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  • 1.
    Aminoff, Ulla Britt
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kjellgren, Karin
    Institute of Nursing, Div. of Health and Caring Sciences, Göteborg University, Göteborg.
    The nurse - a resource in hypertension care2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 35, no 4, p. 582-589Article in journal (Refereed)
    Abstract [en]

    Aim of the study. To explore the content and structure of communication between patient and nurse at follow-up appointments concerning hypertension. Background. Hypertension is a chronic condition and calls for co-operation between health care providers and patients over a long period of time. One important purpose of the follow-up consultations is to transfer knowledge between patients and health care providers in order to empower patients. This is an important determinant of the quality of care. Design/methods. The study was based on 20 audio-recordings of actual follow-up appointments and was approved by ethics committees. The consultations took place at four different health care units for hypertensive patients. Findings. The average length of consultations was 18 minutes. In the consultations, patients initiated an average of eight new topics and nurses an average of 20. All nurses talked with patients about life style. Compared with previous studies of follow-ups with physicians, consultations with nurses addressed lifestyle factors and adherence to treatment to a higher degree. It was also observed that patients were more actively involved in interaction with nurses compared with the follow-ups with physicians. Conclusions. Active patient participation in care is a critical factor in improving adherence to treatment. It would be of value to develop and assess a more patient-centred. organization of hypertension care and thereby more individualized hypertension treatment. Nurses may have a pivot role in such care.

  • 2.
    Audulv, Åsa
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Packer, T.
    School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada.
    Hutchinson, S.
    School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.
    Roger, K. S.
    Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
    Kephart, G.
    Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
    Coping, adapting or self-managing – what is the difference?: A concept review based on the neurological literature2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 11, p. 2629-2643Article, review/survey (Refereed)
    Abstract [en]

    Aim: The aim of this study was to report: (1) an analysis of the concepts of coping, adaptation and self-management in the context of managing a neurological condition; and (2) the overlap between the concepts. Background: The three concepts are often confused or used interchangeably. Understanding similarities and differences between concepts will avoid misunderstandings in care. The varied and often unpredictable symptoms and degenerative nature of neurological conditions make this an ideal population in which to examine the concepts. Design: Concept analysis. Data sources: Articles were extracted from a large literature review about living with a neurological condition. The original searches were conducted using SCOPUS, EMBASE, CINAHL and Psych INFO. Seventy-seven articles met the inclusion criteria of: (1) original article concerning coping, adaptation or self-management of a neurological condition; (2) written in English; and (3) published between 1999–2011. Methods: The concepts were examined according to Morse's concept analysis method; structural elements were then compared. Results: Coping and adaptation to a neurological condition showed statistically significant overlap with a common focus on internal management. In contrast, self-management appears to focus on disease-controlling and health-related management strategies. Coping appears to be the most mature concept, whereas self-management is least coherent in definition and application. Conclusion: All three concepts are relevant for people with neurological conditions. Healthcare teams need to be cautious when using these terms to avoid miscommunication and to ensure clients have access to all needed interventions. Viewing the three concepts as a complex whole may be more aligned with client experience.

  • 3.
    Bårdsgjerde, Elise Kvalsund
    et al.
    Norwegian University of Science and Technology (NTNU), Ålesund, Norway.
    Kvangarsnes, Marit
    Norwegian University of Science and Technology (NTNU), Ålesund, Norway; Møre og Romsdal Hospital Trust, Ålesund, Norway.
    Landstad, Bodil
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
    Nylenna, Magne
    Institute of Health and Society, University of Oslo, Oslo, Norway; Norwegian Institute of Public Health, Oslo, Norway.
    Hole, Torstein
    Møre og Romsdal Hospital Trust, Ålesund, Norway; Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
    Patients' narratives of their patient participation in the myocardial infarction pathway2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 5, p. 1063-1073Article in journal (Refereed)
    Abstract [en]

    Aim: To explore how patients in areas without local percutaneous coronary intervention (PCI) facilities experience patient participation in different phases of the myocardial infarction pathway. Background: Acute treatment of myocardial infarction often involves PCI. In Norway, this treatment is centralized at certain hospitals; thus, patients often require long-distance transportation and experience frequent hospital transfers. Short hospital stays, transfers between hospitals and the patient's emotional state pose challenges to promoting patient participation. Design: A qualitative design with a narrative approach. Methods: Participants were recruited through purposive sampling. Eight men and two women were interviewed in 2016. Findings: Four themes related to the patients' experiences at the beginning, middle and end of the pathway were identified: (a) Lack of verbal communication in the acute phase; (b) trust in healthcare professionals and treatment; (c) lack of participation and coordination at discharge; and (d) shared decision-making in rehabilitation. The findings showed how the patients moved from a low level of patient participation in the acute phase to a high level of patient participation in the rehabilitation phase. Conclusion: This is the first study to explore patient participation in different phases of the myocardial infarction pathway. We argue that individual plans for information and patient participation are important to improve patient involvement in an earlier stage of the pathway. Further research from a healthcare professional perspective can be valuable to understand this topic. Impact: This study gives new insight that can be valuable for healthcare professionals in implementing patient participation throughout the pathway. 

