including a systematic review, focus group interviews, and a pilot study, before conducting the longitudinal interrupted time series study.Results: The focus groups of persons with hypertension have been conducted to perform the needs assessment in a Swedish context. The design and development of digital interventions are in progress, and the interventions are planned to be ready in November 2020. Then, the 2-week pilot study for usability evaluation will start, and the interrupted time series study, which we plan to start in February 2021, will follow it.Conclusions: We hypothesize that iMedA will improve medication adherence and self-care management. This study could illustrate how self-care management tools can be an additional (digital) treatment support to a clinical one without increasing burden on health care staff. © Kobra Etminani, Carina Göransson, Alexander Galozy, Margaretha Norell Pejner, Sławomir Nowaczyk.
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| 3. |
- James, Inger, 1953-, et al.
(author)
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Creating conditions for a sense of security during evenings and nights among older persons receiving home health care in ordinary housing : a participatory appreciative action and reflection study
- 2019
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In: BMC Geriatrics. - London, UK : BioMed Central (BMC). - 1471-2318. ; 19:1, s. 1-12
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Journal article (peer-reviewed)abstract
- Background: Today many older persons in ordinary housing receive home health care. It is stipulated that the care is to provide security; however, deficiencies in home health care are reported in many countries. It may be difficult to implement a sense of security among older persons receiving home health care in ordinary housing, especially during the evenings and nights, due to a lack of knowledge.Methods: This study is part of a larger project with a participatory appreciative action and reflection (PAAR) approach. We invited older persons, relatives, nurse assistants, registered nurses, and their managers to co-create knowledge with us on how conditions for a sense of security can be created during evenings and nights among older persons receiving home health care in ordinary housing. We performed thematic analysis of the data.Results: Five subthemes were developed that gave structure to two main themes. The first main theme, To confirm the self-image, has the following subthemes: To see the home as a reflection of the person’s identity and To maintain self-determination. The second main theme, To create interaction in a sheltered place, has these subthemes: To undress the power, To create control and lifelines, and To create a good sleeping environment. The two themes interact and are each other’s conditions. The person’s self-image must be confirmed in order to create interaction in a sheltered place and through the interaction, the self-image is confirmed.Conclusion: Conditions necessary for older persons to have a sense of security are living in a familiar environment, having habits and routines maintained, and having self-determination. Other conditions are equality, the prevention of falls, and an individualized sleeping environment. Older people’s self-determination should be honored, and they should not being excluded from decision-making. We need to ask them if the conditions are sufficient and their sense of security is great enough to allow them to continue living in their ordinary housing.
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| 4. |
- James, Inger, et al.
(author)
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First-line managers struggling to lead home care based on the individual's needs and goals : conflict between ethical principles
- 2024
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In: Leadership in Health Services. - : Canadian Healthcare Association. - 1751-1879 .- 1751-1887. ; 37:5, s. 84-98
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Journal article (peer-reviewed)abstract
- PURPOSE: The purpose of this paper is to describe how first-line managers (FLMs) in home care (HC) reason about the opportunities and obstacles to lead the work according to the individual's needs and goals.DESIGN/METHODOLOGY/APPROACH: In this participatory appreciative action reflection project, eight managers within one Swedish municipality were interviewed. The data were analysed using a thematic analysis.FINDINGS: The results showed a polarization between two different systems that FLMs struggle to balance when attempting to lead HC that adapts to the needs and goals of individuals. One system was represented by the possibilities of a humane system, with human capital in the form of the individual, older persons and the co-workers in HC. The second system was represented by obstacles in the form of the economic needs of the organization in which the individual receiving HC often felt forgotten. In this system, the organization's needs and goals governed, with FLMs needing to adapt to the cost-effectiveness principle and keep a balanced budget. The managers had to balance an ethical conflict of values between the human value and needs-solidarity principles, with that of the cost-effectiveness principle.ORIGINALITY/VALUE: The FLMs lack the opportunity to lead HC according to the needs and goals of the individuals receiving HC. There is a need for consensus and a value-based leadership model based on ethical principles such as the principles of human value and needs-solidarity to lead the HC according to the individual's needs and goals.
