| 1. |
- Öhlén, Joakim, 1958, et al.
(author)
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Students’ learning as the focus for shared involvement between universities and clinical practice : a didactic model for postgraduate degree projects
- 2012
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In: Advances in Health Sciences Education. - Dordrecht : Springer Netherlands. - 1382-4996 .- 1573-1677. ; 17:4, s. 471-487
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Journal article (peer-reviewed)abstract
- In an academic programme, completion of a postgraduate degree project could be a significant means of promoting student learning in evidence- and experience-based practice. In specialist nursing education, which through the European Bologna process would be raised to the master’s level, there is no tradition of including a postgraduate degree project. The aim was to develop a didactic model for specialist nursing students’ postgraduate degree projects within the second cycle of higher education (master’s level) and with a specific focus on nurturing shared involvement between universities and healthcare settings. This study embodies a participatory action research and theory-generating design founded on empirically practical try-outs. The 3-year project included five Swedish universities and related healthcare settings. A series of activities was performed and a number of data sources secured. Constant comparative analysis was applied. A didactic model is proposed for postgraduate degree projects in specialist nursing education aimed at nurturing shared involvement between universities and healthcare settings. The focus of the model is student learning in order to prepare the students for participation as specialist nurses in clinical knowledge development. The model is developed for the specialist nursing education, but it is general and could be applicable to various education programmes. © 2011 Springer Science+Business Media B.V.
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| 2. |
- German Millberg, Lena, 1958-, et al.
(author)
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Academic learning for specialist nurses: a Grounded Theory study
- 2014
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In: Nurse Education in Practice. - Oxford : Elsevier. - 1471-5953 .- 1873-5223. ; 14:6, s. 714-721
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Journal article (other academic/artistic)abstract
- The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful.
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| 3. |
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| 4. |
- Kirvalidze, Mariam, et al.
(author)
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Effectiveness of integrated person-centered interventions for older people's care : Review of Swedish experiences and experts' perspective
- 2024
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In: Journal of Internal Medicine. - : John Wiley & Sons. - 0954-6820 .- 1365-2796.
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Journal article (peer-reviewed)abstract
- Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers' scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field. image
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| 5. |
- Norbergh, Karl-Gustaf, 1950-, et al.
(author)
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Omvårdnad på avancerad nivå : kärnkompetenser inom sjuksköterskans specialistområden
- 2013
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In: Omvårdnad på avancerad nivå. - Lund : Studentlitteratur. - 9789144071459 ; , s. webb artiklar-
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Editorial collection (other academic/artistic)abstract
- Denna bok och webb är den efterfrågade och fristående fortsättningen på Omvårdnadens grunder. Redan före sin publicering har Omvårdnad på avancerad nivå varit känd för många under det lekfulla arbetsnamnet Omvårdnadens höjder. Innehållet är två sammanflätade delar: en tryckt bokdel och en digital webbdel. Den senare är helt unik i sitt slag. Ett åttiotal forskande och/eller kliniskt verksamma sjuksköterskor har skapat en digital artikelsamling som beskriver tillämpningen av avancerad omvårdnad inom respektive specialistområde. Webbmaterialet innehåller även sammanfattande ljudklipp, frågor samt den tryckta boken i sin helhet så att den kan läsas på exempelvis iPad. Detta är det första bokverket i Sverige som beskriver huvudområdet omvårdnad på avancerad nivå. Utgångspunkten är de sex kärnkompetenser som är gemensamma för alla professioner inom hälso- och sjukvården och som Svensk sjuksköterskeförening rekommenderar bör utgöra en röd tråd med progression genom utbildningarnas nivåer: Personcentrerad vård Samverkan i team Evidensbaserad vård Förbättringskunskap för kvalitetsutveckling Säker vård Informations- och kommunikationsteknologi Tillsammans bildar bok och webb ett gemensamt och mångfaldigt innehåll för specialistsjuksköterskeutbildningarna. Avsikten är att skapa en grund för dessa utbildningar och deras motsvarigheter där omvårdnad på avancerad nivå kan beskrivas och problematiseras. Instruktioner för hur du kommer åt det digitala materialet finns på omslagets insida.
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| 6. |
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| 7. |
- O'Sullivan, Anna, et al.
(author)
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Place of care and death preferences among recently bereaved family members : A cross-sectional survey
- 2024
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In: BMJ Supportive & Palliative Care. - 2045-435X .- 2045-4368.
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim was: (1) to investigate preferred place for end-of-life care and death for bereaved family members who had recently lost a person with advanced illness and (2) to investigate associations between bereaved family members' preferences and individual characteristics, health-related quality of life, as well as associations with their perception of the quality of care that the ill person had received, the ill person's preferred place of death and involvement in decision-making about care.METHODS: A cross-sectional survey with bereaved family members, employing descriptive statistics and multinominal logistic regression analyses.RESULTS: Of the 485 participants, 70.7% were women, 36.1% were ≥70 years old, 34.5% were partners and 51.8% were children of the deceased. Of the bereaved family members, 52% preferred home for place of end-of-life care and 43% for place of death. A higher likelihood of preferring inpatient palliative care was associated with being female and having higher education, whereas a lower likelihood of preferring a nursing home for the place of care and death was associated with higher secondary or higher education. Partners were more likely to prefer hospital for place of care and nursing home for place of death.CONCLUSIONS: Home was the most preferred place for end-of-life care and death. Bereaved people's experiences of end-of-life care may impact their preferences, especially if they had a close relationship, such as a partner who had a higher preference for nursing home and hospital care. Conversations about preferences for the place of care and death considering previous experience are encouraged.
