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  • 1.
    Björk, Annette
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Rönngren, Ylva
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Selander, John
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Perspectives on Everyday Suffering among People with Adult Attention Deficit Hyperactivity Disorder and Concurrent Mental Disorders2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, p. 583-598Article in journal (Refereed)
    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.

  • 2.
    Brodin, Kerstin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Häggström, Marie
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Intraoperative Care of the Conscious Patient from the Perspective of the Operating Theatre Nurse: A Grounded Theory2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 9, p. 1086-1099Article in journal (Refereed)
    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.

  • 3.
    Häggström, Marie
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Rising Holmström, Malin
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Establishing Patient Safety in Intensive Care -A Grounded Theory.: Building Trust-Important for Patient Safety2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 07, no 10Article in journal (Refereed)
    Abstract [en]

    Background: The modern intensive care unit (ICU) is a complex and high-risk environment, and even small adverse events and changes may deteriorate the patient’s conditions and eventually cause harm. Many factors can potentially be associated within an increased amount of errors, leading to adverse events. Nurses, nurse managers, and other leaders all play important roles in establishing patient safety. Aim: This study aimed to obtain a deeper understanding of leaders’ and nurses’ main concerns in establishing patient safety in Swedish intensive care units. Method: A grounded theory methodology was used. Data from 15 interviews with leaders and nurses involved in critical care in Sweden were collected, analysed and constant compared. Findings: The main concern in establishing patient safety was promoting quality of care, work engagement, and staffs well-being in strained ICUs. The core category building trust explained how the leaders’ and nurses’ strove for quality of care and wished a healthy, safe work environment. This is further explained in the categories “Being an accessible and able leader”, “Creating knowledge and understanding”, and “Establishing collaborative practice”. Conclusion: Establishing patient safety in the ICU requires that staffs enjoy going to work, have good work relations, are committed and want to stay at the unit. A healthy, salutogenetic unit with a work environment marked by trust provides a better opportunity to establish patient safety, and various leaders have potential to achieve this.

  • 4.
    Kjällman Alm, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Danielsson, Sandra
    Region Jämtland/Härjedalen.
    Porskrog-Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Non-Pharmalogical Interventions towards Behavioural and Psychological Symptoms of  Dementia—An Integrated Literature Review2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, no 8, p. 434-447Article in journal (Refereed)
    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.

  • 5.
    Kjällman Alm, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hagglund, Per
    Härnösands kommun.
    Norbergh, Karl-Gustav
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Sense of Coherence in Persons with Dementia and Their Next of Kin: A Mixed-Method Study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, p. 490--499Article in journal (Refereed)
    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.

  • 6.
    Kjällman Alm, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Experiences of Family Relationships when a Family Member Has Dementia2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, p. 520-527Article in journal (Refereed)
    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.

  • 7.
    Kleebthong, Duangkaew
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Boromarajonani College of Nursing, Chakriraj, Thailand.
    Chareonsuk, Sukjai
    Boromarajonani College of Nursing, Chakriraj, Thailand..
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Högskolan i Gävle.
    Thai psychiatric nurses' experiences and perceptions of the professional role when caring for older people displaying depressive symptoms2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, no 1, p. 45-59Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to describe Thai psychiatric nurses’ experiences and perceptions of their professional role when caring for older people whom displayed symptoms of clinical depression. Methods: A qualitative descriptive research design was used. Thirteen psychiatric nurses working in the field of mental health and psychiatric nursing at a rural district hospital were purposively included. The data were collected through in-depth, face to face interviews and analyzed using qualitative latent content analysis. Results: All participants were female, and the mean age was 43 years, and the mean experience of caring for mentally ill patients was 8.3 years. The psychiatric nurses’ experiences and perceptions of their professional role were mirrored in the following themes: 1) managing a central role in the care of the patients; 2) conflicting interests between the professional needs of caregiving and other requests; and 3) being compassionate beyond the profession. Conclusion: The psychiatric nurses were challenged by the complexity of the caregiving situations and the partners involved in the process of caring for older people with depression. Professionally, the psychiatric nurses played an important role in preventive care and managerial work. They underwent stress under the influence of stakeholders, but they also contributed to the holistic patient care. Health service authorities may use these results to develop plans for psychiatric nurses in managing a central role and in advocating for holistic care to mitigate the influence of stakeholders to enhance quality of caring for older individuals with depression.

