1. |
- Alm Mårtensson, Anna, et al.
(author)
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Ansvarsområden för olika samhällsfunktioner
- 2022
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In: Äldre personers utsatthet för våld i nära relationer. - Lund : Studentlitteratur AB. - 9789144155142 ; , s. 91-112
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Book chapter (other academic/artistic)
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2. |
- Alm Mårtensson, Anna, et al.
(author)
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Ansvarsområden för olika samhällsfunktioner
- 2022
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In: Äldre personers utsatthet för våld i nära relationer. - : Studentlitteratur AB. - 9789144155142 ; , s. 91-112
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Book chapter (other academic/artistic)abstract
- Frågor om våld i nära relationer är numera vanligt förekommande i media, politiska debatter, offentliga utredningar och lagändringar. Men trots detta uppmärksammas sällan äldre personers utsatthet för våld. Anledningarna kan vara flera, men tanken på att äldre kan utsättas för våld i en nära relation är för många avlägsen.Äldre personers utsatthet för våld i nära relationer vill synliggöra att olika typer av våld förekommer mot och bland äldre personer. Men det allra viktigaste är att ge kunskap om hur omgivningen kan uppmärksamma detta och förhindra våld, samt ge hjälp och stöd. Boken belyser det ansvar som olika myndigheter, såsom socialtjänst, hälso- och sjukvård samt tandvård, har. Ett kapitel beskriver rättsprocessen vid en anmälan och ett annat belyser vilka svårigheter en äldre person kan ha när det gäller att söka hjälp och att bryta upp från en relation. Flera kapitel innehåller konkreta råd för hur exempelvis personal kan ge hjälp och stöd.Äldre personers utsatthet för våld i nära relationer är i första hand skriven för högskoleutbildningar inom socialt arbete, vård, omsorg och medicin. Boken kan också vara till nytta för alla som vill öka sin kunskap om äldre personers utsatthet för våld i nära relationer.
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3. |
- Blomberg, Karin, 1970-, et al.
(author)
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Translating the Patient Dignity Inventory
- 2019
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In: International Journal of Palliative Nursing. - : Pensord Press Ltd.. - 1357-6321 .- 2052-286X. ; 25:7, s. 334-343
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Journal article (peer-reviewed)abstract
- BACKGROUND: The Patient Dignity Inventory (PDI) is based on an empirically-driven dignity model that has been developed and used for clinically assessing the various sources of dignity-related distress. In a recent review, it received the highest score as a useful instrument in both practice and research in palliative care. The PDI has been adapted to and validated for use in various countries, but not yet Sweden.AIMS: To translate the PDI into Swedish, including cultural adaptation for clinical use.METHODS: A multi-step process of translation, negotiated consensus, expert group discussion (n=7: four invited experts and three researchers) and cognitive interviewing (n=7: persons with palliative care needs).FINDINGS: Discussion, by the expert reviewers, of both linguistic and cultural issues regarding the content and readability of the translated Swedish version resulted in revisions of items and response alternatives, focusing mainly on semantic, conceptual, and experiential equivalence. A pilot version for cognitive interviews was produced. The analysis of data showed that most of the items were judged to be relevant by the persons with palliative care needs.CONCLUSION: The process of translation and adaptation added clarity and consistency. The Swedish version of the PDI can be used in assessing dignity-related distress. The next step will be to test this Swedish version for psychometric properties in a larger group of patients with palliative care needs before use in research.
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4. |
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5. |
- Browall, Maria, et al.
(author)
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The course of health related quality of life in postmenopausal women with breast cancer from breast surgery and up to five years post-treatment
- 2013
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In: Breast. - : Elsevier. - 0960-9776 .- 1532-3080. ; 49, s. S344-S345
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Journal article (peer-reviewed)abstract
- Background: Previous studies include too few patients over 70 years to be able to assess treatment effects on Health Related Quality Of Life (HRQOL) in the older age group. We aimed to follow HRQOL in postmenopausal women (55-80 years) with breast cancer receiving adjuvant treatment, until five years post-treatment, and compare with a general population.Patients and methods: The patient sample included 150 women (adjuvant CT n=75 and RT n=75) and two reference samples from the Swedish SF-36 norm database.Results: Data from baseline showed significantly higher levels of physical functioning and general health among the patients compared to the reference sample, and significantly lower levels of bodily pain, emotional role functioning and mental health. Longitudinal analyses showed significant changes in all scales, and three different patterns (a decrease-stable, a decrease-increase, and a stable- increase pattern) were identified.Conclusion: Postmenopausal women seem to successfully manage the effects of adjuvant treatment on HRQOL.
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6. |
- Browall, Maria, et al.
(author)
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The course of health related quality of life in postmenopausal women with breast cancer from breast surgery and up to five years post-treatment
- 2013
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In: European Journal of Cancer. - Oxon, United Kingdom : Elsevier. - 0959-8049 .- 1879-0852. ; 49, s. S344-S345
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Journal article (peer-reviewed)abstract
- Background: Cancer treatment of the elderly patients is an increasingly important concern since the risk for developing breast cancer increases with age. The effects of adjuvant chemotherapy on the breast cancer disease seem to be as good for pre and postmenopausal patients, at least for hormone receptor negative patients. However, very few patients older than 65 years are included in randomised studies. In clinical practice, it is common that elderly women are offered less chemotherapy, because of the unsubstantiated belief that they will experience a larger number and more severe adverse effects as well as poor functional outcomes and significant decrements in health related quality of life (HRQOL). The aim of this study was to follow HRQOL in postmenopausal women (55−80 years) with breast cancer receiving adjuvant treatment after surgery, until five years post-treatment, and compare with a general population.Patients and Methods: The patient sample included 150 women (adjuvant CT n = 75 and RT n = 75) and two reference samples from the Swedish SF- 36 norm database.Results: The results showed that at baseline the women in the patient sample experienced significantly higher levels of physical functioning and general health compared to the general population. They also experienced significantly less bodily pain, lower emotional role functioning and mental health. Five years after completion of treatment, the patient sample experienced better HRQOL than the reference sample in all domains, supporting our hypothesis that the impact on HRQOL would have been resolved over time for these patients. Conclusion: Postmenopausal women (55−80 years) seem to successfully manage the effects of adjuvant treatment on HRQOL.
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7. |
- Brown, Hilary, et al.
(author)
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Identifying care actions to conserve dignity in end-of-life care.
- 2011
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In: British Journal of Community Nursing. - : Mark Allen Group. - 1462-4753 .- 2052-2215. ; 16:5, s. 238-45
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Journal article (peer-reviewed)abstract
- Community nurses have a central role in the provision of palliative and end-of-life care; helping people to die with dignity is an important component of this care. To conserve dignity, care should comprise a broad range of actions addressing the distress that might impact on the patient's sense of dignity. These care actions need to be defined. This study aims to suggest care actions that conserve dignity at the end of life based on evidence from local experience and community nursing practice. Data were collected by focus group interviews and analysed by framework analysis using the Chochinov model of dignity as a predefined framework. Suggestions on care actions were given in relation to all themes. As part of a multi-phase project developing and testing a dignity care pathway, this study might help community nurses to conserve dying patients' dignity.
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8. |
- Bylund-Grenklo, Tove, et al.
