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Kjällman Alm, Annika
Publications (10 of 15) Show all publications
Larsson Gerdin, A., Hellzén, O., Kjällman Alm, A. & Rising Holmström, M. (2024). Older persons' experiences of care encounters in their home: A multiple-case study. Journal of Clinical Nursing, 1-11
Open this publication in new window or tab >>Older persons' experiences of care encounters in their home: A multiple-case study
2024 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, p. 1-11Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim

To explore and describe older persons' unique experiences of care encounters with home care nurses in a real-life context.

Background

The increasing number of older persons in society contributes to increases in age-related impairments compromising their quality of life. Future care consists of “hospitals at home” where care encounters occur in a person's private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted.

Design

Multiple-case study.

Methods

The cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated.

Findings

The cross-analysis emerged in three categories: “Nursing routine rules the care encounters”, “Lack of knowledge and information” and “Dependency on support from others”.

Conclusions

Our research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person-centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time-sensitive care encounters.

Reporting Method

Findings were reported using COREQ guidelines.

Patient or Public Contribution

Patients were interviewed and contributed with data for this study.

Implications for the Profession and Patient Care

This study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality.

Place, publisher, year, edition, pages
Wiley, 2024
Keywords
asymmetry, care encounter, experiences, home care, multiple-case study, older persons, subordination
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-50427 (URN)10.1111/jocn.17043 (DOI)001152556100001 ()
Available from: 2024-02-05 Created: 2024-02-05 Last updated: 2024-02-09Bibliographically approved
Kjällman Alm, A., Hellzén, O. & Rising Holmström, M. (2023). Creating a Dementia-Friendly Community. In: World Academy of Science, Engineering and Technology: International Journal of Medical and Health Sciences. Paper presented at ICADA 2023: International Conference on Alzheimer's Disease and Aging Conference, London, United Kingdom, April 17-18, 2023. , 17
Open this publication in new window or tab >>Creating a Dementia-Friendly Community
2023 (English)In: World Academy of Science, Engineering and Technology: International Journal of Medical and Health Sciences, 2023, Vol. 17Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

The concept of dementia‐friendly communities focuses on the lived experience of people who have dementia and is most relevant to addressing their needs and the needs of those people who live with and provide support for them. The goal of communities becoming dementia‐friendly is for dementia to be normalized and recognized as a disabling condition. People with dementia find being connected to self, to others, and to the environment by meaningful activities as important. According to the concept underlying dementia-friendly communities, people with dementia or cognitive decline can continue to live in the community if their residential community has sufficiently strong social capital. The aim of this study is to explore staff and leaders’ experiences in implementing interventions to enhance a more inclusive dementia-friendly community. A municipality in northern Sweden with a population of approx. 100 000 inhabitants decided to create a dementia friendly municipality. As part of the initiative, a Centre for support was established. The Centre offered support for both individuals and groups, did home visits, and provided information about Dementia. Interviews were conducted with staff who had undergone training in a structured form of multidimensional support, the PER-model®, and worked at the Centre for support. The staff consisted of registered nurses, occupational therapists, and specialized nurses who had worked there for more than five years, and all had training in dementia. All interviews were audio-recorded and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results suggest that implementing the PER-model® of support for persons in the early stages of dementia and their next of kin added a much-needed form of support and perceived possibilities to enhance daily life in the early stages of dementia. The staff appreciated that the structure of PER-model® was evidenced based. They also realized that they never even considered that the person with dementia also needed support in the early stages but that they now had tools for that as well. Creating a dementia friendly municipality offering different kinds of support for all stages of dementia is a challenge. However, evidence-based tools and a broad spectrum of different types of support, whether individual or group, are needed to tailor to everyone’s needs. A conviction that all citizens are equal and should all be involved in the community is a strong motivator.

Keywords
dementia, dementia-friendly, municipality, support
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-48304 (URN)
Conference
ICADA 2023: International Conference on Alzheimer's Disease and Aging Conference, London, United Kingdom, April 17-18, 2023
Available from: 2023-05-10 Created: 2023-05-10 Last updated: 2023-05-10Bibliographically approved
Larsson Gerdin, A., Hellzén, O., Kjällman Alm, A. & Rising Holmström, M. (2023). Encountering patients in their homes: A qualitative study of home care nurses’ experiences. Nordic journal of nursing research, 43(1)
Open this publication in new window or tab >>Encountering patients in their homes: A qualitative study of home care nurses’ experiences
2023 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 43, no 1Article in journal (Refereed) Published
Abstract [en]

Many ill people want to be cared for at home, and home care nurses face an infinite number of encounters when providing that service. Despite the rising prominence of home care organizations worldwide, little research has been conducted on the encounters between home care nurses and patients and how encounters influence the nursing care provided. The aim of the present study was to describe home care nurses’ experiences of encounters with patients in their homes. In total, 11 home care nurses were selected through purposive sampling. The data consisted of individual interviews, which were analyzed through qualitative content analysis, and reported using COREQ reporting guidelines. The results were based on two categories describing the importance of adapting to each patient's needs and collaborating with the person being cared for. Implementing the findings could enable nurses to care for the patients without reducing them to recipients of objectified care.