  • 8.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. University of Gävle.
    Wanting a Life in Decency!: A Qualitative Study from Experienced Electric Wheelchairs Users’ perspective2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 7, p. 419-433Article in journal (Refereed)
    Abstract [en]

    Background: The functionality and the safety of the electric wheelchairs were essential for users’ everyday life. Some evidence indicated that the wheelchair Per Se highly influenced users’ occupational life, their personal identity and social life; further, the wheelchair became an extension of the body and more than a technical device. Besides, there was still both environmental and self-efficacy or/and mental health factors obstacles for full social participation. Even so, there was to some extent stigma related to being a wheelchair user. There was a need to reflect users’ perspective on being depended on electric wheelchair. The aim, accordingly, was to describe and to get a deeper insight into electric wheelchairs users’ perspective and experiences of utilizing this device; a qualitative design with an inductive approach was used. Method: Qualitative latent and interpretative content analysis [1] [2] was used after repeated face-to-face semi-structured interviews with three experienced Swedish electric wheelchair users during the autumn 2017. Findings: The findings showed a high degree of dependability of the assistants that supported the users, and of the quality of that working relationship. The findings were formulated, abstracted and interpreted in several steps. It showed one theme of meaning: “Living in a space shifting between potential violation of or respect for human dignity”. Conclusion: The study showed that electric wheelchair users were relatively content with their lives as well as with their devices in turns of mobility and accessibility, but the meaning of their narrations showed a life at constant risk of having the respect of human rights and human respect violated. Besides, the importance of having access to good and high quality devices, good staffing, and environmental support, all in concordance with human rights, the clinical and practical implications of this study narrows down to a question of encountering the other person as a whole and worthy individual.

  • 9.
    Kristiansen, Lisbeth
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Lif, Ulrika
    Mid Sweden University, Faculty of Human Sciences, Department of Humanities.
    Asklund, Helen
    Mid Sweden University, Faculty of Human Sciences, Department of Humanities.
    Experiences on Participation in Literary Activities: Intellectual Stimuli Empower People with Mental Health Problems2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, no 7, p. 1307-1323Article in journal (Refereed)
    Abstract [en]

    Some research acknowledges engagement in creative and literary activities as constructively impacting rehabilitation and recovery. Nevertheless, there is a deficit of literature describing experiences of participation in literary activities. This study examined how members of a non-profit association for mental health, with experiences of mental problems or illnesses, experienced group-based literary activities facilitated of a bi-disciplinary research team during one semester. This study held a constructive/naturalistic design and used a qualitative methodology with a latent analysis to describe how participants experienced literary activities (creative writing, reading and conversations about published and own written poetry and prose texts). Both individual and focus-group interviews were performed early 2014. Despite previous negative experiences, the findings showed that the participants perceived the literary activities empowering. Four categories were created: Presumptions of personal literacy, leadership role, participants’ role, and literacy development. These were abstracted and interpreted into three themes: Identifying a reading and writing self-image, challenging and redefining one’s reading and writing identity, and strengthening one’s intellectual and humanistic capacity. Literary activities seemed to positively change the participants’ attitudes towards writing and reading, and also enhanced their literacy skills. We argue that literacy skills are interconnected with health literacy. Involvement of literary activities into rehabilitation in mental health practice may be beneficial for some groups, and merits further studies.

  • 10.
    Mentsen Ness, Tove
    et al.
    Högskolen i Nord Tröndelag.
    Enmarker, Ingela
    Hgskolen i Nord Tröndelag.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Experiences of being old and receiving home nursing care. Older South Sami narrations of their experiences—An interview study2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 1, p. 1-7Article in journal (Refereed)
    Abstract [en]

    The Sami people who are the natives of Scandinavia are not a homogeneous group. They consist of differ- ent groups of Sami populations of which the South Sami population are one small group. For the South Sami this means a problem; they have to struggle against a general ignorance about the Sami people and culture, which also may affect received home nursing care. The aim of this study is to describe in- dividual South Sami experiences of being old and re- ceiving home nursing care. A sample of 10 older per- sons with South Sami background was chosen for this study. Narrative interviews were conducted and qualitative content analysis was used to identify and categorize primary patterns in data. The experience of being an old person with South Sami background who receives home nursing care was understood through the use of the following four themes devel- oped from the informants’ own narratives: “Experi- ence of losses in life”; “Feelings of being less valued”; “Feelings of gratitude”; and “Experience of meaning in daily life as old”. The main finding is that the South Sami population still is exposed to an ongoing subtle colonisation. Therefore, it is important to pre- pare and teach nurses who work in the South Sami area in cultural care, traditional values and beliefs specific to the South Sami population. 