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| 8. |
- Wijk, Helle, 1958, et al.
(author)
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Verksamhetsförlagd utbildning på avancerad nivå : ny utmaning för specialistutbildningar för sjuksköterskor
- 2009
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In: Vård i Norden. - København : Sjuksköterskornas samarbete i Norden. - 0107-4083 .- 1890-4238. ; 29:94, s. 41-43
-
Journal article (other academic/artistic)abstract
- The aim of this article is to discuss challenges in the development of Specialist Nursing Educations as a result of the 2007 Swedish Higher EducationReform: the implementation of the so-called Bologna process. Certain challenges follow this reform, particularly since the specialist nursingprogrammes will be part of the second cycle of the higher education system, and it will be possible to combine the professional degree witha masters degree (one year). Possible strategies in four areas related to the Specialist Nursing Education are discussed: integration of researchbasedknowledge, experienced-based knowledge, improvement knowledge, and strategies for collaboration between university institutions andclinics. Specific didactical issues are raised.
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| 9. |
- Öhlén, Joakim, 1958, et al.
(author)
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Möjligheter i ny modell för sjuksköterskors specialistutbildning
- 2018
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In: Dagens Medicin.
-
Journal article (pop. science, debate, etc.)abstract
- Det nya förslaget från utredningen om sjuksköterskors specialistutbildning är i flera stycken banbrytande och lovande, skriver forskarna Joakim Öhlén, Helle Wijk och Carina Sparud Lundin.
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| 10. |
- Alvariza, Anette, et al.
(author)
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A person-centred approach in nursing: Validity and reliability of the Carer Support Needs Assessment Tool
- 2018
-
In: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 35, s. 1-8
-
Journal article (peer-reviewed)abstract
- Purpose: The Carer Support Needs Assessment Tool (CSNAT) was developed for use among family caregivers in palliative care for assessment of their support needs. The purpose of this study was to translate and evaluate the validity and reliability of the CSNAT in a sample of Swedish family caregivers and nurses in a palliative care context. Methods: Data for this validation study was collected during 2016 in the context of palliative home care in two larger Swedish cities. The study was conducted in three stages to reach conceptual, semantic, operational and measurement equivalence between the original UK version and the Swedish version. Stage I consisted of translation to Swedish. In Stage II, cognitive interviews were performed with 8 family caregivers and 10 nurses. Data were analyzed based on relevance, clarity and sensitivity. In Stage III, the CSNAT and related self-rating measures (caregiver burden, preparedness for caregiving and quality of life) were completed by 118 family caregivers. Data quality, construct validity and test-retest reliability were evaluated. Results: The CSNAT items were considered relevant and useful to identify areas of support needs. The Swedish CSNAT showed sound psychometric properties with satisfactory data quality and few problems with missing data across items (1.8%-6.1%). All items except one correlated as expected (rho>0.3) with caregiver burden, supporting construct validity. All items had satisfactory test-retest reliability (κw=0.45-0.75). Conclusions: This study further adds to the validity of the CSNAT and shows in addition that it is reliable and stable for use among family caregivers in palliative care. © 2018 Elsevier Ltd
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| 11. |
- Alvariza, Anette, et al.
(author)
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Carer Support Needs and Quality of Life in Palliative Care: A Methodological and Empiri-cal Study
- 2019
-
In: 16th Word Congress of the European Association for Palliative Care (EAPC). Berlin, May 23-25, Abstract P01-148..
-
Conference paper (other academic/artistic)abstract
- Background: The Carer Support Needs Assessment Tool (CSNAT) was developed to identify support needs of family carers in the context of palliative care which aims to improve quality of life, not just of patients but also their families. Aims: This study aims to 1) evaluate validity and reliability of the CSNAT in a sample of Swedish family carers and nurses in a specialised palliative care context, 2) investigate associations between carer support needs and quality of life. Methods: The study was conducted in four stages I: translation of CSNAT to Swedish; II: cognitive interviews with 8 family carers and 10 nurses; III: completion of the CSNAT, Preparedness for Caregiving Scale, Caregiver Burden Scale, Quality of Life in Life Threatening Illness- Family Carer Version by 118 family carers (spouses/partners: mean age 68 years; 69 women and 45 men). Evaluation of data quality, construct validity and test-retest reliability; IV: Investigation of associations between carer support needs and qual- ity of life using linear regression analyses. Results: CSNAT items were considered relevant and useful to identify support needs and demonstrated sound psychometric properties with satisfactory data quality and few problems with missing data. All items had satisfactory test-retest reliability. Construct validity was supported, as CSNAT items correlated with caregiver burden and preparedness. Associations were found between CSNAT items and seven different domains that represent carer quality of life; carer state, patient wellbe- ing, quality of care, outlook, environment and finances. Having more support needs was associated with poorer quality of life. Conclusion: This study adds to the validity of the CSNAT and shows in addition that it is reliable and stable for use among family carers in pal- liative care. Associations between carer support needs and quality of life suggests that carers’ quality of life may be improved by acknowledging and addressing their needs for support.
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| 12. |
- Alvariza, Anette, et al.
(author)
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Omvårdnad i livets slut
- 2019
-
In: Edberg A-K & Wijk H (Red). Omvårdnadens grunder: Hälsa och ohälsa. - Lund : Studentlitteratur AB. ; , s. 707-745, s. 707-745
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Book chapter (other academic/artistic)
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| 13. |
- Andersson, B, et al.