  • 4.
    Dallender et al, J
    et al.
    England.
    Nolan, P
    Soares, Joaquim
    Thomsen, S
    Arnetz, B
    A comparative study of perceptions of British mental health nurses and psychiatrists of their work environment1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 29, no 1, p. 36-43Article in journal (Refereed)
    Abstract [en]

    This comparative study of the perceptions of mental health nurses and psychiatrists about aspects of their work environment was undertaken in the West Midlands in England. The aim of the study was to ascertain the extent to which the environment in which mental health professionals' work impacts on their own mental and physical well-being. Seventy-four psychiatrists and 301 mental health nurses responded to a postal questionnaire. Analysis of data indicated that significant differences exist between nurses and psychiatrists in their working conditions, their physical working environment, their sources of support with a work-related problem, and the effects of their work on their own mental and physical health. The main recommendation derived from this study was to improve communication between mental health professionals and their managers by giving more structured feedback and guidance about one's work performance. This may help to alleviate the mental strain many mental health professionals experience in their work.

  • 5.
    Danielson, Ella
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg and Department of health Sciences Mid Sweden University.
    Redefining relationships and identity in young adults with type 1 diabetes.2010In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 66, no 1, p. 128-138Article in journal (Refereed)
    Abstract [en]

    Abstract

    AIM: This paper is a report of a study exploring the meaning of interactions with and supports of self-management from parents and other significant others for young adults with type 1 diabetes.

    BACKGROUND: Adolescence and young adulthood is known to be a critical period for people living with diabetes in terms of diabetes control, which is why support from significant others is of utmost importance during the transition to adult life.

    METHOD: A grounded theory approach was used. Interviews with 13 young adults with type 1 diabetes and 13 parents 2 years after transfer to adult diabetes care were conducted during 2006-2007. Internet communication between young people on a diabetes website was also included in the constant comparative analysis.

    FINDINGS: Transition to adult life for young adults with diabetes was characterized by a relational and reflexive process leading to ongoing redefinition of relationships and identity. Parents were perceived as the most reliable supporters, compared to partners, siblings and other significant others. Chat friends can also become important through emotional, social and diabetes-related support in internet communication. The young adults showed growing awareness of their own capacities, shortcomings and emotional reactions, reflections which contribute to a redefinition of self.

    CONCLUSION: Further research is needed to explore how contemporary interactions contribute to development of the self. By focusing on supporting relationships, nurses are in a strategic position to develop knowledge and modify clinical programmes that promote diabetes management and care by taking supporting interactions into account from a contemporary point of view.

  • 6. Engström, Å
    et al.
    Söderberg, Siv
    Receiving power through confirmation: The meaning of close relatives for people who have been critically ill2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 59, no 6, p. 569-576Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study to elucidate the meaning of close relatives for people who have been critically ill and received care in an intensive care unit. Background. Falling critically ill can bring about a difficult change in life. In previous reports such events are described as frightening experiences, and close relatives are described as an important source of support in this difficult situation. Method. A purposive sample of 10 adults, eight men and two women, narrated how they experienced their close relatives during and after the time they were critically ill. The data were collected in 2004. The interview texts were transcribed and interpreted using a phenomenological hermeneutic approach influenced by the philosophy of Ricoeur. Findings. One major theme was identified, experiencing confirmation, with six sub-themes: receiving explanations; a feeling of being understood; a feeling of safety; gaining strength and will-power; having possibilities and realizing their value. Close relatives served as tools for the person who was ill, facilitating better communication and an increased ability to do various things. Simultaneously, feelings of dependence on the close relatives were expressed. There were descriptions of loneliness and fear in the absence of close relatives and, in order to feel safe, the participants wanted their close relatives to stay near them. Conclusion. Close relatives are vital, as they are the ill person's motivation to stay alive and to continue the struggle. Their presence is of great importance for the ill person and must be facilitated by staff. © 2007 The Authors.

  • 7.
    Hallin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Being a personal preceptor for nursing students: Registered Nurses' experiences before and after introduction of a preceptor model2009In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 1, p. 161-174Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study to compare Registered Nurses’ experiences of acting as personal preceptors for nursing students in the year 2000 with the year 2006 and explores relationships between preceptors’ experiences and personal/clinical characteristics.