  • 11.
    Mentsen Ness, Tove
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    The Experience of Nurses Providing Home Nursing Care to Oldest Old Persons Living Alone in Rural Areas—An Interview Study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 4, p. 336-344Article in journal (Refereed)
    Abstract [en]

    The rapidly increasing population of older persons worldwide, and the fact that the majority of them want to continue living in their own homes, mean there is a growing focus on home based care. Because of this, it is necessary to increase the number of studies, including rural areas, as earlier studies are sparse. Rural areas cannot be seen as a homogeneous phenomenon, meaning more research is needed to increase knowledge about cultural differences in rural areas. The aim of this study was therefore to describe registered nurses’ experiences of providing home nursing care to oldest old persons living alone in rural areas. A sample of 15 registered nurses in rural South Sami areas was chosen for this study, 13 women and 2 men. Narrative interviews were conducted, and qualitative content analysis was used to interpret the data. The analysis revealed four themes and eight subthemes in addition to a core-theme. The latent meaning of the themes “Feeling responsible”, “Trying to accommodate”, “Being challenged” and “Feeling significant” formed the core-theme: contradictions between nurses’ ideals of being professional and the reality faced in rural home nursing care with close social relationships. The findings in this study showed that the experiences of providing home nursing care in rural areas to oldest old persons were multifaceted and altering, as well as emotionally and socially contradictory.

  • 12.
    Moe, Aud
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. 1Faculty of Health and Science, Nord-Trøndelag University College, Levanger, Norway.
    Ekker, K
    Faculty of Agricuclture and Information Technology, Nord-Trøndelag University College, Steinkjer, Norway.
    Enmarker, Ingela
    4Faculty of Health Science, Nord-Trøndelag University Collage, Namsos, Norway.
    A description of resilience for Norwegian home-living chronically ill oldest old persons2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, p. 241-248Article in journal (Refereed)
    Abstract [en]

    Background: Despite worsening health the chroni- cally ill oldest older persons have expressed feelings of inner strength, which can be understood as resil- ience. The objective was to describe and compare the characteristics of resilience in two different age groups of chronically ill oldest older persons living at home and who needed help from home nursing care. Design: Cross-sectional design was used to describe and com- pare the resilience qualities between the two age groups. Methods: The inclusion criteria were 80 years or old- er, living at home with chronic disease, receiving help from home nursing care, and with the capacity to be interviewed. A sample of 120 oldest older women (n = 79) and men (n = 41) separated in two age groups, aged 80 - 89 and 90+ years, participated in the study. Resil- ience characteristics were measured by Resilience Scale. Results: The whole group of oldest older people was vulnerable in relation to the characteristics of persever- ance, self-reliance, and existential aloneness. Despite reduced physical health they reported a meaningful life, and equanimity. Even if there were no significant differences between the age groups among the oldest older persons in the characteristics of Resilience Scale (RS), in the characteristic of meaning there was a ten- dency of interaction between age and how much help from home nursing care the participants received. Con- clusions: It is important to focus on the individual aging and the risk of developing illness and disabilities rather than focusing on chronologic age. Possessing meaning in life and equanimity may be strengths to meet challenges through illness and growing older.

  • 13.
    Rygg, Lisbeth
    et al.
    Faculty of Nursing and Health Sciences, Nord Universitetet, Norway.
    Lohre, Audhild
    Faculty of Teacher and Interpreter Education, NTNU, Trondheim, Norway.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Lifestyle Changes in Diet and Physical Activities after Group Education for Type 2 Diabetes: The Active Ingredient in the Education. A Qualitative Study2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 10, p. 1181-1195Article in journal (Refereed)
    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.

