miun.sePublications
Change search
Refine search result
1 - 38 of 38
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1. Ahlström, B H
    et al.
    Skarsäter, I
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The meaning of major depression in family life: the viewpoint of the ill parent2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 1-2§, p. 284-293Article in journal (Refereed)
    Abstract [en]

    Aim and objective.

    The aim was to elucidate the meaning of major depression in family life

    from the viewpoint of an ill parent.

    Background.

    Major depression according to Diagnostic and Statistical Manual of

    Mental Disorders is common and may appear repeatedly over several

    years, and affects family life. Depression in parents has a negative

    impact on family function and children's health; however, studies

    regarding the deeper understanding of major depression in family life

    are lacking.

    Design.

    A qualitative explorative study using narrative interviews with eight

    parents who were identified with major depression.

    Methods.

    A phenomenological-hermeneutic method of interpretation was used for

    analysing interview texts and included naive understanding, a

    structural analysis where text was divided into meaning units, which

    were condensed and abstracted, and finally a comprehensive

    understanding.

    Result.

    Two themes were extracted: 'to be afflicted in an almost unmanageable

    situation' with sub-themes 'feeling hopelessly bad', 'being worthless',

    'being unsatisfied' and the theme 'to reconcile oneself to the

    situation' with sub-themes 'being active', 'being satisfied' and

    'maintaining parenthood'.

    Conclusion.

    Comprehensive understanding revealed the parents' simultaneous

    suffering and dignity in family life; suffering with serious lack of

    well-being and health, destroyed self-confidence and unhappiness, and

    dignity with strength, confidence and joy in children. The movement

    between suffering and dignity complicated family life. Dignity was

    threatened by the awareness that suffering in major depression was

    recurrent. Dignity had to be repeatedly restored for self and the

    family, and family dignity has to be restored before others outside the

    family circle.

    Relevance to clinical practice.

    A deeper understanding of the meaning of major depression in family

    life is helpful and for healthcare professionals to prevent individual

    and family suffering by assisting and preserving dignity.

     

  • 2.
    Backman Lönn, Beatrice
    et al.
    Region Västernorrland, Sundsvall Hospital, Sundsvall.
    Olofsson, Niclas
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Translation and validation of the Clinical Trial Nursing Questionnaire in Swedish: A first step to clarify the clinical research nurse role in Sweden2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 13-14, p. 2696-2705Article in journal (Refereed)
    Abstract [en]

    Aim and objectives: To translate the Clinical Trial Nursing Questionnaire (CTNQ) into Swedish and test it for face and content validity as well as internal consistency and reproducibility using test–retest procedures. Introduction/Background: In many countries, as in Sweden, a registered nurse can be involved in research by becoming a clinical research nurse. The clinical research nurse plays a pivotal role in clinical studies as a part of the research team. Scales have been developed and used with the objective to clarify the role of clinical research nurses: one of them is the CTNQ. Methods: A quantitative cross-sectional design with a test–retest procedure was applied to validate the translated questionnaire. By using a snowball sampling method, relevant participants were identified and 49 registered nurses working in the field of research as clinical research nurses answered the questionnaire on two occasions. An expert panel of three clinical research nurses evaluated the questionnaire for face and content validity. The STROBE checklist for observational research has been followed for presenting the research (see File S1). Results: Face and content validity was agreed upon in the expert panel group. Tests for internal consistency of the CTNQ was calculated and showed a high Cronbach's alpha for both the frequency and importance subscales. The test–retest correlation analysis (reproducibility) also revealed a high correlation coefficient for both subscales. Conclusion: The CTNQ-SWE is a valid and robust instrument in a Swedish version. The instrument can be of importance in assessing the role of clinical research nurses in Sweden in future studies. Relevance to clinical practice: Use of the CTNQ-SWE in future research can be of value for clarification and professional development of the clinical research nurse role in Sweden. The further use of the CTNQ in Sweden can be of value in understanding the process where licensed nurses make a transition into becoming a clinical research nurse, and to identify needs for customised education.

  • 3.
    Edwall, L L
    et al.
    Göteborgs Universitet.
    Hellström, A L
    Göteborgs Universitet.
    Öhrn, I
    Göteborgs Universitet.
    Danielson, Ella
    Göteborgs Universitet.
    The lived experience of the diabetes nurse specialist regular check-ups, as narrated by patients with type 2 diabetes2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 6, p. 772-781Article in journal (Refereed)
    Abstract [en]

    AIM: The aim was to elucidate the lived experience of regular diabetes nurse specialist check-ups among patients with type 2 diabetes. BACKGROUND: Diabetes care with diabetes nurse-led clinics in primary care has been established in Sweden since the 1980s. Information about patients' lived experience of these regular check-ups is important in the further development of diabetes nursing in primary care. METHODS: Narrative interviews were conducted with 10 women and 10 men with type 2 diabetes regarding their lived experience in everyday life and the regular check-ups by the diabetes nurse specialist. A phenomenological-hermeneutic method inspired by Ricoeur was used in the analysis. RESULTS: Patients'- with type 2 diabetes - lived experience of regular check-ups showed an overall positive influence on the patients' way of living with the disease by underpinning and developing their understanding and management of daily life. This influence was interpreted as an interlinked chain comprising the following elements; being confirmed, being guided within the disease process, becoming confident and independent and being relieved. Every link contained a positive influence from being dependent-independent, autonomous and a feeling of freedom in patients striving for an everyday life with a disease under control. RELEVANCE TO CLINICAL PRACTICE: The development of diabetes-nurse-led clinics from the perspective of the patient must consider the patient's individual need for support and continuity with the diabetes nurse specialist. Consultations with collaborative partnership and specific expertise that is easy to access implied autonomous disease self-management in terms of patients' own control of the disease over time. In view of the increasing number of patients with diabetes, this could positively impact the availability of diabetes nursing care.

     

     

  • 4. Eilertsen, G.
    et al.
    Ormstad, H.
    Kirkevold, M.
    Mengshoel, A. M.
    Söderberg, Siv
    Luleå University of Technology.
    Olsson, M.
    Similarities and differences in the experience of fatigue among people living with fibromyalgia, multiple sclerosis, ankylosing spondylitis and stroke2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 13-14, p. 2023-2034Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To elucidate the experience of fatigue across several long-term illnesses, focusing on the similarities and differences. Background: Fatigue is common to many long-term illnesses, but it has been studied mainly within the context of a single illness; qualitative studies comparing the experience and its impact on daily life across different long-term illnesses are lacking. Design: Qualitative design. Methods: A secondary analysis was conducted of five original interview studies involving 95 persons with ankylosing spondylitis, fibromyalgia, multiple sclerosis or stroke. Results: Similarities and differences concerning experiences of fatigue were found across the studied long-term illnesses. All patients expressed the perception of having an unfamiliar body. Fatigue was also commonly expressed as unpredictable, uncontrollable and invisible to others. Differences were related to a constant versus a varying condition, a sudden and an uncontrollable sleepiness, a mutual reinforcement with pain and increased stress sensitivity. A lack of energy and a need for sleep and rest were common experiences, as was the impact on social relationships. There were also similarities regarding how the patients managed their daily life. The search for practical solutions and attitude adjustment differed with the fatigue characteristics. All patients felt a lack of understanding and disbelief from others. Conclusion and relevance to clinical practice: Fatigue is commonly expressed by patients with long-term illnesses. Variations in experience are related to the type of diagnosis. The disparity between experiences influences how patients managed and adjusted to the conditions of everyday life. The illness-specific characteristics of fatigue warrant increased clinical awareness and may allow professionals to offer adequate information and establish effective methods of managing the condition. The feeling of invisibility and difficulty describing the experience of fatigue in particular highlights this need. © 2015 John Wiley & Sons Ltd.