Keywords
collaboration, home care, nurse-patient relationship, well-being
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-47777 (URN)10.1177/20571585231158950 (DOI)2-s2.0-85150445465 (Scopus ID)
Available from: 2023-03-10 Created: 2023-03-10 Last updated: 2023-03-28Bibliographically approved
Kjällman Alm, A., Hellzén, O. & Rising Holmström, M. (2023). Sense of Involvement and Support in Persons with Cognitive Decline in Ordinary Dwelling. In: World Academy of Science, Engineering and Technology: International Journal of Medical and Health Sciences. Paper presented at ICADA 2023: International Conference on Alzheimer's Disease and Aging Conference, London, United Kingdom, April 17-18, 2023. , 17
Open this publication in new window or tab >>Sense of Involvement and Support in Persons with Cognitive Decline in Ordinary Dwelling
2023 (English)In: World Academy of Science, Engineering and Technology: International Journal of Medical and Health Sciences, 2023, Vol. 17Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Worldwide, the number of people who are living with dementia is increasing because of an aging population, which leads to increased financial and social costs, including reduced quality of life for people with dementia and their care partners. Most people who have dementia reside in the community. Aging in place could be described as having the health and social supports and services you need to live safely and independently in your home or your society for as long as you wish and are able. People with dementia are not different than people without dementia where they want to remain at home, if possible, with a sense of familiarity and engagement in typical everyday activities. So how do persons with dementia or cognitive decline see their possibilities to be socially involved and experience support? The aim of this study was to explore persons with cognitive decline's sense of involvement and support living in the ordinary dwelling. The study was approved by the Ethical Review Authority in Sweden prior to the interviews. Interviews were conducted with 20 persons living at home, either alone or in a relationship. The persons had perceived cognitive decline; some were under investigation or already had a diagnose of early dementia. Thematic analysis was used to identify, analyze, and report patterns within the data. Researchers extracted three main themes through participants’ interviews: a) Importance of social involvement with family and friends. b) Hindrances for social involvement. c) Struggling mentally with a new life situation. Results found that going to activity centers, staying involved, and meeting friends and family enhanced the sense of involvement and support. There were also hindrances to a sense of involvement and support as they struggled with the diagnose and the changes in daily life, such as physical problems, mental problems, or economic issues. The mental struggle of accepting the cognitive decline and the changes in daily life it brought was also an issue for some of the participants. A multidimensional support should be provided by the community to enable persons with cognitive decline to stay involved in family and community in the comfort of their own homes.

Keywords
aging in place, cognitive decline, dementia, sense of involvement
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-48303 (URN)
Conference
ICADA 2023: International Conference on Alzheimer's Disease and Aging Conference, London, United Kingdom, April 17-18, 2023
Available from: 2023-05-10 Created: 2023-05-10 Last updated: 2023-05-10Bibliographically approved
Carlsson, M., Kjällman Alm, A. & Rising, M. H. (2022). An evaluation of registered nurses’ experiences of person-centered care and competence after participating in a course in digital competence in care. BMC Nursing, 21(1), Article ID 368.
Open this publication in new window or tab >>An evaluation of registered nurses’ experiences of person-centered care and competence after participating in a course in digital competence in care
2022 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 21, no 1, article id 368Article in journal (Refereed) Published
Abstract [en]

Background

Health care’s rapid transition from in-person visits to more digital care meetings has challenged nurses to find new, sustainable ways of using digital technology.

Methods

The aim was to describe registered nurses’(RN) experiences with person-centred care (PCC) and competence after participating in a course in Digital Competence in Care (DCC). In this study, a qualitative descriptive design was used, and 16 individual interviews were carried out with RNs. Data were analysed using qualitative content analysis. The COREQ checklist was used in this study.

Results

The results were presented in four categories: being open to change and new ways of working with patients; struggling to handle requirements; developing new ways of working and focusing on patients despite the distance.