(author)
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Being a hospice volunteer
- 2005
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In: Palliative Medicine. - 0269-2163 .- 1477-030X. ; 19, s. 602-609
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Journal article (peer-reviewed)
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| 14. |
- Andersson, Birgit, et al.
(author)
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Being a hospice volunteer
- 2005
-
In: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 19, s. 602-609
-
Journal article (peer-reviewed)abstract
- The aim of this study was to obtain an understanding of what it means to be a hospice volunteer in a country without a tradition of hospice or palliative volunteer care services. Ten volunteers from three different hospices in Sweden were interviewed. Their narratives were interpreted with a phenomenological hermeneutic method. Three themes were disclosed: motives for becoming involved in hospices, encountering the hospice and encountering the patient. The interpretations disclose a need for the volunteer to be affirmed as a caring person and received in fellowship at the hospice. Positive encounters with a hospice are closely related to personal growth. Volunteers feel rejected if their need for meaning and for belonging to the hospice is not satisfied. This shows that hospices need to set goals in terms of volunteer support, particularly regarding existential issues following the encounter with the hospice and the patient. PMID: 16450877 [PubMed - indexed for MEDLINE]
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| 15. |
- Andersson, Viktor, 1994, et al.
(author)
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Relating person-centredness to quality-of-life assessments and patient-reported outcomes in healthcare: A critical theoretical discussion
- 2022
-
In: Nursing Philosophy. - : Wiley. - 1466-7681 .- 1466-769X. ; 23:3
-
Journal article (peer-reviewed)abstract
- Engagement with the historical and theoretical underpinnings of measuring quality of life (QoL) and patient-reported outcomes (PROs) in healthcare is important. Ideas and values that shape such practices—and in the endgame, people's lives—might otherwise remain unexamined, be taken for granted or even essentialized. Our aim is to explicate and theoretically discuss the philosophical tenets underlying the practices of QoL assessment and PRO measurement in relation to the notion of person-centredness. First, we engage with the late-modern history of the concept of QoL and the act of assessing and measuring it. Working with the historical method of genealogy, we describe the development of both QoL assessments and PRO measures (PROMs) within healthcare by accounting for the contextual conditions for their possibility. In this way, the historical and philosophical underpinnings of these measurement practices are highlighted. We move on to analyse theoretical and philosophical underpinnings regarding the use of PROMs and QoL assessments in clinical practice, as demonstrated in review studies thereof. Finally, we offer a critical analysis regarding the state of theory in the literature and conclude that, although improved person-centredness is an implied driver of QoL assessments and PROMs in clinical practice, enhanced theoretical underpinning of the development of QoL assessments is called for.
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| 16. |
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| 17. |
- Anna, O'Sullivan, et al.
(author)
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Bereaved Family Members’ Satisfaction with Care during the Last Three Months of Life for People with Advanced Illness
- 2019
-
In: 16th Word Congress of the European Association for Palliative Care (EAPC). Berlin, May 23-25, Abstract P01-191.
-
Conference paper (other academic/artistic)abstract
- Background: Studies evaluating the end-of-life care for longer periods of illness trajectories and in several care places are currently lacking in the Swedish context. Aims: This study explored bereaved family members’ satisfaction with care in several care places, during the last three months of life for people with advanced illness, and associations between satisfaction with care and characteristics of the deceased persons and their family members. Methods: A retrospective cross-sectional survey design using the VOICES (SF) questionnaire, descriptive statistics and logistic regression was applied. The sample was 485 family members (age range 20-90 years, 70% women) of persons who died in hospitals in two Swedish health care regions. The deceased persons (age range 27-100) died mainly of circulatory or respiratory diseases, or malignant neoplasm. Results: Of the family members 77, 3% were satisfied with all care received during the last three months of life, when added together and rated as one. The results show variations in care satisfaction between different care places and care services; 87,2 % of the bereaved family members had a high satisfaction with care in hospices, followed by hos- pitals (85,9%), district nurses (68,9%), nursing homes (63,0%), special- ized home care (60,0%) and GPs (55,6%). Spouses were more likely to be satisfied with the care than children or other family members. Family members of deceased persons with cancer were more likely to have a higher satisfaction with the care. A lower satisfaction was more likely if the deceased person or the bereaved family member had a higher edu- cational attainment and a length of illness before death for one year or longer. Conclusions: The satisfaction with care is influenced by the care place/ type of care service, as well as by diagnoses, length of illness, educa- tional attainment and the relationship between the deceased person and the family member.
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| 18. |
- Axelsson, Lena, et al.
(author)
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Unmet Palliative Care Needs Among Patients With End-Stage Kidney Disease : A National Registry Study About the Last Week of Life
- 2018
-
In: Journal of Pain and Symptom Management. - : Elsevier. - 0885-3924 .- 1873-6513. ; 55:2, s. 236-244
-
Journal article (peer-reviewed)abstract
- Context. End-stage kidney disease (ESKD) is characterized by high physical and psychological burden, and therefore, more knowledge about the palliative care provided close to death is needed. Objectives. To describe symptom prevalence, relief, and management during the last week of life, as well as end-of-life communication, in patients with ESKD. Methods. This study was based on data from the Swedish Register of Palliative Care. Patients aged 18 or older who died from a chronic kidney disease, with or without dialysis treatment (International Classification of Diseases, Tenth Revision, Sweden; N18.5 or N18.9), during 2011 and 2012 were selected. Results. About 472 patients were included. Of six predefined symptoms, pain was the most prevalent (69%), followed by respiratory secretion (46%), anxiety (41%), confusion (30%), shortness of breath (22%), and nausea (17%). Of patients with pain and/or anxiety, 32% and 44%, respectively, were only partly relieved or not relieved at all. Of patients with the other symptoms, a majority (55%-84%) were partly relieved or not relieved at all. End-of-life discussions were reported in 41% of patients and 71% of families. A minority died in specialized palliative care: 8% in hospice/inpatient palliative care and 5% in palliative home care. Of all patients, 19% died alone. Bereavement support was offered to 38% of families. Conclusion. Even if death is expected, most patients dying with ESKD had unmet palliative care needs regarding symptom management, advance care planning, and bereavement support. (C) 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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| 19. |
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| 20. |
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| 21. |
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| 22. |
- Berg, Linda, 1961, et al.