  • 5.
    Ek, Bosse
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Registered nurses’ experiences of their decision-making at an Emergency Medical Dispatch Centre2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 7-8, p. 1122-1131Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To describe registered nurses experiences at an Emergency Medical Dispatch Centre.

    Background: It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patients arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses.

    Design: A qualitative design was used for this study.

    Methods: Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used.

    Results: Two themes emerged during the analysis: ‘Having a profession with opportunities and obstacles’ and ‘Meeting serious and difficult situations’, with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned.

    Conclusions: Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses.

    Relevance to clinical practice: Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame-free culture are important factors to attract and retain employees.

  • 6. Engström, Å
    et al.
    Söderberg, Siv
    Luleå University of Technology.
    Critical care nurses' experiences of follow-up visits to an ICU2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 19-20, p. 2925-2932Article in journal (Refereed)
    Abstract [en]

    Aim.: The aim of this study was to describe critical care nurses' experiences of follow-up visits for formerly critically ill people discharged from an intensive care unit and their close relatives. Background.: The critical illness experience affects the ill person and their close relatives not only during the stay in an intensive care unit, but also for a long time afterwards. Follow-up visits were introduced to offer people the opportunity to talk about their experiences. This activity has not been studied earlier from the perspective of critical care nurses. Design.: The design of this study was qualitative. Method.: Eight critical care nurses narrated their experiences of follow-up visits by formerly critically ill people and their close relatives to an intensive care unit. Data were collected during 2007-2008. Qualitative thematic content analysis was applied to the interview texts. Results.: The findings show that to feel they were doing a good job it was vital for the critical care nurses to be well prepared for the follow-up visits. It was difficult, in a positive way, to recognise formerly critically ill people when they returned looking healthy. The critical care nurses were disappointed that their former patients remembered so few real events. The follow-up visits gave the critical care nurses a new picture of how the critically illness experience influenced the former patient's everyday life during and after their stay in the intensive care unit and how it affected the lives of their close relatives. Conclusions.: Through sharing the experiences of formerly critically ill peoples' and their close relatives' critical care nurses receive valuable feedback about their work. Relevance to clinical practice.: Receiving feedback about one's work from follow-up visits gives critical care nurses the possibility for to evaluate given care. Follow-up visits to intensive care units can provide them with valuable knowledge that might lead to improved nursing care. © 2010 Blackwell Publishing Ltd.

  • 7.
    Engström, Åsa
    et al.
    Luleå University of Technology.
    Söderberg, Siv
    Luleå University of Technology.
    Close relatives in intensive care from the perspective of critical care nurses2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 9, p. 1651-1659Article in journal (Refereed)
    Abstract [en]

    Aim.  The aim was to describe critical care nurses’ experiences of close relatives within intensive care.

    Background.  There is a lack of research describing critical care nurses' experiences of the significance of close relatives in intensive care. Knowledge in this area will support critical care nurses to develop good nursing care for the critically ill person and their close relatives.

    Design and method.  The design of the study was qualitative. Data collection was carried out through focus group discussions with 24 critical care nurses in four focus groups during spring 2004. The data were subjected to qualitative thematic content analysis.

    Results.  The focus groups discussions showed that the presence of close relatives was taken for granted by critical care nurses and it was frustrating if the critically ill person did not have any. Information from close relatives made it possible for critical care nurses to create individual care for the critically ill person. They supported close relatives by giving them information, being near and trying to establish good relations with them. Close relatives were important. Critical care nurses lacked forums for reflection and discussion about the care given.

    Relevance to clinical practice.  This study indicates that close relatives are a prerequisite for critical care nurses to give good nursing care to meet the needs of the critically ill person. A communication based on mutual understanding is necessary if critical care nurses are to be able to support close relatives. Dealing constantly with situations that were ethically difficult without any chance to reflect was an obstacle for critical care nurses to improve their work with close relatives.

  • 8.
    Eriksson, Monica
    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.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Couples´ thoughts about and expectations of their future life after the patient´s hospital discharge following acute myocardial infarction2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 23-24, p. 3485-3493Article in journal (Refereed)
    Abstract [en]

    Aim: To describe and interpret couples’ thoughts and expectations about their future life after the patient’s discharge following acute myocardial infarction [AMI].

    Background: An AMI is a challenge for both the patient and his/her partner, as it can disrupt family functioning and dynamics. Earlier research has generally focused on either the patient or the partner and few studies have explored the experiences of the couple.   

    Design: Qualitative descriptive and interpretative.

    Methods: 15 couples took part in individual interviews, 4-8 weeks after discharge. Data were analysed in two phases using qualitative content analysis.

    Results: The first phase of the analysis revealed two categories: ‘an active approach to the future’ and ‘a wait-and-see approach to the future’, both of which described the participants’ thoughts about the future. In the second phase, the couples’ stories were interpreted and grouped into four positions: ‘the life companions’, ‘the tightrope walkers’, ‘the pathfinders’ and ‘the observers’, which illustrated their visions of the future.

    Conclusions: Our results reveal differences in the couples’ thoughts about and expectations of their future life, most of them managed the situation by having a positive attitude to life and their future. The couples discovered their resources and compensated for or balanced each other in the early recovery period.

    Relevance to clinical practice: The results indicate the importance of giving both partners the opportunity to express their views of the situation, as this increases nurses’ understanding of the impact of the illness on their life and relationship. However, the results also highlight the significance of seeing the couple and showing them consideration both as individuals and as a unit.