    Background: Preceptoring is experienced as stressful and challenging. How successful preceptors are in this role depends largely on the support they receive. Knowledge about preceptors’ experiences over time and in relation to a preceptor model is limited.

    Method: Data were collected by questionnaire in 2000 (n=113) and 2006 (n=109) with preceptor groups in a hospital in Sweden before and after introduction of a preceptor model. Data were analysed with descriptive and correlational statistics using parametric and nonparametric methods.

    Findings: Statistically significant improvements were noted in preceptors’ experiences between 2000 and 2006. Statistically significantly more preceptors in 2006 reported that they felt prepared for their role and felt support from teachers, colleagues, chief nurses and enrolled nurses. Least improvement was seen in relation to the questionnaire items workload, constructive feedback and support in linking research results to practice. A strong positive relationship existed between preceptors’ experiences of the preceptor role and the level of interest in preceptoring.

    Conclusion: The preceptor model offers a way to support and facilitate preceptors and to develop co-operation between university and hospital. Future research should focus on students’ experiences, experiences of first-time preceptors, head preceptors and teachers from a longitudinal perspective.

  • 8.
    Hallin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Registered Nurses' perceptions of their work and professional development2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 61, no 1, p. 62-70Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study to elucidate Registered Nurses' perceptions of their work and professional development 6 years after graduation. BACKGROUND: Nursing education and health care has rapidly changed in the last two decades. Education and experience are important components in Registered Nurses' ability to promote a high quality of care, but a great deal depends on their work circumstances. This study emphasizes Registered Nurses' view of their work in health care, at a time in their career when they have several years of experience. METHOD: Data were collected in 2003 from in-depth interviews with 15 Registered Nurses 6 years after their graduation. The interviews were semi-structured and analysed with interpretive content analysis. FINDINGS: The findings revealed two themes and five sub-themes. The first theme, An appropriate but demanding profession, consisted of two sub-themes: 'having found one's niche' and 'growing old in nursing may be difficult'. The second theme, A profession with opportunities and obstacles, consisted of three sub-themes: 'being aware of Registered Nurses' potential', 'having knowledge that is seldom made use of' and 'attaining professional growth is no matter of course'. CONCLUSION: Keeping Registered Nurses' satisfied and avoiding their dissatisfaction is crucial for both educators and employers. It is essential that employers give priority to Registered Nurses' time with patients and to motivate and support them in professional development. Further intervention studies regarding a change of the balance between obstacles and opportunities are needed.

  • 9.
    Hellzén, Ove
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Being in a fragmented and isolated world: Iinterviews with carers working with a person with severely autistic disorder. An interview study2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 37, no 4, p. 346-354Article in journal (Refereed)
    Abstract [en]

    Aim: To illuminate the meaning of being a carer for a person having a severe autistic disorder. Background: Carers working with people with severe autim are occasionally exposed to residents’ self-injurious behaviours and violent actions and at time residents appear resistant to all forms of treatment. Design/Method: A qualitative case study was conducted. Six Swedish carers (ENs), working at a special ward on a nursing home were interviewed about their lived experiences when caring for an individual having a severe autistic disorder. Narrative interviews were conducted and interpreted using a phenomenological-hermeneutic method inspired by Paul Ricoeur. Findings: Two themes were formulated which describe the carers’ reality and their dream of an ideal, which described carers’ experiences of being trapped in a segmented and isolated care reality and thier longing to achieve a sense of wholeness. The findings were interpreted and reflected on in the light of a framework inspired by the German philosopher Karl Jaspers in order to achieve a deeper understanding of the text. Concusions: In their desperation the carers used their empirical knowledge based on scientific knowledge, which could be understood as a substitute for their vision of a consolating wholeness. This paper shows that searching for a substitute to consolation seems to be an important aspect of the meaning of being a carer for a person with severe autistic disorder.