(author)
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Dignity in life and care : The perspectives of Swedish patients in a palliative care context
- 2019
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In: International Journal of Palliative Nursing. - : MA Healthcare Ltd. - 1357-6321 .- 2052-286X. ; 25:4, s. 193-201
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Journal article (peer-reviewed)abstract
- Background: How patients preserve their sense of dignity in life is an important area of palliative care that remains to be explored. Aims: To describe patients' perspectives of what constitutes a dignified life within a palliative care context. Methods: Twelve palliative care patients were interviewed about their views on living with dignity. Data were analysed using qualitative content analysis. Results: What constitutes a dignified life during end-of-life care was captured by the theme 'I may be ill but I am still a human being' and presented under the categories 'preserving my everyday life and personhood', 'having my human value maintained by others through 'coherence' and 'being supported by society at large'. Conclusion: Patients' sense of dignity can be preserved by their own attitudes and behaviours, by others and through public support. Health professionals need to adopt a dignity-conserving approach, for which awareness of their own attitudes and behaviours is crucial.
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9. |
- Campbell, Pauline, et al.
(author)
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Recognizing European cancer nursing: Protocol for a systematic review and meta-analysis of the evidence of effectiveness and value of cancer nursing
- 2017
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In: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 73, s. 3144-3153
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Journal article (peer-reviewed)abstract
- Aim: To identify, appraise and synthesize the available evidence relating to the value and impact of cancer nursing on patient experience and outcomes.Background: There is a growing body of literature that recognizes the importance and contribution of cancer nurses, however, a comprehensive review examining how cancer nurses have an impact on care quality, patient outcomes and overall experience of cancer, as well as cost of services across the entire cancer spectrum is lacking.Design: A systematic review and meta-analysis using Cochrane methods.Methods: We will systematically search 10 electronic databases from 2000, with pre-determined search terms. No language restrictions will be applied. We will include all randomized and controlled before-and-after studies that compare cancer nursing interventions to a standard care or no intervention. Two reviewers will independently assess the eligibility of the studies and appraise methodological quality using the Cochrane Risk of Bias tool. Disagreements will be resolved by discussion and may involve a third reviewer if necessary. Data from included studies will be extracted in accordance with the Template for intervention Description and Replication reporting guidelines. Missing data will be actively sought from all trialists. Data will be synthesized in evidence tables and narrative to answer three key questions. If sufficient data are available, we will perform meta-analyses.Discussion: This review will allow us to systematically assess the impact of cancer nursing on patient care and experience. This evidence will be used to determine implications for clinical practice and used to inform future programme and policy decisions in Europe.
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10. |
- Charalambous, Andreas, et al.
(author)
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A scoping review of trials of interventions led or delivered by cancer nurses
- 2018
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In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 86, s. 36-43
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Journal article (peer-reviewed)abstract
- BACKGROUND: Advances in research and technology coupled with an increased cancer incidence and prevalence have resulted in significant expansion of cancer nurse role, in order to meet the growing demands and expectations of people affected by cancer (PABC). Cancer nurses are also tasked with delivering an increasing number of complex interventions as a result of ongoing clinical trials in cancer research. However much of this innovation is undocumented, and we have little insight about the nature of novel interventions currently being designed or delivered by cancer nurses.OBJECTIVES: To identify and synthesise the available evidence from clinical trials on interventions delivered or facilitated by cancer nurses.DATA SOURCES AND REVIEW METHODS: A systematic review of randomised controlled trials (RCT), quasi-RCTs and controlled before and after studies (CBA) of cancer nursing interventions aimed at improving the experience and outcomes of PABC. Ten electronic databases (CENTRAL, MEDLINE, AMED, CINAHL, EMBASE, Epistemonikos, CDSR, DARE, HTA, WHO ICTRP) were searched between 01 January 2000 and 31 May 2016. No language restrictions were applied. Bibliographies of selected studies and relevant Cochrane reviews were also hand-searched. Interventions delivered by cancer nurses were classified according to the OMAHA System. Heat maps were used to highlight the volume of evidence available for different cancer groups, intervention types and stage of cancer care continuum.RESULTS: The search identified 22,450 records; we screened 16,169 abstracts and considered 925 full papers, of which 214 studies (247,550 participants) were included in the evidence synthesis. The majority of studies were conducted in Europe (n = 79) and USA (n = 74). Interventions were delivered across the cancer continuum from prevention and risk reduction to survivorship, with the majority of interventions delivered during the treatment phase (n = 137). Most studies (131/214) had a teaching, guidance or counselling component. Cancer nurse interventions were targeted at primarily breast, prostate or multiple cancers. No studies were conducted in brain, sarcoma or other rare cancer types. The majority of the studies (n = 153) were nurse-led and delivered by specialist cancer nurses (n = 74) or advanced cancer nurses (n = 29), although the quality of reporting was poor.CONCLUSIONS: To the best of our knowledge, this is the first review to synthesise evidence from intervention studies across the entire cancer spectrum. As such, this work provides new insights into the nature of the contribution that cancer nurses have made to evidence-based innovations, as well as highlighting areas in which cancer nursing trials can be developed in the future.
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11. |
- Doohan, Isabelle, et al.
(author)
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Exploring injury panorama, consequences, and recovery among bus crash survivors : a mixed-methods research study
- 2017
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In: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 32:2, s. 165-174
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of this study was to explore physical and mental consequences and injury mechanisms among bus crash survivors to identify aspects that influence recovery.METHODS: The study participants were the total population of survivors (N=56) from a bus crash in Sweden. The study had a mixed-methods design that provided quantitative and qualitative data on injuries, mental well-being, and experiences. Results from descriptive statistics and qualitative thematic analysis were interpreted and integrated in a mixed-methods analysis.RESULTS: Among the survivors, 11 passengers (20%) sustained moderate to severe injuries, and the remaining 45 (80%) had minor or no physical injuries. Two-thirds of the survivors screened for posttraumatic stress disorder (PTSD) risk were assessed, during the period of one to three months after the bus crash, as not being at-risk, and the remaining one-third were at-risk. The thematic analysis resulted in themes covering the consequences and varying aspects that affected the survivors' recoveries. The integrated findings are in the form of four "core cases" of survivors who represent a combination of characteristics: injury severity, mental well-being, social context, and other aspects hindering and facilitating recovery. Core case Avery represents a survivor who had minor or no injuries and who demonstrated a successful mental recovery. Core case Blair represents a survivor with moderate to severe injuries who experienced a successful mental recovery. Core case Casey represents a survivor who sustained minor injuries or no injuries in the crash but who was at-risk of developing PTSD. Core case Daryl represents a survivor who was at-risk of developing PTSD and who also sustained moderate to severe injuries in the crash.CONCLUSION: The present study provides a multi-faceted understanding of mass-casualty incident (MCI) survivors (ie, having minor injuries does not always correspond to minimal risk for PTSD and moderate to severe injuries do not always correspond to increased risk for PTSD). Injury mitigation measures (eg, safer roadside material and anti-lacerative windows) would reduce the consequences of bus crashes. A well-educated rescue team and a compassionate and competent social environment will facilitate recovery. Doohan I , Björnstig U , Östlund U , Saveman BI . Exploring injury panorama, consequences, and recovery among bus crash survivors: a mixed-methods research study. Prehosp Disaster Med. 2017;32(2):165-174.
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12. |
- Dorell, Åsa, et al.
(author)
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Experiences With Family Health Conversations at Residential Homes for Older People
- 2016
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In: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 25:5, s. 560-582
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Journal article (peer-reviewed)abstract
- The aim of this study was to highlight family members' experiences of participating in Family Health Conversation (FamHC), based on families in which a family member was living in a residential home for older people. A total of 10 families and 22 family members participated in evaluating family interviews 1 month after participating in FamHC. The interviews were analyzed by qualitative content analysis. The main finding was being a part of FamHC increased family members' insights, understanding, and communication within the family. Getting confirmation from nurses was essential to cope with the new life situation, which also meant that they felt comfortable to partly hand over the responsibility for the older person who moved to the residential home. By being open and expressing their feelings, a bad conscience could be relieved. These findings showed that FamHC could be helpful for family members in adapting to this novel situation.