(author)
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Characterisation of Cancer Support and Rehabilitation Programmes: A Swedish Multiple Case Study
- 2014
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In: The open nursing journal. - : Bentham Science Publishers Ltd.. - 1874-4346. ; 8, s. 1-7
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Journal article (peer-reviewed)abstract
- Cancer support and rehabilitation are suggested to be an integral part of cancer care strategies. This study focuses on comparativeness of cancer support and rehabilitation programmes. The aim of this study was to analyse available cancer support and rehabilitation programmes in Sweden presented as complementary to cancer rehabilitation at cancer clinics. A multiple case study design was chosen in order to inquire the small number of existing supportive and rehabilitative cancer programmes. Based on the structures, processes and outcomes of the nine included programmes, three types of cancer support and rehabilitation programmes were identified: multimodal rehabilitation, comprehensive cancer support and art therapy. Cancer support and rehabilitation programmes offer a variety of activities and therapies which are highly valuable and relevant for people with cancer. The typology of cancer support and rehabilitation programmes and comparability between programmes need further inquiry.
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| 23. |
- Berg, Linda, et al.
(author)
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Students’ learning as the focus for shared involvement : an action research project
- 2012
-
Conference paper (other academic/artistic)abstract
- The aim of this participatory action research project was to develop a didactic model for specialist nursing students' postgraduate degree projects within the second cycle of higher education. The specific focus was on nurturing shared involvement between universities and practice. A series of activities at five Swedish universities and their regional practice settings was performed and a number of data sources secured before proposing a model. Tensions and conflicting views during the process of change were identified. Meaningful academic learning was found as a major concern for students. The proposed didactic model is general and can be applied in various profession-oriented programmes.
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| 24. |
- Berg, Linda, 1961, et al.
(author)
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Tensions during a process of change - implementation of the Bologna educational reform in Swedish specialist nursing programmes
- 2014
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In: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 4:5, s. 64-72
-
Journal article (peer-reviewed)abstract
- Background/Objective: This study is an enquiry into the process of change during the implementation of the European educational reform, the Bologna process. The aim was to critically elaborate tensio ns during the process, focusing on the implementation of the degree project into Swedish specialist nursing programmes. Methods: Data were collected in a multi-centre participatory research project during the period August 2007 to January 2011, and consisted of memorandums kept by the project members and written vignettes from questionnaires answered by students. Eighteen faculty members from five universities, 69 male and 268 female students participated. The data were analysed according to a theoretical framework of thesis: the prevailing perspective, antithesis; a challenging perspective, and synthesis: an amalgamated perspective opening for constructive development. Main findings: The findings revealed conflicting views on research-based versus clinical development-based degree projects, and deductive versus inductive didactic development. The tensions consisted of lack of trust and confidence and were expressed as excluding and supercilious behaviour from the defenders of the traditional model. Conclusions: The implementation process, addressing conflicting views, resulted in a synthesized perspective between research and clinical development, paving the way for shared involvement between students, faculty members and clinicians in regard to the students’ degree projects.
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| 25. |
- Bergius, Anki, et al.
(author)
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Stödverksamhet för barn som förlorat en förälder : En litteraturstudie
- 2004
-
In: Vård i Norden. - : SAGE Publications. - 0107-4083 .- 1890-4238. ; 24:4, s. 41-44
-
Research review (other academic/artistic)abstract
- The aim with this literature review was to describe content, objectives, design, and outcomes of support groups for parentally bereaved children three to twelve years of age. In a support group with children in similar situation the children's thoughts, experiences and feelings will be normalised through different activities. Pedagogical methods include creative activities of different kinds, e.g. painting, writing letters and poems, reading stories, play and games. The purposes of the methods are to accept and understand the reality of the loss, to understand and work through the grieving, to enhance family communication, and to keep the memory of the death and go on living. Organisation and structure are described in relation to development levels and ages of children and youths. Outcomes of groups are characterized by clinical observations and a dearth of evaluative studies. All bereaved children should have the opportunity to participate in a support group when a parent, sibling or other relative dies. Well developed services for bereaved children should be a matter of health care policy and quality.
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| 26. |
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| 27. |
- Berndtsson, Inger, 1957, et al.
(author)
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Issues about thinking phenomenologically while doing phenomenology
- 2007
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In: Journal of Phenomenological Psychology. - : Brill Academic Publishers. - 0047-2662 .- 1569-1624. ; 38:2, s. 256-277
-
Journal article (peer-reviewed)abstract
- This methodological article explores issues related to having the ontological ground for phenomenological empirical research present throughout the research process. We discuss how ontology needs to be taken into consideration regarding the phenomena to be studied and how ontological aspects of phenomena need to be highlighted during various data collection and analysis procedures. Here, we discuss how philosophical works can be used in the context of specific research projects. In illustrating our statements, we present four empirical examples connected to the themes of life changes and learning processes with the purpose of exemplifying and discussing how general lifeworld ontology can be integrated as an active resource in empirical phenomenological research.
