| 1. |
- Andersson, Anna-Karin, et al.
(author)
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Triage in the emergency department : A qualitative study of the factors which nurses consider when making decisions
- 2006
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In: Nursing in Critical Care. - 1362-1017 .- 1478-5153. ; 11:3, s. 136-145
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Journal article (peer-reviewed)abstract
- Triage, as a concept, is relatively new in Sweden and means 'sorting'. The triage process was developed to grade patients who needed immediate care. Triage is currently important for the emergency treatment system, and nurses are expected to work with it professionally. The aim of this study is to describe how nurses implement triage when patients arrive at the emergency department of a county hospital, situated in a rural area of Sweden, as well as to highlight the factors considered when prioritizing, in connection with nurses' decision-making. The method used was observations of 19 nurses, with minimal disturbance in their triage work, followed by a short tape-recorded interview, during which the nurses were asked to reflect upon their decision of priorities. Qualitative content analysis of data has been used. The results were divided into two areas, internal factors and external factors. The internal factors reflect the nurse skills and personal capacity. The external factors reflect work environment, including high workload and practical arrangements, and should always be perceived and taken into consideration. Using these factors as a basis, the patients' clinical condition, clinical history, various examinations and tests form an assessment, which subsequently results in a prioritization.
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| 2. |
- Björkman Randström, Kerstin, et al.
(author)
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Activity and participation in home rehabilitation : Older people's and family members perspectives
- 2013
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 45:2, s. 211-216
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Journal article (peer-reviewed)abstract
- Objective: To explore the experiences of older people and their supporting family members in relation to home rehabilitation, with a focus on activity and participation. Methods: Qualitative interviews were carried out with 6 older people and 6 family members at 1 and 6 months after the older person’s discharge to their home. Qualitative content analysis of the data was carried out. The International Classification of Functioning, Disability and Health provides a guiding framework for rehabilitation. Results: Informants’ experiences of home rehabilitation contributed to the formation of 6 categories: (i) living with a frail body; (ii) striving for well-being in daily life; (iii) being close at hand; (iv) feeling dependent in daily life; (v) struggling to carry on; and (vi) striving to be at home. Conclusion: Older people’s goals were to return to daily routines and to perform meaningful activities without feeling dependent on other people. Family members’ participation was crucial. Psychosocial support and autonomy were essential for facilitating activity and participation. Healthcare professionals should consider each individual’s unique experiences along with the significance of being at home.
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| 3. |
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| 4. |
- Björkman Randström, Kerstin
(author)
-
Hemmet som arena för äldres rehabilitering
- 2013
-
Doctoral thesis (other academic/artistic)abstract
- Avhandlingens övergripande syfte var att studera multidisciplinära teams, äldre personers och familjemedlemmars erfarenheter av hemrehabilitering. Avhandlingen baseras på fyra studier (I-IV). Alla studierna har en kvalitativa beskrivande design. Datamaterialet utgjordes av fokusgruppsintervjuer med personal arbetande i team i kommunal hälso- och sjukvård (I), intervjuer med äldre personer, över 65 år, som vårdats på sjukhuset och därefter fortsatt rehabilitering i hemmet (II,III,IV), samt familjemedlemmar involverade i de äldres rehabilitering (II).Studie I visade på betydelsen av att möta äldres individuella behov och att arbeta utifrån ett rehabiliterande förhållningssätt i avsikt att ge en hjälp som inte innebär att ta över handlingar från den äldre. Väsentligt var att i teamet reflektera över hur man agerar utifrån den egna professionen för att kunna utveckla ett rehabiliterande förhållningssätt i det dagliga arbetet. I resultatet framkom att teamen uppfattade hemrehabilitering som positiv för de äldre, men mindre lämpligt om de äldre var svårt sjuka och de kände sig otrygga i sitt hem. Respekt för de äldres integritet i deras hem och att göra de närstående delaktiga i rehabiliteringen betonades. Resultatet visade på att för att kunna utveckla samarbetet i teamet finns behov av att diskutera varje professions ansvarsområde och klargöra gränser mellan varandras ansvarområden. Behovet av att tillföra psykosocial kompetens i teamet framhölls för att möta de äldres behov. I studie II framkom att de äldre upplevde rehabiliteringen vara en balansgång i att känna av vad kroppen orkar med för dagen och vad som är realistiskt att uppnå för att känna välbefinnande. Tryggheten i att ha någon i familjen nära sig i hemmet var oumbärligt för att våga utföra träning och vardagliga aktiviteter. Resultatet visar på de äldres upplevelse av otillfredsställelse med att vara beroende av andra. Familjemedlemmar var engagerade i de äldres rehabilitering genom att finnas till hands, hjälpa till och vara stödjande, vilket var en självklar handling men också utmanande i att kunna hjälpa på rätt sätt. Bristande information om hjälpmedels funktion och användning skapade frustration. Resultatet visar att både de äldre och deras familjemedlemmar ser hemmiljön bidra till att underlätta rehabilitering. Det som försvårar är när gränsen för det egna hemmet inskränkts i och med att och personal ofta gick "in och ut" i det egna hemmet.Studie III visar på ett flertal faktorer i de äldres vardag och i det omgivande samhället som inverkat underlättande eller hindrande på aktiviteter och delaktighet vid