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13. |
- Dorell, Åsa, et al.
(author)
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Family Health Conversations have positive outcomes on families : A mixed method study
- 2017
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In: Open Nursing Journal. - : Bentham Open. - 1874-4346. ; :11, s. 14-25
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Journal article (peer-reviewed)abstract
- Background: A Family Systems Nursing intervention, “Family Health Conversations” (FamHC) was conducted in order to strengthen the health of families having relatives at residential home for older people. Having a family member living in a residential home affects the entire family and can be hard to handle. Family members require encouraging and open communication support from nurse during and after relocation to a residential home.Objectives: The aims of this study were to evaluate the responses to and effects of the Family Health Conversations in families with a member living at a residential home for older people and to integrate the empirical results with a theoretical assumption upon which the intervention was based.Methods: A mixed method research design was used. The Swedish Health-Related Quality of Life Survey and the Family Hardiness Index were administered before and 6 months after the intervention. Qualitative data was collected by semi-structured interviews with each family 6 months post-intervention. The sample included families of residents, a total of 10 families comprising 22 family members.Result: Main finding was that FamHCs helped family members process their feelings about having a member living at a residential home and made it easier for them to deal with their own situations. FamHCs helped to ease their consciences, improve their emotional well-being, and change their beliefs about their own insufficiency and guilt. Seeing problems from a different perspective facilitated the families’ thinking in a new way.Conclusion: These findings showed that FamHC can be an important type of intervention to improve family functioning and enhance the emotional well-being.
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14. |
- Dorell, Åsa, et al.
(author)
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Nurses' perspective of conducting family conversation
- 2016
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In: International Journal of Qualitative Studies on Health and Well-being. - : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 11
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Nurses are in a prime position to manage to support families that have a family member living in a residential home for older people. Nurses' attitudes about meeting patients' family members vary. Studies describe that some nurses consider family members as a burden. But some nurses consider family members a resource and think it is important to establish good relationships with them.AIM: The aim of this study was to describe how registered nurses (RNs) experienced to participate in and conduct the intervention Family Health Conversations (FamHCs) with families in residential homes for older people.METHODS: The intervention FamHC was accomplished at three residential homes for older people. FamHC is a family systems nursing (FSN) intervention developed to support families facing the ill health of someone in the family. One RN from each residential home conducted the conversations. The RNs wrote diary notes directly after each conversation. The RNs were also interviewed 1 month after they had each conducted four FamHCs. The diary notes and the interviews were analysed separately by qualitative content analysis, and the findings were then summarized in one theme and further discussed together.FINDINGS: The main findings were that the RNs experience the conversations as a valuable professional tool involving the whole family. The RNs grasped that silence can be a valuable tool and had learned to attentively listen to what the families were saying without interrupting, allowing them and the families to reflect upon what the family members said.CONCLUSION: The findings show that the FamHC can be helpful for RNs in their work, helping them to perceive and understand the needs and desires of the families.
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15. |
- Dorell, Åsa, 1974-
(author)
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Tröst genom hälsostödjande familjesamtal : upplevelser och effekter av en familjecentrerad intervention
- 2016
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Doctoral thesis (other academic/artistic)abstract
- Aim: The overall aim of this thesis was to evaluate the experiences of nurses and families participated in Family Health Conversations (FamHC) and the effects of this intervention on those families with a family member living in a residential home for older people. Methods: This thesis comprises four studies. The FamHC were structured as three conversations held at two-week intervals and a closing letter. In two of the studies (I and II), group interviews with family members were interpreted using qualitative content analysis. A mixed-method research design was used in study three (III). Data were collected through group interviews with families and by using the instruments FHI and SWED-QUAL completed by the family members. The qualitative and quantitative data were analyzed and then integrated. In the fourth study (IV), registered nurses who had performed the FamHC participated in individual interviews after they had completed four conversation series each. The RNs also wrote diary notes about what they experienced directly after conducting each conversation. The interviews and diary notes were interpreted with qualitative content analyses. Result: The findings from study I one month after participating in the conversations showed that the families felt alleviated from guilty consciences. The FamHC gave the family members confirmation that they were, indeed, good enough. Study II showed that, six months after participating in the conversations, the families had experienced the FamHC as healing because the sharing and reflections through dialogue within the conversations mediated confirmation, which made the families feel consoled. Study III revealed that the families’ emotional wellbeing had increased six months after participating in the FamHC. The families also showed an improved ability to work together. In study IV, the nurses reported that the FamHC was a useful care action in their work with families. Conclusion: The overall conclusion from the findings is that the families were consoled by participating in the FamHC. The conversations offered an arena for families to listen to each other’s narration which provided a better relationship and cooperation within the family and a greater sense of well-being for the family members.
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16. |
- Höglund, Arja, et al.
(author)
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Like a Wave in Its Variable Shape, Breadth, and Depth : A Qualitative Interview Study of Experiences of Daytime Sleepiness in People with Parkinson's Disease
- 2022
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In: Parkinson's Disease. - : Hindawi Limited. - 2090-8083 .- 2042-0080. ; 2022, s. 1-9
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Journal article (peer-reviewed)abstract
- Introduction: Daytime sleepiness is a common nonmotor symptom in Parkinson's disease (PD) which is associated with decreased quality of life and perceived health. However, experiences of daytime sleepiness in people with PD have not been explored. The aim of this qualitative study was to explore experiences of daytime sleepiness in people with PD. Materials and Methods: Five women and seven men (42-82 years) with PD for 1.5 to 21 years and excessive daytime sleepiness (i.e., a score of >10 on the Epworth Sleepiness Scale) participated in the study. Data were collected through individual, semistructured, face-to-face interviews and analyzed with qualitative content analysis. Results: Three themes of the experience of daytime sleepiness were revealed: (1) not an isolated phenomenon, (2) something to struggle against or accept, and (3) something beyond sleepiness. Conclusion: Daytime sleepiness is a complex nonmotor symptom in PD which manifests itself in several ways. Some experiences are similar, for instance, the attribution of daytime sleepiness to PD and its medical treatment. Differences depend on how sleepiness manifests itself, affects the person, and impacts daily life, as well as whether it causes feelings of embarrassment. Some participants needed to struggle against daytime sleepiness most of the time, and others had found a way to handle it, for example, with physical activity. However, sleepiness may also be used to benefit the person, for example, if they allow themselves to take a power nap to regain energy. The health care professionals can easily underestimate or misinterpret the prevalence and burden of daytime sleepiness because people with PD may describe daytime sleepiness as tiredness, drowsiness, or feeling exhausted, not as sleepiness.
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17. |
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18. |
- Jakobsson, Sofie, 1968, et al.
(author)
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Performance of the Swedish version of the Revised Piper Fatigue Scale.