  • 14.
    Segevall, Cecilia
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Björkman Randström, Kerstin
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    A spider in a broken web: nurses' views on discharge planning for older patients after hip fracture surgery who live in their own homes in rural areas2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 7Article in journal (Refereed)
    Abstract [en]

    Introduction: The in-hospital rehabilitation of patients who have undergone surgery for hip fracture requires a team-based effort, in which nurses play an all-embracing role throughout the patients’ hospital stays. Although discharge planning has been widely studied, little is known about discharge planning from hospitals to homes in rural settings. Aim: To describe nurses’ views on discharge planning for older patients after hip fracture surgery who live in their own homes in rural areas. Methods: A qualitative method was used. Four focus group interviews were conducted with 18 nurses who work at an orthopaedic clinic. The interview texts were analysed with qualitative content analysis. Findings: Nurses expressed that patients needed support from healthcare personnel as well as relatives in order to prepare for life at home. They also expressed that patients were not supported in all aspects of discharge planning because they faced difficulties in having their voices heard. Nurses described that many of those aspects were beyond their own control, which had left them with little to non-ability to influence discharge planning. Findings additionally indicate that discharge planning seems not affected by occurring in rural settings. Conclusions: Although discharge planning is intended to meet the unique wishes and needs of each patient given the realities of existing resources, nurses’ responsibilities in discharge planning are unclear. This study shows an organisation in which healthcare personnel continue to make decisions for patients. Significance for nurses to perform a discharge planning that support patients’ participation seems to be a communication based on shared understanding.

  • 15.
    Skotnes, Liv H.
    et al.
    Nord-Trondelag University College, Namsos, Norway.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Kuhry, E.
    St Olavs Hospital Trondheim, Norway.
    Perceptions and barriers that influence the ability to provide appropiate incontinence care in nursing home residents: Statements from nursing staff2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 6, p. 437-444Article in journal (Refereed)
    Abstract [en]

    among nursing home residents. Urinary incontinence in older people has a multifactorial etiology and is therefore more difficult to assess and treat than uri- nary incontinence in younger people. Previous re- search has shown that incontinence care in nursing home residents often is inadequate and little systema- tized. The aim of this study was to identify percep- tions and barriers that influence the ability of the nursing staff to provide appropriate incontinence care. This was a qualitative study using focus-group meth- odology. Data were collected from three focus-group interviews with 15 members of the nursing staff from six different units in a nursing home. The focus-group interviews were recorded on tape, transcribed verba- tim and analyzed according to qualitative content analysis. Three topics and eight categories were iden- tified. The first topic, Perceptions and barriers associ- ated with residents, consisted of one category: "phy- sical and cognitive problems". The second topic, Per- ceptions and barriers associated with nursing staff, consisted of three categories: "lack of knowledge", "attitudes and beliefs" and "lack of accessibility". The third topic, Perceptions and barriers associated with organizational culture, consisted of four cate- gories: "rigid routines", "lack of resource", "lack of documentation" and "lack of leadership". The find- ings from this study show that there are many barri- ers that might influence the possibilities of nursing staff to provide appropriate incontinence care to re- sidents in nursing homes. However, it can neverthe- less seem like opinions and the attitude of nursing staff, together with a lack of knowledge about UI, are the most important barriers to provide appropriate incontinence care.

  • 16.
    Skotnes, Liv H.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Omli, R.
    Romild, Ulla
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kuhry, E.
    Urinary incontinence in Norwegian nursing home residents2012In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 2, no 2, p. 116-122Article in journal (Refereed)
    Abstract [en]

    Urinary incontinence is a multi-factorial condition that has a high impact on older persons living in nursing homes. While urinary incontinence is common, only a small percentage of nursing home residents have an official diagnosis. Factors influencing urinary incontinence in this population are poorly understood. The aim of this study was to evaluate the prevalence of urinary incontinence in Norwegian nursing home residents and to study the factors associated with urinary incontinence in this population. Residents from six different nursing homes were included in this study. Data on sex, age, medication, comorbid illnesses, urinary incontinence and the use of absorbent pads was collected. Barthel`s Index of Activities of Daily Living (ADL) was used to estimate residents’ functional levels. Post-voiding residual urine was measured by means of a portable ultrasound. A questionnaire was completed by the nursing staff for each of the residents. In total, 173 residents participated in the study. One hundred and twenty-two residents (69%) were incontinent for urine and 144 used absorbent pads (83%). Fourteen percent of residents used absorbent pads ‘just to make sure’. They did not have a history of urinary incontinence. Low ADL score, dementia and urinary tract infection were significantly associated with incontinence for urine. The prevalence of urinary incontinence in Norwegian nursing homes is high. Absorbent products are frequently used without a history of urinary incontinence. Physical impairment, dementia and urinary tract infections are significantly associated with urinary incontinence.