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| 5. |
- James, Inger, 1953-, et al.
(author)
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Nurse assistants' experiences and knowledge of how they create a meaningful daily life for older persons receiving municipal home healthcare
- 2024
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In: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:1, s. 159-168
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Journal article (peer-reviewed)abstract
- Aims and Objectives: To explore nurse assistants' experiences and knowledge of how they create a meaningful daily life for older people receiving municipal home healthcare.Design: A participatory appreciative action reflection approach.Methods: Interviews, participant observations and informal conversations with 23 nurse assistants in municipal home healthcare generated the data. A thematic analysis was used.Results: Two main themes were developed. The first main theme, building a reciprocal relationship, was structured by three subthemes: To strengthen the older person's self-esteem, to co-create care and to create equality. The second main theme, creating meaning, was structured by two subthemes: To create closeness and to receive appreciation. The two main themes are each other's prerequisite. Nursing assistants' building reciprocal relationships gives meaning; through the meaning, reciprocal relationships are achieved, and by that, meaningful daily lives for both the older people and the nurse assistants.Conclusion: Nurse assistants built a reciprocal relationship both for the older people and for the nurse assistant. This contributes to create a meaningful daily life for the older people. The older person was the main character, and it seems that the nurse assistants apply person-centred care, which can represent a shared common vision that can be used in the encounter.
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| 6. |
- Karlsson, Sofie, et al.
(author)
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Health Promotion Practices in Nursing for Elderly Persons in Municipal Home Care : An Integrative Literature Review
- 2020
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In: Home Health Care Management & Practice. - Thousand Oaks : Sage Publications. - 1084-8223 .- 1552-6739. ; 32:1, s. 53-61
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Journal article (peer-reviewed)abstract
- Elderly patients sometimes seek emergency services unnecessarily. Emergency clinics can be detrimental to the elderly. The purpose of this study was to find health promotion practices that enable a registered nurse in community health to reduce the need for home care clients to seek emergency care. The method of integrative literature review was used. Through health promotion work in the home, the registered nurses in community health (in conjunction with other professionals) can strengthen patients’ self-esteem and reduce their emergency care visits. Patient involvement is part of this work, and the registered nurses in community health needs to get to know patients to learn their health needs, design individual care plans, and find out whether they need education about their own health and/or health care services available to them. Registered nurses in community health experience difficulties in performing health promotion because they perceive that other tasks have higher priority. Copyright © 2019 by SAGE Publications
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| 7. |
- Karnehed, Sara, 1979-, et al.
(author)
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Developers' beliefs and values – a discursive analysis of e-health technology in home healthcare
- 2023
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Conference paper (peer-reviewed)abstract
- BackgroundThe implementation of e-health is transforming healthcare. The acknowledged benefits of digitalization are quality improvement, patient empowerment, and increased efficiency. The mobility of e-health makes it especially suitable for home healthcare. eMar is a common e-health technology used in Swedish home healthcare. Decisions about technology design are governed by developers’ perceptions of intended users. These perceptions can be identified in the description and promotion of a specific product.PurposeThe purpose of the presentation is to contribute to increased knowledge about the values entailed in a specific eMar used in Swedish home healthcare, and furthermore to discuss how these values conform with existing national missions such as people-centered care.MethodInformation consisting of sales materials about a specific eMar used in several Swedish municipalities has been analyzed through critical discourse analysis to visualize values embedded in the eMar.FindingsPreliminary results show that the provider of the specific eMar describes care in terms borrowed from the industrial sector, such as shift changes and production of care. Good and safe care is defined as the right person receiving the right medicine at the right time. Furthermore, the app is advertised as a tool for monitoring assuming that the performance of tasks can be influenced through the remote control of the employee. The eMar is described as representing new and modern technologies that are expected to raise the status of healthcare professions and facilitate the recruitment of employees.
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| 8. |
- Karnehed, Sara, 1979-, et al.