- 2013
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In: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 17:6, s. 808-13
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Journal article (peer-reviewed)abstract
- PURPOSE: The Revised Piper Fatigue scale is one of the most widely used instruments internationally to assess cancer-related fatigue. The aim of the present study was to evaluate selected psychometric properties of a Swedish version of the RPFS (SPFS).METHODS: An earlier translation of the SPFS was further evaluated and developed. The new version was mailed to 300 patients undergoing curative radiotherapy. The internal validity was assessed using Principal Axis Factor Analysis with oblimin rotation and multitrait analysis. External validity was examined in relation to the Multidimensional Fatigue Inventory-20 (MFI-20) and in known-groups analyses.RESULTS: Totally 196 patients (response rate = 65%) returned evaluable questionnaires. Principal axis factoring analysis yielded three factors (74% of the variance) rather than four as in the original RPFS. Multitrait analyses confirmed the adequacy of scaling assumptions. Known-groups analyses failed to support the discriminative validity. Concurrent validity was satisfactory.CONCLUSION: The new Swedish version of the RPFS showed good acceptability, reliability and convergent and- discriminant item-scale validity. Our results converge with other international versions of the RPFS in failing to support the four-dimension conceptual model of the instrument. Hence, RPFS suitability for use in international comparisons may be limited which also may have implications for cross-cultural validity of the newly released 12-item version of the RPFS. Further research on the Swedish version should address reasons for high missing rates for certain items in the subscale of affective meaning, further evaluation of the discriminative validity and assessment of its sensitivity in detecting changes over time.
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19. |
- Jaldestad, Ellen
(author)
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Job Crafting: Changing and adapting work as one piece of the puzzle for a sustainable working life
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Introduction: This thesis focuses on job crafting as one way to increase work-related well-being and enable people to extend their working lives. The studies included were conducted within two different contexts, namely the manufacturing industry and public healthcare. These two contexts struggle with, for example, challenging working environments and staff shortages, as well as enabling older workers to extend their working lives. Job crafting, an active form of job redesign, can be defined as employees actively changing the physical and cognitive boundaries of work to better suit the person’s abilities and desires. These kinds of bottom-up-driven strategies to change and adapt work have been found to increase employee well-being and productivity, as well as reduce staff turnover. According to previous research, job crafting thus has positive effects on both people at work and their organizations. Previous research also shows that organizational structures as well as individual factors can facilitate and enhance employees’ job crafting. There is, however, a lack of studies focusing on how to best promote and facilitate employee-driven job crafting in practice. Aim: This thesis aimed to explore job crafting as one part of a health-promoting and extended working life. Job crafting was analysed in relation to an extended working life among blue-collar workers in one company in the manufacturing industry, and in relation to being able to work and feel well within public healthcare and manufacturing industry. Methods: Data was collected at one global manufacturing company and different workplaces within Swedish public healthcare. In the manufacturing company, data was collected from 100 blue-collar workers as part of an age management project focusing on factors influencing employees’ retirement decisions. The respondents represented older employees in three different countries: Sweden, the Netherlands, and France. These respondents completed a questionnaire and participated in semi-structured interviews. The quantitative data was descriptively analysed and the qualitative data was analysed with content analysis. Within public healthcare, a questionnaire was first administered to 421 healthcare employees at two times (T1-T2), six to eight months apart. A response rate of 59% provided data from 250 respondents. Secondly, semi-structured interviews were conducted with 16 healthcare employees and five managers. The quantitative data from the survey was analysed with SEM analysis, whereas the qualitative data was analysed with reflexive thematic analysis. Findings: Factors that influenced blue-collar workers’ decisions about retirement and an extended working life included perceived health and economic situation, task characteristics, support from colleagues and managers, work autonomy and work setup, and national pension schemes. Job crafting strategies that were perceived as health-promoting among blue-collar workers included adapting work whenever possible, asking colleagues for help to finish work, and changing their way of thinking about work. For some, these strategies were considered as contributing to being able to extend working life. Among the healthcare employees, health-promoting job crafting strategies included asking for new assignments and opportunities for professional development, organizing work in close cooperation with others, and involving patients in the planning of daily activities. These strategies were derived from different motives, including crafting for their development, crafting for a common good, crafting for manageability, and crafting for meaningfulness in work. Working conditions such as having support from managers and colleagues, and formal autonomy in work, facilitated job crafting among the healthcare employees. The health-promoting crafting strategies were connected to increasing work-related sense of coherence through comprehensibility, manageability, and meaningfulness. Job crafting strategies and motives were said to change over time, for example in relation to work-life balance and work experience, among respondents in both contexts. Within both contexts, it was also indicated that a strong inner drive for personal development sometimes outweighed hindering structural conditions when employees crafted for their development and manageability in work. Conclusions: Factors that influenced the retirement decisions were found on different levels within the blue-collar workers’ work context. Perceived antecedents of health-promoting job crafting among the respondents within both contexts in this thesis were found in organizational structures, workplace conditions, and individual factors. Job crafting motives and strategies were also said to change over time and were influenced by both individual factors and workplace-related conditions. From the findings in this thesis, it is suggested to further explore how to facilitate job crafting on the different work-system levels, as well as to plan job crafting interventions directed to healthcare employees and older blue-collar workers within the manufacturing industry.
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20. |
- Johnston, Bridget, et al.
(author)
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Dignity-conserving care in palliative care settings : An integrative review
- 2015
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:13-14, s. 1743-1772
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Research review (peer-reviewed)abstract
- Aims and objectivesTo report an integrative review of evidence relating to dignity-conserving care in palliative care settings. It will also suggest avenues for future research. BackgroundResearch suggests that dignity is welcomed by those receiving palliative and end of life care. However, as dignity is a subjective term, it is not always explicit how this may be employed by nurses. Given that the preferred place of care for patients with palliative care needs is the home, the issue of dignity may be particularly important for community nurses. Therefore, synthesising evidence of dignity-conserving care for community nurses caring for people with palliative care needs provides clarity in a complex area of palliative care research. DesignIntegrative literature review. MethodThe review involved key bibliographic and review databases CINAHL, MEDLINE, EMBASE, ASSIA and PsycInfo. Medical Subject Headings and free terms were undertaken for articles published from January 2009-September 2014 and retrieved papers were assessed against inclusion criteria. Final included articles were reviewed for reported dignity-conserving care actions, which were classified under nine themes of the Dignity Model. ResultsThirty-one articles were included. Nine Dignity Model themes were used to classify care actions: Level of Independence; Symptom Distress; Dignity-Conserving Perspectives; Dignity-Conserving Practices; Privacy Boundaries; Social Support; Care Tenor; Burden to Others; and Aftermath Concerns. Reported care actions included listening, conveying empathy, communication and involving patients in care. ConclusionCare actions could be classified under most of Dignity Model themes. However, there were less reported care actions related to Level of Independence and Aftermath Concerns, which meant that these had to be formulated independently. Future research should be structured around these areas to determine appropriate care actions for nurses to give dignity-conserving care that addresses these specific themes. Relevance to clinical practiceSynthesising the available evidence of dignity-conserving care identifies evidence-based care actions and provides guidance to nursesin clinical practice caring for patients with palliative care needs. Future opportunities for research are identified to guide promotion of dignity in palliative care.
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21. |
- Johnston, Bridget, et al.
(author)
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Evaluation of the Dignity Care Pathway for community nurses caring for people at the end of life.
- 2012
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In: International Journal of Palliative Nursing. - : Mark Allen Group. - 1357-6321 .- 2052-286X. ; 18:10, s. 483-9
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Journal article (peer-reviewed)abstract
- BACKGROUND: People nearing the end of life fear loss of dignity, and a central tenet of palliative care is to help people die with dignity. The Dignity Care Pathway (DCP) is an intervention based on the Chochinov theoretical model of dignity care. It has four sections: a manual, a Patient Dignity Inventory, reflective questions, and care actions.METHOD: The feasibility and acceptability of the DCP were evaluated using a qualitative design with a purposive sample of community nurses. Data was collected from April to October 2010 using in-depth interviews, reflective diaries, and case studies and then analysed using framework analysis.RESULTS: The DCP was acceptable to the community nurses, helped them identify when patients were at the end of life, identified patients' key concerns, and aided nurses in providing holistic end-of-life care. It requires the nurse to have excellent communication skills. Some of the nurses found it hard to initiate a conversation on dignity-conserving care.CONCLUSION: The DCP helps nurses to deliver individualised care and psychological care, which has previously been identified as a difficult area for community nurses. All of the nurses wished to continue to use the DCP and would recommend it to others.