  • 10.
    Hellzén, Ove
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norbergh, Karl Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Nurses' attitudes towards older residents with long-term schizophrenia.2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 43, no 6, p. 616-622Article in journal (Refereed)
    Abstract [en]

    Aim: to investigate whether the carers’ approach could be explained as referring to the clinical picture or the fact that the patient had a diagnosis of schizophrenia. Background: In institutional care, a symptom-oriented approach is a frequently used but seldom-discussed method for treating people with severe mental illness. Design/method: An exploratory study of the staff’s view of a caring approach for a fictitious elderly long-term schizophrenic resident was conducted. All the carers working in the field of psychiatry at seven different units in one municipality in northern Sweden were an integral part of the study. The units were divided into two groups and classified as ‘dwelling’ and ‘support’. The ‘dwelling group’ was characterised by carers working at traditional group dwellings, the ‘support group’ by carers working in small teams and visiting people with long-term mental illness in their homes. Answers were received from 62 women and 23 men, of whom 14 were RNs and 69 were ENs. Measurements: A questionnaire was used; it was developed from a case description of a 68-year-old woman with typical symptoms of severe cognitive decline with problematic behaviour and a diagnosis of long-term schizophrenia. Findings: The main finding in this study is that carers with long experience become less sensitive in their relationship with the resident than less experienced carers. There appears to be a tendency for long work experience to have a negative effect on the carers’ attitude towards the resident. Conclusions: The carers could be interpreted as being caught in a moral dilemma between ends and means. On the one hand, the ‘conformist mode’, with the acceptance of ends and means, and, on the other hand, the ‘innovation mode’, with acceptance of ends but with few legitimate means to achieve them.

  • 11.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Rådestad, Ingela
    Mälardalens högskola, Inst för vård och folkhälsovetenskap.
    Swedish women's satisfaction with medical and emotional aspects of antenatal care2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 52, no 3, p. 239-249Article in journal (Refereed)
    Abstract [en]

    AIM: This paper reports a study to investigate how satisfied Swedish women are with their antenatal care. BACKGROUND: Medical care is of high priority, but other aspects, such as psychosocial support are also important for women during pregnancy. Identifying women who are dissatisfied with their antenatal care could help us to improve this. Methods. A national cohort of 2746 Swedish-speaking women completed a questionnaire in early pregnancy and at 2 months postpartum. The data were collected in 1999-2000. RESULTS: The majority of participants were satisfied with their antenatal care, but 23% were dissatisfied with the emotional aspects and 18% with the medical aspects. The strongest predictors of dissatisfaction were women's opinions that midwives had not been supportive and had not paid attention to their partners' needs. If the women believed that there were not enough antenatal visits or had met three or more midwives during their antenatal visits, they were more likely to be dissatisfied with the care received. Those with low levels of education were more likely to be dissatisfied with both medical and emotional aspects of antenatal care. CONCLUSIONS: Midwives working in antenatal care should support pregnant women and their partners in a professional and friendly way in order to increase satisfaction with care. Organizing teamwork with no more than two midwives taking care of a woman during a normal pregnancy could make women feel more supported by their midwives.

  • 12.
    Nilsson, Stefan
    et al.
    Sahlgrens Univ Hosp, Dept Paediat Anaesthesia, Queen Silvia Childrens Hosp, Gothenburg, Sweden .
    Hallqvist, Carina
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Information Technology and Media.
    Sidenvall, Birgitta
    Jonkoping Univ, Dept Nursing Sci, Sch Hlth Sci, Jonkoping, Sweden .
    Enskär, Karin
    Jonkoping Univ, Dept Nursing Sci, Sch Hlth Sci, Jonkoping, Sweden .
    Children's experiences of procedural pain management in conjunction with trauma wound dressings2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 7, p. 1449-1457Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of the experiences of children (5-10 years) of procedural pain when they underwent a trauma wound care session. Background. Procedural pain in conjunction with trauma wound care often induces anxiety and distress in children. Children need to alleviate pain and avoid the development of fear in conjunction with examinations and treatments. The nurse could help children to reach this goal by using the comfort theory, which describes holistic nursing in four contexts: physical, psychospiritual, environmental and sociocultural. Few studies have focused on children's experiences of comforting activities in conjunction with trauma wound dressings. Methods. This study was conducted between May 2008 and January 2010. Thirty-nine participants aged 5-10 were consecutively included in this study. The wound care session was standardized for all the participants, and semi-structured qualitative interviews with open-ended questions were conducted with all the children in conjunction with the procedure. All the interviews were transcribed verbatim and analysed with qualitative content analysis. Findings. Four themes were identified: clinical competence, distraction, participation and security. The children were helped to reach comforting activities to enhance pain management. Conclusion. Children require more than just analgesics in wound care. They also need to experience security and participation in this context. When children feel clinical competence in wound care, they trust the nurse to carry out the wound dressing and instead can focus on the distraction that increases their positive outcomes. © 2011 Blackwell Publishing Ltd.