hemrehabilitering. Resultatet beskrivs utifrån Klassifikation av funktionstillstånd, funktionshinder och hälsa (ICF) i 19 kategorier i domänen omgivningsfaktorer. Som underlättande faktorer framträder bl.a. tillgång till hjälpmedel, en fysisk miljö tillgänglig för aktiviteter samt att få stöd från närstående, vänner och personal i hälso- och sjukvård och omsorg. I resultatet framkom betydelsen av ett empatiskt förhållningssätt när personal möter den äldre personen i dennes hem. Resultatet indikerar att hemrehabilitering inte till fullo tillgodoser äldres behov av rehabilitering. I studie IV framkommer personliga faktorer som inre styrka, motivation, engagemang och tålamod för att nå positiva resultat i en rehabilitering som sträcker sig över flera år. Rehabilitering beskrivs i fysiska och psykiska faser som övergick i att hantera en fysisk funktionsnedsättning med svårigheter att gå i dagligt liv. Resultatet visar på betydelsen av adekvat information, vikten av socialt stöd och tillgänglighet till hälso- och sjukvårdspersonal under rehabiliteringsprocessen.Avhandlingen bidrar till en ökad kunskap om hur multidisciplinära team, äldre personer och familjemedlemmar upplever rehabilitering i hemmiljö. Nyttan med avhandlingen kan medföra att hemrehabilitering som vårdform kan bli föremål för diskussioner om hur det utformas och organiseras för att på bästa sätt stödja de äldre och närstående med utgångspunkt från de äldres och närståendes erfarenheter och upplevelser. Detta kan ses gagna deltagarna på individnivå men även för utveckling inom yrkesprofessionen. Avhandlingen har även visat på möjligheten att implementera ICF i rehabiliterande omvårdnad.
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| 5. |
- Björkman Randström, Kerstin, et al.
(author)
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"I have to be patient" - A longitudinal case study of an older man's rehabilitation experience after a hip replacement surgery
- 2013
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In: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 3:8, s. 160-169
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Journal article (peer-reviewed)abstract
- Background: Aging can bring about an increased risk of disability. Following illness or injures, rehabilitation is essentialif the individual affected is to attain and maintain independence. Performing rehabilitation with a person-centeredapproach is vital for positive outcomes. Health providers are increasingly interested in developing rehabilitation servicesin outpatient settings for older people in their own homes. Aim: The aim of this study was to describe an older man’s rehabilitation experience after a hip replacement surgery.Design: A longitudinal qualitative descriptive single case study.Methods: Interviews were conducted on four occasions with the participant in his own home. The interviews wereconducted one month, seven months, one year, and five years after the patient was discharged from the hospital. The datawere analyzed using qualitative content analysis.Results: Three categories emerged: (i) having feelings of despair, (ii) being in charge, and (iii) having rehabilitative support. The results demonstrate the participant’s decreased ability to walk after a complicated hip surgery, and his physical and psychological struggle for well-being in everyday life. A strong motivation to return to as normal a life aspossible facilitated the rehabilitation. Also, a supportive family and accessible health care professionals were essential tothe positive outcome of the home rehabilitation.Conclusion: Rehabilitation can extend over a long period to maintain and improve mobility. Also, living with a disability causes feelings of despair. The home can be a source of energy but also a place of challenges during rehabilitation. To support older people in achieving their rehabilitation goals and engaging in meaningful activities, professionals should focus on personal factors, psychosocial support and on influential factors in the home environment and in society in general.
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| 6. |
- Björkman Randström, Kerstin, et al.
(author)
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Impact of environmental factors in home rehabilitation − a qualitative study from the perspective of older persons using the International Classification of Functioning, Disability and Health to describe facilitators and barriers
- 2012
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In: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 34:9, s. 779-787
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Journal article (peer-reviewed)abstract
- Purpose: The aim of this study was to explore older people’s experience of environmental factors that impact on their activity and participation in home rehabilitation. Method: Older people aged between 68 and 93 years and receiving home rehabilitation were interviewed. A qualitative content analysis was performed on the interview text using the predetermined structure of the International Classification of Functioning, Disability and Health (ICF) environmental domain. The text was linked to the closest ICF category. Results: The results identified environmental facilitators and barriers that influenced activity and participation among older people receiving home rehabilitation. Approaches that provided a facilitative environment were access to assistive products and technologies, alterations to the physical environment, social support and relationships, and adjusted health and social care services. Conclusions: A qualitative study using ICF-listed environmental factors contributed a holistic view of facilitators and barriers in home rehabilitation for older people. Awareness of the importance of the impact of the social environment on activities and participation could improve home rehabilitation services for older people. The study represents an important step towards a holistic approach using the ICF, which aims to enable all health care professionals to describe, plan and evaluate rehabilitation services together with older people across the health and social care sectors.
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| 7. |
- Björkman Randström, Kerstin, et al.