  • 9.
    Eriksson, Ulrika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Struggling for confirmation - patients' experiences of dissatisfaction with hospital care2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 3, p. 438-446Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of the study was to illuminate patients' experiences of dissatisfaction with hospital care. BACKGROUND: During the last decade, interest in measuring patient satisfaction has become an important indicator of the quality of care. Researchers have, however, criticized the concept theoretically and methodologically. Subsequently, researchers have increasingly argued that the focus of attention should shift to explore patient dissatisfaction. DESIGN: A qualitative approach. METHODS: Narrative interviews were conducted with six people who had experienced dissatisfaction during a hospital care episode. The interview text was analysed using qualitative content analysis. RESULTS: The results show the patients' struggle for confirmation, the feeling of distrust in health care and what they have been forced to sacrifice because of lack of treatment. A feeling of being a troublesome patient is also apparent. At the same time a positive encounter is described, as well as situations of confirmation from caregivers. The results also show hope and a will to get on with life. CONCLUSIONS: Dissatisfaction relating to aspects of encounter is a common problem in health care and conceivable causes and possible solutions are discussed from different perspectives. RELEVANCE TO CLINICAL: PRACTICE: Caregivers as well as patients are in need of confirmation. If management were to take notice of and confirm caregivers this could consequently help them to gain the strength and energy necessary to provide care permeated with confirmation. A veritable, trustworthy care can be established through personal presence. To take notice of, confirm and listen to patients, creates opportunities for providing them with a positive experience of human encounter, which in the long run is rewarding from all perspectives.

  • 10. Forsberg, A.
    et al.
    Söderberg, Siv
    Luleå University of Technology.
    Engström, A.
    People's experiences of suffering a lower limb fracture and undergoing surgery2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 1-2, p. 191-200Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To describe people's experiences of suffering a lower limb fracture and undergoing surgery, from the time of injury through to the care given at the hospital and recovery following discharge. Background: There is a lack of research on people's experiences of suffering a lower limb fracture and undergoing surgery - from injury to recovery. Design: A qualitative approach was used. Methods: Interviews with nine participants were subjected to thematic content analysis. Results: One theme was expressed: from realising the seriousness of the injury to regaining autonomy. Participants described feelings of frustration and helplessness when realising the seriousness of their injury. The wait prior to surgery was a strain and painful experience, and participants needed orientation for the future. They expressed feelings of vulnerability about being in the hands of staff during surgery. After surgery, in the postanaesthesia unit, participants expressed a need to have control and to feel safe in their new situation. To mobilise and regain their autonomy was a struggle, and participants stated that their recovery was extended. Conclusions and relevance to clinical practice: Participants found themselves in a new and unexpected situation and experienced pain, vulnerability and a striving for control during the process, that is, 'from realising the seriousness of the injury to regaining autonomy'. How this is managed depends on how the patient's needs are met by nurses. The nursing care received while suffering a lower limb fracture and undergoing surgery should be situation specific as well as individual specific. The safe performance of technical interventions and the nurse's comprehensive explanations of medical terms may help the patient to feel secure during the process. © 2013 John Wiley & Sons Ltd.

  • 11. Forslund, A. S.
    et al.
    Lundblad, D.
    Söderberg, Siv
    Luleå University of Technology.
    Sudden cardiac death among people with diabetes: Preventive measures documented in their medical records2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 23-24, p. 3401-3409Article in journal (Refereed)
    Abstract [en]

    Aims: The purpose of this study was to examine how prevention of complications for people with diabetes mellitus had been conducted, as described in their medical records, focusing particularly on sudden cardiac death. A further aim was to compare the documentation with guidelines for diabetes care. Background: Diabetes mellitus is associated with an increased risk of cardiovascular disease, death and sudden cardiac death. About half of those affected by sudden cardiac death are assumed to have had one or more risk factors for cardiovascular disease that could have been treated effectively resulting in a reduced risk of sudden death. Design: Survey. Method: Fifty-six people diagnosed with diabetes mellitus, who had died of a sudden cardiac arrest between the years 2003-2005, from the Northern Sweden MONICA myocardial registry were included. These people's medical records were examined with regard to documentation of the care given during the year prior to the person's sudden cardiac death. Results: The qualitative content analysis resulted in four categories: individualised goals for diabetes care; prevention of complications; self-care; and factors which may affect ability to adhere to treatment. The quantitative analysis showed that few people with diabetes mellitus achieved goals for metabolic control, compared with those set in guidelines for diabetes mellitus care.Conclusion. To prevent complications for people with diabetes mellitus, it is a challenge for nurses and physicians to involve people with diabetes mellitus in their own care to improve the prognosis. Relevance to clinical practice: Examination of medical records of people with diabetes mellitus showed that documentation could be more informative and systematic. It is important to achieve better adherence to treatment and to increase people's understanding of their illness. © 2010 Blackwell Publishing Ltd.

  • 12.
    Grav, Siv
    et al.
    Department of Health Science, Nord-Trøndelag University College.
    Hellzèn, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Romild, Ulla
    Swedish Natl Inst Publ Hlth, Ostersund, Sweden.
    Stordal, Eystein
    Norwegian Univ Sci & Technol, Fac Med, Dept Neurosci, N-7034 Trondheim, Norway.
    Association between social support and depression in the general population: the HUNT study, a cross-sectional survey.2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 1-2, p. 111-120Article in journal (Refereed)
    Abstract [en]

    Aim.  The aim was to investigate the associations between perceived social support and depression in a general population in relation to gender and age. Background.  Social support is seen as one of the social determinants for overall health in the general population. Studies have found higher probability of experiencing depression among people who have a lack of social support; evidence from the general population has been more limited. Subjective perception that support would be available if needed may reduce and prevent depression and unnecessary suffering. Design.  A cross-sectional survey with self-reported health was used. Method.  A total of 40,659 men and women aged 20-89 years living in Nord-Trøndelag County of Norway with valid ratings of depression subscale of the Hospital Anxiety and Depression Scale in the The Nord-Trøndelag Health Study 3 were used. Logistic regression was used to quantify associations between two types of perceived support (emotional and tangible) and depression. Gender, age and interaction effects were controlled for in the final model. Results.  The main finding was that self-rated perceived support was significantly associated with Hospital Anxiety and Depression Scale-defined depression, even after controlling for age and gender; emotional support (OR = 3·14) and tangible support (OR = 2·93). The effects of emotional and tangible support differ between genders. Interaction effects were found for age groups and both emotional and tangible support. Conclusion.  Self-rated perceived functional social support is associated with Hospital Anxiety and Depression Scale-defined depression. In the group of older people who have a lack of social support, women seem to need more emotional support and men tangible support. Relevance to clinical practice.  Health care providers should consider the close association between social support and depression in their continuing care, particularly in the older people.