(author)
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Digital technologies in home healthcare – implications for job demands, job control, and support among healthcare professionals
- 2022
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In: Abstract Book of the 7th International Triennial Conference on Healthcare Systems Ergonomics and Patient Safety (HEPS) 2022. - Delft : Delft University of Technology. - 9789463666237 ; , s. 165-167
-
Conference paper (peer-reviewed)abstract
- Increased use of digital technologies in healthcare offers healthcare professionals multiple ways to perform tasks and interact with patients and colleagues. We used the JDCS model to identify employee´s well-being in relation to the use of an eMar. The analysis indicated that the specific technology influenced the work environment for registered nurses and nursing assistants in different ways.
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| 9. |
- Karnehed, Sara, 1979-, et al.
(author)
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Electronic medication administration record (eMAR) in Swedish home healthcare—Implications for Nurses' and nurse Assistants' Work environment : A qualitative study
- 2024
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In: Scandinavian Journal of Caring Sciences. - Chichester : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:2, s. 347-357
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Journal article (peer-reviewed)abstract
- Background: The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper-based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment. Aim: The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job-demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration. Method: We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job-demand-control-support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model. Results: NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive. Conclusion: Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare. © 2024 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.
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| 10. |
- Karnehed, Sara, 1979-, et al.
(author)
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Nurses’ Perspectives on an Electronic Medication Administration Record in Home Health Care : Qualitative Interview Study
- 2022
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In: JMIR Nursing. - Toronto : JMIR Publications. - 2562-7600. ; 5:1
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Journal article (peer-reviewed)abstract
- Background:eHealth is considered by policy makers as a prerequisite for meeting the demands of health care from the growing proportion of older people worldwide. The expectation about what the efficiency of eHealth can bring is particularly high in the municipal home health care sector, which is facing pressure regarding resources because of, for example, earlier discharges from hospitals and a growing number of patients receiving medications and treatments at home. Common eHealth services in home health care are electronic medication administration records (eMARs) that aim to communicate delegated tasks between professionals. However, there is an extensive gap in the research on how technology affects and is experienced by home health care professionals.Objective: The objective of this paper is to shed light on how home care nurses experience eMARs in a Swedish municipality.Methods: This qualitative interview study was conducted among home health care nurses using eMARs to facilitate communication and signing of delegated nursing tasks. The analysis of the interviews was performed using constructivist grounded theory, according to Charmaz.Results: Of the 19 day-employed nurses in the municipality where an eMAR was used, 16 (84%) nurses participated in the study. The following two categories were identified from the focus group interviews: nurses become monitors and slip away from the point of care. The nurses experienced that they became monitors of health care through the increased transparency provided by the eMAR and the measurands they also applied, focusing on the quantitative aspects of the delegated nursing tasks rather than the qualitative aspects. The nurses experienced that their monitoring changed the power relations between the professions, reinforcing the nurses’ superior position. The experience of the eMAR was regarded as transitioning the nurses’ professional role—away from the point of care and toward more administration—and further strengthened the way of managing work through delegation to health care assistants.Conclusions: Previous analyses of eHealth services in health care showed that implementation is a complex process that changes health care organizations and the work of health care professionals in both intended and unintended ways. This study adds to the literature by examining how users of a specific eHealth service experience its impacts on their daily work. The results indicate that the inscribed functions in an eHealth service may affect the values and priorities where the service is in use. This presents an opportunity for future research and for health care organizations to assess the impacts of specific eHealth services on health care professionals’ work and to further examine the effects of inscribed functions in relation to how they may affect actions and priorities at individual and organizational levels. ©Sara Karnehed, Lena-Karin Erlandsson, Margaretha Norell Pejner.
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| 11. |
- Kihlgren, Annica, 1957-, et al.