(author)
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Working with 'hands-off' support: a qualitative study of multidisciplinary teams' experiences of home rehabilitation for older people
- 2014
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In: International Journal of Older People Nursing. - : Wiley. - 1748-3735 .- 1748-3743. ; 9:1, s. 25-33
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Journal article (peer-reviewed)abstract
- BackgroundThere is a move towards the provision of rehabilitation for older people in their homes. It is essential to ensure that rehabilitation services promote independence of older people.AimThe aim of the study was to explore multidisciplinary teams' experiences of home rehabilitation for older people.MethodsFive focus groups were conducted with multidisciplinary teams based in a municipality in Sweden, covering seven different professions. In total, 28 participants volunteered to participate in these interviews. Interviews were transcribed verbatim and analysed according to content analysis.ResultsTwo main categories, as well as four subcategories, emerged. The first main category, having a rehabilitative approach in everyday life, consisted of the subcategories: ‘giving ‘hands-off’ support’ and ‘being in a home environment’. The second main category, working across professional boundaries, consisted of the subcategories: ‘coordinating resources’ and ‘learning from each other’.ConclusionCommon goals, communication skills and role understanding contributed to facilitating the teams' performances of rehabilitation. A potential benefit of home rehabilitation, because the older person is in a familiar environment, is to work a rehabilitative approach into each individual's activity in their everyday life in order to meet their specific needs. At an organisational level, there is a need for developing services to further support older people's psychosocial needs during rehabilitation.Implications for practiceTeam performance towards an individual's rehabilitation should come from an emerged whole and not only from the performance of a specific professional approach depending on the traditional role of each profession. A rehabilitative approach is based on ‘hands-off’ support in order to incorporate an individual's everyday activities as a part of their rehabilitation.
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| 8. |
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| 9. |
- Bosse, Ek, 1951-, et al.
(author)
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Registered nurses’ experiences of their decision-making at an Emergency Medical Dispatch Centre
- 2015
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In: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 24:7-8, s. 1122-1131
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Journal article (peer-reviewed)abstract
- Aims and objectives: To describe registered nurses experiences at an Emergency Medical Dispatch Centre.Background: It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patients arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses.Design: A qualitative design was used for this study.Methods: Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used.Results: Two themes emerged during the analysis: ‘Having a profession with opportunities and obstacles’ and ‘Meeting serious and difficult situations’, with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned.Conclusions: Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses.Relevance to clinical practice: Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame-free culture are important factors to attract and retain employees.
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| 10. |
- Ek, Bosse, 1951-, et al.
(author)
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Reliability of a Swedish pre-hospital dispatch system in prioritizing patients
- 2013
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In: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 21:2, s. 143-149
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Journal article (peer-reviewed)abstract
- The need of emergency help often begins with a call to a dispatch center. The operator uses a medical index to prioritize dispatches. Since the resources of ambulances are limited, it is important that the priority grading decided by the operator at the dispatch center is as adequate as possible. In the county of Jamtland in Sweden, a system for triage named METTS-A (Medical Emergency Triage and Treatment System-A) has been in use since 2009, when the patient is coded according to priority level. The aim of this study was to analyse the sensitivity and specificity of the priority grading made by the dispatch center in comparison with the METTS-A priority assessed by the ambulance nurse. Statistics from a data-base in northern Sweden were analyzed. The material covered every ambulance that was dispatched, 6986 times during the period of data collecting. The results show a high sensitivity but low specificity in the dispatch system. The results also indicate that over prioritization exists since most of the patients with a high acute need of an ambulance are correctly identified, while many patients without that need are also given a high priority ambulance service. Therefore the conclusions were that both over- and under prioritizations were made.
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| 11. |
- Eriksson, Monica, et al.
(author)
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Changes in hope and health-related quality of life in couples following acute myocardial infarction : A quantitative longitudinal study
- 2013
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 27:2, s. 295-302
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Journal article (peer-reviewed)abstract
- Acute myocardial infarction (AMI) is a life-changing event that affects both the patient and the family and can have an influence on hope as well as HRQoL during the recovery period. Aims: To compare self-rated scores of hope and health-related quality of life (HRQoL) 1, 7, 13 and 25months, after an AMI with regard to (i) differences across time, and (ii) differences between patients and their partners. Design: Explorative and longitudinal study. Methods: In this nonrandomized study, Short Form 36 Health Questionnaire (SF-36) and Herth Hope Index-Swedish (HHI-S) questionnaires were completed by thirteen post-AMI patients and their partners. Data were collected on four occasions. Results: In general, hope as well as HRQoL scores increased over time. A 2 (groups)×4 (times) anova for mixed design showed significant changes in mental as well as in physical health over time but no significant effect of group on mental or physical health. Calculation of the minimum detectable change (MDC-index) for HHI-S and SF-36 revealed that scores between data collection points were not stable. Conclusion: Our results show that although hope and HRQoL scores increased, only a few of the changes were statistically significant. Neither HHI-S nor SF-36 seems to measure stable states. Changes in hope and HRQoL levels may be due to participants striving to adapt to the current situation. Relevance to clinical practice: These results can be used in the training of nursing staff to enhance their understanding of the significance of a family-centred approach after an AMI. © 2012 Nordic College of Caring Science.
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| 12. |
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| 13. |
- Eriksson, Monica, 1960-, et al.