  • 13.
    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.
    Gilje, Fredricka
    Sandman, Per-Olof
    Norbergh, Astrid
    From optimism to pessimism: A case study of a psychiatric patient1998In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 7, no 4, p. 360-370Article in journal (Refereed)
    Abstract [en]

    This article focuses on the results of a single case study which illuminates an understanding of phases in nursing care for a patient in a psychiatric setting in Sweden. The focus of this study is a fifty year old man who showed progressive deterioration from increased motor activity to oral, sexual, destructive and aggressive actions. The data collection using five methods occurred during a 21 months period. Results of the content analyses processes identified four distinct but indiscreet phases of the patient’s complex condition. The medical and nursing care was categorised in three approaches: optimistic, strategic and resigned. The results raise the question whether there is action that is without any meaning as an expression of the patient´s wishes, thoughts and feelings. It seems clear that the patient in this study felt really angry and in despair. However, during moments of lucidity, he also indicated that he felt this was not an authentic expression of his "real" self. His experience was that of a splintered world.

  • 14.
    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.
    Sandman, Per-Olof
    Norberg, Astrid
    Unwillingness to be violated: Carers' experiences of caring for a person acting in a disturbing manner. An interview study1999In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 8, no 6, p. 653-662Article in journal (Refereed)
    Abstract [en]

    Carers working in psychiatric care are sometimes exposed to insane, unpredictable and violent actions. In rare cases a patient appears to be resistant to all forms of pharmacological treatment. · Fifteen carers (4 RNs, 11 ENs) on a psychiatric ward in Sweden were interviewed about their experiences when caring for a person who acted in a disturbing manner. Narrative interviews were conducted and interpreted using a method inspired by Ricoeur. · Four themes were formulated which describe the carers’ uncertainty about the future, their inability to interpret the patient’s disturbing behaviour and their own overall feeling of meaninglessness. · Carers believed that the patient had power and ruled the ward, which led to them feeling they were subjugated victims. Interviews also revealed the carers’ recognition of forbidden feelings and actions and own unknown negative sides. · These results were interpreted and reflected on in the light of an ethical framework in order to achieve a deeper understanding of the text. · This paper shows that an ethical perspective is important when searching for the meaning of caring for patients acting in a disturbing manner. The study raises the question: ‘Is it possible to establish good when evil has dominion?

  • 15.
    Høgsnes, Linda
    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.
    Norbergh, Karl-Gustaf
    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. Institute of Health and Care Sciences, The Salhlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Healthcare professionals' documentation in nursing homes when caring for patients with dementia in end of life - a retrospective records review2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 11-12, p. 1663-1673Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To investigate how end-of-life care was described by healthcare professionals in records of deceased persons affected by dementia who had lived in Swedish nursing homes. Background: In the final stage of dementia disease, the persons are often cared for at nursing homes and they often die there. The research concurs that a palliative approach to end-of-life care is essential but there are still some limitations regarding research about what constitutes the end-of-life care provided to persons affected by dementia in Sweden. Design: Descriptive qualitative method with a retrospective approach. Method: Nursing records (n = 50) and medical records (n = 50) were retrospectively reviewed in two nursing homes. The analysis was conducted using deductive and inductive content analysis. Three phases of The Liverpool Care Pathway; Initial assessment, Continuous assessment and Follow-up, were used deductively to first sort the text in the records, then the text in each phase was further analysed with inductive content analysis. Four categories and 11 subcategories described the content in the records. Results: The end-of-life care was described in the healthcare records based on such categories as decision-making, participation and communication, assessment and prevention of symptom and following up after the residents had died. Conclusion: Paticularly, physical symptoms were documented and, to a lesser degree, psychological or existential/spiritual needs. Relevance to clinical practice: Healthcare professionals must have a holistic view of the person affected by dementia during the end-of-life care and, according to this study, more focus must be placed on their psychosocial and existential needs in the documentation of end-of-life care.

  • 16. Jumisko, E.
    et al.
    Lexell, J.
    Söderberg, Siv
    The meaning of feeling well in people with moderate or severe traumatic brain injury2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 16, p. 2273-2281Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to elucidate the meaning of feeling well for people with moderate or severe traumatic brain injury. Background. Considerable attention has been given to research consequences, quality of life and satisfaction with life in people with traumatic brain injury. Most studies reveal negative aspects of living with traumatic brain injury. Knowledge that provides an understanding of the meaning of feeling well for people with a traumatic brain injury entails the possibility that they could receive support to feel well, despite their injury. Design. This study used a qualitative research approach, as the aim was to elucidate meaning. Methods. Data were collected through qualitative research interviews with two women and six men with moderate or severe traumatic brain injury who had lived with the injury for between 7-15 years. A phenomenological hermeneutic method was used to interpret the data. Results. The meaning of feeling well for people with moderate or severe traumatic brain injury was that the initially unfamiliar life with traumatic brain injury became familiar. This included finding strength, regaining control over everyday life, being close to someone and being good enough. People with traumatic brain injury felt well when they became reconciled with the circumstances of their life and created a new entity in that life, in which their complete health had been lost. Relevance to clinical practice. This study helps professionals to enhance their understanding and awareness of the possibilities for people with moderate or severe traumatic brain injury to feel well. The study showed that people with traumatic brain injury needed a lot of strength to achieve this. Professionals can help them to feel well by getting to know them and thus find ways to support the person's feeling of wellbeing. © 2009 Blackwell Publishing Ltd.

  • 17.
    Juthberg, Christina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, Sture
    Norberg, Astrid
    Sundin, Karin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Stress of conscience and perceptions of conscience in relation to burnout among care providers in older people2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 14, p. 1897-1906Article in journal (Refereed)
    Abstract [en]

    Aims. The aim was to study the relationship between conscience and burnout among care-providers in older care, exploring the relationship between stress of conscience and burnout, and between perceptions of conscience and burnout.Background. Everyday work in healthcare presents situations that influence care-providers' conscience. How care-providers perceive conscience has been shown to be related to stress of conscience (stress related to troubled conscience), and in county council care, an association between stress of conscience and burnout has been found.Method. A questionnaire study was conducted in municipal housing for older people. A total of 166 care-providers were approached, of which 146 (50 registered nurses and 96 nurses' aides/enrolled nurses) completed a questionnaire folder containing the stress of conscience questionnaire, the perceptions of conscience questionnaire and the maslach burnout inventory. Multivariate canonical correlation analysis was used to explore relationships.Result. The relationship between stress of conscience and burnout indicates that experiences of shortcomings and of being exposed to contradictory demands are strongly related to burnout (primarily to emotional exhaustion). The relationship between perceptions of conscience and burnout indicates that a deadened conscience is strongly related to burnout.Conclusion. Conscience seems to be of importance in relation to burnout, and suppressing conscience may result in a profound loss of wholeness, integrity and harmony in the self.Relevance to clinical practice. The results from our study could be used to raise awareness of the importance of conscience in care.

  • 18.
    Karlström, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Engström-Olofsson, Regina
    Nystedt, Astrid
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Women's postoperative experiences before and after the introduction of spinal opioids in anaesthesia for caesareansection2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 9-10, p. 1326-1334Article in journal (Refereed)
    Abstract [en]

    Aim.

