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  • 1.
    Bäckström, Britt
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Sundin, Karin
    Umeå universitet.
    The experience of being a middle-aged close relative of a person who has suffered a stroke, 1 year after discharge from a rehabilitation clinic: A qualitative study2009Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, nr 11, s. 1475-1484Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Living in close emotional and physical proximity to a person who has suffered a stroke may alter almost every aspect of daily living and will inevitably impact family life. Age seems to be a factor in the experiences of stroke sufferers’ close relatives after the stroke.

    Objectives

    This study aimed to illuminate the experience of being a middle-aged close relative of a person who has suffered a stroke; 1 year after the stroke sufferer's discharge from a rehabilitation clinic.

    Participants

    Nine middle-aged close relatives of persons with a confirmed diagnosis of a first-time stroke were consecutively included in the study and interviewed.

    Methods

    The narrative interviews were audio-taped, transcribed verbatim and analyzed using a thematic content analysis. The study was part of a longitudinal study.

    Results

    Four themes emerged from the data, intertwined and in conflict with one another. A turning point was reached, and the inevitability of an altered future became self-evident, so much so that the middle-aged close relatives felt forced to accept and become reconciled to a changed way of living, even if feelings of grief from loss were still present. The middle-aged close relatives’ process of coming to awareness and recognition of their own needs was part of a complex interplay of emotions, in which they learned to leave feelings of shame and guilt behind. They experienced movement from self-denial to self-recognition in their search for their own well-being and the recovery of their strength for a functioning family life. Even if they experienced a greater sense of freedom, they still face living life within limits. A significant challenge appears to be the effects of the personality changes among the person with a stroke, and the resulting sense of being an outsider. Relatives struggled with health care providers for visibility and confirmation. Their experiences were ones of standing alone, outside a closing door to the rehabilitation. Their ability to work, the benefits of functioning home care, and support from their family helped them through these challenges.

    Conclusion

    This study highlights the middle-aged relatives’ realization that they will live an inevitability altered future. Individually, the stroke sufferer's relatives need support in their relationships within the family for emotional confirmation and to help them recognize and verbalize their needs without feeling guilt; gaining these supportive factors may help the relatives to recover their sense of well-being and give strength for a future, properly functioning family life.

  • 2.
    Hallin, Karin
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Registered nurses' experiences of daily work, a balance between strain and stimulation: A qualitative study2007Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, nr 7, s. 1221-1230Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The challenges in the health care have given rise to a highly stressful work situation and a more complicated role for registered nurses (RNs). Qualitative studies about daily work as a whole is limited. It is therefore vital for future development of nursing knowledge and nursing education to recurrently investigate RNs' experiences of their ability to grasp and manage their daily work situation and to promote a high quality of care. Aim: The aim of this study was to explore RNs' experiences of their daily work. Methods and participants: This follow up study was carried out involving 15 Swedish RNs six years after their graduation. Interviews, conducted with conversational strategy, were chosen for the data collection and content analysis was used to handle the interview texts. Results: The analysis resulted in a main theme 'to balance strain and stimulation', two themes and seven sub-themes. The first theme 'a stressful work situation' consisted of the sub-themes: 'to meet all demands', 'to be insufficient', 'to be unsure of oneself', 'too little contact with patient'. The second theme 'a stimulating work situation' consisted of the sub-themes: 'to encounter patients and health care staff is enriching', 'to have the situation under control', 'to have the skills necessary to be independent'. A pattern emerged throughout the themes, which showed that due to the increasing number of patients RNs' capacity for management, prioritising and planning out of team work, and performing exacting documentation diminished. Conclusion: The RNs' daily work has been illustrated as a scale of balance that oscillated between strain and stimulation; an oscillation towards strain could lead to a vicious circle. The RNs need support from the start through nursing education and continuously in profession. This is a crucial issue for nursing education and health care sector.