(author)
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Couples´ thoughts about and expectations of their future life after the patient´s hospital discharge following acute myocardial infarction
- 2010
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In: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 19:23-24, s. 3485-3493
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Journal article (peer-reviewed)abstract
- Aim: To describe and interpret couples’ thoughts and expectations about their future life after the patient’s discharge following acute myocardial infarction [AMI]. Background: An AMI is a challenge for both the patient and his/her partner, as it can disrupt family functioning and dynamics. Earlier research has generally focused on either the patient or the partner and few studies have explored the experiences of the couple. Design: Qualitative descriptive and interpretative. Methods: 15 couples took part in individual interviews, 4-8 weeks after discharge. Data were analysed in two phases using qualitative content analysis. Results: The first phase of the analysis revealed two categories: ‘an active approach to the future’ and ‘a wait-and-see approach to the future’, both of which described the participants’ thoughts about the future. In the second phase, the couples’ stories were interpreted and grouped into four positions: ‘the life companions’, ‘the tightrope walkers’, ‘the pathfinders’ and ‘the observers’, which illustrated their visions of the future. Conclusions: Our results reveal differences in the couples’ thoughts about and expectations of their future life, most of them managed the situation by having a positive attitude to life and their future. The couples discovered their resources and compensated for or balanced each other in the early recovery period. Relevance to clinical practice: The results indicate the importance of giving both partners the opportunity to express their views of the situation, as this increases nurses’ understanding of the impact of the illness on their life and relationship. However, the results also highlight the significance of seeing the couple and showing them consideration both as individuals and as a unit.
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| 14. |
- Eriksson, Monica, et al.
(author)
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Elderly Spouses Experiences In Connection With Their Partners’ Death : A Literature Review
- 2007
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In: Vård i Norden. - 0107-4083 .- 1890-4238. ; 27:1, s. 43-46
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Journal article (peer-reviewed)abstract
- Previous generations’ inherent and natural knowledge of encouraging routines and rituals for mourning is no longer an obvious part of our society of today. The aim with this literature review was to present elderly spouses experience in connection with their partners’ death. The result has been achieved be qualitative content analysis of eleven scientific articles. The categories and sub- categories that appeared have been used to describe the altered life situation the elderly faced. Death involves a series of experiences for the surviving relatives and in order to cope with the situation there is a need to adapt to the different requirements. The spouses undergo varying stages of adjustment during the mourning. The conclusions from this literature review were that elderly surviving experiences altered over time but that loneliness remains during a very long space of time. Lack of social support and close connections compose risk factors, which have negative influences on the mental health. Over the years, the overall majority of the surviving adjusts well to the loss of their partner
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| 15. |
- Eriksson, Monica, 1960-, et al.
(author)
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Patients´and their partners´experiences of returning home after hospital discharge following acute myocardial infarction
- 2009
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In: European Journal of Cardiovascular Nursing. - : Elsevier. - 1474-5151 .- 1873-1953. ; 8:4, s. 267-273
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Journal article (peer-reviewed)abstract
- Background: Returning home from hospital after an acute myocardial infarction [AMI] can be a period of vulnerability both for the patient and his/her partner. This study focuses on the time immediately after discharge. Aims: The aim of this study was to describe the patient’s and his/her partner’s experiences after hospital discharge following AMI. Methods: 15 couples took part in individual interviews, 4- 8 weeks after discharge. Data were analysed using qualitative content analysis. Results: The results are presented by means of three themes, ´ at home in one’s own home`, ´ at home within oneself ` and ´having normality in sight`, comprising ten categories that describe the experiences of both the patient and his/her partner. Conclusions: The patients as well as partners described the period after discharge from hospital comprising ambitions of feeling safety in their home, an inner sense of security and seeking normalisation.The results of this study could be useful for nurses when planning for patient discharge. During hospitalization nurses can prepare both the patient and their partner for what to expect when the patient returns home.