  • 13.
    Nolan, P
    et al.
    England.
    Dallender, J
    Soares, Joaquim
    Thomsen, S
    Arnetz, B
    Violence in mental health care: The experience of mental nurses and psychiatrists1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 30, no 4, p. 934-941Article in journal (Refereed)
    Abstract [en]

    Violence against mental health service personnel is a serious workplace problem and one that appears to be increasing. This study aimed to ascertain the extent and nature of violence against mental health nurses and psychiatrists, and to identify what support, if any, they received following exposure to violence. Mental health staff working within five West Midlands Trusts in the United Kingdom were surveyed using a postal questionnaire to investigate the extent and nature of violence they encountered in their daily work. There was an overall response rate of 47%, which included a response rate for psychiatrists of 60% (n=74) and for mental health nurses of 45% (n=301). Though both groups experienced violence at work, nurses were found: to have been exposed to violence significantly more during their career; to have been a victim of violence within the previous 12 months of the survey; and to have suffered a violent incident involving physical contact. Whilst a higher proportion of nurses than psychiatrists received some support following a violent incident, a large proportion of both groups did not receive any, although most felt in need of it. The implications of this study for training and management are discussed.

  • 14. Normann, H K
    et al.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norberg, Astrid
    Episodes of lucidity in people with severe dementia as narrated by formal carers1998In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 28, no 6, p. 1295-1300Article in journal (Refereed)
    Abstract [en]

    Twenty formal carers employed in three nursing homes narrated 92 episodes of lucidity (ELs) in people with severe dementia. Sixty-two episodes concerned speech, nine concerned actions and 21 episodes concerned both speech and actions. Most ELs were said to occur spontaneously when the patients were acting closely together with a carer who did not make demands on them and regarded them as valuable human beings whose behaviour was a meaningful expression of their experiences. The narrations showed characteristics that indicated trustworthiness and the episodes described in three separate nursing homes were very similar and resembled descriptions given in previous research reports as well as in relatives' reports. Further research seems necessary and the assumption that severe dementia implies the destruction of the self or personhood must be questioned.

     

     

  • 15. Normann, Hans Ketil
    et al.
    Norberg, Astrid
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Confirmation and lucidity during conversations with a woman with severe dementia2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 39, no 4, p. 370-376Article in journal (Refereed)
    Abstract [en]

    Rationale. Patients with severe dementia sometimes surprise the care providers because they seem to be much more aware of their situation and function much more adequately than usual. Such episodes are labelled 'episodes of lucidity' (ELs). The aim of this study was to describe the characteristics of the particular conversations with a woman with severe dementia when ELs occurred as compared with conversations when she was not lucid.

     

    Methodological design. A woman with a probable diagnosis of Alzheimer's disease (AD) was selected. Her Mini Mental State Examination (MMSE) was estimated as 3. The first author met the woman for 4 hours five times over a period of 2 weeks.

     

    Research methods. The conversations were tape-recorded and transcribed verbatim. The text was divided into 278 content units and analysed.

     

    Findings. Lucidity is promoted by supporting the patient in various ways, that is sharing the patient's view, repeating and reformulating the patient's utterance, reinforcing the patient by using positive utterances, not emphasizing errors and supporting the patient's language in various ways, and avoiding making demands. The relation between the patient and her conversation partner during ELs is characterized by confirmation and communion.

     

    Conclusions. This case study indicates that a supportive attitude in conversation with the patient with severe dementia promotes lucidity. A supportive attitude includes the avoidance on the part of the conversational partner making demands on the patient, confirming the patient as an important, unique and valuable person and creating communion. The connection between supporting and avoiding demands and lucidity/nonlucidity during conversation needs further study.

     

     

  • 16.
    Nystedt, Astrid
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Högberg, Ulf
    Umeå universitet.
    Lundman, Berit
    Umeå universitet.
    Women's experiences of becoming a mother after prolonged labour2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 63, no 3, p. 250-258Article in journal (Refereed)
    Abstract [en]

    This paper is a report of a study to explore women's experiences of becoming a mother after prolonged labour. Background.

    The negativity associated with a complicated labour such as prolonged labour can lead to a struggle to become a healthy mother and could restrict the process of becoming a mother. Methods.

     

    Interviews were conducted in 2004 with 10 mothers who had been through a prolonged labour with assisted vaginal or caesarean delivery 1-3 months previously. Thematic content analysis was used. Findings.

     

    Three themes were formulated, describing women's experiences as fumbling in the dark, struggling for motherhood and achieving confidence in being a mother. The difficulties and suffering involved in becoming a mother after a prolonged labour were interpreted to be like `fumbling in the dark'. Women experienced bodily fatigue, accompanied by feelings of illness and detachment from the child. Having the child when in this condition entailed a struggle to become a mother. In spite of these experiences and the desire to achieve confidence in being a mother, the reassurance of these women regarding their capacity for motherhood was crucial: it was central to their happiness as mothers, encouraged interaction and relationship with the child, and contributed to their adaptation to motherhood. Conclusion.