  • 17.
    Solum Myren, Gunn Eva
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Centre for Care Research, Mid-Norway, Steinkjer, Norway; Nord-Trøndelag University College, Namsos, Norway.
    Enmarker, Ingela
    Nord-Trøndelag University College, Namsos, Norway; Centre for Care Research, Mid-Norway, Steinkjer, Norway.
    Saur, Ellen
    Norwegian University of Science and Technology, Trondheim, Norway.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    “Being Free Like a Bird”?: The Meaning of Being an Informal Caregiver for Persons with Dementia Who Are Receiving Day Care Services2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 2, article id 53858Article in journal (Refereed)
    Abstract [en]

    Respite care in the form of day care is one of the several respite services that aims to provide temporary relief to informal caregivers from their responsibilities of caring for a person with dementia. The purpose of this study was to illuminate the meaning of being an informal caregiver for a person with dementia living at home and receiving day care services. Narrative interviews were conducted, and data were analyzed using the phenomenological hermeneutic method. Two main themes emerged: “Living with limitations in everyday life” and “Having a life besides being a caregiver”. The comprehensive understanding suggested living with a person with dementia, changes and influences the informal caregiver’s life through a set of new roles and a new way of living and thinking. The result is discussed in light of Goffman’s analysis of the structures of social encounters from the perspective of the dramatic performance.

  • 18.
    Valan, Lotha
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Region Västernorrland.
    Kristiansen, Lisbeth
    Högskolan i Gävle.
    Sundin, Karin
    Umeå Universitet.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Health-Related Internet Information Both Strengthens and Weakens Parents’ Potential for Self-Care: A Mixed-Methods Study on Parents’ Search Patterns2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 10, p. 731-745, article id 88148Article in journal (Refereed)
    Abstract [en]

    Today’s parents belong to the digital generation and regularly use the Internet as a source of information. Parents’ quests for health-related online information comprise an effort to manage symptoms of illness or address questions about child development which may be an expression of self-management or self-care. Purpose: This study aims to describe health and child development related Internet search patterns used by parents of children ages zero to six, and further, how the obtained information was used in contacts with Child Health Care. Design and Methods: A two-step mixed- method approach is used in this study, comprising both a quantitative and a qualitative approach. First, a questionnaire was distributed to parents (n = 800) at 13 health centers in a medium sized county in Sweden. Second, one narrative interview with two parents total was conducted. Descriptive and non-parametric statistics were calculated, and qualitative manifest content analyses were performed. Results: A total of 687 completed the questionnaire, which corresponds to a response rate of 86%. The results show that 97% used the Internet for health-related and developmental child issues. The results show that parents often look at basic tips and the Internet is seen as a fast and accessible forum to obtain information. Parents often initiated their Internet searches using Google search for the specific subject, but the most common and most used website (used by 95% of parents), was the Swedish health site 1177.se. 98.4% of parents evaluated the general information searches they made on the Internet as reliable despite only 31% of the parents checking to see if the websites they used were scientifically based. Parents (81.7%) stated that they wanted their Child Health Nurses (CHN) to give them recommendations for valid websites. Conclusions: The results in this study show that, on the one hand, the Internet could strengthen parental knowledge (support self-care capacity), but, on the other hand, the found information could worry them and increase their anxiety—negatively affected self-care capacity. The parents suggested that the information should be double-checked to establish trust and develop self-care knowledge. Having a good resource to rely on, such as personal contact with a CHN, or using reliable websites seems to strengthen and reassure parents.

  • 19.
    Voraroon, Supaporn
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Boromarajonani College of Nursing, Suphanburi, Thailand.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Meebunmak, Yaowaluck
    Boromarajonani College of Nursing, Ratchaburi, Thailand.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Högskolan i Gävle; Centre for Care Research Mid-Norway, Steinkjer, Norway..
    Older People’s Lived Experiences with Participation in Shareholding Networks for the Care of Older People in Rural Areas of Thailand: A Phenomenological Hermeneutic Study2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 7, p. 875-892Article in journal (Refereed)
    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.

  • 20.
    Voraroon, Supaporn
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Boromarajonani College of Nursing, Suphanburi, Thailand.
    Meebunmak, Yaowaluck
    Boromarajonani College of Nursing, Ratchaburi, Thailand.
    Enmarker, Ingela
    University of Gävle; Centre for Care Research Mid-Norway, Steinkjer, Norway.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Shareholding Networks for Care in Rural Thailand: Experiences of Older Persons and Their Family Members2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 07, no 02, article id 74497Article in journal (Refereed)
    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.

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