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| 16. |
- Eriksson, Monica, 1960-
(author)
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Recovery from an Acute Myocardial Infarction : A Longitudinal Study of Couples
- 2010
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis was to investigate recovery in the relationshipbetween couples following an acute myocardial infarction [AMI]. An additionalaim was to compare differences over time regarding hope and health‐relatedquality of life [HRQoL] for both patient and partner. The thesis is based on fourempirical studies (I‐IV), and has a longitudinal design employing both qualitativeand quantitative methods. A purposive sample was recruited comprising 15couples in which one partner had been diagnosed with an AMI. Study I wascarried out as individual tape‐recorded interviews aimed at describing thepatient´s and their partner´s experiences after hospital discharge. Study II alsoused individual tape‐recorded interviews, this time with the aim of describing andinterpreting the couple´s thoughts and expectations about their future life after thepatients’ discharge. Study III used the HHI‐S and SF‐36 measures to comparechanges over time in self‐rated hope and health‐related quality of life, anddifferences between patients’ ratings and their partner´s. Study IV used repeatedindividual tape‐recorded interviews with the aim of interpreting the couples´narratives about their relationship and daily life. The data were analysed andinterpreted using a number of qualitative content analysis methods (I, II, IV) anddescriptive and comparative statistics (III).Overall, the couples´ recovery from an AMI in the two years after an AMI consisted of a striving to reach some kind of balance and stability in their currentlife situation. The period after discharge from the hospital involved understandingthe importance of the home as a place in which one feels at home and which bringsa feeling of safety, experiencing the phenomenon of security and being at homewithin oneself, and seeking normalisation in returning to an ordinary life (I). Thecouples´ thoughts about their future lives were either optimistic, taking an activeapproach, or pessimistic, taking a wait‐and‐see approach. The couples could bedivided into four positions in terms of their visions of the future: life companions,who were in concordance regarding their future; tightrope walkers, who had incommon a need to reprioritise what they considered important in their future;pathfinders, who had in common an undefined vision of their future and observers, who saw their future including both physical as well as sociallimitations (II). Self‐rated hope and HRQoL both improved over time, but few ofthese improvements were statistically significant, and I found no statistically groupeffects. Estimation of the MDC index revealed that neither HHI‐S nor SF‐36measures stable traits (III). Finally, the repeated interviews revealed how thecouples viewed their daily life, mutual relationships and roles in their relationshipVIIover time. There was an abundant variation in a number of the couples´ storiesabout their relationship and daily life during the recovery period (IV).In conclusion, it is clear that what happen to one party in a relationship influencesthe other party. The couples in the studies showed improvements in both hope andhealth‐related quality of life over time. The HHI‐S and SF‐36 measures seemed tobe sensitive to and affected by the current situation. Going through an AMI is alife‐changing event that makes it necessary for the couple to make adjustments andadapt to their new situation. Different couples have different approaches tohandling this situation; no two couples are the same, and every couple willperceive and deal with the AMI differently. An AMI starts a process of transition,and over time a couple affected by AMI will undergo external as well as internal changes.
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| 17. |
- Eriksson, Monica, et al.
(author)
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The intruder': spouses' narratives about life with a chronically ill partner
- 2006
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 15:3, s. 324-333
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Journal article (peer-reviewed)abstract
- AIM: The aim of this study was to illuminate the meaning of middle-aged spouse's experiences of living with a chronically ill partner. A purposive sample of four female spouses was selected for interviews using a narrative approach. BACKGROUND: When someone is diagnosed with a chronic illness, it is easy to understand that a considerable number of devastating consequences follow, both for the afflicted as well as for the family. Families often feel neglected and that their problems and needs are underestimated, if they do not personally draw attention to this fact. METHODS: A phenomenological hermeneutic method, inspired by the philosophy of Ricoeur, was used when interpreting the interview text. RESULTS: The experiences of spouses living with a chronically ill partner often brought a feeling of detachment from their partner's lives. The women experienced changes in their relationships because of their partners' disabilities; they had emotions of loneliness, despite living together as a couple. Through their actions, the women sought reassurance and support in order to maintain a meaningful partnership with their spouses and this is expressed in three themes: feelings of limitation, the struggle of everyday life and a striving for normalization. CONCLUSIONS: Middle-aged women living with a chronically sick partner are still of an active disposition and regard themselves as still being in mid-life. They wish to be loved as a wife and not as a care provider. RELEVANCE TO CLINICAL PRACTICE: The findings from this study can help increase the knowledge and understanding of the problems and concerns encountered by middle-aged spouses living with chronically ill partners and can be useful in the education and supervision of nurses and in relationship with relatives.
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| 18. |
- Eriksson, Ulrika, et al.
(author)
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Struggling for confirmation - patients' experiences of dissatisfaction with hospital care
- 2007
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:3, s. 438-446
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Journal article (peer-reviewed)abstract
- AIM: The aim of the study was to illuminate patients' experiences of dissatisfaction with hospital care. BACKGROUND: During the last decade, interest in measuring patient satisfaction has become an important indicator of the quality of care. Researchers have, however, criticized the concept theoretically and methodologically. Subsequently, researchers have increasingly argued that the focus of attention should shift to explore patient dissatisfaction. DESIGN: A qualitative approach. METHODS: Narrative interviews were conducted with six people who had experienced dissatisfaction during a hospital care episode. The interview text was analysed using qualitative content analysis. RESULTS: The results show the patients' struggle for confirmation, the feeling of distrust in health care and what they have been forced to sacrifice because of lack of treatment. A feeling of being a troublesome patient is also apparent. At the same time a positive encounter is described, as well as situations of confirmation from caregivers. The results also show hope and a will to get on with life. CONCLUSIONS: Dissatisfaction relating to aspects of encounter is a common problem in health care and conceivable causes and possible solutions are discussed from different perspectives. RELEVANCE TO CLINICAL: PRACTICE: Caregivers as well as patients are in need of confirmation. If management were to take notice of and confirm caregivers this could consequently help them to gain the strength and energy necessary to provide care permeated with confirmation. A veritable, trustworthy care can be established through personal presence. To take notice of, confirm and listen to patients, creates opportunities for providing them with a positive experience of human encounter, which in the long run is rewarding from all perspectives.
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| 19. |
- Jakobsson, Björn, et al.
(author)
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Multi-professional vocational rehabilitation group meetings with female clients - a qualitative study.