(author)
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Core values and local guarantees of dignity in the care of older persons – Application, obstacles and further actions
- 2020
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In: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell Publishing Inc.. - 0283-9318 .- 1471-6712. ; 35:2, s. 616-625
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Journal article (peer-reviewed)abstract
- Background and aim: Due to reported shortcomings in elderly care in Sweden, the government has introduced national guidelines to establish core values and guarantees of dignity. With a bottom-up perspective, core values and local guarantees of dignity were developed using an participatory and appreciative action and reflection (PAAR) approach and implemented in municipal elderly care. The aim of this study was to evaluate the core values and local guarantees of dignity applied by the municipal healthcare staff caring for older persons. Method and results: A cross-sectional descriptive design study using a questionnaire was conducted one year after the implementation of core values and local guarantees of dignity in municipal elderly care. In total, 608 caregivers answered the questionnaire. The results show that the caregivers strived to apply the core values and local guarantees of dignity, but experienced obstacles from the organisation. Proposals were given to facilitate further application of the core values. © 2020 Nordic College of Caring Science
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| 12. |
- Kihlgren, Annica, 1957-, et al.
(author)
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Psychometric evaluation of the Decision Support System (DSS) for municipal nurses encountering health deterioration among older adults
- 2024
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In: BMC Geriatrics. - : BMC. - 1471-2318. ; 24:1
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Journal article (peer-reviewed)abstract
- Background: A valid and reliable tool is crucial for municipal registered nurses (RNs) to make quick decisions in older adults who show rapid signs of health deterioration. The aim of this study was to investigate the psychometric properties of the Decision Support System (DSS) among older adults in the municipal healthcare system.Methods: Firstly, we utilized the Rasch dichotomous model to analyze the DSS assessments (n=281) that were collected from municipal RNs working with older adults in the municipal healthcare system. We examined the properties of the DSS in terms of its unidimensionality, item fit, and separation indices. Secondly, to investigate inter-rater agreement in using the DSS, four experienced municipal RNs used the DSS to assess 60 health deterioration scenarios presented by one human patient simulators. The 60 DSS assessments were then analyzed using the ICC (2,1), percentage agreement, and Cohen kappa statistics.Results: The sample of older adults had a mean age of 82.8 (SD 11.7). The DSS met the criteria for unidimensionality, although two items did not meet the item fit statistics when all the DSS items were analyzed together. The person separation index was 0.47, indicating a limited level of separation among the sample. The item separation index was 11.43, suggesting that the DSS has good ability to discriminate between and separate the items. At the overall DSS level, inter-rater agreements were good according to the ICC. At the individual DSS item level, the percentage agreements were 75% or above, while the Cohen kappa statistics ranged from 0.46 to 1.00.Conclusions: The Rasch analysis revealed that the psychometric properties of the instrument were acceptable, although further research with a larger sample size and more items is needed. The DSS has the potential to assist municipal RNs in making clinical decisions regarding health deterioration in older adults, thereby avoiding unnecessary emergency admistion and helping.
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| 13. |
- Kihlgren, Annica, 1957-, et al.
(author)
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We have to turn a transatlantic liner-Leaders' perspectives on creating a meaningful life for older persons receiving municipal care
- 2023
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In: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:10, s. 6836-6844
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Journal article (peer-reviewed)abstract
- Aims: To describe leaders' perspectives on what is important to create a meaningful daily life for older persons receiving municipal elderly care.Design: This study combined the Participatory Appreciative Action Reflection approach and qualitative methods.Methods: Focus Group Discussions were performed with eighty leaders that was analysed with qualitative content analysis.Results: One overall theme emerged "We have to turn a transatlantic liner". The leaders proposed a need to change from an institutional care to a more person-centered care approach on all levels of the healthcare system. This meant that everyone in the organization needed to think outside the box and find new ways to provide care to older persons. They needed to hire the right persons with the right values and knowledge. The leaders would need to provide for and support staff empowerment. There was also a need to see the older person and their relatives as co-participants.No Patient or Public Contribution.
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| 14. |
- Lindner, Helen Y, 1967-, et al.