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| 28. |
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| 29. |
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| 30. |
- Böling, Susanna, et al.
(author)
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No ordinary consultation : a qualitative inquiry of hospital palliative care consultation services
- 2020
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In: Journal of Health Organization and Management. - : Emerald Group Publishing Limited. - 1477-7266. ; 34:6, s. 621-638
-
Journal article (peer-reviewed)abstract
- Purpose – Considering the great need for palliative care in hospitals, it is essential for hospital staff to havepalliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care.However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need forfurther knowledge about the process of palliative consultations. The purpose of this study therefore was toexamine how palliative consultations in hospitals are practised, as perceived by consultants and health careprofessionals on receiving wards.Design/methodology/approach – Focus groups with palliative care consultation services, health carepersonnel from receiving wards and managers of consultation services. Interpretive description and constantcomparative method guided the analysis.No ordinaryconsultationThe authors would like to thank participating colleagues for sharing their knowledge and experiencesabout palliative consultations.Ethics approval and consent to participate: The project received ethical approval from the SwedishEthical Review Authority, No. 809–16. Informed consent preceded participation for all of the participants.Consent for publication: Not applicable.Availability of data and material: The datasets generated and analysed during the current study are notpublicly available due to the inclusion of potentially sensitive individual data about health status. Theethical approval includes a statement that the data will be kept in a private repository but are availablefromthe corresponding author on reasonable request.Funding: Sahlgrenska Academy at the University of Gothenburg.Authors' contributions: JO, HB and JB planned the study. All authors conducted focus group €interviews. Analysis and interpretation of focus group data was performed by SB with support from JO, €HB and JB. SB wrote the first draft of the manuscript, JO, HB and JB commented on the manuscript and €contributed to the final version. The final manuscript was read and approved by all authors.Competing interests: The authors declare that they have no competing interests.The current issue and full text archive of this journal is available on Emerald Insight at:https://www.emerald.com/insight/1477-7266.htmReceived 14 April 2020Revised 24 June 2020Accepted 2 July 2020Journal of Health Organization andManagement© Emerald Publishing Limited1477-7266DOI 10.1108/JHOM-04-2020-0130Findings – Variations were seen in several aspects of practice, including approach to practice and representedprofessions. The palliative consultants were perceived to contribute by creating space for palliative care,adding palliative knowledge and approach, enhancing cooperation and creating opportunity to amelioratetransition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultationservices utilised proactive practices that took the initiative in relation to the receiving wards.Originality/value – A lack of policy and divergent views on how to conceptualise palliative care appeared tobe associated with variations in consultation practices, tentative approaches and a bottom-up drivendevelopment. This study adds knowledge, implying theoretical transferability as to how palliative careconsultations can be practised, which is useful when designing and starting new consultation services.
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| 31. |
- Böling, Susanna, et al.
(author)
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Rethinking Consultation - Investigating the Perceived Work Models of a Palliative Consultation Team
- 2018
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In: Palliative Medicine : A Multiprofessional Journal. Vol. 32, Suppl. 1. Abstract PO38. - : SAGE Publications. - 0269-2163 .- 1477-030X.
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Conference paper (other academic/artistic)abstract
- Background: Previous research has shown that palliative consultation in hospital contexts sometimes face multifaceted challenges. Possibly creat- ing barriers between the consulting team and patients in need of palliative care. Hence, there is a need to consider how we implement and perform palliative consultation to inform future initiatives. This study is part of an ongoing project with the aim to analyse the discourse around implement- ing palliative care in a hospital context. Aim: The aim of this study was to identify and analyse various work models applied in a hospital context by a palliative consultation team. Method: Repeated focus group discussions with a palliative consultation team and its managers. A total of six focus group discussions were held from April 2016 to June 2017. The focus groups were audio recorded and transcribed verbatim. The data was read and analysed; identifying and categorising different work models. Result: According to what was expressed in the focus groups there were variations in how the consultation team operated in different hospital units and wards. Consulting as a team, consisting of a nurse, social worker and physician, was emphasised. One of the significant features was that they visited several wards on a weekly basis without receiving formal referrals beforehand. Although varying in form, the visits shared the function of being a forum for the wards to raise questions regarding palliative care relating to specific patients with palliative needs. Furthermore, during the introduction of consultation in some of the wards, the consultation team chose to designate time where a nurse from the team were present in the ward and among other things; identified patients with palliative care needs together with the ward staff and paved the way for the weekly palliative consultation.
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| 32. |
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| 33. |
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| 34. |
- Carling Elofsson, Linnea, et al.
(author)
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Meanings of being old and living with chronic obstructive pulmonary disease
- 2004
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In: PALLIATIVE MEDICINE. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 18:7, s. 611-618
-
Journal article (peer-reviewed)abstract
- The aim of this study was to achieve a deeper understanding of the meaning of the lived experiences of elderly persons who are severely ill with chronic obstructive pulmonary disease (COPD) and in need of everyday care. Narratives from dialogues with six persons were interpreted using phenomenological–hermeneutic methodology. The structural analyses showed severe problems in daily life due to old age with a decaying body and dialectic experiences of resignation–contentedness, loneliness–connectedness, and being homeless–being at home. The interpreted whole reveals that life, suffering and comfort must be understood as an interlaced experience where ageing is just as important as the experience of illness. These elderly people's concerns and problems due to old age, a decaying body and being severely ill with COPD call for palliative and comfort care and thus challenge all professionals involved in their care.