- 2008
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In: Work. - 1051-9815 .- 1875-9270. ; 30:4, s. 413-421
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Journal article (peer-reviewed)abstract
- Many women require vocational rehabilitation before they can return to work. The objective with the present study was to describe female clients' situation during the rehabilitation process, as it became apparent during the rehabilitation meetings with the various actors involved. The clients' diagnoses varied, but the majority was affected with musculoskeletal disorders. The meetings were audio-taped and transcribed verbatim, after which they were analysed by qualitative content analysis. The following themes emerged: Adaptation to the rehabilitation group; client's health status; the workplace's significance for rehabilitation; and the client's decision-point. Conflict between health and work was immensely important for rehabilitation. Differences in attitude were apparent during the rehabilitation meetings, as some clients were passive and exercised less influence on the planning, than the other more active clients did.
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| 20. |
- Junehag, Lena, et al.
(author)
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A qualitative study : Perceptions of the psychosocial consequences and access to support after an acute myocardial infarction
- 2014
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In: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 30:1, s. 22-30
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to describe individuals' perceptions of the psychosocial consequences of an acute myocardial infarction (AMI) and of their access to support one year after the event. Methods: The study included 20 participants (14 men and six women) who lived in rural areas and had experienced their first AMI. Eleven were offered contact with a mentor. The participants were interviewed one year after their AMI. Results: The findings are presented in three themes: having a different life, having to manage the situation and having access to support, with 11 subthemes. During their recovery, the participants experienced psychosocial consequences, consisting of anxiety and the fear of being afflicted again. Most mentees appreciated their mentor and some of those without mentors wished they had received organised support. Participants were often more dissatisfied than satisfied with the follow-up provided during recovery. Conclusions: After an AMI, follow-up is important during recovery, but the standardised information provided is inadequate. During recovery, people need help dealing with existential crises. After discharge, receiving peer support from lay people with similar experiences could be valuable. The knowledge gleaned from this study could be used in education at coronary care units and in health care outside the hospital setting. © 2013 Elsevier Ltd.
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| 21. |
- Junehag, Lena, et al.
(author)
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Being a peer mentor for a person recovering from an acute myocardial infarction
- 2016
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In: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 6:5, s. 41-48
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Journal article (peer-reviewed)abstract
- Challenge after an acute myocardial infarction (AMI) is to manage the disease and to prevent a second AMI. Other people with the same illness have a unique understanding of the situation; therefore, they can provide valuable support. Being a peer mentor and contributing one’s own experiences of the same illness can even lead to increased self-confidence. The aim was to describe personal perceptions of being a peer mentor for a person recovering from an AMI. Patients in three sparsely populated counties, who had experienced their first AMI the previous year, were offered contact with peer mentors. The peer mentors had experienced an AMI between one and ten years ago. Sixteen of them were interviewed after one year as mentor. The interview texts were analysed using qualitative content analysis. Two themes summarized the interview results, “being in charge” and “being comfortable”, which incorporated six subthemes. The peer mentors also answered a questionnaire, and according to the purpose of the study, certain parts of the questionnaires were analysed using a paired-sample t-test. The dimensions measured in the Revised Illness Perception Questionnaire (IPQ-R) showed significant increased mean values, including Illness Coherence (p ≤ .001) and Emotional representation (p ≤ .05). Highlights of the results included that being a peer mentor led to feelings of pride and that peer mentors should be preceded by a careful matching between patients and mentors.
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| 22. |
- Junehag, Lena
(author)
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Peer mentoring - A complementary support to persons after an acute myocardial infarction
- 2014
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of the thesis was to investigate the experience of having an acute myocardial infarction in newly afflicted persons living in sparsely populated counties, and whether an intervention with peer mentors would provide support by affecting the perception of illness, health related quality of life and everyday life. The aim was also to describe the support of peer mentors from their perspective and what the mentoring meant to them. The thesis was based on four empirical studies (I-IV) and had a prospective, longitudinal, quasi-experimental, comparative design. A suitable sample was recruited, comprising 72 individuals who were newly afflicted with an acute myocardial infarction (AMI) for the first time; 34 of them were offered contact with a peer mentor, while 38 were not. Furthermore, 34 peer mentors participated in the project. The results were based on data collected from 28 individuals with mentors, 33 individuals without and 22 peer mentors. In studies I and III, qualitative approaches were used based on individual interviews with 20 newly afflicted individuals with (n=11) and without (n=9) mentors one year after AMI. The aims were to describe individuals’ perceptions of the psychosocial consequences of an acute myocardial infarction (AMI) and of their access to support one year after the event (I) and to describe individual perceptions of their lifestyle and support, 1 year after an AMI with or without mentorship (III). Study II was quantitative, consisting of data from questionnaires IPQ-R and SF-36 answered by 61 newly afflicted individuals with (n=28) and without (n=33) mentors. It aimed to investigate whether changes in illness perception and health-related quality of life occur over time after an intervention with peer mentors 1, 6 and 12 months after an AMI. Study IV had a mixed design and included peer mentors with the purpose to describing