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22. |
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23. |
- Johnston, Bridget, et al.
(author)
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What's Dignity Got To Do With It? Patient Experience of the Dignity Care Intervention : A Qualitative Evaluation Study
- 2017
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In: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 3
-
Journal article (peer-reviewed)abstract
- The delivery of palliative care in the community setting has been recognized as a valued and challenging aspect of nursing care. To this end, care pathways have been shown to support nurses in a variety of settings to deliver individualized patient care. This study provides a qualitative evaluation of an end-of-life intervention known as the Dignity Care Intervention (DCI) based on patients' perspectives. The DCI consists of four sections: a manual, the Patient Dignity Inventory, reflective questions, and evidence-based care actions. A qualitative design underpinned by the philosophy of Merlau-Ponty was employed for the evaluation of the DCI. Data collection included individual interviews with participants (n = 25). Interview data were analyzed using framework thematic analysis. Four theme categories were identified: "experience of DCI,'' "responding to my illness concerns,'' "how illness affects me as a person,'' and "how illness concerns affect my relationships.'' The DCI was found to enable patients to discuss openly important issues with community nurses that they might not otherwise have raised. Participants conveyed satisfaction with the support they received through the DCI. The use of care pathways detailing interventions to manage clinical problems and ensure systematic integration of the best available evidence into care delivery can improve end-of-life care.
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24. |
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25. |
- Lindh, Viveca, et al.
(author)
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An initiative to teach family systems nursing using online health-promoting conversations : A multi-methods evaluation
- 2013
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In: Journal of Nursing Education and Practice. - Toronto : Sciedu Press. - 1925-4040 .- 1925-4059. ; 3:2, s. 54-66
-
Journal article (peer-reviewed)abstract
- Background: Family systems nursing embraces the view that one family member’s illness affects other family members and vice versa. Family nursing developed as a way for nurses to work with families to promote health. Previously, teachers performed most of the education on health-promoting conversations with families on campus. Because online education is increasingly requested in nursing, this article evaluates teaching family systems nursing by using synchronous online health-promoting conversations.Methods: Fifteen registered nurses attended the course “Health-Promoting Family Focused Nursing”, an advanced-level nursing elective 10-week course. The course used technology enhanced learning and was evaluated qualitatively and quantitatively. Students and teachers participated in semi-structured focus group interviews analyzed qualitatively. The students filled in a traditional course evaluation. Students responded before and after the course to the multidimensional research instrument “Families’ Importance in Nursing Care—Nurse’s Attitudes” (FINC-NA).Results: The students were satisfied with the course and the synchronous health-promoting conversations. They learned to “think family” and acknowledged the importance of inviting families to take part in the care of a family member. They stated that the online practice had helped them gain a useful tool for their future family nursing practice. The teachers appreciated working in a team to develop the course. At the start of the project they viewed the online technology as a challenge. However, during the course they saw many pedagogical possibilities with the synchronous meetings and that the online family conversation training worked well. The ability to record the meetings offered educational advantages and the opportunity for students to reflect on the conversations. Even if the students rated families importance in nursing care positively prior to the course on FINC-NA, the students still gave the following domains even stronger support post-course: Family as a resource in nursing care, Family as a burden, and Family as own resource.Conclusions: Family systems nursing and health-promoting conversations with families, comprising interaction between several participants, can be learned using online pedagogical methods. Furthermore, the belief that health-promoting family conversations need to be held with all participants in the same room has been challenged.
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26. |
- Lundh Snis, Ulrika, 1970-, et al.
(author)
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Crossing Boundaries Through Work-integrated Knowledge Communities
- 2003
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In: E-Learn. - San Diego, CA : Association for the Advancement of Computing in Education (AACE). - 9781880094501 ; , s. 1707-1710
-
Conference paper (peer-reviewed)abstract
- This paper reports from the preliminary lessons learned of an action case study in which learning initiatives in a business organisation are investigated. The main question is abouthow to integrate knowledge and learning processes in business work processes? We are at present facing the challenge of integrating an actual business work process with an sustainable knowledgeand learning process in an on-going action case research project together with a company withinthe chemical industry. We argue for a greater appreciation of informal learning processes as powerful complements to formal training and capability building. The implications from the casestudy so far, are that the business processes need to reconsider its learning capacity from the pointof view of actual work practice. We propose the vision of a work-integrated knowledge community that is facilitated by crossing boundaries in the daily work practice of business organisations
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27. |
- Lundh Snis, Ulrika, 1970-, et al.
(author)
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Exploring Tools and Methods for Work-Integrated Learning
- 2002
-
In: Proceedings of E-Learn 2002--World Conference on E-Learning in Corporate, Government, Healthcare, and Higher Education. - : Association for the Advancement of Computing in Education (AACE). - 9781880094464 ; , s. 2234-2237
-
Conference paper (peer-reviewed)abstract
- Most organizations have high hopes regarding the potential for eLearning to address the increasing demands for constant learning that characterizes life in a knowledge society. However, most existing designs are strongly influenced by traditional classroom-based education, and are consequently poorly adapted to the situated conditions of real work practices. This paper tries to frame a research domain labeled work-integrated learning, where focus is set on developing innovative tools and methods for technology-mediated learning, rooted in understanding of the specific conditions for various organizational settings. The paper proposes a four-level stage model as a framework for both analysis of organizations and design of new tools and methods for eLearning.
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28. |
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29. |
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30. |
- Lämås, Kristina, et al.
(author)
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Possibilities for evaluating cost-effectiveness of family system nursing : an example based on Family Health Conversations with families in which a middle-aged family member had suffered stroke
- 2016
-
In: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 38:2, s. 74-81
-
Journal article (peer-reviewed)abstract
- Family Health Conversations (FamHC) increase health and well-being, but knowledge about their cost-effectiveness, and how to best calculate this, is lacking. In this feasibility study we evaluated the cost-effectiveness of using FamHC with families in which a middle-aged family member had suffered stroke. Seven families participated in a FamHC intervention and seven families received ordinary care. Health-related quality of life (HRQoL) was estimated with SF-6D and EQ-5D over a six-month period. The costeffectiveness of the intervention was calculated. Families receiving FamHC intervention had significantly increased HRQoL at follow up. Cost per quality adjusted life year differed depending on the instrument and analysis method used in the calculation. However, all calculations showed that FamHC were cost-effective. We conclude that FamHC significantly increase HRQoL and suggest that they are cost-effective. Both instruments seemed to be able to capture changes. Considering the participants’ experience of answering the two instruments, we advocate the use of EQ-5D.
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31. |
- Löfkvist, Ulrika, et al.