  • 3.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Living in a group dwelling: how do residents spend their time in a psychiatric group dwelling?2004Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 41, nr 6, s. 651-659Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to investigate how residents at psychiatric group dwellings spend their time. The study consisted of two parts: questionnaires and an observation survey. It included all the staff at two municipal psychiatric group dwellings where the residents were primarily diagnosed as having long-term schizophrenia. This study indicated that, even if the dwellings had a creative climate, there was a negative process in terms of nurses' well-being with a high level of depersonalisation. The residents who displayed a predominant picture of negative symptoms were left alone for 84% of the day, and 29.5% of this could be explained by their illness. The remainder of the residents' time alone remains unexplained. Copyright 2004 Elsevier Ltd

  • 4.
    Nolan, P
    et al.
    England.
    Soares, Joaquim
    Dallender, J
    Thomsen, S
    Arnetz, B
    A comparative study of the experiences of violence of English and Swedish mental health nurses2001Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 38, nr 4, s. 419-426Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Recent studies suggest that violence in health care environments, especially mental health care, appears to be increasing. Although there is a lack of cross-cultural studies to prove it, this increase in violence would seem to be an international phenomenon. The present study sought to compare the extent and nature of violence encountered by mental health nurses in Sweden and England. Systematic studies of violence have previously been carried out independently in both countries but this was the first attempt to compare levels of violence. Clearly defined study protocols were put in place, an operational definition of 'violence' adhered to, and random samples recruited. A specially designed questionnaire was sent to every subject (Swedish nurses n=720; English nurses n=296) enquiring about the extent of nurses' exposure to violence, the nature and severity of the violence experienced, and the effect of violence on self-esteem and job satisfaction. Significant differences were found with English nurses experiencing more violence than their Swedish counterparts. Yet support for English nurses appeared to be less good than for Swedish nurses. Reasons for the differences are discussed along with possible measures to minimise the frequency of violence against nurses and the negative effects on their work.

  • 5. Norberg, Astrid
    et al.
    Melin, Else
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Reactions to music, touch and object presentation in the final stage of dementia: an exploratory study2003Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 40, nr 5, s. 473-479Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Two patients in the final stage of dementia of Alzheimer type were stimulated with music, touch and object presentation during 12 consecutive days (16 trials per patient). Evaluations were made by direct observations, analysis of video-taped recordings and registrations of pulse and rate of respiration. Both patients reacted differently to music than to touch and object presentation.

  • 6.
    Sjöling, Mats
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Ågren, Ylva
    Olofsson, Niclas
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Waiting for surgery; living a life on hold: A continuous struggle against a faceless system2005Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 42, nr 5, s. 539-547Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This interpretive-phenomenological study examined the lived experience of being on the waiting list for arthroplastic surgery of the knee or hip and its impact on daily life. The interviews reveal that respondents experience suffering from different points of view; illness-, caring- and life- suffering. Suffering leads to a struggle in order to have their caring needs met and the struggle is often fruitless - against a faceless enemy - "the system". No one is there to answer their plea or to address the frustration that then arises and, in combination with their present life situation, this may lead to a disrupted self-image. Finding or creating meaning in suffering appears to be a crucial issue in the struggling process. Respondents who are able to preserve or create meaning in life may find it easier to accept the waiting times and wait for their turn in the queue. They are able to reformulate their life-world and live a full life, in spite of severe pain and disability.

  • 7. Sparud Lundin, Carina
    et al.
    Öhrn, Ingbritt
    Göteborgs universitet, Institutionen för vårdvetenskap och hälsa.
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    From multidimensional support to decreasing visibility: A field study on care culture in paediatric and adult diabetes outpatient clinics2008Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 47, nr 2, s. 180-190Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: As the incidence of Type 1 diabetes mellitus has increased during childhood, more patients will experience the transfer from paediatric diabetes care to adult diabetes care. In order to achieve a coherent care system it is essential to identify conditions, events and actions that hinder and facilitate a successful transition between these settings. OBJECTIVES: The aim of this study was to describe care culture in paediatric and adult diabetes outpatient clinics and implications for care of adolescents in those settings. METHODS: Fifty-one participant observations and 10 semi-structured interviews with diabetes care providers were carried out in two paediatric clinics and two adult clinics in Sweden. Data were analysed simultaneously with data collection, using a constant comparative method developed in the grounded theory tradition. RESULTS: In the analysis process, one core category, four categories and subcategories were generated. The core category shifting aspects of diabetes care culture is related to the categories. The categories support of self-management and unfocused behaviour describes mostly similar strategies and attitudes in paediatric and adult diabetes care, while multidimensional support and decreasing visibility describes differences in characteristics of care culture in paediatric versus adult diabetes care. CONCLUSIONS: The decreased visibility might have consequences for vulnerable patients, such as those with insufficient metabolic control and self-management abilities. By illuminating shifting aspects of care culture, care providers can be given a basis for reflection and discussion of how the care is provided in their own setting and how different environmental conditions and care strategies can promote formal and informal contacts between patients and care providers.