the personal meaning of being a peer mentor, for a person recovering from an acute myocardial infarction. Data consisted of individual interviews (n=15) and some data from IPQ-R and SF-36 that were provided on two occasions (n=22). All of the interviews (I, III, IV) were digitally recorded and analysed by qualitative content analysis, while the quantitative studies included descriptive data and were further compared using analysis of variance (ANOVA) (II) and the paired-sample t-test (IV). The results from all four studies are interpreted and presented together, and they show differences and similarities between the newly afflicted with or without peer mentors and the peer mentors. The results comprise six main areas; the meaning of becoming a person with an AMI (I, II, III) pointed toward an awareness of the situation expressed both in positive and negative terms, as being thankful or of being afraid of having a second AMI. View at health care (I) indicated that follow-up after discharge was sometimes a positive experience but more often resulted in dissatisfaction with this part of the health-care system. Consequences (II) showed significant effects between groups in the dimensions ‘consequences’ and ‘timeline acute/chronic’ (IPQ-R), with higher mean values for those without mentors and a significant effect of time in both dimensions. There were also physical consequences for many of the participants (I, II, III, IV) as well as psychological consequences (I, II, IV). Everyday life (I, III) was affected by AMI that sometimes limited activities. There were demands to change areas of life-style that were perceived as both positive and negative. Health (II, III, IV) showed that health increased for most individuals during the year, as confirmed by significant values for time for those newly afflicted. The peer mentors showed a decrease in mean values but expressed that they felt healthier after compared with before their commitment. Meaning of support (I, IV) indicated that families and relatives had an important, supportive role for newly afflicted participants. The mentorship showed that the relationship was, in some cases and for different reasons, unsuccessful. However, most of them were satisfied, and new friendships arose. More of the mentors felt pride and were thankful because their experience was shown to be valuable to others in addition to themselves. The results were synthesised using the Human Becoming nursing theory, which confirmed that recovery after an AMI is a process that occurs over time in which that those afflicted must accept and be comfortable being a person who is afflicted by an AMI. Some tendencies indicated an advantage for the newly afflicted participants who had received contact with a peer mentor. Conclusion: Because the mentor had experienced the same event, the relationship contributed to the security of the mentee. The peer mentors matured with the task because they felt that their experience was valuable and they felt unique.
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| 23. |
- Junehag, Lena, et al.
(author)
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Perceptions of illness, lifestyle and support after an acute myocardial infarction
- 2014
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 28:2, s. 289-296
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Journal article (peer-reviewed)abstract
- After an acute myocardial infarction (AMI), people are encouraged to adopt a healthy lifestyle. But they are not always motivated to maintain the necessary lifestyle changes and need the right support to do it. In sparsely populated areas, people afflicted by an AMI have difficulty in finding standard rehabilitation programmes near their homes during the recovery, so they need alternative forms of support. The aim was to describe individual perceptions of their lifestyle and support, 1year after an AMI, with or without mentorship. This study has a qualitative, descriptive design with data collected in individual interviews. Twenty men and women were interviewed 1year after their first AMI, and 11 had been offered contact with mentors who had had an AMI. Content analysis was used to analyse the data. Those with and without mentors had similarities and tendencies to variation in their perceptions, with both a positive and negative view of life. The participants were aware of the necessity of living a healthy lifestyle but some resisted doing so. They wished to live as before, and all saw the future positively. Having a mentor with the same experience could be valuable for some people, but more research is needed to understand the lack of motivation to make beneficial lifestyle changes after a serious health event as AMI.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Svedlund, Marianne, et al.
(author)
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Acute myocardial infarction in middle-aged women : narrations from the patients and their partners during rehabilitation
- 2000
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In: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397. ; 16:4, s. 256-265
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Journal article (peer-reviewed)abstract
- The purpose of this study was to examine the meaning of lived experiences after an acute myocardial infarction (AMI) and being a partner to an afflicted woman, as it is narrated during rehabilitation. Nine women and their partners narrated their experiences three and twelve months after AMI. The interview texts were transcribed and then interpreted, using a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur. The result showed that their experiences of the illness contained two themes: 'rehabilitation needed' and 'loss of freedom' which contains eight sub-themes; 'adapting to it', 'struggling against it', 'living as normally as possible', 'having insight into how it can be', 'feeling guilty and ashamed about being weak', 'withholding feelings', 'feeling useless', and 'feeling fatigued and losing strength'. After further interpretation, the themes gave a deeper meaning of living with AMI and how it affects women and their partners. The women conceded that they felt distressed and vulnerable but struggled against the fear the illness means. The partner's role appears to be one of trying to adapt to the women's experiences of the illness. That the women withheld their feelings and did not talk about them indicates a lack of communication between the couples. As coronary care nurses often come very close both to the afflicted persons and the relatives they fill an important function in each patient's recovery. The nurses could help and prepare the patients and their relatives to understand better such feelings and reactions as could appear after discharge from hospital.
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| 28. |
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| 29. |
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| 30. |
- Svedlund, Marianne, et al.
