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Rasmussen, H., Hellzén, O., Stordal, E. & Enmarker, I. (2018). Family caregivers experiences of the pre-diagnostic stage in frontotemporal dementia. Geriatric Nursing
Open this publication in new window or tab >>Family caregivers experiences of the pre-diagnostic stage in frontotemporal dementia
2018 (English)In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984Article in journal (Refereed) Epub ahead of print
Abstract [en]

Frontotemporal dementia (FTD)is a neurodegenerative disease with symptoms that differs from other dementias. Commonly early symptoms in FTD are changes in personality and behavior, which can be interpreted as psychiatric disease. The delay in FTD diagnos is contributes to the burden of family caregivers. Therefore, it is important to have more knowledge about the pre-diagnostic stage. In this qualitative interview study, we explored fourteen family caregiver's experiences of the pre-diagnostic stage of frontotemporal dementia (FTD). Our findings suggest that the family caregivers experienced the pre-diagnostic stage of FTD as changes in the interpersonal relationship with their loved one.  These changes were often subtle and difficult for family caregivers to explain to others. The findings from our study illuminate the importance of medical staff paying attention when a next of kin is concerned about subtle changes in a loved one. The findings also illuminate that awareness of FTD should be raised.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-35080 (URN)10.1016/j.gerinurse.2018.10.006 (DOI)
Available from: 2018-12-06 Created: 2018-12-06 Last updated: 2018-12-10Bibliographically approved
Hellzén, O., Haugenes, M. & Ostby, M. (2018). 'It's my home and your work': the views of a filmed vignette describing a challenging everyday situation from the perspective of people with intellectual disabilities. International Journal of Qualitative Studies on Health and Well-being, 13(1), Article ID 1468198.
Open this publication in new window or tab >>'It's my home and your work': the views of a filmed vignette describing a challenging everyday situation from the perspective of people with intellectual disabilities
2018 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1, article id 1468198Article in journal (Refereed) Published
Abstract [en]

Purpose: Examining everyday challenges in the interactions between people with intellectual disabilities and their staff, as seen from the user's perspective, is an important perspective in health care research. Involving people with intellectual disabilities as so-called co-researchers is a relatively unexplored research strategy. In this paper, co-researchers participated in all the steps of the research process, from planning to reporting, in addition to the written reporting of the findings. The aim of this study was to explore how people with intellectual disabilities experienced a filmed vignette of an everyday situation. Method: Based on audio-recorded and transcribed individual and focus-group interviews with people with intellectual disabilities, performed by co-researchers with intellectual disabilities together with researchers, qualitative content analysis was used. Results: The analysis reveals three themes: "being emotionally touched", "being aware of the other", and "being unclear". Conclusions: The results are discussed in light of normalization and participation in society with independence and one's own decision-making. Regarding the care of people with intellectual disabilities, the main finding is the need to focus not only on greater involvement of this population in their own daily lives, but also to teach self-determination skills. Another finding is the importance of involving people with intellectual impairment as co-researchers.

Keywords
Content analysis, ethical issues, focus-group interviews, intellectual disabilities, vignettes
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-33678 (URN)10.1080/17482631.2018.1468198 (DOI)000431817300001 ()29733261 (PubMedID)2-s2.0-85046860160 (Scopus ID)
Available from: 2018-05-30 Created: 2018-05-30 Last updated: 2018-07-04Bibliographically approved
Eivergård, K., Enmarker, I., Livholts, M., Aléx, L. & Hellzén, O. (2018). The Importance of Being Acceptable: Psychiatric Staffs’ Talk about Women Patients in Forensic Care. Issues in Mental Health Nursing
Open this publication in new window or tab >>The Importance of Being Acceptable: Psychiatric Staffs’ Talk about Women Patients in Forensic Care
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2018 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673Article in journal (Refereed) Epub ahead of print
Abstract [en]

Currently, women comprise about ten percent of those sentenced to psychiatric forensic clinics in Sweden. Those who are sentenced to forensic care because of offending and violent behaviour have already taken a step away from the usually expected female behaviour. On the other hand, there are many women in forensic care who have not committed crimes, but who instead selfharm. Studies have identified a gender bias in diagnosing and care in psychiatric settings, but there are few studies conducted on women in forensic care. The present study therefore examined how the situation of women patients and female norms are expressed in the staff’s talk about these women during verbal handovers and ward rounds at a forensic clinic in Sweden. The aim was to explore how psychiatric staff, in a context of verbal handovers and ward rounds, talk about women who have been committed to forensic psychiatric care, and what consequences this might have for the care of the patients. The content of speech was examined using audio recordings and a method of analysis that was inspired by thematic analysis. The analysis identified that the staff talked about the women in a way that indicates that they expected the women to follow the rules and take responsibility for their bodies in order to be regarded as acceptable patients.                        