(author)
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Gender differences in caregiver's use of spoken language with young children who are hard-of-hearing
- 2022
-
In: International Journal of Pediatric Otorhinolaryngology. - : Elsevier BV. - 0165-5876 .- 1872-8464. ; 156
-
Journal article (peer-reviewed)abstract
- PURPOSE: Shared parenting among caregivers of different gender is common in the Swedish society. It is unclear if this includes shared contribution for children's language development. The objective of this cross-sectional study was to explore the natural language environment of children who were hard-of-hearing compared to typically hearing controls.METHODS: Seventy-two families with children aged 7-35 months participated; 22 children who were hard-of-hearing (Cochlear implants, n=11; Hearing aids, n=11) and 50 controls with typical hearing. The majority of caregivers had higher education background level, especially in the control group. Families conducted a daylong recording with the Language Environment Analysis technology, when both parents were present at home. An Interpreted Time Segmental analysis was performed to extract information about female versus male caregivers quantitative word use.RESULTS: The results showed significant gender differences related to number of adult words, with less male words than female words (p <0.001). Male caregivers of children who were hard-of-hearing contributed with around 27 % of adult words during the recordings while males in the control group contributed with 37 %. There was a larger variation in number of female words in the study group than for controls, especially in mothers of children with cochlear implants.CONCLUSIONS: Female caregivers talk significantly more close to young children than male caregivers, and especially in the subgroup of children with cochlear implants. Children who are hard-of-hearing are dependent on a rich language environment, and might be especially vulnerable if male caregivers are less involved as language facilitators. More studies are needed to explore caregiver gender differences, both related to quantitative and qualitative language stimulation.
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32. |
- Olausson, Kristina, 1972-, et al.
(author)
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Development and psychometric testing of an instrument to measure the patient’s experience of external radiotherapy : The Radiotherapy Experience Questionnaire (RTEQ)
- 2017
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In: Technical Innovations & Patient Support in Radiation Oncology. - : Elsevier BV. - 2405-6324. ; 3-4, s. 7-12
-
Journal article (peer-reviewed)abstract
- BackgroundThe patient’s perception of external radiotherapy (RT) procedures and equipment is important to evaluate as a complement to endpoints such as treatment outcome and reproducibility. There is a lack of a proper, psychometrically robust instrument to evaluate the patient’s comfort and experience of the external RT procedure. Hence, this study aimed to develop and test an instrument to measure the patient’s experience during external RT.Material and MethodsA preliminary 34-item questionnaire was generated from research literature, expert consultations and patient interviews, and it was distributed to patients (n = 825) at 8 RT units in Sweden. The answers were subjected to item analysis and reduction by using exploratory factor analysis. The reliability of the final questionnaire was evaluated using Cronbach’s alpha. Mean scale scores were compared across gender, length of RT and treatment area.ResultsMost items were highly skewed towards positive responses. Scree plot analyses of the 34-item correlation matrix identified six underlying themes explaining 68% of the total variance. After item reduction, the 6 themes explained 73% of the variance in a 23-item questionnaire. Cronbach’s alpha was satisfactory for all themes (between 0.79 and 0.9). Significant differences between treatment areas were found for two scales: situational unease and situational repose.ConclusionThe RT Experience Questionnaire is a tentatively valid and reliable instrument to measure how patients experience the external RT session process and the environment in the treatment room.
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33. |
- Olausson, Kristina, 1972-
(author)
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Patient experiences of the radiotherapy process and treatment
- 2016
-
Doctoral thesis (other academic/artistic)abstract
- BackgroundMost cancer patients undergo external radiotherapy (RT) at some stage during their treatment trajectory. RT is often associated with unfamiliar procedures where the technical environment, side effects and interaction with staff seem to play a major role in the patient’s treatment experience. These experiences could sometimes lead to disruption of the treatment which may have negative consequences for the outcome. The overall aim of this thesis was to gain further knowledge about how patients experience RT and the related processes. Such knowledge is of vital importance when developing and improving care within a high-tech RT environment.AimThe overall aim of this thesis was to gain further knowledge about how patients experience RT and the related processes. Such knowledge is of vital importance when developing and improving care within a high-tech RT environment.MethodsTo gain further knowledge and understanding about patients experience of RT both quantitative (I, II, III) and qualitative (III, IV) methodology were used. The data in the thesis focused on patients undergoing external RT at different RT units in Sweden. Study I and II, focused on two regions, the northern region of Sweden and the region of Stockholm and Gotland. Study III and IV were performed at eight different RT units in Sweden.ResultsIn Study I, two types of topical agents (Calendula Weleda cream vs. Essex cream) were compared regarding reducing the risk of severe acute radiation skin reactions (ARSR). No difference in severe ARSR was found between the groups and the patients reported low levels of ARSR. In Study II, the influence of an RT unit’s psychosocial climate and treatment environment on cancer patients’ anxiety during external RT was evaluated. Data was collected (questionnaire) from 892 patients. The results showed that both the treatment environment and the psychosocial climate of the RT unit significantly impacted cancer patient anxiety levels. In Study III & IV, a questionnaire to measure the patient´s experience during external RT was developed and tested. The results showed that the RT Experience Questionnaire (RTEQ), with 23 items, was a tentatively valid and reliable instrument to measure how patients experience the RT process and the environment in the treatment room. In Study IV, written comments from the open-ended question “Is there anything else you want us to know?” in the preliminary RTEQ was analysed with qualitative content analysis. This data was abstracted into the following four major categories reflecting the experience of the RT process: Experiences in the high tech RT environment; Understanding the RT procedures and side effects; Dealing with daily life during RT and The nurses’ role and performance.ConclusionThe RT environment and the RT related processes seem to impact cancer patients, both physically and psychologically. A person-centered care approach, as well as attention to the design, both of the treatment process and the physical environment could significantly improve the patient experience and patient involvement. The results also highlight the importance of taking patient experiences into account when introducing new RT methods and techniques.
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34. |
- Olausson, Kristina, 1972-, et al.
(author)
-
What matters to you? : Free-text comments in a questionnaire from patients undergoing radiotherapy
- 2020
-
In: Technical Innovations & Patient Support in Radiation Oncology. - : Elsevier. - 2405-6324. ; 13, s. 11-16
-
Journal article (peer-reviewed)abstract
- Background: Most cancer patients undergo external radiotherapy (RT) at some stage during their treatment trajectory and RT is often associated with unfamiliar procedures in a highly technical environment. The purpose of this study was to explore how patients experience RT and the related processes, as described in free-text comments in a large Swedish survey with questionnaires including items on psychosocial climate and treatment environment.Methods: The data consisted of free-text comments from one open-ended question: "Is there anything else you want us to know" and were analysed using qualitative content analysis.Results: Of 825 returned questionnaires, 261 contained free-text comments from patients (32%). The hand-written, free-text comments reflected the patients' experience of the RT process and were abstracted into the four major categories with sub-categories: experiencing the high-tech RT environment, understanding the RT procedures and side effects, dealing with daily life during RT, and the nurses' role and performance. The categories reflect the patients' experiences and emphasize how important it is to evaluate what really matters to the patients when changing procedures, practices, and how to minimize disturbances in the patients' daily lives.Conclusion: The main conclusions from this study are that the involvement of patients in choosing daily appointment times, providing good information during the RT process to make the patients feel safe, experience and attitude of the staff and respect for the patient's autonomy are highly ranked values for patients. An implementation of person-centred care may help relieve many of these problems.
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35. |
- Olausson, Kristina, 1972-, et al.