    The aim was to evaluate a new anaesthetic routine and to study the effect of spinal opioids for caesarean section on postoperative pain, expectations of pain, satisfaction with pain treatment, breastfeeding, infant care and length of hospital stay.

    Background.

    Inadequate postoperative pain relief is a problem among hospitalised patients. Women undergoing caesarean section have been shown to experience high levels of pain during the first days after operation. Women are expected to breastfeed and care for their newborn while recovering from major abdominal surgery and sufficient pain relief are of importance.

    Design.

    Comparative patient survey.

    Methods.

    Data were collected through a questionnaire distributed to two independent samples of women undergoing elective and emergency caesarean section before and after the introduction of an additive of opioids in obstetric spinal anaesthesia. Chi-square tests were performed, and risk ratios were used for bivariate analysis. Logistic regression modelling was used for multivariate analysis.

    Results.

    The group of women undergoing caesarean section with opioids added to the spinal anaesthesia reported significantly lower levels of experienced pain. High pain levels irrespective of mode of caesarean section affected breastfeeding and infant care. Length of hospital stay for caesarean women was shortened and the consumption of analgesics was reduced.

    Conclusions.

    Women receiving an additive of opioids in spinal anaesthesia experienced lower levels of pain. Low pain levels facilitate breastfeeding and infant care and are of relevance for financial considerations.

    Relevance to clinical practice.

    The results of this study indicate that spinal opioids for women undergoing caesarean section have a positive effect on the postoperative pain experience. Women undergoing caesarean section and have high pain levels are in special need of attention and care because of a higher risk of a decreased ability to breastfeed and to take care of their newborn.

  • 19.
    Lundahl, Maja-Klara
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Olovsson, Karl Johan
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Rönngren, Ylva
    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.
    Nurse's perspectives on care provided for patients with gamma-hydroxybutyric acid and gamma-butyrolactone abuse2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 17-18, p. 2589-2598Article in journal (Refereed)
    Abstract [en]

    Aims and objectives To describe registered nurses' views and experiences providing care for gamma-hydroxybutyric acid and gamma-butyrolactone abuse inpatients in a psychiatric unit.

    Background Gamma-hydroxybutyric acid and gamma-butyrolactone are illegal drugs with potentially fatal outcomes that are entering wider use in Scandinavia. Gamma-hydroxybutyric acid-dependent persons with withdrawal symptoms often require forceful withdrawal treatment provided in psychiatric units.

    Design A qualitative study with a purposive sample including interviews from registered nurses.

    Methods Data were collected from interviews with 15 registered nurses working in specialised dependency units in psychiatric wards. The data collected were analysed through a descriptive, qualitative analysis.

    Results The registered nurses' narratives revealed four main areas of convergence: feelings of anxiety and despair, preparation for unpredictable and precarious situations, striving for good relationship and striving to optimise and develop nursing care. The interviews revealed that registered nurses reflect on and discuss their feelings about their patients' situations with colleagues; prepare themselves for potential aggressiveness and unpredictable situations; improve their care through conscious attitude adjustment and relationship-forming behaviours; and strive to increase their personal knowledge, maintain a hopeful outlook and exhibit a positive approach. These themes were found in all nine categories and sixteen subcategories.

    Discussion The findings based on the registered nurses' narratives indicated that the registered nurses experienced their work situation when caring for these patients to be very complex and demanding.

    Conclusion The study revealed that registered nurses worked extensively to craft their approach and attitude towards their patients. It is clear that registered nurses use themselves as tools or instruments for the creation of good relationships, thus providing the best care possible.

    Relevance to clinical practice Registered nurses should be given more education, clearer guidelines and better guidance to assist them in facing such challenging and often problematic situations. One-on-one shadowing provides the possibility to create and develop relationship.

  • 20.
    Melin-Johansson, Christina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Palmqvist, Rebecca
    Region Jämtland Härjedalen, Östersund.
    Rönnberg, Linda
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Clinical intuition in the nursing process and decision-making: A mixed studies review2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 23-24, p. 3936-3949Article in journal (Refereed)
    Abstract [en]

    Aims and objectives

    To review what is characteristic of registered nurses’ intuition in clinical settings, in relationships and in the nursing process.

    Background

    Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence-based activities, where intuition is an important component associated with the nursing process.

    Design

    An integrative review strengthened with a mixed-studies review.

    Methods

    Literature searches were conducted in the databases CINAHL, PubMed and PsycINFO, and literature published 1985–2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors.

    Results

    After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients’ intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision-making, and validating decisions.

    Conclusion

    Intuition is more than simply a “gut feeling,” and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care.

    Relevance to clinical practice

    We find that intuition plays a key role in more or less all of the steps in the nursing process as a base for decision-making that supports safe patient care, and is a validated component of nursing clinical care expertise.

  • 21.
    Nilsson, Åsa
    et al.
    Luleå University of Technology.
    Skär, Lisa
    Luleå University of Technology.
    Söderberg, Siv
    Luleå University of Technology.
    Nurses' views of shortcomings in patent care encounters in one hospital in Sweden2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 19-20, p. 2807-2814Article in journal (Refereed)
    Abstract [en]

    Aim and objective: To describe nurses' views of shortcomings in patient care encounters in one hospital in Sweden. Background: Shortcomings in encounters in healthcare have increased during recent years. Dissatisfaction with encounters in healthcare can affect patients' experiences of dignity, health and well-being. Design: A qualitative design was used in the study. Methods: Three focus group discussions with 15 nurses were conducted. The nurses worked in five different wards. The focus group discussions were subjected to a thematic content analysis. Results: The results are presented in two themes. The first theme, 'Disregard for the patient's unique nursing needs', describes that information without consideration of the patient's needs, and nurses not being completely present in the meeting with the patient affected healthcare encounters and experiences of quality of care. In the second theme, 'Difficulty managing obstacles', nurses described care situations over which they could not always prevail due to lack of time and/or lack of awareness of the patient's vulnerability. Conclusion: The findings illustrate the importance of nurses and their approaches to patients. The nurse's attitude is important for the patient's experiences of participation, security, dignity, and well-being. The findings also illustrate the importance of routines in the healthcare organisation that support and facilitate positive encounters between patients, their close relatives and the healthcare staff. Relevance to clinical practice: Nurses require understanding, presence and commitment in their relationships to every unique patient, and their goal should be to adopt interventions with regard to positive healthcare encounters based on each patient's experiences of good nursing care.