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| 35. |
- Carlsson, Eva, 1959, et al.
(author)
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Development and validation of the preparedness for Colorectal Cancer Surgery Questionnaire: PCSQ-pre 24
- 2016
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In: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 25, s. 24-32
-
Journal article (peer-reviewed)abstract
- Purpose The aims of the study were to develop and psychometrically evaluate a patient-reported outcome instrument for the measurement of preoperative preparedness in patients undergoing surgery for colorectal cancer. Methods This study was conducted in two stages: a) instrument development (item generation, construction of items and domains), empirical verification and b) instrument evaluation. A questionnaire with 28 items measuring preparedness for surgery was developed covering four domains and was tested for content validity with an expert panel and with patients. Psychometric testing of the questionnaire was conducted on 240 patients undergoing elective surgery for colorectal cancer. Results The scale content validity index of the preparedness items was 0.97. The final version consisted of 24 items measuring 4 subscales: Searching for and making use of information, Understanding and involvement in the care process, Making sense of the recovery process and Support and access to medical care. Confirmatory factor analysis revealed good model fit with standardized factor loadings ranging from 0.58 to 0.97. A well-fitting second-order factor model provided support for a total preparedness score with second-order factor loadings ranging from 0.75 to 0.93. The ordinal alpha values of the four latent factors ranged from 0.92 to 0.96, indicating good internal consistency. The polyserial correlations with the total score were 0.64 (p<0.01) for the overall preparedness question and 0.37 (p<0.01) for overall well-being. Conclusion The Swedish Preparedness for Colorectal Cancer Surgery Questionnaire for use in the preoperative phase demonstrated good psychometric properties based on a sound conceptualization of preparedness. © 2016 Elsevier Ltd
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| 36. |
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| 37. |
- Carlsson, Eva, 1959, et al.
(author)
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Structure and content in consultations with patients undergoing surgery for colorectal cancer
- 2013
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In: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 17:6, s. 820-826
-
Journal article (peer-reviewed)abstract
- Purpose: To explore the structure and content of pre-planned consultations as part of the care and treatment of patients undergoing surgery for colorectal cancer. Methods: The study was based on 50 transcripts of audio-recorded pre-planned consultations between seven patients and 36 healthcare professionals from the time of diagnosis, pre-operative consultation, discharge consultation and pathology report in a colorectal unit. Results: The spread of consultation time between professions was considerable. Total mean consultation time for patients during the care process (7 consultations/patient) was 111 mm (range 83-191). The mean consultation time for surgeons was 18 min (7-40), anaesthesiologists 12 min (5-18) and nurses 14 min (5-49). Patients took up 40% of the word space, healthcare professionals used 59% and significant others 1%. Word space changed in such a way that the patient became more active towards the final consultation. Neither during the diagnosis consultation nor during the pre-operative consultation did the patients meet the operating surgeon. Six major subjects emerged: general health, diagnosis, surgical procedure, pre-operative preparations, recovery and treatment and follow-up. Conclusions: There is a need for clearer structure in the consultations. Most consultations lacked a clear introduction to the subject of the conversation. The study makes it possible to develop methods and structure for supporting conversations in which the patient is given space to help with the difficult issues present after undergoing surgery for colorectal cancer. The study also contributes to providing knowledge of how to organise surgical consultations in order to optimise person-centeredness, teamwork and clinical efficiency. (C) 2013 Elsevier Ltd. All rights reserved.
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| 38. |
- Diffin, Janet, et al.
(author)
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Person-Centred Care: Principles and Practice Barriers (oral presentation). In: Enabling Person-Centred Care for Palliative Care Patients and Their Informal Carers: Definitions, Models of Practice and Implementation; invited session (Gunn Grande & Gail Ewing, moderators)
- 2019
-
In: 16th Word Congress of the European Association for Palliative Care (EAPC). Berlin, May 23-25, Abstract PS16. Palliative Medicine, vol. 33, issue 1. - : SAGE Publications. - 0269-2163 .- 1477-030X.
-
Conference paper (other academic/artistic)abstract
- Aim: Barriers to the implementation of person-centred care within pal- liative care practice have been identified for patients and family carers. A shared understanding of (i) the principles of person-centred care, and (ii) how to successfully implement person-centred interventions is there- fore required. This paper aims to to define the key principles of person- centred care and identify barriers and enablers to implementation success within palliative care practice. Methods: This paper brings together the international evidence on person-centred care, and reviews the enablers and barriers to imple- mentation within palliative care practice. It will draw on the experi- ences of the development of person-centred care practice and the implementation of the Carer Support Needs Assessment Tool inter- vention, a person-centred process of assessment and support for fam- ily carers. Results: Person-centred care is characterised by practitioners initiat- ing, working through and safeguarding a partnership ‘with’ patients and/or family carers. As such, a change in practice from a practi- tioner-led approach, to one which is led by a patient/family carer is often required. Implementation barriers at the individual level include viewing a person-centred approach as an ‘add-on’ to existing practice, and at the organisational level include a lack of managerial support and protected time. Training is therefore required for the individual practitioner to help them integrate this approach into their everyday practice, and for the organisation to ensure adequate prep- aration, and the establishment of a strategy to support implementa- tion. A team of practitioners within the organisation is needed to drive this implementation planning and ensure organisational readi- ness for change. Conclusions: The evidence presented provides vital lessons learned for implementation of person-centred interventions for patients or family carers within palliative care practice.
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| 39. |
- Ekman, Inger, 1952, et al.