(author)
-
What matters to you? – Free-text comments in a questionnaire from patients undergoing radiotherapy
-
Other publication (other academic/artistic)abstract
- Background: Most cancer patients undergo external radiotherapy (RT) at some stage during their treatment trajectory and RT is often associated with unfamiliar procedures in a highly technical environment. The purpose of this study was to explore how patients experience RT and the related processes, as described in free-text comments in a large Swedish survey with questionnaires including items on psychosocial climate and treatment environment. Methods: The data consisted of free-text comments from one open-ended question: “Is there anything else you want us to know” and were analysed using qualitative content analysis. Results: Of 825 returned questionnaires, 261 contained free-text comments from patients (32%). The analysis of the data resulted in four major categories: experiencing the high-tech RT environment, understanding the RT procedures and side effects, dealing with daily life during RT, and the nurses’ role and performance. Conclusion: The categories reflect the patients’ experiences and emphasize how important it is to evaluate what really matters to the patients when changing procedures, practices, and how to minimize disturbances in the patients’ daily lives.
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36. |
- Olausson, Kristina, 1972-, et al.
(author)
-
What matters to you? – Free-text comments in a questionnaire from patients undergoing radiotherapy
-
Other publication (other academic/artistic)abstract
- Background: Most cancer patients undergo external radiotherapy (RT) at some stage during their treatment trajectory and RT is often associated with unfamiliar procedures in a highly technical environment. The purpose of this study was to explore how patients experience RT and the related processes, as described in free-text comments in a large Swedish survey with questionnaires including items on psychosocial climate and treatment environment. Methods: The data consisted of free-text comments from one open-ended question: “Is there anything else you want us to know” and were analysed using qualitative content analysis. Results: Of 825 returned questionnaires, 261 contained free-text comments from patients (32%). The analysis of the data resulted in four major categories: experiencing the high-tech RT environment, understanding the RT procedures and side effects, dealing with daily life during RT, and the nurses’ role and performance. Conclusion: The categories reflect the patients’ experiences and emphasize how important it is to evaluate what really matters to the patients when changing procedures, practices, and how to minimize disturbances in the patients’ daily lives.
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37. |
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38. |
- Persson, Carina, et al.
(author)
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Health-related quality of life in significant others of patients dying from lung cancer
- 2008
-
In: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 22:3, s. 239-247
-
Journal article (peer-reviewed)abstract
- This study compares health-related quality of life (HRQOL) in significant others of patients dying from lung cancer, with a general population sample. Further, it explores the course of HRQOL from diagnosis (T1), at a time point close to the patient's death M), and six months after the patient's death (T3). The group comparisons at T1 showed that the significant others scored significantly lower on the scales in the mental domain compared with a general population sample. These results were the same at T3, when the significant others also scored lower on most of the scales in the physical and social domains. In the longitudinal analyses, there were significant changes in four scales, and three patterns of change were identified: a decrease-increase pattern for 'self-rated health' and 'positive affect'; a constant decrease pattern for 'family functioning'; and a decrease-stable pattern for 'satisfaction with family functioning'. Thus, living with inoperable lung cancer in the family and then facing the death of a family member affects most of the HRQOL dimensions.
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39. |
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40. |
- Rullander, Anna-Clara, et al.
(author)
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Adolescents' experiences of scoliosis surgery and the trajectory of self-reported pain : a mixed-methods study
- 2017
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In: Orthopedic Nursing. - : Lippincott Williams & Wilkins. - 0744-6020 .- 1542-538X. ; 36:6, s. 414-423
-
Journal article (peer-reviewed)abstract
- Scoliosis surgery for adolescents is a major surgery with a diffi cult recovery. In this study, a mixed-methods design was used to broaden the scope of adolescents' experiences of surgery for idiopathic scoliosis and the trajectory of self-reported pain during the hospital stay and through the fi rst 6 months of recovery at home. Self-reports of pain, diaries, and interviews were analyzed separately. The results were then integrated with each other. The trajectory of self-reported pain varied hugely between individuals. Adolescents experienced physical suffering and struggled to not be overwhelmed. The adolescents described the environmental and supportive factors that enabled them to cope and how they hovered between suffering and control as they strived toward normality. This study highlights areas of potential improvement in perioperative scoliosis care in terms of nursing support and pain management.
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41. |
- Sahlén, Klas-Göran, et al.
(author)
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Nursing research in Sweden
- 2014
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In: The Japanese Journal of Nursing Research. - 0022-8370. ; 47:2, s. 126-133
-
Journal article (peer-reviewed)
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42. |
- Sahlén, Klas-Göran, et al.
(author)
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Nursing research in Sweden II
- 2014
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In: The Japanese Journal of Nursing Research. - Tokyo : Igaku Shoin. - 0022-8370. ; 47:3, s. 234-240
-
Journal article (peer-reviewed)
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43. |
- Sundin, Karin, et al.
(author)
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Envisioning the future as expressed within family health conversations by families of persons suffering from stroke
- 2018
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In: Scandinavian Journal of Caring Sciences. - Oxford : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 32:2, s. 707-714
-
Journal article (peer-reviewed)abstract
- BACKGROUND: The whole family is affected when a person suffers from stroke, but few studies have focused on families' expectations following the stroke.OBJECTIVE: The aim of this study was to illuminate what persons with stroke and their family members talk about in Family Health Conversations (FamHCs) with focus on the future and how nurses leading these conversations apprehended the families' future shown in closing letters based on these conversations.METHOD: In this study, seven families with a member ≤65 years who had suffered a stroke participated in FamHC in their homes after the person with stroke had been discharged from the rehabilitation clinic. The FamHC comprised a series of three conversations conducted every other week and a closing letter sent by the nurses to the family to conclude the series. In this study, the third conversations were recorded and they and the closing letters were transcribed and analysed using qualitative content analysis.RESULT: The family members including the persons with stroke were found to be able to tell their stories and express their feelings, worries, losses, hopes and wishes for the future within the context of the Family Health Conversations. Support within the family was highlighted as essential to the satisfactory management of future situations.CONCLUSION: The persons with stroke and their belonging family members' vision of the future was reflected over in the light of theories about beliefs, possible selves, hope and suffering, and the findings highlight the need for broader use of family conversations to support persons with stroke and their families to manage the future.
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44. |
- Sundin, Karin, et al.
(author)
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Responses after participating in Family Health Conversations in families with a family member who has suffered a stroke : A mixed methods research study
- 2016
-
In: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 4:4, s. 46-57
-
Journal article (peer-reviewed)abstract
- Background: It has been proposed that support for families in which a family member has suffered a stroke should involve the whole family system. Aim: The aim was to evaluate the responses of Family Health Conversation (FamHC) in families with a member under the age of 65 who has been diagnosed with stroke. Methods: In this mixed methods research study, families were included in an intervention group and in a control group. For both groups pre- and post-intervention quantitative data was collected and for the intervention group, qualitative data was collected post-intervention. Underlying theoretical propositions and the two data sets were then integrated. Results: Family health measured as “the general atmosphere of the interaction of the family” had improved in the intervention group when compared to the control group. The intervention families, moreover, described how they had become more cooperative, their communication had improved, they had become more confident with their situation and also when planning for the future when comparing to before the FamHC. Conclusions: Based on the empirical results supporting the theoretical proposition underlying FamHC, we conclude that it works as intended, and the evidence for the theoretical proposition is thereby strengthened. This paper contributes to the scientific evidence concerning FamHC. With the available evidence, RNs are suggested to consider changing practice so as to work in a more family-centred way to support families living with ill-health. Implementing FamHC can be one way of undertaking such supportive work.
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45. |
- Sundin, Karin, et al.
(author)
-
What Couples Choose to Focus on During Nurse-led Family Health Conversations When Suffering Stroke
- 2015
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In: International journal for human caring. - : Springer Publishing Company. - 1091-5710 .- 2578-2304.