  • 22.
    Norbergh, Karl-Gustaf
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sandman, Per-Olaf
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The relationship between organisational climate and the content of daily life for people with dementia living in group-dwelling2002In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 2, p. 237-246Article in journal (Refereed)
    Abstract [en]

    One factor influencing the outcome of care may be nursing staff's experience of the organizational work climate. The aim of the study was to investigate how people with dementia spend their time in group-dwelling units (GD) with either a creative or less creative organizational climate. 2. For the study, two GD units assessed as having a creative organizational climate and two units assessed as having a less creative climate were selected. Eighteen residents living in the units assessed as creative and 20 residents living in the units assessed as less creative participated in the study. 3. For measuring the organizational climate the Creative Climate Questionnaire was used. Observations of residents' activities were classified according to the Patient Activity Classification. For measuring residents' functional ability the Multi-Dimensional Dementia Assessment Scale was used. Their cognitive capacity was measured with the Mini Mental State Examination. 4. Residents living in the units assessed as having a creative organizational climate spent 45.2% of the time with nursing staff, while those in the less creative climate spent 25.6% (P < 0.001). Time spent with fellow residents in the creative climate was 13.9% and in the less creative climate 31.3% (P < 0.001). There was no significant difference between the units according time spent with relatives and time spent alone. 5. Since the purpose of GD is to offer care adapted to the abilities and psychosocial needs of people suffering from dementia, a less creative climate can be a threat to the aims of GD. In order to maintain these, it is important for managers to be aware of the work climate and its impact on care for people with dementia.

  • 23. Norman, Hans Ketil
    et al.
    Henriksen, Nils
    Norberg, Astrid
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Lucidity in a woman with severe dementia related to conversation.: A case study2005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 7, p. 891-896Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of this study was to explore the presence of lucidity in a woman with severe dementia during conversations and whether it occurred when conversational partners or the woman with severe dementia initiated the conversation topics about the present, past or future time and whether she was presented with support or demands during the conversation. BACKGROUND: Communication problems as well as episodes of lucidity in people with dementia are reported in the literature. DESIGN: A researcher held 20 hours of conversation with a woman with severe dementia. A daughter participated for about three and a half hours. The conversation was tape-recorded and transcribed verbatim. METHODS: The text was divided into units of analysis. Each unit of analysis was then assessed separately and discussed among the authors. Chi-square tests and logistic regression analysis were performed. An ethics committee approved the study. RESULTS: The woman as initiator of the conversation topic and support to the women during conversation from the conversation partner were found to be the most significant factors explaining lucidity, while conversation about the present or past time showed no connection with lucidity. Very few topics (n = 7) concerned future time and they were not used in the statistical analysis. The researcher initiated 41%, the woman 43% and the daughter 16% of the topics. Support was registered in 49%, demands in 15% and both support and demands in 16% of the units of analysis. There were 58% topics about present and 40% about the past time. CONCLUSIONS: The presented study is a case study and the results cannot be generalized. For the woman with severe dementia, lucidity was promoted by the conversational parties carefully focusing on conversation topics initiated by the woman while supporting her during conversation. RELEVANCE TO CLINICAL PRACTICE: To share the same perception of reality, focusing on the topics initiated by the patient with severe dementia and a supporting attitude to what the patient tells, will hopefully give more episodes of lucidity in the patient. This approach in caring for patients with severe dementia might give more meaning and well-being to the conversational partners in daily care.

  • 24. Normann, K
    et al.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norberg, Astrid
    Attitudes of Registered Nurses towards patients with severe dementia1999In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 8, no 4, p. 353-359Article in journal (Refereed)
    Abstract [en]

    • Meeting the needs and wishes of people with severe dementia is difficult and demanding for carers, and a number of approaches can be used in encounters with dementia sufferers.

     

    • The aim of this study was to explore how registered nurses in a northern Norwegian county thought about approaching people with severe dementia.

     

    • A patient case was used as a vignette, followed by a questionnaire with 13 sets of statements, each set containing two alternative approaches (one reality orientation approach and one personhood focused approach).

     

    • In 12 out of the 13 sets of statements the reality orientation alternative was usually chosen, but responses to the statement regarding the meaning of confusion tended more towards the personhood focused approach.

     

    • RNs with more than the basic education and staff nurses working in a team nursing system, chose the personhood focused approach significantly more often than RNs with no post-basic education and nurses working in a primary nursing system.

     

    • The article discusses how reflection on daily experiences can improve one's ability to reflect on one's own experiences and encourage a personhood focused approach.

     

    • Working in a team means gaining opportunities to reflect together with coworkers, while working in a primary nursing care system might afford fewer such opportunities.

     

     

  • 25.
    Nygren Zotterman, Anna
    et al.
    Division of Nursing Department of Health Science, Luleå University of Technology Luleå.
    Skär, Lisa
    Department of Health Blekinge Institute of Technology, Karlskrona .
    Olsson, Malin
    Division of Nursing Department of Health Science, Luleå University of Technology, Luleå .
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Being in togetherness: Meanings of encounters within primary healtcare setting for patients living with long-term illness2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 19-20, p. 2854-2862Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: The aim of this study was to elucidate meanings of encounters for patients with long-term illness within the primary healthcare setting. Background: Good encounters can be crucial for patients in terms of how they view their quality of care. Therefore, it is important to understand meanings of interactions between patients and healthcare personnel. Design: A phenomenological hermeneutic method was used to analyse the interviews. Methods: Narrative interviews with ten patients with long-term illness were performed, with a focus on their encounters with healthcare personnel within the primary healthcare setting. A phenomenological hermeneutical approach was used to interpret the interview texts. Results: The results demonstrated that patients felt well when they were seen as an important person and felt welcomed by healthcare personnel. Information and follow-ups regarding the need for care were essential. Continuity with the healthcare personnel was one way to establish a relationship, which contributed to patients' feelings of being seen and understood. Good encounters were important for patients' feelings of health and well-being. Being met with mistrust, ignorance and nonchalance had negative effects on patients' perceived health and well-being and led to feelings of lower confidence regarding the care received. Conclusions: Patients described a great need to be confirmed and met with respect by healthcare personnel, which contributed to their sense of togetherness. Having a sense of togetherness strengthened patient well-being. Relevance to clinical practice: By listening and responding to patients' needs and engaging in meetings with patients in a respectful manner, healthcare personnel can empower patients' feelings of health and well-being. Healthcare personnel need to be aware of the significance of these actions because they can make patients experience feelings of togetherness, even if patients meet with different care personnel at each visit. 