(author)
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Person-centred care in nursing homes during the COVID-19 pandemic : a cross sectional study based on nursing staff and first-line managers' self-reported outcomes
- 2023
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In: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 22:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: COVID-19 has presented many difficulties in providing person-centred care (PCC) in nursing homes (NH). Factors such as organisational support, work condition and leadership may play a crucial role in supporting the performance of PCC during COVID restrictions. The study aim was to evaluate nursing staff and manager perceptions of the opportunities to perform person-centred care during the COVID-19 pandemic.METHODS: Nursing staff (NS) (n = 463) and First Line Managers (FLM) (n = 8) within all NHs in one community filled in the SVENIS questionnaire which consists of five areas: perceived organizational support, work climate, person-centred care, work conditions and leadership. A Kruskal-Wallis test was used to perform inter-group comparisons and standard multiple regression was used to investigate which factor contributed most to perform PCC.RESULTS: The comparison analyses indicate that staff from nursing homes for persons with dementia had the highest opportunities to perform PCC during the pandemic. The day shift staff had more opportunities to perform PCC than night shift staff. The results from the standard multiple regression show that a NA's current nursing home was the most significant variable affecting the opportunities to perform PCC. The analyses of both the comparison analyses and the regression suggest that day shift staff from nursing homes for persons with dementia had the highest opportunities to perform PCC during the pandemic. The same group also rated the importance of leadership as high for performing PCC.CONCLUSION: Despite the COVID-19 restrictions and all the criticism directed against the care of older people; the day staff felt that they conducted PCC. Staff in nursing homes for dementia had the highest opportunities for PCC and this may be because they are better prepared to provide care for the individual in NH. The importance of leadership was also evident, which means that investment in FLMs is seen as necessary.
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| 15. |
- Norell Pejner, Margaretha, 1958-, et al.
(author)
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Care priorities : Registered nurses’ clinical daily work in municipal elderly care settings
- 2012
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In: Scandinavian Journal of Caring Sciences. - Chichester : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 27:2, s. 388-395
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Journal article (peer-reviewed)abstract
- Common in Swedish elderly home care is that Registered Nurses work independently, and lead the care team without being a part of it. People involved in the care of the patient can be social services, physician, Registered Nurse (RN), nurses in inpatient care and family. Inaccording to current model for nursing documentation RNs interventions is described as participation, information/education, support, environment, general care, training, observation/surveillance, special care drug administration and coordination. Time pressure isperceived as high, but the nurses have the opportunity to influence their daily work situation and make priorities. The purpose of this study was to investigate how RNs prioritise interventions in municipal elderly care settings. A quantitative descriptive method was used for the study. Data were collected during the months of April and October 2004 – 2008, using a web-based form. The nurses filled in patient’s type of housing, performed interventions, and if the interventions were delegated. Interventions were described as keywords and wereattributed a certain amount of time, calculated in previous time studies. The inclusion criteria were: all patients 80 years of age and older, in a municipality in southwestern Sweden, who received some form of health care from a RN, or performed by non-certified staff by delegation. Results indicate that differences in priority could be observed, depending on the patient’s gender, or whether the patient was living in independent or sheltered housing. Drug administration was prioritised for female patients, while coordination became a priority for patients living in ordinary housing. Support received the highest priority, regardless if the patient lived in ordinary or sheltered housing. However, it is not entirely clear what support signifies in municipal health care settings, and this issue would therefore require further investigation. © 2012 Nordic College of Caring Science.
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| 16. |
- Norell Pejner, Margaretha, 1958-, et al.
(author)
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Dealing with today’s emotions - supportive activities for the elderly in a municipal care setting
- 2012
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Conference paper (peer-reviewed)abstract
- Background; There are diverse descriptions of supportive activities in nursing to be found in the literature. That which they have in common is their association with good care outcomes, but they may differ depending on the context in which the care is given. In a Swedish municipal elderly care setting registered nurses work in a consultative way and they describe a part of their tasks as being comprised of supportive activities without specifying what kind supportive activities they mean. Aim; The aim of the study was to explore the main concern of the support given by registered nurses to a group of patients in an elderly home care setting. Method; The study was conducted using Grounded Theory (GT). Data was collected using non participant observations regarding the supportive activities of 12 registered nurses at the home of 36 patients between 80 and 102 years. Result; The core category was about dealing with today's emotions. This was done by encouraging the situation and reducing patient's limitations, but situations also occurred in which there was a gap of support. Support was about capture the emotions that the patient expressed for the moment, but there were also situations in which registered nurses chose not to give support. Conclution; The main purpose of supportive activities to a group of elderly persons in a municipal care setting is about dealing with today's emotions. The core category reflects the moment and emotions significance in the care of elderly. In some occasions it occurred a gap of support and this coincided with the inability of the RN to identify the patient’s inner needs. In order to develop a holistic elderly care more knowledge about psychological and spiritual needs is needed.