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-35074 (URN)10.1080/01612840.2018.1514551 (DOI)
Available from: 2018-12-06 Created: 2018-12-06 Last updated: 2018-12-06Bibliographically approved
Devik Andreasen, S., Hellzen, O. & Enmarker, I. (2017). Bereaved family members' perspectives on suffering among older rural cancer patients in palliative home nursing care: A qualitative study. European Journal of Cancer Care, 26(6), Article ID e12609.
Open this publication in new window or tab >>Bereaved family members' perspectives on suffering among older rural cancer patients in palliative home nursing care: A qualitative study
2017 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 26, no 6, article id e12609Article in journal (Refereed) Published
Abstract [en]

Little is known about experiences with receiving home nursing care when old, living in a rural area, and suffering from end-stage cancer. The aim of this study was thus to investigate bereaved family members' perceptions of suffering by their older relatives when receiving palliative home nursing care. Qualitative semi-structured interviews were conducted with 10 family members, in Norway during autumn 2015, and directed content analysis guided by Katie Eriksson's theoretical framework on human suffering was performed upon the data. The two main categories identified reflected expressions of both suffering and well-being. Expressions of suffering were related to illness, to care and to life and supported the theory. Expressions of well-being were related to other people (e.g. familiar people and nurses), to home and to activity. The results indicate a need to review and possibly expand the perspective of what should motivate care. Nursing and palliative care that become purely disease and symptom-focused may end up with giving up and divert the attention to social and cultural factors that may contribute to well-being when cure is not the goal.

Keywords
bereaved family members, home nursing care, palliative care, qualitative directed content
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-29555 (URN)10.1111/ecc.12609 (DOI)000414613000027 ()2-s2.0-85006049737 (Scopus ID)
Available from: 2016-12-14 Created: 2016-12-14 Last updated: 2018-02-28Bibliographically approved
Brodin, K., Hellzén, O. & Häggström, M. (2017). Intraoperative Care of the Conscious Patient from the Perspective of the Operating Theatre Nurse: A Grounded Theory. Open Journal of Nursing, 7(9), 1086-1099
Open this publication in new window or tab >>Intraoperative Care of the Conscious Patient from the Perspective of the Operating Theatre Nurse: A Grounded Theory
2017 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 9, p. 1086-1099Article in journal (Refereed) Published
Abstract [en]

Introduction: Intraoperative care includes a unique knowledge of how to

perform a safe and effective surgery procedure. Surgery performed under regional

or local anaesthesia allows the patient to remain conscious during the

procedure and is rather common in Swedish healthcare today. Aim: The aim

was to obtain a deeper understanding of the main concerns of operating theatre

nurses (OTN) when caring for conscious patients during the intraoperative

phase. Methods: Interviews were conducted with 23 OTNs from five different

hospitals in Sweden and analysed according to grounded theory. Findings:

The main concern among the OTNs was to take the patient in consideration.

The core category “achieve and maintain ethical treatment of patients”

in the operating theatre (OT) was a strategy used throughout the intraoperative

process. Ethical treatment was described as moral behaviour at

different levels and included the team’s behaviour, respectful and individualised

patientcare, and the working-morale of the professionals. Being vigilant

and being flexible were the categories related to the core category. The OTNs

constantly assessed where to pay most attention as they balanced between the

needs of the patient, the team, and the surgery procedure. Conclusion: It is

important that every patient is taken into consideration and that ethical principles

are held to the highest standards in the OT. A familiar team can facilitate

that. The complex skills that operating theatre nurses develop can be

added to explain important competencies within the profession.