(author)
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Person-centered care -ready for prime time.
- 2011
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In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:4, s. 248-251
-
Journal article (peer-reviewed)abstract
- Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.
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| 40. |
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| 41. |
- Elofsson Carling, Linnéa, et al.
(author)
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Meanings of living with chronic obstructive pulmonary disease in old age
- 2004
-
In: Palliative Medicine. - 0269-2163. ; 8, s. 611-18
-
Journal article (peer-reviewed)abstract
- The aim of this study was to achieve a deeper understanding of the meaning of the lived experiences of elderly persons who are severely ill with chronic obstructive pulmonary disease (COPD) and in need of everyday care. Narratives from dialogues with six persons were interpreted using phenomenological-hermeneutic methodology. The structural analyses showed severe problems in daily life due to old age with a decaying body and dialectic experiences of resignation-contentedness, loneliness-connectedness, and being homeless-being at home. The interpreted whole reveals that life, suffering and comfort must be understood as an interlaced experience where ageing is just as important as the experience of illness. These elderly people's concerns and problems due to old age, a decaying body and being severely ill with COPD call for palliative and comfort care and thus challenge all professionals involved in their care.
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| 42. |
- Falk, Hanna, 1977, et al.
(author)
-
Differences in Symptom Distress Based on Gender and Palliative Care Designation Among Hospitalized Patients.
- 2016
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In: Journal of Nursing Scholarship. - : Wiley. - 1527-6546 .- 1547-5069. ; 48:6, s. 569-576
-
Journal article (peer-reviewed)abstract
- PURPOSE: To explore patient-reported symptom distress in relation to documentation of symptoms and palliative care designation in hospital inpatients.DESIGN: This cross-sectional study analyzed data from 710 inpatients at two large hospitals in Sweden using the Edmonton Symptom Assessment Scale and the Memorial Symptom Assessment Scale. Chart reviews focused on nurses' and physicians' symptom documentation and palliative turning point.METHODS: Descriptive statistics were calculated for all variables and provided summaries about the sample. Patients were grouped according to gender, age, palliative care designation, and symptom documentation. The t test and chi-square test were used to calculate whether symptom distress varied between groups. A two-way analysis of variance was conducted for multiple comparisons to explore the impact of gender and age on mean symptom distress.FINDINGS: Females reported higher levels of symptom distress than did males related to pain, fatigue, and nausea. When comparing symptom distress between males and females with documentation pertaining to symptoms, there were significant differences implying that females had to report higher levels of symptom distress than males in order to have their symptoms documented.CONCLUSIONS: Females need to report higher levels of symptom distress than do males for healthcare professionals to identify and document their symptoms. It can be hypothesized that females are not receiving the same attention and symptom alleviation as men. If so, this highlights a serious inequality in care that requires further exploration.CLINICAL RELEVANCE: Considering that common reasons why people seek health care are troublesome symptoms of illness, and that the clinical and demographic characteristics of inpatients are changing towards more advanced ages with serious illnesses, inadequate symptom assessment and management are a serious threat to the care quality.
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| 43. |
- Feldthusen, Caroline, 1977, et al.
(author)
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Centredness in health care: A systematic overview of reviews
- 2022
-
In: Health Expectations. - : Wiley. - 1369-6513 .- 1369-7625. ; 25:3, s. 885-901
-
Journal article (peer-reviewed)abstract
- Introduction The introduction of effective, evidence-based approaches to centredness in health care is hindered by the fact that research results are not easily accessible. This is partly due to the large volume of publications available and because the field is closely linked to and in some ways encompasses adjoining fields of research, for example, shared decision making and narrative medicine. In an attempt to survey the field of centredness in health care, a systematic overview of reviews was conducted with the purpose of illuminating how centredness in health care is presented in current reviews. Methods Searches for relevant reviews were conducted in the databases PubMed, Scopus, Cinahl, PsychINFO, Web of Science and EMBASE using terms connected to centredness in health care. Filters specific to review studies of all types and for inclusion of only English language results as well as a time frame of January 2017-December 2018, were applied. Results The search strategy identified 3697 unique reviews, of which 31 were included in the study. The synthesis of the results from the 31 reviews identified three interrelated main themes: Attributes of centredness (what centredness is), Translation from theory into practice (how centredness is done) and Evaluation of effects (possible ways of measuring effects of centredness). Three main attributes of centeredness found were: being unique, being heard and shared responsibility. Aspects involved in translating theory into practice were sufficient prerequisites, strategies for action and tools used in safeguarding practice. Further, a variety and breadth of measures of effects were found in the included reviews. Conclusions Our synthesis demonstrates that current synthesized research literature on centredness in health care is broad, as it focuses both on explorations of the conceptual basis and the practice, as well as measures of effects. This study provides an understanding of the commonalities identified in the reviews on centredness in healthcare overall, ranging from theory to practice and from practice to evaluation. Patient or Public Contribution Patient representatives were involved during the initiation of the project and in decisions about its focus, although no patient or public representatives made direct contributions to the review process.
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| 44. |
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| 45. |
- Forsgren, Emma, 1982, et al.
(author)
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The use of text-mining software to facilitate screening of literature on centredness in health care.
- 2023
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In: Systematic Reviews. - 2046-4053. ; 12:1
-
Journal article (peer-reviewed)abstract
- Research evidence supporting the implementation of centredness in health care is not easily accessible due to the sheer amount of literature available and the diversity in terminology and conceptualisations used. The use of text-mining functions to semi-automate the process of screening and collating citations for a review is a way of tackling the vast amount of research citations available today. There are several programmes that use text-mining functions to facilitate screening and data extraction for systematic reviews. However, the suitability of these programmes for reviews on broad topics of research, as well as the general uptake by researchers, is unclear. This commentary has a dual aim, which consists in outlining the challenges of screening literature in fields characterised by vague and overlapping conceptualisations, and to exemplify this by exploratory use of text-mining in the context of a scoping review on centredness in health care.