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| 17. |
- Norell Pejner, Margaretha, 1958-, et al.
(author)
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Maintaining wellness in everyday life- supportive activities to elderly in municipal care setting
- 2011
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Conference paper (other academic/artistic)abstract
- Literature describes supportive activities in nursing in many different ways. In common they have that they are associated with good care outcomes, but may differ depending on the context in which it is given. In Swedish municipal elderly care setting registered nurses works consultative. They describes part of their tasks as supportive activities without specifying what or what kind of support that is meant and it looks as in this form of organization supportive activities expanded to not only include patients. The aim of the study was to obtain a deeper understanding of which support RN express to elderly and explore the main concern of support in municipal care setting. The study was conducted using Grounded Theory. Data was collected using non participant observations. The observations were concerning registered nurses supportive activities interacting with the patient. A total of 12 registered nurses participated in the study which was performed at the home of 36 patients between 80- 102 years. The main concern of registered nurses supportive activities was maintaining wellness in everyday life. This was made by support patient’s internal and external resources, but it also turned out to be situations where it was lack of support.
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| 18. |
- Norell Pejner, Margaretha, 1958-, et al.
(author)
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Reporting adverse events-Swedish Registered Nurses experience in a municipal home care context
- 2019
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In: Nursing Open. - Chichester : John Wiley & Sons. - 2054-1058. ; 6:2, s. 426-433
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Journal article (peer-reviewed)abstract
- Aim: To describe how Registered Nurses in a municipal home care context experience adverse event reports.Design: A qualitative design was used.Method: Twelve semistructured individual interviews with Registered Nurses in a municipal home care context were collected on two occasions and analysed with qualitative content analysis.Results: The results show that conflicts exist between being able to trust the managers and their feedback, being loyal to colleagues and retaining professional pride. These are described in the theme "Contradiction" and the three categories: "Awareness"; "Uncertainty"; and "Concealment."
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| 19. |
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| 20. |
- Norell Pejner, Margaretha, 1958-
(author)
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The bright side of life - Emotional support in elderly care
- 2014
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In: Journal of Nursing & Care. - Los Angeles : Journal of Nursing & Care. - 2167-1168. ; 3:7, s. 75-75
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Journal article (peer-reviewed)abstract
- Introduction: When older patients are in need of care the desire for help is often related to practical duties, but they also express a preference for support with the emotional difficulties that disease and illness cause. The concept of support in nursing is widely used and in nursing practice it is seldom specified which kind of support that has been performed.Aim: Aim was to explore and describe which supportive intervention registered nurses use in municipal elderly home care settings and if it is in agreement with the patient’s preferences.Methods: One retrospective descriptive study (I) were conducted and followed up by three qualitative studies using Grounded Theory as a method (II-IV). Grounded Theory allowed to explore actions/interactions and processes that occur between complex social phenomena. A process is seen as a continuous action in relation to a determinate purpose to reach a goal with a problem or a situation and actors can choose actions to influence the course of events.Data collection and sampling: I/Using a web based form describing 7053 interventions given to patients 80 years or older during the months of April and October 2004-2008. II/ Observation of 12 registered nurses supportive interventions during the home visit of 36 patients between 80 and 102 years. III/ Interviews with 16 registered nurses. IV/Interviews with 18 patients between 80 and 96 years.Results: Combined, the four studies show in a substantive theory that supportive interventions were based on patient’s preferences and guided by their emotions. The emotional support resulted in that the patient could experience serenity. Serenity is a state of relief and the moment required for the patient to be able to move forward. Patients lost or reduced ability to process their emotions makes that they get stuck in a state, which fatigue them with additional experience of disease and illness. To get out of their state the patient searched the registered nurse whose mission is to identify their needs in order that they could find relief. The theory also shows the strengths and weaknesses in the process. Emotional support should be developed as a nursing intervention and be integrated as a part of nursing.