  • 26.
    Nystedt, Astrid
    et al.
    Institutionen för Omvårdnad Umeå Universitet.
    Edvardsson, David
    Institutionen för Omvårdnad Umeå Universitet.
    Willman, Ania
    Epidural analgesia for pain relief in labour and childbirth - a review with a systematic approach.2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 4, p. 455-66Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Clinical ambiguity concerning effects of epidural analgesia for pain relief in labour seems to reflect a need for evidence-based knowledge for midwives. AIMS: This study aimed to review, with a systematic approach, the literature about effects and risks associated with the use of epidural analgesia for pain relief in labour and childbirth. DESIGN: A structured question was formulated and used for deriving search terms, establishing the inclusion of certain criteria and retrieving articles, i.e. what are the effects of epidural analgesia for pain relief in labour and childbirth? References were obtained through searches using MeSH-terms in Medline and Subheadings (SH) in CINAHL (e.g. Obstetrical Analgesia combined either with psychology or adverse effects and together with, Dystocia, Caesarean Section, Infant Newborn and Breastfeeding). The articles were divided into prospective randomized trials (C), non-randomized prospective studies (P) and retrospective studies (R). Scientific quality of the studies was assessed on a three-grade scale: high scientific quality (I), moderate scientific quality (II) or low scientific quality (III). RESULTS: Twenty-four articles were retrieved and systematically assessed. Seven studies were judged as high quality, 15 as moderate quality and two as low quality. The majority of studies appraised in this review failed to obtain or establish a cause and effect relationship. According to the data, it seems clear that the use of epidural analgesia is considered to be an effective method of pain relief during labour and childbirth from the perspective of women giving birth. RELEVANCE TO CLINICAL PRACTICE: Midwives and doctors can recommend this form of pain relief. However, information about possible associations with adverse effects in mothers and infants must be provided to expectant couples.

  • 27.
    Nystedt, Astrid
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Edvardsson, David
    Willman, Ania
    To Mander R (2004) commentary on Nystedt et al. (2004).2005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 7, p. 911-Article in journal (Refereed)
  • 28.
    Nystedt, Astrid
    et al.
    Institutionen för Omvårdnad Umeå Universitet.
    Högberg, Ulf
    Lundman, Berit
    The negative birth experience of prolonged labour: a case-referent study.2005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 5, p. 579-86Article in journal (Refereed)
    Abstract [en]

    AIMS: This study aimed to analyse and describe women's different perceptions and experiences of childbirth following prolonged or normal labour. BACKGROUND: In clinical practice prolonged labour, or dystocia, is a common delivery complication often causing a negative birth experience. METHOD: Women giving singleton live birth to their first child with spontaneous labour after more than 37 completed weeks' pregnancy at three hospitals in northern Sweden were recruited to a case-referent study. Cases (n = 84) were women following a prolonged labour with assisted vaginal or abdominal delivery, and referents (n = 171) delivered following a normal labour. Participants completed a questionnaire that investigated childbirth experiences, previous family relationships and childhood experiences. RESULTS: Women with prolonged labour had a negative childbirth experience more often (34%) than did women who had a normal labour (4%) (P < 0.05). Cases agreed significantly more than the referents with the statement, 'Pain relief during the delivery saved me' (OR 4.5, 95% CI: 1.9-11.1) and 'My difficulties during the delivery will mark me for life' (OR 12.4, 95% CI: 4.4-35.9). There were no differences between the cases and referents regarding perceived experience of professional or social support. RELEVANCE TO CLINICAL PRACTICE: To improve care, midwives and doctors can alleviate pain and relieve the negativity and difficulty associated with the experience of prolonged labour from the perspective of the woman giving birth.

  • 29.
    Olsen, Rose Mari
    et al.
    Faculty of Health and Science, Nord-Trøndelag University College, Namsos.
    Østnor, Bjørg H.
    Faculty of Nursing Education, Sør-Trøndelag University College, Trondheim.
    Enmarker, Ingela
    Faculty of Health and Science, Nord-Trøndelag University College, Namsos.
    Hellzén, Ove
    Faculty of Health and Science, Nord-Trøndelag University College, Namsos.
    Barriers to information exchange during older patients' transfer: nurses' experiences2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 19-20, p. 2964-2973Article in journal (Refereed)
    Abstract [en]

    Aims and objectives To describe nurses' experiences of barriers that influence their information exchange during the transfer of older patients between hospital and home care. Background The successful transfer of an older patient across health organisations requires good communication and coordination between providers. Despite an increased focus on the need for cooperation among providers across healthcare organisations, researchers still report problems in the exchange of information between the hospitals and the healthcare systems in the municipalities. Design A qualitative study using focus group methodology. Methods Three focus group interviews using topic guides were conducted and interpreted. The study included registered nurses (n = 14) from hospital and home care. The data were analysed through content analysis. Results Three main themes were identified: barriers associated with the nurse, barriers associated with interpersonal processes and barriers associated with the organisation. These themes included several subthemes. Conclusions The findings highlight the challenges that nurses encounter in ensuring a successful information exchange during older patients' transfer through the healthcare system. The barriers negatively influence the nurses' information exchange and may put the patients in a vulnerable and exposed situation. In order for nurses to conduct a successful exchange of information, it is critical that hospital and home care systems facilitate this through adequate resources, clear missions and responsibilities, and understandable policies. Relevance to clinical practice Recognition of the barriers that affect nurses' exchange of information is important to ensure patient safety and successful transitions. The barriers described here should help both nurses in practice and their leaders to be more attentive to the prerequisites needed to achieve a satisfactory nursing information exchange and enhance informational continuity.

  • 30.
    Pejlert, Anita
    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.
    Norberg, Astrid
    Towards recovery: living in a home-like setting after the move from a hospital ward1999In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 8, no 6, p. 663-674Article in journal (Refereed)
    Abstract [en]

    • Six clients with a diagnosis of schizophrenia were interviewed about their experiences of their lives in a home-like setting, their key care provider and the care received.

     

    • Their narratives of lived experiences in care were interpreted as living a process of health in the midst of severe mental illness, involving: 'becoming more', 'being disabled', 'comforting/confirming relationship', 'discomforting/unconfirming relationship' and 'caring about the caring relationship'.

     

    • Fatigue and lack of strength influenced the lives of most clients considerably, and the stories were about problems and conflicts. Nevertheless, the clients seemed really to struggle to make communal life work, and there were experiences of increased competence and better self-confidence in most of the stories.

     

    • On the whole care was described as good, and the process of health seemed to be supported by experiences of comfort and being confirmed in the client–care provider relationship.

     

     

  • 31.
    Pejlert, Anita
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norberg, Astrid
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    From a psychiatric ward to a home-like setting: the meaning of caring as narrated by nurses2000In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 9, no 5, p. 689-700Article in journal (Refereed)
    Abstract [en]

    This study presents interviews with nurses 1 and 2 years after they moved to a home-like setting, compared with results from interviews with nurses before their move. A phenomenological hermeneutic perspective inspired by Ricoeur guided the study. The interviews focused on the meaning of their work, including their view of the client as a person and the care they provide. The meaning of caring was interpreted in terms of the following themes: 'being free and entrusted with the task of caring makes a difference'; 'sharing the activities of everyday life is a natural way of being together'; 'providing a warm, open and supportive eating atmosphere', 'sharing the client's everyday world with compassion and love, glimpsing possibilities'; and 'dealing with limiting circumstances in care, the lack of "homeliness"'. Findings suggest a transformation in the view of care that reveals itself in increased closeness in the client-carer relationship and a change in values. The narratives revealed a caring atmosphere, valuing the client as well as the carer. The same questions guided all interviews, allowing developments to be followed. The carer and the interviewer thus became increasingly familiar with the situation on each interview occasion and the possibility that this has influenced the study must be taken into consideration. However, the similarity between nurses' narratives validated their trustworthiness.