Conclusions

The DCC course helped develop RNs' skills and practice of PCC in digital care meetings. Training in digital care theory increased RNs' competence and facilitated the creation of new knowledge. The RNs' professional role was strengthened by participating in the changing of work routines. Digital care meetings were shown to be distance bridging and complementary to physical care meetings contributing to PCC. The increased availability of health care via digital means has affected the consumption of care and tailored education needs for RNs must be met by nursing education programs. Digital care is accessible, efficient and enables care regardless of geographical conditions, its innovative development needs to be based on science and experience and RNs are key personnel in this process.

National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-46755 (URN)10.1186/s12912-022-01151-2 (DOI)000903524900001 ()2-s2.0-85144909922 (Scopus ID)
Available from: 2022-12-30 Created: 2022-12-30 Last updated: 2023-05-10Bibliographically approved
Hellzén, O., Kjällman Alm, A. & Rising Holmström, M. (2022). Primary Healthcare Nurses’ Views on Digital Healthcare Communication and Continuity of Care: A Deductive and Inductive Content Analysis. Nursing Reports, 12(4), 945-957
Open this publication in new window or tab >>Primary Healthcare Nurses’ Views on Digital Healthcare Communication and Continuity of Care: A Deductive and Inductive Content Analysis
2022 (English)In: Nursing Reports, ISSN 2039-439X, E-ISSN 2039-4403, Vol. 12, no 4, p. 945-957Article in journal (Refereed) Published
Abstract [en]

Primary healthcare in the Western world faces significant functional challenges, resulting in the implementation of digital communication tools. Nurses are key professionals in primary care and focusing on the impact of digital communication and continuity of care in primary care organisations is important. This qualitative descriptive study explores digital communication and continuity of care from primary healthcare nurses’ perspective. Data from individual semi-structured interviews with 12 nurses were collected; deductive and inductive content analyses were performed. Three descriptive categories emerged from the deductive (digital communication as interpersonal, information, and management continuities) and inductive (‘digital care does not suit everyone’, ‘new technology is contextually intertwined with daily work’, and ‘patient-positive aspects of digital information’) phases. Additionally, a structural risk of obscuration of patients’ needs by the contextual conditions emerged. To ensure digital communication-aligned continuity of care, compatible information technology systems should be developed. Allowing nurses to provide high-quality care based on their own values would enhance person-centred patient care.

Keywords
digital communication, digital healthcare, interviews, nursing, person-centred care, qualitative methods
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-46570 (URN)10.3390/nursrep12040091 (DOI)000902871100001 ()2-s2.0-85144375405 (Scopus ID)
Available from: 2022-12-02 Created: 2022-12-02 Last updated: 2023-05-10Bibliographically approved
Kjällman Alm, A., Danielsson, S. & Porskrog-Kristiansen, L. (2018). Non-Pharmalogical Interventions towards Behavioural and Psychological Symptoms of  Dementia—An Integrated Literature Review. Open Journal of Nursing (8), 434-447
Open this publication in new window or tab >>Non-Pharmalogical Interventions towards Behavioural and Psychological Symptoms of  Dementia—An Integrated Literature Review
2018 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, no 8, p. 434-447Article in journal (Refereed) Published
Abstract [en]

The objective of this integrated literature review was to identify and examine

effectiveness of non-pharmacological interventions towards BPSD. Database

searches were documented following the PRISMA flow diagram and included

papers were judged by the researchers using the SAHTAASS protocol. Coding

of the papers was carried out using Polit and Beck matrix for literature review.

It was concluded that several non-pharmacological interventions showed a

positive influence on BPSD such as stimulating interventions, social and personalized

activities and physical exercise. Also, education/training of healthcare

professionals and equipment in form of a structured BPSD protocol resulted

in decreased BPSD.

Keywords
BPSD, Complimentary Therapies, Dementia, Integrated Literature Review
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-35032 (URN)10.4236/ojn.2018.87034 (DOI)
Available from: 2018-12-04 Created: 2018-12-04 Last updated: 2023-05-10Bibliographically approved
Kjällman Alm, A., Hagglund, P., Norbergh, K.-G. & Hellzén, O. (2015). Sense of Coherence in Persons with Dementia and Their Next of Kin: A Mixed-Method Study. Open Journal of Nursing, 5, 490--499
Open this publication in new window or tab >>Sense of Coherence in Persons with Dementia and Their Next of Kin: A Mixed-Method Study
2015 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, p. 490--499Article in journal (Refereed) Published
Abstract [en]

Indications of dementia disease include deterioration of memory, thinking, behaviour, and the

ability to perform everyday activities. Any of these symptoms can lead to stress and difficulties

organizing everyday life. As a way to view factors that support human health and well-being despite

stressful situations, Antonovsky introduced a salutogenic model. This model proposes that

sense of coherence primarily determines physical and mental health i.e. psychological well-being.