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| 21. |
- Norell Pejner, Margaretha, 1958-
(author)
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The bright side of life Support in municipal elderly home care
- 2014
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Conference paper (peer-reviewed)abstract
- Registered nurses in municipal elderly home care have in some oc-casions difficulties in identifying the patients’ needs and prioritize intervention in accordance with the patients’ preferences. The overall aim was to explore and describe which supportive intervention regis-tered nurses use in municipal elderly home care settings and if it is in agreement with the patient’s preferences. Methods: One retrospective descriptive study (I) were conducted and followed up by three qualitative studies using Grounded Theory as a method (II-IV). Grounded Theory allow to explore actions/ interac-tions and processes that occur between complex social phenomena. A process is seen as a continuous action in relation to a determinate purpose to reach a goal with a problem or a situation and actors can choose actions to influence the course of events. Results: Combined, the four studies show in a substantive theory that supportive interventions were based on patients preferences and guided by their emotions. The aim with the emotional support was that the patient would experience serenity. Serenity is a state of relief and the moment required for the patient to be able to move forward with dignity. Patients lost or reduced ability to process their emotions makes that they get stuck in a state, which fatigue them with additional experience of disease and illness. To get out of their state the patient uses the registered nurse as a reliever whose mis-sion is to identify their needs and guide them into a state of serenity. The theory also shows the strengths and weaknesses in the process. Emotional support should be developed as a nursing intervention and be integrated as a part of nursing.
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| 22. |
- Papiol Espinosa, Geórgia, et al.
(author)
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Análisis del concepto de serenidaden relación con el apoyo psicológicoy emocional del paciente crónico : [Analysis of the concept of serenity in the emotional support of the chronic patient]
- 2020
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In: Gerokomos. - Barcelona. - 1134-928X .- 1578-164X. ; 31:2, s. 86-91
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Research review (peer-reviewed)abstract
- The aging process and chronic diseases involve vital changes in the elderly that, in many cases, involve stressful events that lead to psychological discomfort and a deterioration in the quality of life. Old age is a stage characterized by feelings of loss and decreased functional and affective abilities. Serenity is investigated as a coping strategy in relation to psychological and emotional support to improve the abilities of the elderly to face the problems or difficulties that entail the consequences of aging.Objective:To analyze the concept of serenity in relation to the psychological and emotional support of the chronic patient.Methodology:Review of the literature. The search was performed in PubMed, CINAHL, Cochrane Library, Medline. The 1999-2017 period was included, including those studies that only apply the concept of serenity for the promotion of mental health.Results:Of the 40 studies reviewed, 8 referred to aging and chronicity; 15 to affective disorders in the chronicity; 13 to emotional and psychological support in the chronically elderly patient; 4 to serenity and nursing care. Three related topics were identified: emotional support in chronicity, the concept of serenity and psychic and emotional well-being, defining attributes and levels of serenity, emotional support in chronicity.Conclusions:The serenity can represent a tool that promotes the psychic and emotional well-being of the chronic elderly patient, helping to accept and manage the health situation. Greater scientific evidence on the concept and its use in nursing professionals is necessary.
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| 23. |
- Pejner, Margaretha Norell, 1958-, et al.
