| 1. |
- Eriksson, Erik, 1977, et al.
(författare)
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When they talk about motherhood: a qualitative study of three groups’ perceptions in a Swedish child health service context
- 2016
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Ingår i: International Journal for Equity in Health. - : Springer Science and Business Media LLC. - 1475-9276. ; 15:1, s. Article number 99-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn light of the growing emphasis on individualization in healthcare, it is vital to take the diversity of inhabitants and users into consideration. Thus, identifying shared perceptions among group members may be important in improving healthcare that is relevant to the particular group, but also perceptions of the staff with whom interactions take place. This study investigates how motherhood is perceived among three groups: Somali-born mothers; Swedish-born mothers; and nurses at Swedish child health centers. Inequities in terms of access and satisfaction have previously been identified at the health centers.MethodsParticipants in all three groups were asked to finalize two statements about motherhood; one statement about perfect motherhood, another about everyday motherhood. The responses were analyzed using qualitative coding and categorization to identify differences and similarities among the three groups.ResultsThe responses to both statements by the three groups included divergences as well as convergences. Overall, biological aspects of motherhood were absent, and respondents focused almost exclusively on social matters. Working life was embedded in motherhood, but only for the Somali-born mothers. The three groups put emphasis on different aspects of motherhood: Somali-born mothers on the community; the Swedish-born mothers on the child; and the nurses on the mother herself. The nurses – and to some extent the Swedish-born mothers – expected the mother to ask for help with the children when needed. However, the Somali-born mothers responded that the mother should be independent, not asking for such help. Nurses, more than both groups of mothers, largely described everyday motherhood in positively charged words or phrases.ConclusionThe findings of this paper suggest that convergences and divergences in perceptions of motherhood among three groups may be important in equitable access and utilization of healthcare. Individualized healthcare requires nuance and should avoid normative or stereotypical encounters by recognizing social context and needs that are relevant to specific groups of the population.
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| 2. |
- Gyberg, Anna, et al.
(författare)
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Women's help-seeking behaviour during a first acute myocardial infarction
- 2016
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 30:4, s. 670-677
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Tidskriftsartikel (refereegranskat)abstract
- Studies indicate that the time from onset of symptoms to medical treatment has decreased in acute myocardial infarction (AMI). However, there are still variations indicating that women wait longer than men before making the decision to seek medical care. Multidimensional factors hindering and facilitating the decision have been identified in previous studies, though few have fully explored how social context affects women's expectations, interpretations and actions and so influences the decision-making process. The aim of this study was therefore to identify how women's experiences interacted and influenced the decision to seek medical care at their first AMI. Seventeen women, aged 38-75 years, were interviewed, at home or in the hospital, between June 2011 and May 2012. Grounded theory was used as a method, and data collection and analysis were carried out simultaneously. The results showed that before deciding to seek medical care, these women went through three defined but interrelated processes that together hindered their normal activities and made them act according to existential needs. The women's experiences of the progression of the disease, in terms of both symptoms and time, were very different, so they sought medical care at different times, sometimes life-threateningly late and sometimes before developing an AMI. Three mechanisms had to coincide if the women were to receive medical care. First, the women had to acknowledge their symptoms as something more than common bodily changes. Second, the healthcare system had to be accessible when the women made their decision to seek care. Third, the women must have come into contact with healthcare providers when the heart muscle had taken enough damage to measure.
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| 3. |
- Määttä, Sylvia, et al.
(författare)
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Contract theories and partnership in health care. A philosophical inquiry to the philosophy of John Rawls and Seyla Benhabib
- 2017
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Ingår i: Nursing Philosophy. - : Wiley. - 1466-7681. ; 18:3
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Tidskriftsartikel (refereegranskat)abstract
- Over the last 20 years, a paternalistic view in health care has been losing ground. The question about less asymmetrical positions in the healthcare professional-patient relationship is, for example, being addressed by the increased emphasis on person-centred care, promoted in disciplines such as medicine and nursing. Partnership is considered as a key component in person-centred care. Although the previous studies have addressed the attributes inherent in partnership, there is still potential for further discussion on how the various interpretations of partnership influence their use in healthcare literature. A vague understanding might also affect education and evaluation. As we see it, the philosophical underpinnings of the idea of partnership have not been sufficiently explored and discussed. The study reveals that partnership originates in the term partener defined as a relationship between individuals or groups characterized by cooperation and responsibility. Etymologically speaking, partnership is hence bound by a contract, which in this study is discussed in the frame of Rawls' contract theory, which in turn intersects with Benhabib and her distinction between the abstract and the concrete Other. Further, the expression equal partnership, which often appears in the context of person-centredness, is explored in relation to the philosophies of Rawls and Benhabib. The opportunity for partnership, as well as the risk of partnership becoming a tempting magnet with a vague and imprecise meaning, is discussed. Without exploration, reflection and discussion of the philosophical underpinnings, partnership carries a substantial risk of becoming an indistinct idea used in health care.