(author)
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Men's experiences during the acute phase of their partners' myocardial infarction
- 1999
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In: Nursing in Critical Care. - 1362-1017 .- 1478-5153. ; 4:2, s. 74-80
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Journal article (peer-reviewed)abstract
- The men's narratives about the women reveal a disturbance in the balance of their daily life, showing how they, the men, perceive powerlessness, and also how they passively adapted themselves to what happened. The narratives reveal that the women are 'ignoring and withholding' their feelings and that they want to be as 'responsible and independent' as they used to be. The women are disclosed as 'not wanting to face reality': there is an enervating lack of communication.
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| 31. |
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| 32. |
- Svedlund, Marianne, et al.
(author)
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Nurses' narrations about caring for inpatients with acute myocardial infarction
- 1999
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In: Intensive and Critical Care Nursing. - 0964-3397. ; 15:1, s. 34-43
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Journal article (peer-reviewed)abstract
- The purpose of this study was to examine the meaning of lived experiences of caring for people affected by acute myocardial infarction. Thirty-four registered nurses at a Coronary Care Unit in the north of Sweden narrated their experiences of this specialized care of inpatients. The interview texts were transcribed and then interpreted using a phenomenological-hermeneutic method, inspired by the philosophy of Ricoeur. Two groups of texts were identified. One comprised 'narratives about the patient' within which were the themes: 'distancing oneself from what is happening' and 'showing oneself as vulnerable'. The other was 'narratives about caring', with the themes: 'reading of', 'adapting', 'coming close' and 'helping'. Various views on caring were disclosed and interpreted with reference to Martin Buber's philosophy. A comprehensive understanding of caring as oscillations between the poles distance and relation was formulated.
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| 33. |
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| 34. |
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| 35. |
- Svedlund, Marianne, et al.
(author)
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Women’s narratives during the acute phase of their myocardial infarction
- 2001
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In: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 35:2, s. 197-205
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Journal article (peer-reviewed)abstract
- Aim. The purpose of this study was to illuminate the meaning of lived experiences during the acute phase of an acute myocardial infarction (AMI). Method. Ten women (< 60 years old) afflicted with AMI narrated their experiences during their stay in the coronary care unit (CCU). The interview texts were interpreted using a method with a phenomenological hermeneutic approach, inspired by the philosophy of Ricoeur. The text was divided into meaning units that were condensed and abstracted. Three themes were then extracted from the text. Findings. One theme was ‘oneself as vulnerable’ with the subthemes: ‘the feeling of being dependent upon others’, ‘the feeling of being insulted’ and ‘the feeling of being a troublesome person’. Another theme was ‘oneself as distanced’, with the subthemes: ‘not facing the reality’, ‘captive in an unreal situation’, and ‘inhibition out of concern for others’. The last theme was: ‘oneself as making sense’ with the subthemes: ‘acquirement of some insight’ and ‘discovery of a new meaning with life’. Conclusion. The reported comprehensive understanding revealed the phenomena guilt and shame. These, in combination with the experience of being in an unreal situation and the withholding of feelings may have led to a deterioration of communication. It seems that relatives and the staff at CCU were not allowed to share the burden of being afflicted with an AMI.
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| 36. |
- Utkovic Westergren, Helena, et al.
(author)
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Randomized clinical trial studying effects of a personalized supervised lifestyle intervention program on cardiovascular status in physically inactive healthy volunteers.
- 2018
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In: Oncotarget. - : Impact Journals, LLC. - 1949-2553. ; 9:10, s. 9498-9511
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Journal article (peer-reviewed)abstract
- The impact of personalized exercise training and a healthy dietary lifestyle in healthy volunteers on coronary flow reserve and cardiovascular function remains to be investigated in a controlled study setting.To examine the effects of a Mediterranean-inspired diet combined with regular physical exercise (standard) and a personalized supervised exercise program (DAPS) on coronary flow reserve and cardiovascular function.The number of males were 10 (59%) and 9 (47%) and mean age was 54 ± 12 and 55 ± 5 years in standard versus DAPS group, respectively. Primary outcomes were in addition to improved body composition and aerobic capacity, increased TDE-CFR (5.0%, CI:1.62,8.64, p = 0.005) and left ventricle ejection fraction (LVEF) during hyperemia (10.2%, CI:1.62,19.4, p = 0.022) in DAPS adjusted for the control period. Also, plasma fibrinogen decreased (-12.1%, CI:-22.0,-0.92, p = 0.035) in the DAPS group. Secondary outcomes, after adjusting DAPS intervention effects for the standard-training period, TDE-CFR and hyperemic LVEF remained significantly improved.This randomized, controlled clinical trial (URL: http://www.clinicaltrials.gov NCT02713724) included 36 healthy volunteers who underwent exercise ECG before randomization to standard or DAPS groups. Standard-group was given gym-membership with limited instructions and general dietary advice. DAPS-group received personalized supervised exercise programs and more detailed dietary advice with regular contact with a personal trainer. Effects were evaluated after 3 months. All participants underwent coronary flow reserve by transthoracic ultrasound (TDE-CFR), blood marker analysis and examinations of vascular function. Standard-group was evaluated pre-control, post-control (=pre-intervention) and post-intervention. DAPS-group was examined at pre-intervention and post-intervention.A personalized supervised training- and diet program improves cardiovascular status in healthy subjects with a physically inactive lifestyle and may be a promising approach for cardiovascular prevention in the general population.
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