     

    Women experiencing prolonged labour may be comparable with the experience of and recovery from illness, which could contribute to difficulties transitioning to motherhood and limit a woman's ability to be emotionally available for the child.

  • 17. Olsson, M.
    et al.
    Lexell, J.
    Söderberg, Siv
    The meaning of fatigue for women with multiple sclerosis2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 49, no 1, p. 7-15Article in journal (Refereed)
    Abstract [en]

    Aim. This paper reports the findings of a study that aimed to elucidate the meaning of fatigue for women with multiple sclerosis (MS). Background. Living with chronic illness can involve giving up usual activities. MS is a chronic autoimmune disease of the central nervous system. Fatigue is a common experience among people with MS; however, little is known about the meaning of fatigue experienced by women with this condition. Method. Ten women with MS were interviewed about their experience of fatigue. A phenomenological hermeneutic method influenced by Ricoeur was used to interpret the transcribed interviews. Findings. The findings were presented in two major themes with five subthemes; experiencing the body as a barrier and experiencing a different absence. Fatigue seemed to give rise to an experience of being absent and divided into two parts. This also led to a feeling of not being able to participate in the surrounding world. The feeling of being an outsider and lacking the ability as a healthy person is interpreted as a form of suffering. Although the fatigue had a great impact on the women's daily life, the women still hoped for some relief. Fatigue seemed to imply that instead of working as an implement to manage in the world the body has become an enemy of survival. Conclusion. This study highlights the importance for nurses of understanding how women with MS experience fatigue, which is a prerequisite for communication based on a shared understanding. This awareness would enhance nurses' opportunities to alleviate suffering. More research is needed to investigate what kinds of interventions can help these women to manage their everyday lives and to maintain a sense of normality despite their fatigue and illness. Such interventions should be subject to empirical evaluation research.

  • 18.
    Paulson, Margareta
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norberg, Astrid
    Institutionen för omvårdnad, Umeå universitet.
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Men living with fibromyalgia-type pain: Experiences as patients in the Swedish health care system2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 40, no 1, p. 87-95Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Individuals with fibromyalgia (FM) frequently use health care services and experience only short-term improvements. They often feel that health care staff do not take them seriously. This increases the burden of living with the illness. AIM: To describe how men living with fibromyalgia-type pain experienced being patients in the Swedish health care system. METHOD: Narrative interviews with 14 men who fulfilled the American College of Rheumatology criteria for classification of fibromyalgia. Content analysis was used when analysing the data. RESULTS: The results are described using five themes. Theme I 'Feeling afraid of being looked upon as being a whiner' highlights how the men endured a lot of pain before they sought health care, and how difficult it was to find a receptive listener. Theme 2 'Feeling like a guinea pig' shows that the men's feelings were twofold; they wanted examinations, even if these made them feel that they were being exposed to numerous treatments without any cure. Theme 3 'Feeling hopeful' describes the hope for a cure after having been referred to a specialist clinic. Theme 4 'Feeling neglected' illustrates being looked upon as an uninteresting patient and theme 5 'Feeling no recovery' illustrates the pain relief they gained, but not the actual cure. CONCLUSION: Men with FM type pain experienced a long wait before treatment at a specialist clinic as well as no continuity and follow-ups in primary care and general hospitals. Encounters with engaged and skilful staff promoted the men's well-being despite the fact that no cure was available. Not being respected led to a feeling of being neglected despite the care received. Thus, the men had to accept the fact that they would never recover.

  • 19.
    Skär, Lisa
    et al.
    Blekinge tekniska högskola.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    The importance of ethical aspects when implementing eHealth services in healthcare: a discussion paper2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 5, p. 1043-1050Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim of this paper is to discuss the importance of ethical aspects when implementing eHealth services in healthcare.

    Background

    Challenges in healthcare today include a growing older population and, as a consequence, an increased need for healthcare services. One possible solution is the use of eHealth services.

    Design

    Discussion paper.

    Data sources

    Research literature published from 2000 - 2017 in CINAHL, PubMed and Scopus.

    Implications for nursing

    Implementing eHealth services in healthcare involves ethical challenges where different technologies can solve different problems in different ways. eHealth services should therefore be developed and implemented based on the patient's specific needs and conditions for use and in accordance with the healthcare professionals’ presumption to provide high quality care.

    Conclusion

    To preserve patients’ integrity, dignity and autonomy, healthcare professionals must include ethical aspects when implementing and using eHealth services in healthcare. Healthcare professionals have to take responsibility for the eHealth services introduced, explaining why and how they are implemented based on a person-centered approach. More knowledge is needed about ethical aspects when implementing eHealth services to improve the quality of care.