Keywords
Conscious Patient, Grounded Theory, Intraoperative Care, Nursing
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-32241 (URN)10.4236/ojn.2017.79079 (DOI)
Available from: 2017-12-04 Created: 2017-12-04 Last updated: 2018-09-13Bibliographically approved
Rygg, L., Lohre, A. & Hellzén, O. (2017). Lifestyle Changes in Diet and Physical Activities after Group Education for Type 2 Diabetes: The Active Ingredient in the Education. A Qualitative Study. Open Journal of Nursing, 7(10), 1181-1195
Open this publication in new window or tab >>Lifestyle Changes in Diet and Physical Activities after Group Education for Type 2 Diabetes: The Active Ingredient in the Education. A Qualitative Study
2017 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 10, p. 1181-1195Article in journal (Refereed) Published
Abstract [en]

Background: Diabetes self-management education (DSME) for patients with

type 2 diabetes requires efficient teaching methods that make patients want to

change lifestyle in terms of their diabetes. The study looks at what may be the

active ingredient in this DSME. Objective: To explore how participants in

DSME, with an interactive learning method, experienced changes in relation

to diet and physical activity. Method: We studied possible changes in diet and

physical activity by semi-structured individual interviews of 16 participants

attending DSME. Results: Before the DSME, the participants felt insecure

about what to eat, and they expressed little interest in changing their physical

activity. Just after the DSME, they were more optimistic about diet because

they had learned how to interpret food labels and compose their meals. Furthermore,

they had experienced the benefit of physical activity in relation to

their blood glucose levels. Behavior changes appeared to persist the following

half year. We discuss the findings in light of the principles of interactive

learning. The participants experienced an effect of their behavior changes, and

blood glucose measurement was used as a tool to gain control and reach a

state of well-being. Conclusion: From being insecure about what to eat, the

patients acquired knowledge to handle their diet through the DSME. They

learned how to compose their meals and use physical activity to regulate their

blood glucose. We suggest that the interactive learning used in the DSME was

an active ingredient that led to changes in behavior and should be considered

as an educational method in DSME for patient with type 2 diabetes.

Keywords
Behavior Change, Diabetes, Self-Management Education, Nursing, Quality Improvement, Qualitative Research, Teaching/Learning Strategies, Interactive Learning
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-32240 (URN)10.4236/ojn.2017.710086 (DOI)
Available from: 2017-12-04 Created: 2017-12-04 Last updated: 2017-12-05Bibliographically approved
Voraroon, S., Hellzén, O., Meebunmak, Y. & Enmarker, I. (2017). Older People’s Lived Experiences with Participation in Shareholding Networks for the Care of Older People in Rural Areas of Thailand: A Phenomenological Hermeneutic Study. Open Journal of Nursing, 7(7), 875-892
Open this publication in new window or tab >>Older People’s Lived Experiences with Participation in Shareholding Networks for the Care of Older People in Rural Areas of Thailand: A Phenomenological Hermeneutic Study
2017 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 7, p. 875-892Article in journal (Refereed) Published
Abstract [en]

Background: Older people participating in shareholding networks are ex-posed to diverse situations, which may be associated with dignity. Aims: This study aimed to illuminate the meaning of lived experiences when participating in shareholding networks for the care of older people in rural areas. Methods: This qualitative study is based on individual interviews. Ten older Thai per-sons with at least 12 months of lived experiences participating in shareholding networks for older people in rural areas were interviewed. A phenomenologi-cal-hermeneutic approach, inspired by Ricoeur, was used to understand the meaning of the narrated text. Findings: The structural analysis resulted in four themes: 1) being satisfied with activities, 2) being valued as important, 3) being frustrated and feeling sad, and 4) being bored and feeling disinterest. The meaning of participation in a shareholding network for the elderly can be understood as a pathway to feelings of confidence and presence of others. Confidence and allowing the presence of others mean facing humanity and sensing vulnerability, because in a trusting relationship the person who gives confidence is susceptible to the other’s betrayal. Conclusion: An individual’s dignity should be a high priority in health and social care strategies. There-fore, it is important for healthcare professionals to initiate a dialogue with the shareholding participants for support and information. The narrations in this study can be used as a basis for developing cooperating care with older people in shareholding network focusing on their needs and dignity.