-
Journal article (peer-reviewed)abstract
- The aim of this study was to illuminate which topics 2 couples, ages younger than 65 years old, where 1 partner has suffered a stroke, choose to focus on when participating in nurse-led family health conversations. Six conversations were audiotaped, transcribed, and analyzed by qualitative content analysis. Three categories emerged illustrating that the couples choose to talk about how they were affected on a personal and family level and, moreover, the importance of support within and outside the family. The altered way of living involved distressed feelings, gratitude, and hopes. This study highlights the importance of nurses viewing the family as a unit.
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46. |
- Söderman, Annika, 1980-, et al.
(author)
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Community nurses' experiences of the Swedish Dignity Care Intervention for older persons with palliative care needs : A qualitative feasibility study in municipal home health care
- 2021
-
In: International Journal of Older People Nursing. - : Blackwell Publishing. - 1748-3735 .- 1748-3743. ; 16:4
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: The Swedish Dignity Care Intervention (DCI-SWE) is an intervention for people with palliative care needs to enhance their dignity. The original DCI was developed in Scotland, where it was tested by nurses in municipal care. In this study, the DCI has been tested for the first time in a Swedish home health care context. The aim was to describe experiences of the DCI-SWE from the perspectives of community nurses (CNs).METHODS: This was a feasibility study with a qualitative design. Three focus group interviews and one individual interview were performed with CNs (n = 11). Reflective diaries and field notes were written by the CNs and researchers, respectively. Data were analysed using inductive content analysis.RESULTS: Two main categories and six subcategories were identified. The first main category, 'Practising the palliative approach while responding to palliative care needs', consisted of the subcategories: gives structure while providing palliative care; gives older people opportunities to be confirmed; and responding to existential and sensitive needs. The second main category, 'Aspects influencing the use of the DCI-SWE' had two subcategories about facilitators and barriers to the use of the DCI-SWE, and another about how to establish the DCI-SWE in the context of home health care.CONCLUSION: The DCI-SWE offers CNs an overview of older people's concerns while providing palliative care, and gives the older people opportunities to be listened to. Essential prerequisites for using the DCI-SWE in municipal home health care are that CNs are comfortable holding conversations and are given time and space for these by the organisation. Other aspects facilitating the use of the DCI-SWE are managers' engagement and support, continuing training for CNs and CNs' opportunities for reflection.
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47. |
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48. |
- Söderman, Annika, 1980-, et al.
(author)
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Dignity-conserving care for persons with palliative care needs — identifying outcomes studied in research : an integrative review
- 2020
-
In: Palliative & Supportive Care. - NEW YORK, USA : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 18:6, s. 722-740
-
Research review (peer-reviewed)abstract
- ObjectivesWith people living longer, palliative care may be required for lengthier periods of time. This puts demands on healthcare organizations to provide optimal palliative care. Maintaining dignity is central for any person's health and quality of life, but especially for a person with palliative care needs. Dignity-conserving care needs to be evaluated to increase knowledge about outcomes and how to assess these. The purpose of this integrative review was to identify outcomes studied within dignity-conserving care and how these have been operationalized.MethodsAn integrative review was conducted in 26 quantitative or mixed-method studies and study protocols. Thematic synthesis with an abductive approach was used for analysis.ResultsSeven themes of studied outcomes were identified, as well as four cluster themes: themes related to Illness-Related Concerns, themes related to the Dignity-Conserving Repertoire, themes related to the Social Dignity Inventory, and themes regarding Overarching Dignity Issues. Most outcomes studied dealt with Illness-Related Concerns within the themes of “Performance, symptoms and emotional concerns” and “End-of-life and existential aspects”. Themes linked to the Social Dignity Inventory had the lowest number of outcomes studied. Outcomes regarding overarching dignity issues such as “Dignity-related distress” and “Quality of life” were common. However, the results lacked concrete communication outcomes.Significance of resultsThe results will underpin future research in which dignity-conserving care is implemented and evaluated, and contribute to the provision of evidence-based palliative care. A greater focus on outcomes within cluster themes related to the Dignity-Conserving Repertoire and the Social Dignity Inventory is needed, as is more focus on communication outcomes.
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49. |
- Söderman, Annika, 1980-, et al.
(author)
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En intervention för att bevara sköra äldre personers värdighet : utveckling och anpassning till en svensk kontext
- 2018
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In: Forskningen och utvecklingens dag, 2018. - Örebro.
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Conference paper (other academic/artistic)abstract
- Bakgrund: Utvärdering av palliativ vård i Sverige har visat att vården är ojämlik och att äldre personer får sämre palliativ vård. För att främja äldre personers livskvalitet den sista tiden i livet är bevarande av värdighet grundläggande. Förlust av värdighet kan innebära förtvivlan, en känsla av att vara en börda för andra och en önskan om att få dö, vanliga upplevelser hos sköra äldre personer. Konkreta arbetssätt behöver därför utvecklas för att bevara äldre personers värdighet, vilket idag saknas inom svensk palliativ vård. En värdighetsbevarande intervention (DCI) har utvecklats och prövats i Skottland och Irland. Interventionen består av ett formulär för kartläggning av värdighet, reflekterande frågor samt evidensbaserade vårdhandlingar.Syfte: Syftet var att utveckla och anpassa DCI till en svensk kontext.Metod: Utveckling och kulturanpassning skedde genom 1) översättning och anpassning av formuläret till svensk kontext via en expertpanel och via kognitiva intervjuer med äldre personer 2) identifiering av värdighetsbevarande vårdhandlingar relevanta för en svensk kontext, utifrån en litteraturgenomgång samt via intervjuer med äldre personer, deras närstående och vårdpersonal.Resultat: Mindre revideringar av formuläret genomfördes, men överlag accepterades det av de äldre personerna. Identifierade värdighetsbevarande vårdhandlingar speglade mestadels de redan angivna i originalversionen DCI. Dock framkom fler vårdhandlingar än i originalet vid några av kategorierna i den svenska DCI (DCI-SWE) som t.ex. ”socialt stöd”, medan det framkom färre vårdhandlingar än originalet vid t.ex. ”dödens följder för andra”. I DCI-SWE konkretiserades generella vårdhandlingar som t.ex. att lyssna och visa respekt, till skillnad från originalet.Konklusion: DCI-SWE har möjlighet att främja sköra äldre personers värdighet, och prövas nu av sjuksköterskor i en genomförbarhetsstudie inom hemsjukvården.
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- Söderman, Annika, 1980-, et al.
(author)
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Enhancing dignity in older persons in Sweden : adaptation of the Dignity Care Intervention
- 2018
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In: 24th Nordic Congress of Gerontology.
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Conference paper (other academic/artistic)abstract
- Background : In end of life, the older persons´ experiences of dignity can be affected due to serious illness and life changes, derived from physical, psychological, social and existential dimension. Loss of dignity impact the persons´ will to live. The Dignity Care Intervention (DCI) was developed and tested in Scotland and Ireland, to enhance dignity of older persons with palliative care needs, by nurses in municipality care. DCI consists a patient dignity inventory, reflective questions and examples of evidence-based care actions.The aim was to develop and adapt the DCI to a Swedish context.Methods: The patient dignity inventory was overall accepted by older persons in home care, however some changes in the wording were performed. The Swedish care actions reflected mostly earlier care actions described in the original version. However some more care actions derived in some of the categories in the Swedish DCI (DCI-SWE) e.g. “social support”, and some less care actions derived for example in the category “aftermath concerns”. In DCI-SWE general care actions like e.g. to show respect were concretized unlike the original DCI.Conclusions: The DCI-SWE has prospects to enhance older persons´ dignity, and is now tested in a feasibility study by twelve nurses in home care.
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