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| 4. |
- Nielsen, Susanne, 1969, et al.
(författare)
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Experiences and Actions During the Decision Making Process Among Men With a First Acute Myocardial Infarction.
- 2015
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Ingår i: The Journal of cardiovascular nursing. - 1550-5049. ; 30:4, s. 332-339
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have shown that people hesitate to seek medical attention when experiencing the initial symptoms of acute myocardial infarction (AMI), but the reasons why and the events underpinning the decision-making process are unclear. The aim of this study was to describe the actions and experiences involved in the process of seeking medical attention in men with a first AMI.
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| 5. |
- Nielsen, Susanne, 1969, et al.
(författare)
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Trends in mortality risks among 94,328 patients surviving 30 days after a first isolated coronary artery bypass graft procedure from 1987 to 2006: A population-based study
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 244, s. 316-321
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Tidskriftsartikel (refereegranskat)abstract
- Background: Updated knowledge about survival after coronary artery bypass graft (CABG) surgery is needed. We examined 20-year trends in 4-year survival after a first isolated CABG procedure, compared with that of the general population. Methods: We identified 94,328 patients surviving 30 days after a first isolated CABG 1987-2006 from the Swedish Inpatient Register. Results: Crude annual mortality rates remained stable at approximately 1% in patients aged 18-54 years and at approximately 2% in those aged >= 55 years. After adjustment for comorbidities, 4-year survival in men aged 18-54 and >= 55 years improved by 37% (HR: 0.63, 95% CI, 0.46-0.88) and 31% (HR: 0.69, 95% CI, 0.63-0.76), respectively, (1987-1991 vs. 2002-2006). The corresponding estimate for women aged >= 55 years was 38% (HR: 0.62, 95% CI, 0.52-0.75), with no significant change in survival in women aged b55 years (HR: 1.02, 95% CI, 0.52-2.03). Men and women aged b55 years had higher mortality than the general population, with standardized mortality ratios (SMR) of 1.76 (95% CI, 1.35-2.22) in men and 4.49 (95% CI, 2.74-6.68) in women during the last period (2002-2006). In contrast, patients aged >= 55 years had better survival with a SMR of 0.74 (95% CI, 0.70-0.78) in men and 0.82 (95% CI, 0.74-0.91) in women during 2002-2006. Conclusion: During 1987-2006, there was a significant improvement in survival after CABG for all categories, except in women aged < 55 years. Men and women aged >= 55 years who survived the first 30 days after CABG had a lower mortality risk than the general population.
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| 6. |
- Oresland, S., et al.
(författare)
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Disclosing discourses: biomedical and hospitality discourses in patient education materials
- 2015
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Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881. ; 22:3, s. 240-248
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Tidskriftsartikel (refereegranskat)abstract
- Patient education materials have the potential to strengthen the health literacy of patients. Previous studies indicate that readability and suitability may be improved. The aim of this study was to explore and analyze discourses inherent in patient education materials since analysis of discourses could illuminate values and norms inherent in them. Clinics in Sweden that provided colorectal cancer surgery allowed access to written information and welcome letters' sent to patients. The material was analysed by means of discourse analysis, embedded in Derrida's approach of deconstruction. The analysis revealed a biomedical discourse and a hospitality discourse. In the biomedical discourse, the subject position of the personnel was interpreted as the messenger of medical information while that of the patients as the carrier of diagnoses and recipients of biomedical information. In the hospitality discourse, the subject position of the personnel was interpreted as hosts who invite and welcome the patients as guests. The study highlights the need to eliminate paternalism and fosters a critical reflective stance among professionals regarding power and paternalism inherent in health care communication.