Keywords
Shareholding Networks
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-32236 (URN)10.4236/ojn.2017.77065 (DOI)
Available from: 2017-12-04 Created: 2017-12-04 Last updated: 2017-12-05Bibliographically approved
Björk, A., Rönngren, Y., Selander, J., Vinberg, S. & Hellzen, O. (2017). Perspectives on Everyday Suffering among People with Adult Attention Deficit Hyperactivity Disorder and Concurrent Mental Disorders. Open Journal of Nursing, 7, 583-598
Open this publication in new window or tab >>Perspectives on Everyday Suffering among People with Adult Attention Deficit Hyperactivity Disorder and Concurrent Mental Disorders
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2017 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, p. 583-598Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe the perceptions of everyday suffering among adults with attention deficit hyperactivity disorder (ADHD) and comorbid mental disease. Directed content analysis guided by Eriksson’s theory on human suffering was performed on data from 20 individual interviews. Expressions of both suffering and well-being were identified; the former centred on loneliness and related to life, illness, and care, which supported Eriksson’s theory, whereas expressions of well-being related to ADHD diagnosis and supportive social relationships. Nevertheless, results indicate the need to expand those expressions in order to better contribute to developing a supportive rehabilitation regimen that can provide more interpersonal care.

Keywords
Adult Attention Deficit Hyperactivity Disorder, Directed Content Analysis, Suffering, Supportive Rehabilitation
National Category
Health Sciences
Identifiers
urn:nbn:se:miun:diva-30783 (URN)10.4236/ojn.2017.75044 (DOI)
Available from: 2017-05-28 Created: 2017-05-28 Last updated: 2017-05-29Bibliographically approved
Voraroon, S., Meebunmak, Y., Enmarker, I. & Hellzén, O. (2017). Shareholding Networks for Care in Rural Thailand: Experiences of Older Persons and Their Family Members. Open Journal of Nursing, 07(02), Article ID 74497.
Open this publication in new window or tab >>Shareholding Networks for Care in Rural Thailand: Experiences of Older Persons and Their Family Members
2017 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 07, no 02, article id 74497Article in journal (Refereed) Published
Abstract [en]

Most  members  of  the  older  population  in  Thailand  live  in  rural  areas  while  their  children  live  in  cities.  With  the  joint  family  system  separated,  elderly  Thai persons often have to care for themselves, and opportunities for them to get  involved  in  community  care  remain  limited.  In  response,  the  aim  of  this  study  was  to  describe  olderpersons’  and  their  family  members’  experiences  with  shareholding  networks  for  the  care  of  older  people  in  rural  Thailand.  Paired  interviews  with  five  older  persons  and  five  of  their  family  members  were conducted, and collected data were subjected to content analysis, which yielded  results  organized  around  two  themes: older  persons’  outsider  status  and disregard for older persons’ individuality.Whereas the theme of outsider status  describes  shortcomings  in  healthcare  encounters,  the  theme  of  disre-gard for individuality describes the lack of engagement of authorities and ca-regivers  in  older  persons’  care.  In  that  sense,  the  concept of  participation  emerged  as  a  framework  for  understanding  interviewees’  experiences.  Given  findings  from  local  authorities,  older  individuals  and  theirfamily  members  should engage in dialogue in order to support healthcare based on shared un-derstanding.

Keywords
community health care, content analysis, older persons, participation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-29334 (URN)10.4236/ojn.2017.72026 (DOI)
Available from: 2016-11-23 Created: 2016-11-23 Last updated: 2017-12-14Bibliographically approved
Solum Myren, G. E., Enmarker, I., Hellzén, O. & Saur, E. (2017). The influence of place on everyday life: Observations of persons with dementia in regular day care and at the green care farm. Health, 9(2), 261-278, Article ID 74140.
Open this publication in new window or tab >>The influence of place on everyday life: Observations of persons with dementia in regular day care and at the green care farm
2017 (English)In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 9, no 2, p. 261-278, article id 74140Article in journal (Refereed) Published
Abstract [en]

Day care services for persons with dementia are becoming an important aspect of community services. Place, therefore, becomes vital concerning how such establishments are organized regarding both the physical and social environment and the programs that are offered. The aim of this study was to describe the influence of place on everyday life in two different organized daycare services for persons with dementia. Based on observations and informal conversations with persons with dementia and staff members at a green care farm and a regular day care, we used an inductive manifest content analysis. The analysis reveals a main category: enabling and collaboration in daily life. The results are discussed in light of Goffman’s analysis of the structures of social encounters from the perspective of the dramatic performance. The main findings in this study involve how place contributes to enabling activities and collaboration between participants and staff, as it influences participants’ ability to achieve an active or passive role in everyday life at the day care services.

Keywords
Day care services, green care, dementia, place, Goffman
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-29768 (URN)10.4236/health.2017.92018 (DOI)
Available from: 2016-12-22 Created: 2016-12-22 Last updated: 2018-04-19Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-1614-7379

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