Having a sense of coherence in everyday life can reduce the impact of stress on the individual in

everyday life. The study’s aim of this study was to explore how participants in existing support

groups scored on the Sense of Coherence Scale (SOC), and what they perceived as contributory

factors to a meaningful, manageable, and comprehensible everyday life in the presence of dementia

using a mixed method. Persons with dementia had the highest scores on the SOC scale and their

partners the lowest. Persons with dementia expressed that being with others who understood

them made their everyday life comprehensible and manageable. Their partners expressed that

learning about dementia was helpful in managing and comprehending everyday situations. The

adult children expressed that it was meaningful to care for their parents and they scored slightly

higher than the partners on the SOC scale. Long-term ongoing support supplemented with information

and social support can contribute to the sense of coherence in persons with dementia and

their next of kin.

Keywords
Dementia, Next of Kin, Nursing, Mixed Method, Sense of Coherence, Support Groups
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-28766 (URN)10.4236/ojn.2015.55052 (DOI)
Available from: 2016-09-13 Created: 2016-09-13 Last updated: 2023-05-10Bibliographically approved
Kjällman Alm, A., Hellzén, O. & Norbergh, K.-G. (2014). Experiences of Family Relationships when a Family Member Has Dementia. Open Journal of Nursing, 4, 520-527
Open this publication in new window or tab >>Experiences of Family Relationships when a Family Member Has Dementia
2014 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, p. 520-527Article in journal (Refereed) Published
Abstract [en]

Approximately 66 million people worldwide will suffer from dementia in 2030. The dementia’s impact affects people with the disorder and those in their social networks, most notably, their families. This study’s aim was to explore the experiences of family relationships when a family member has dementia. We conducted semi-structured interviews with people diagnosed with dementia, their spouses and adult children. Seventeen participants were interviewed. All participants were recruited in open-ended ongoing structured support groups provided by a Swedish municipality in order to elicit the participants’ subjective experiences on family relationships after the dementia diagnosis. Researchers used content analysis to examine the transcripts. Two main themes were identified, one relating to changed relationships where the participants experienced longing, lost closeness, loneliness and changed sibling relationships. The second theme related to supporting relationships within the family with experiences such as kinship, shared responsibilities and love and appreciation. Support should therefore focus on creating relationships and giving opportunities for conversations about changes within the families and difficult decisions, creating family or team support for those who need it.

Place, publisher, year, edition, pages
Scientific Research Publishing, 2014
Keywords
Dementia, Family Relationships, Next of Kin, Qualitative Study
National Category
Humanities
Identifiers
urn:nbn:se:miun:diva-22676 (URN)10.4236/ojn.2014.47055 (DOI)
Available from: 2014-08-27 Created: 2014-08-27 Last updated: 2022-05-11Bibliographically approved
Kjällman Alm, A., Hellzén, O. & Norbergh, K.-G. (2014). Experiences of long-term ongoing structured support in early stage of dementia – a case study. International Journal of Older People Nursing, 9(4), 289-297
Open this publication in new window or tab >>Experiences of long-term ongoing structured support in early stage of dementia – a case study
2014 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, no 4, p. 289-297Article in journal (Refereed) Published
Abstract [en]

The prevalence of dementia diseases is increasing worldwide with advancing age and growing populations. In Sweden alone, which currently has a population of approximately 9 million, there are about 25, 000 persons diagnosed each year with a dementia disease. Consequently, after such a diagnosis there is a tremendous need for support not only in Sweden but other countries as well. The recipients of that support include next of kin who seek all sorts of information including conversations about upcoming lifestyle changes and ways to handle personality changes in their loved one who is suffering from dementia. The aim of this study was to explore four couples´ experiences in structured support groups. A single case study with multiple data collection methods was used. Semi-structured interviews were analyzed by content analysis, which revealed three main categories representing the findings in four cases: Kinship through shared experiences, Knowledge about the disease, and Sense of comfort and support. One category, Longing for kinship was created exclusively for one of the couples. Viewing the emerging categories from a healthy aging perspective, both comfort and support and kinship through shared experiences can be considered as components of larger themes of support and social interaction. Findings suggest that structured support groups are a good way to encourage discussions, allow persons with dementia to express themselves, and support healthy aging in partners. Facilitators, regardless of whether they are social workers or registered nurses, should be trained in the group process to enable the individuals in the group to communicate and find meaning in their experiences.

Keywords
Case study, Experiences, Dementia, Older people, Support groups
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-20627 (URN)10.1111/opn.12034 (DOI)23758956 (PubMedID)2-s2.0-84911477518 (Scopus ID)
Note

Publ online 11 June 2013

Available from: 2013-12-11 Created: 2013-12-11 Last updated: 2023-05-10Bibliographically approved
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