  • 8. Sundin, Lisa
    et al.
    Hochwälder, Jacek
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap.
    A scale for measuring specific job demands within the health care sector: Development and psychometric assessment2008Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, nr 6, s. 914-923Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Earlier research has indicated that the psychological demand dimension in one of the most commonly used occupational stress models, the job-demand-control-support model, can be too generic and does not capture the multidimensionality of different job demands within health care work. OBJECTIVE: The main objective of the study was to develop and psychometrically evaluate a new job demand scale, which captures specific job demands within health care work. Further, to analyse whether a congruent component structure could be obtained in two different occupational groups, namely registered and assistant nurses. The final objective was to analyse the relationship between the new job demand scale and the dimensions in the job-demand-control-support model. PARTICIPANTS: Seven hundred and ninety five registered nurses and 527 assistant nurses from three hospitals and two primary health care centres in Stockholm, Sweden participated voluntarily in the study DATA AND METHOD: A questionnaire, which collected information on demographics, various job demands, job control and social support, was used in both occupational groups. Descriptive statistics, correlation analyses, principal component analyses and independent samples t-test were used in the study RESULTS: A congruent component structure was obtained in both occupational samples, consisting of four demand indices "pain and death", "patient and relative needs", "threats and violence" and "professional worries". The four-component solution explained 69.6% and 72.1% of the variance for registered nurses and assistant nurses, respectively. The new job demand indices also showed satisfactory internal consistencies, which ranged from .62 to .91 and had inter-item correlations, which varied from .33 to .84 in both occupational groups. The strongest relationship was shown with the psychological job demand dimension in the job-demand-control-support-model. CONCLUSION: The scale is short and could be used to obtain information concerning different job demands that are related to the interaction with, and care of patients and their relatives as an addition to the more generic psychological demand dimension that is specified in the job-demand-control-support model.

  • 9.
    Sundin, Lisa
    et al.
    National Institute for Working Life, Östersund.
    Hochwälder, Jacek
    Karolinska Institutet.
    Bildt, Carina
    National Institute for Working Life, Östersund.
    Lisspers, Jan
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap.
    The relationship between different work-related sources of social support and burnout among registered and assistant nurses in Sweden: A questionnaire survey2007Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, nr 5, s. 758-769Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: This cross-sectional study addresses the relationship between organisational and social factors and burnout in a group of registered and assistant nurses in Sweden. Objective: The main objective of the study was to analyse the relationship (and the specific relationship patterns) between three different work-related sources of social support and Maslach's three burnout dimensions, while taking the dimensions in the Karasek job-demand-control model, emotional demands, workload outside the work situation and demographic factors into account. Data and method: Data was collected using a questionnaire which was based on validated instruments, in accordance with the job-demand-control model and Maslach's Burnout Inventory. Descriptive statistics, correlation analysis and three hierarchical regression analyses were conducted using a sample of 1561 registered and assistant nurses in Sweden. Results: The results showed statistically significant correlations between the three support indicators and all three burnout dimensions. In the regression analyses, co-worker and patient support were statistically significantly related to all three burnout dimensions, whereas supervisor support was only statistically significantly related to emotional exhaustion. In accordance with prior findings, high levels of psychological demands were most strongly related to high emotional exhaustion. Further, high levels of emotional demands showed the strongest correlations with high personal accomplishment.

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