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| 46. |
- Friberg, Febe, 1950, et al.
(author)
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Communicating bodily changes : Physicians' ways of enabling patient understanding in gastrointestinal cancer consultations
- 2015
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In: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; 13:03, s. 661-671
-
Journal article (peer-reviewed)abstract
- Objective: To explore how physicians communicatively enable patients' understanding of bodily changes in gastrointestinal cancer care consultations.Method: Two datasets were used. The first consisted of transcribed video-recorded palliative care consultations with three oncologists and six patients diagnosed with advanced gastrointestinal cancer, in the context of outpatient palliative care. The second dataset was audio-recorded transcriptions from diagnostic consultations with six surgeons and seven patients diagnosed with colorectal cancer, in the context of cancer surgery. An inductively driven and iterative analysis of interaction was performed, guided by Wetherell et al. (2001).Results: Two overarching communicative strategies were identified: (1) “visualizing strategies,” with the dimensions: visible strategies (visualizing with what you actually or potentially can see), sensory strategies (visualizing with what is possible to feel), and imaginative strategies; and (2) “contrasting strategies,” with the dimensions: contrasting subjective experiences and contrasting between the patient and other people.Significance of results: The visualizing and contrasting communicative strategies form parts of physicians' tacit and experience-based knowledge. The strategies employed by physicians reveal clear potentials to enable patients' understanding and sense making of bodily changes. However, these strategies need to be explicated and problematized as parts of both consultation practice and basic medical education. By means of increased awareness, physicians can more easily identify turning points in patients' levels of understanding, thereby enriching ordinary medical consultations with reflected pedagogical strategies and skills in how to dialogue in a person-centered manner.
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| 47. |
- Friberg, Febe, 1950, et al.
(author)
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Context and methodological decontextualisation in nursing research with examples from phenomenography
- 2000
-
In: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 14, s. 37-43
-
Journal article (peer-reviewed)abstract
- In both human science and nursing research the concept of context is important. However, context can be understood in different ways. The aim of this article is to elucidate, discuss and problematize context, decontextualization and recontextualization in some health care-related phenomenographical studies. A further aim is to problematize the concept of context in a wider perspective of human science, in order to gain a better understanding of phenomenographical research related to nursing care. Our analysis indicates that the complex phenomena which characterize nursing research demand a broad contextual understanding. Both the local or immediate context and the global or mediated context must be considered, as they are dialectically related. This includes the informants' experiences of the phenomenon of interest as well as the socio-cultural discourse. A balance between openness and pliability to the phenomenon is suggested. Reflection is considered an important tool in this process. Within phenomenography, the interest is directed towards conceptions of certain aspects of the world. Thus, context in a wider sense is given a subordinate role. Accordingly, phenomenography is considered to have limited applicability in nursing research when complex phenomena are to be studied. PMID: 12035261 [PubMed - indexed for MEDLINE]
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| 48. |
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| 49. |
- Friberg, Febe, 1950, et al.
(author)
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Creating space for learning at oncology outpatient units.
- 2008
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In: The Fourth Pan-Pacific Nuring Conference. The Sixth Hong-Kong Nursing Symposium on Cancer Care. Managing Chronic Illness: Challenges and Opportunities for Nursing Practice and research, 13-15 November 2008. Hong Kong.
-
Conference paper (peer-reviewed)
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| 50. |
- Friberg, Febe, 1950, et al.
(author)
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Developing Clinical Communication Intervention: Merging Qualitative Results from Patients with Palliative Cancer Care Teams Professional Experience by means of Qualitative Outcome Analysis
- 2010
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In: 18 th Congress on Palliative Care. October 5-8 2010 Montreal, Canada.
-
Conference paper (other academic/artistic)abstract
- Recent decades have witnessed the development of qualitative methods as well as intense debate concerning the significance of methodological rigor. Although qualitative research has become an established part of palliative care, questions have been raised concerning how results can inform practice. Qualitative Outcome Analysis (QOA) is a method derived from qualitative research that allows interventions to be evaluated and that bridges the theory-practice gap on the path from knowledge generation to knowledge implementation. The aim is to describe QOA by means of examples from an ongoing project about communication in palliative cancer care and on the basis of our results from phenomenological and conversational analysis studies of person centred information in palliative care for patients with recurrent gastrointestinal cancer. The participatory dimensions identified in the project will be related to QOA procedures. Focus groups with the palliative care team at an oncology outpatient unit were held, and major results from previous studies in the project were used as facilitators for discussion and reflection on the team’s professional experiences. In this way patient-reported qualitative findings were merged with professionals’ experience. Group discussion data were analyzed concurrently. A preliminary clinical intervention model was developed and refined by means of small scale clinical tests conducted by the team as well as other focus groups made up of different palliative care teams. The tentative model of communication in palliative cancer care for patients with gastrointestinal cancer will be presented, including main concepts, strategies and outcomes. The applicability of QOA will be presented. A particular dimension identified in the process was participatory aspects related to the shared commitment between the clinicians and the researchers. Such participatory aspects will be elaborated upon and related to the Participatory Action Research tradition. Implications of the model and relating QOA to Participatory Action Research will be reflected upon.
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