  • 20.
    Svedlund, Marianne
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norberg, A.
    Department of Nursing, Umeå University, Umeå.
    Women’s narratives during the acute phase of their myocardial infarction2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 35, no 2, p. 197-205Article in journal (Refereed)
    Abstract [en]

    Aim. The purpose of this study was to illuminate the meaning of lived experiences during the acute phase of an acute myocardial infarction (AMI). Method. Ten women (< 60 years old) afflicted with AMI narrated their experiences during their stay in the coronary care unit (CCU). The interview texts were interpreted using a method with a phenomenological hermeneutic approach, inspired by the philosophy of Ricoeur. The text was divided into meaning units that were condensed and abstracted. Three themes were then extracted from the text. Findings. One theme was ‘oneself as vulnerable’ with the subthemes: ‘the feeling of being dependent upon others’, ‘the feeling of being insulted’ and ‘the feeling of being a troublesome person’. Another theme was ‘oneself as distanced’, with the subthemes: ‘not facing the reality’, ‘captive in an unreal situation’, and ‘inhibition out of concern for others’. The last theme was: ‘oneself as making sense’ with the subthemes: ‘acquirement of some insight’ and ‘discovery of a new meaning with life’. Conclusion. The reported comprehensive understanding revealed the phenomena guilt and shame. These, in combination with the experience of being in an unreal situation and the withholding of feelings may have led to a deterioration of communication. It seems that relatives and the staff at CCU were not allowed to share the burden of being afflicted with an AMI.

  • 21. Söderberg, Siv
    Erratum: The meaning of fatigue for women with multiple sclerosis (Journal of Advanced Nursing (2005) 492005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 49, no 5, p. 561-Article in journal (Refereed)
  • 22. Söderberg, Siv
    et al.
    Strand, M.
    Haapala, M.
    Lundman, B.
    Living with a woman with fibromyalgia from the perspective of the husband2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 42, no 2, p. 143-150Article in journal (Refereed)
    Abstract [en]

    Background. Fibromyalgia (FM) is a chronic pain syndrome, which affects mostly middle-aged women. The syndrome is poorly understood and treatment is mainly palliative. The diagnosis is established from diagnostic criteria. Living with FM means living a life greatly influenced by the illness in various ways for people affected. Aim of the study. The aim of this study was to describe the experiences of living with a woman with FM from the husbands' perspective. Methods. Five men married to women with FM were interviewed using a narrative approach. The interviews were analysed using qualitative thematic content analysis. Findings. The analysis resulted in the following seven themes: increasing responsibility and work in the home; being an advocate for and supporting the wife; learning to see the woman's changing needs; changing relationship between spouses; changing relationship with friends and relatives; deepening relationship with the children and lacking information and knowledge about FM. The findings show that the women's illness had a great impact on husbands' lives, and that husbands lacked information about the woman's illness. Conclusion. This study shows that it is not only the women with FM who experience a changed life; the whole family life is influenced and limited by FM. The husband's role in the family changes, first and foremost concerning responsibility and workload within the family. This must be taken into consideration in care planning. This study also highlighted the need of information and knowledge about FM expressed by the participants, information that health care personnel have a great responsibility to give.

  • 23.
    Thomsen, S
    et al.
    Arnetz, Bengt
    Nolan, Peter
    Soares, Joaquim
    Dallender, Janie
    Individual and organisational well-being in psychiatric nursing: A cross-cultural study1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 30, no 3, p. 749-757Article in journal (Refereed)
    Abstract [en]

    Although health care systems around the world are undergoing rapid changes, there is an absence of comparative studies of how these changes affect nurses’ well-being and work life. The purpose of this study was (i) to identify and describe possible differences between the psycho-social work environments of English and Swedish mental health nurses, and (ii) to attempt to explain these differences. 1016 psychiatric nurses from Stockholm (Sweden) and Birmingham (England) responded to a postal questionnaire on their psycho-social work environment and feelings of professional fulfilment, mental energy and work-related exhaustion. The study was given ethical clearance in Stockholm and Birmingham. Results indicated that while the English nurses rated their organizational well-being more favourably, Swedish psychiatric nurses reported greater individual well-being than their counterparts. Multiple regression analyses indicated that self-esteem was important for explaining mental energy and work-related exhaustion, but less so for explaining professional fulfilment, which was predicted primarily by organizational factors. When controlling for self-esteem, which was higher amongst the Swedish nurses, the differences in professional fulfilment and mental health were no longer significant. Reasons for the differences in self-esteem and experiences of the workplace are discussed. Low response rate may have contributed to a selection bias.