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| 7. |
- Smirthwaite, Goldina, 1965-
(författare)
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Genom genuslinser : Om patienters jämställdhet i tillgång till operation av gråstarr i Sverige
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim was to examine waiting times for cataract extraction in Sweden from an intersectional gender perspective; quantitative with regard to waiting times for different patient groups, and qualitative in order to identify factors that might contribute to gender differences in waiting time. Furthermore, the aim was to examine implications of critical realism and situated knowledges for studies of gender differences among patients regarding access to cataract extraction and more generally as grounds for studies of (in)equity in care. Methods: Studies I and II were register studies, and linear regression was performed in Study I and logistic regression in Study II. Mean waiting times for female and male patients were calculated in both studies. In Study III, focus group interviews were conducted at two eye clinics with differences in gender-related waiting times. The analysis method used was constructivist grounded theory, and text analyses were performed in Study IV. Main findings: Longer waiting times were associated with patients who were female, retired, of higher age, born outside the Nordic countries, having lower income, lacking education at university level and not being categorized by means of NIKE. Female patients had longer waiting time in all categories.The following factors might contribute to why female patients have longer waiting times: Traditional male occupations were constructed as being more demanding for visual acuity, while the need for good visual acuity in women’s work life was questioned; Assertive behaviour among men was explained in legitimizing ways; Behaviour among men with poor vision was constructed as safety risks in relation to driving and hunting. Concerning meta-theoretical aspects, both critical realism and situated knowledges can be fruitful for studies of (in)equity in care but are to some degree incompatible with each other. Conclusions: Differences in waiting times at eye clinics can be related to gender constructions. The prevailing pattern of female cataract patients systematically having longer waiting time than male patients that emerges in this thesis is noteworthy in relation to the principle of equity in care. Furthermore, it is noteworthy that waiting times were related to age, retirement, and native country as well as income and education levels.
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| 8. |
- Vaughn, L. M., et al.
(författare)
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Partnering with insiders: A review of peer models across community-engaged research, education and social care
- 2018
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410. ; 26:6, s. 769-786
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Tidskriftsartikel (refereegranskat)abstract
- Within community-engaged research, education and social care, peer models that partner with local "insiders" are increasingly common. Peer models are composed of insider "lay" community members who often share similarities or background with a project's target population. Peers are not academically trained, but work alongside researchers and professionals to carry out specific tasks within a project, or in the truest sense of partnership, peers collaborate throughout the project from start to finish as an equal member of the team. Although peer models are used widely, the literature lacks consistency and clarity. This systematic review of literature used a qualitative thematic synthesis to examine and report how, where and why peer models have been used in research, education and social care. We examined the language and titles used to describe the peers, details of their involvement in community-engaged projects, the setting, content/topic of study, level of engagement and related benefits/outcomes of such models. Focusing on the last 10 years, we conducted a comprehensive literature search twice between September 2016 and June 2017. The search resulted in 814 articles which were assessed for eligibility. Overall, 251 articles met our inclusion criteria and were categorised into three categories: empirical (n = 115); process/descriptive (n = 93); and "about" peers (n = 43). Findings suggest that there is a wide variety of peers, titles and terminology associated with peer models. There is inconsistency in how these models are used and implemented in research studies and projects. The majority of articles used an employment peer model, while only a handful involved peers in all phases of the project. The results of this literature review contribute to understanding the use, development and evolution of peer models. We highlight potential benefits of peer models for peers, their communities and community-engaged work, and we offer recommendations for future implementation of peer models.
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| 9. |
- Wallström, Sara, 1982, et al.
(författare)
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Impact of long-term stress in Takotsubo syndrome: Experience of patients
- 2016
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 15:7, s. 522-528
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Tidskriftsartikel (refereegranskat)abstract
- Background: The connection between stress and disease has been part of folk wisdom for a long time and has even made its way into our language with phrases such as ‘scared to death’ and ‘a broken heart’. Takotsubo syndrome is a formof acute, reversible heart failure characterized by ballooning of the left ventricle. Post-menopausal women are primarilyaffected, but cases have been described in both sexes and at all ages. The complete pathophysiology is unknown, but the disease has been connected to psychological or physical stress and a surge in catecholamines. Despite the strong connection with stress, knowledge about the life of patients before the onset of Takotsubo syndrome is lacking. Aim: The aim of this study was to describe and interpret patients’ narratives about long-term stress experienced before the onset of Takotsubo syndrome. Method: Nineteen people diagnosed with Takotsubo syndrome were interviewed. The narrative interviews were recorded and transcribed verbatim. The resulting texts were analysed using phenomenological hermeneutics. Results: The analysis revealed that the interviewees lived under stressful circumstances, characterized by feeling burdened by responsibilities, injustice and uncertainty, long before the onset of Takotsubo syndrome. This long-term stress wore down the defences of the interviewees to the degree that their capacity was exhausted and the smallest stressor could ‘tip them over the edge’. The findings indicated that the social structure of gender possibly contributed to the interviewees’ condition. Conclusions: These findings indicated that long-term stressful circumstances may cause vulnerability to acute psychological or physical stressors and, subsequently, to the onset of Takotsubo syndrome.
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