(author)
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A Smart Home System for Information Sharing, Health Assessments, and Medication Self-Management for Older People : Protocol for a Mixed-Methods Study
- 2019
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In: JMIR Research Protocols. - Toronto : JMIR Publications. - 1929-0748. ; 8:4
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Journal article (peer-reviewed)abstract
- Background: Older adults often want to stay in a familiar place, such as their home, as they get older. This so-called aging in place, which may involve support from relatives or care professionals, can promote older people's independence and well-being. The combination of aging and disease, however, can lead to complex medication regimes and difficulties for care providers in correctly assessing the older person's health. In addition, the organization of health care is fragmented, which makes it difficult for health professionals to encourage older people to participate in their own care. It is also a challenge to perform adequate health assessments and to engage in appropriate communication between health care professionals.Objective: The purpose of this paper is to describe the design for an integrated home-based system that can acquire and compile health-related evidence for guidance and information-sharing among care providers and care receivers in order to support and promote medication self-management among older people.Methods: The authors used a participatory design approach for this mixed-methods project, which was divided into four phases. Phase I, Conceptualization, consists of the conceptualization of a system to support medication self-management, objective health assessments, and communication between health care professionals. Phase II, Development of a System, consists of building and bringing together the conceptualized systems from Phase I. Phase III, Pilot Study, and Phase IV, Full-Scale Intervention, are described briefly.Results: Participants in Phase I were people who were involved in some way in the care of older adults and included older adults themselves, relatives of older adults, care professionals, and industrial partners. With input from Phase I participants, we identified two relevant concepts for promoting medication self-management, both of which related to systems that participants believed could provide guidance for the older adults themselves, relatives of older adults, and care professionals. The systems will also encourage information-sharing between care providers and care receivers. The first is the concept of the Intelligent Age-Friendly Home (IAFH), defined as an integrated residential system that evolves to sense, reason, and act in response to individuals' needs, preferences, and behaviors as these change over time. The second concept is the Medication safety, Objective assessments of health-related behaviors, and Personalized medication reminders (MedOP) system, a system that would be supported by the IAFH, and which consists of three related components: one that assesses health behaviors, another that communicates health data, and a third that promotes medication self-management.Conclusions: The participants in this project were older adults, relatives of older adults, care professionals, and our industrial partners. With input from the participants, we identified two main concepts that could comprise a system for health assessment, communication, and medication self-management: the IAFH and the MedOP system. These concepts will be tested in this study to determine whether they can facilitate and promote medication self-management among older people.
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| 24. |
- Pejner, Margaretha Norell, 1958-, et al.
(author)
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Couples in Need of Home Care Services : Experiences With Support From Care Professionals
- 2018
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In: Home Health Care Management & Practice. - Thousand Oaks, CA : Sage Publications. - 1084-8223 .- 1552-6739. ; 30:3, s. 116-121
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Journal article (peer-reviewed)abstract
- Many older people desire to remain in their homes and be cared for by a family member, but this arrangement requires support from care professionals. The aim was to describe how couples in need of home care services experienced the received support from care professionals. A qualitative design with content analysis was used. Data were collected through diaries and focus groups consisting of eight couples between 65 and 80 years, and two registered nurses. The main findings are described by the following categories: Organizational adapted, Withholding, Being in a gap, resulting in the theme Lack of professional support. Couples experienced shortcomings that were related to the organization, the care professionals, and the couples themselves. The theme Lack of professional support requires more knowledge.
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| 25. |
- Pejner, Margaretha Norell, 1958-, et al.
(author)
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Older patients' in Sweden and their experience of the emotional support received from the registered nurse : a grounded theory study
- 2015
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In: Aging & Mental Health. - Abingdon, United Kingdom : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 19:1, s. 79-85
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Journal article (peer-reviewed)abstract
- Objectives: This study intends to explore older patients' experiences of the emotional support received from registered nurses (RNs). We also aimed to gain deeper knowledge about the process of how getting the support they need is managed by the patient.Methods: The study was conducted using the grounded theory method. Data were collected by interviewing 18 patients between 80 and 96 years old.Results: Reasons why older patients experienced the emotional support received from the RN are reflected in the categories 'Meets my needs when I am irresolute', 'Meets my needs when I am vulnerable' and 'Meets my needs when I am in need of sympathy'. Reasons to the emotional support resulted in that patients experienced 'A sense of being able to hand over', which is therefore the core category of this study.Conclusion: Older patients' experiences of emotional support are about obtaining relief. Patients were active participants and had strategies for which they wanted to share their emotions with the RN. In order to develop participatory care for older patients, we need more knowledge about how emotional support can be used as a nursing intervention.
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