  • 24.
    Udo, Camilla
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Melin-Johansson, Christina
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Existential issues among nurses in surgical care - a hermeneutical study of critical incidents2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 3, p. 569-577Article in journal (Refereed)
    Abstract [en]

    Aims.  To report a qualitative study conducted to gain a deeper understanding of surgical nurses’ experiences of existential care situations.

    Background.  Existential issues are common for all humans irrespective of culture or religion and constitute man’s ultimate concerns of life. Nurses often lack the strategies to deal with patients’ existential issues even if they are aware of them.

    Design.  This is a qualitative study where critical incidents were collected and analysed hermeneutically.

    Methods.  During June 2010, ten surgical nurses presented 41 critical incidents, which were collected for the study. The nurses were first asked to describe existential care incidents in writing, including their own emotions, thoughts, and reactions. After 1–2 weeks, individual interviews were conducted with the same nurses, in which they reflected on their written incidents. A hermeneutic analysis was used.

    Findings.  The majority of incidents concerned nurses’ experiences of caring for patients’ dying of cancer. In the analysis, three themes were identified, emphasizing the impact of integration between nurses’ personal self and professional role in existential care situations: inner dialogues for meaningful caring, searching for the right path in caring, and barriers in accompanying patients beyond medical care.

    Conclusion.  Findings are interpreted and discussed in the framework of Buber’s philosophy of the relationships I-Thou and I-It, emphasizing nurses’ different relationships with patients during the process of caring. Some nurses integrate their personal self into caring whereas others do not. The most important finding and new knowledge are that some nurses felt insecure and were caught somewhere in between I-Thou and I-It.

  • 25. Westin, Lars
    et al.
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Encounters in Swedish nursing homes A hermeneutic study of residents´ experiences2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 2, p. 172-180Article in journal (Refereed)
    Abstract [en]

    Encounters in Swedish nursing homes: a hermeneutic study of residents’ experiences Aim. This paper is a report of a study to illuminate and interpret the meaning of residents’ experiences of encounters with nurses in nursing homes. Background. A large number of older people suffer from illness and become dependent on other people in their daily living. These people are often in need of care in nursing homes. It is assumed that encounters between nurses and residents are of importance in how residents experience care in nursing homes. Method. Twelve residents from three nursing homes in Sweden were interviewed in 2004–2005 about their experiences in encounters with nurses. The interviews were tape-recorded and transcribed verbatim. A hermeneutic method was used to describe and interpret the meaning of residents’ experiences. Findings. Three themes emerged: ‘being somebody’, ‘being nobody’ and ‘being in a community’. The encounters had both positive and negative influences on residents, expressed as being somebody and belonging somewhere or being nobody and not being seen as a person or simply being left out of things. Encounters between residents and nurses have a mutual dependency where residents certainly have some influence on the relationship. The nurses have both an influence on the relationship and a professional responsibility for the outcome of encounters with residents. Conclusion. The insights gained from the study can guide nurses in their encounters with residents in nursing homes so that they feel respected as unique human beings and part of a community.

  • 26.
    Ödling, Gunvor
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norberg, Astrid
    Institutionen för omvårdnad, Umeå universitet.
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Göteborgs universitet.
    Care of women with breast cancer on a surgical ward: Nurses' opinions of the need for support for women, relatives and themselves2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 39, no 1, p. 77-86Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In Sweden women with newly diagnosed breast cancer are admitted to surgical wards in order to undergo surgery and receive postoperative care. On these wards, nursing staff take care of women both with newly diagnosed breast cancer and those with cancer in advanced stages. Nurses have to meet the varying needs of patients and their relatives. AIM: To describe nurses' opinions of the need for care and support for women and their relatives in connection with surgery for breast cancer, as well as their own need for support on a surgical ward. METHODS: Thirty-one nurses from a surgical ward participated in semi-structured interviews. The interviews were tape-recorded and transcribed verbatim. Thereafter a step-by-step, qualitative content analysis was carried out. RESULTS: The nurses described the need to talk and receive information as being the most important among women and their relatives, as well as among themselves. Only a few nurses mentioned the need for physical care among the women. Contact with relatives was described as being almost nonexistent. There was a discrepancy between what nurses described as important needs and how these needs were provided for. CONCLUSION: This study shows that what the nurses described as being the most important needs, and the way how these needs were provided for, was more often seen from a theoretical point of view with few examples of self-experienced situations in the daily care. Needs among women and their relatives seemed to be not fully known to nurses and therefore, possibly, were not met. Nurses themselves had a pronounced need for support, which was sometimes unsatisfactorily met.

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