  • 32.
    Sjöblom, Lena-Mari
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Pejlert, Anita
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Nurses' view of the family in psychiatric care2005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 5, p. 562-569Article in journal (Refereed)
    Abstract [en]

    AIMS: The aim of this study is to examine nurses' view of the family in psychiatric care. BACKGROUND: The families of people who are mentally ill carry a heavy burden. Research has shown that they experience sorrow, shame and guilt. They are often involved in informal caring and there is evidence of families playing an important role in the recovery of the patient. In spite of this, a great deal could still be made to create more family-oriented care. This development depends to a large extent on nurses' view of involving families in the care and the perceived value of family-oriented work. METHOD: Four focus groups, with four to six carers in each group, were conducted. The recorded focus groups lasted 75-90 minutes and the data were transcribed and interpreted using content analysis. RESULTS: The results present four themes: compassion for and understanding of close relatives, the carer as the recipient of negative feelings, difficulties and dilemmas in the meeting with close relatives and preconceptions of mental illnesses in the family and in society. The results were interpreted as meaning that the carers found themselves in something that can be described as a double-bind situation. CONCLUSION: From analysis and interpretation, the conclusion is drawn that improved communication between nurses, patients and families could be a way to resolve the double-bind situation. RELEVANCE TO CLINICAL PRACTICE: To promote family health and also improve things for the patient, it can be argued, from the results of this study, that nurses should carefully consider whether and how to involve family members in care.

  • 33.
    Sundin, Karin
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jansson, Lilian
    Understanding and being understood as a creative caring phenomenon - in care of patients with stroke and aphasia2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 1, p. 107-116Article in journal (Refereed)
    Abstract [en]

    Five care providers particularly successful at communicating with patients with communication difficulties were video-recorded together with three patients with aphasia after stroke, during morning care activities. The care providers were then interviewed immediately after the video-recordings, about their experiences of communicating with such patients.The interviews with the care providers were interpreted by means of a phenomenological hermeneutic method.Co-creating was the main theme found.Care providers invite the patient to participate in the creative act of communication. They have a communicative attitude and show interest in the patients' personal desires. The care providers encounter the patient as a presence in a caring communion. In part, care providers communicate by continuously conveying their presence to the patient and even creating availability in a close and open intersubjective relationship.A relaxed and supportive atmosphere facilitates reciprocity between care provider and patient. The communication is not technical or strategic; instead care providers share the patients' experiences in a silent dialogue. This silent dialogue involves sharing the patients' feelings and thus receiving messages from the patient.

  • 34.
    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.
    Commentary on Svedlund M and Danielson E (2004) myocardial infarction: narrations by afflicted women and their partners of lived experiences in daily life following an acute myocardial infarction. Journal of Clinical Nursing 13, 438-446 - Response2005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 3, p. 409-410Article in journal (Other academic)
  • 35.
    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.
    Myocardial infarction: Narrations by afflicted women and their partners of lived experiences in daily life following an acute myocardial infarction2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 4, p. 438-446Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The review of the literature showed that many people and their family members share feelings of distress after an acute myocardial infarction. Therefore, it is important to show how the illness affects the relationship in the couple's daily life when the closest relatives involved are men. AIM: The aim was to illuminate the meaning of lived experiences in daily life after an acute myocardial infarction, as narrated by afflicted women and their partners. METHODS: Nine women and their partners narrated their experiences three and 12 months after an infarction. The interview texts were then interpreted, using a phenomenological hermeneutic method, inspired by the philosophy of Ricoeur. The text was divided into meaning units that were condensed and abstracted. Two themes and eight sub-themes were then extracted from the text. RESULTS: The first theme was 'living in a changed life situation' with the sub-themes: 'showing consideration', 'taking responsibility', 'living side by side' and 'desiring what to do'. The second theme was 'looking to the future' with the sub-themes: 'feeling uncertain', 'feeling powerless', 'feeling limited' and 'feeling hope'. CONCLUSIONS: The results revealed that couples lived in a changed life situation, somewhat in 'discordance', and showed consideration to each other in order to protect the partner. There seemed to be a lack of verbal communication, but both women and their partners revealed that they sensed how their partners felt without verbal communication. In this 'discordance', couples may experience loneliness, in that they may not share feelings about the event and the situation it causes. RELEVANCE TO CLINICAL PRACTICE: Women and their partner have specific needs in daily living following an acute myocardial infarction. Therefore, nurses should acknowledge the specific needs for the female patient and the partner more clearly.

  • 36. Svärdby, Karin
    et al.
    Nordström, Lennart
    Sellström, Eva
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Primiparas with or without oxytocin augmentation: A prospective descriptive study2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 1, p. 179-184Article in journal (Refereed)
    Abstract [en]

    AIMS: The aim of this study was to determine during which phase of delivery augmentation is started when used and to establish any correlation that might exist between the oxytocin infusion and the evaluations by primiparas themselves of their labour pain, strength of contractions and fatigue. In addition, we wanted to determine any differences in duration between labour with and labour without augmentation. We finally wanted to measure the incidence of instrumental deliveries, perineal trauma and neonatal outcome among the augmented vs. the non-augmented groups. BACKGROUND: The most commonly diagnosed complication in primiparas is ineffective contractions or protracted labour, otherwise known as dystocia, which literally means arrested or prolonged labour. Different treatments have been tried during the active phase of labour as well as the second stage of labour. The most common treatment today is amniotomy, often used in combination with an intravenous oxytocin infusion. MATERIALS AND METHODS: The study was conducted at the hospital in Ostersund in central Sweden from August 1998 to September 1999. Consecutive primiparas giving birth at full-term were selected to the study. The inclusion criteria were an uncomplicated pregnancy and a spontaneous single delivery with head presentation. The total number of participants was 164. RESULTS: The results showed that 50 of 164 primiparas needed no augmentation, while 88 were augmented during the active phase and 26 during the second stage of labour. The duration of the active phase [median (md) 4 hours 45 minutes, 6 hours 49 minutes and 6 hours 20 minutes respectively for the different groups, P = 0.03], the time between full dilation of the cervix and the start of the second stage (md 20 minutes, 30 minutes and 60 minutes respectively, P = 0.012) and the duration of the second stage of labour (md 40 minutes, 44 minutes and 60 minutes respectively, P = 0.04) were significantly longer in the augmented groups. Operative deliveries, too, were more frequent in the augmented groups. There was a significantly higher rate of perineotomies in the group augmented during the second stage of labour. There were, however, no differences in Apgar score <7 at 1 minute. pH in the umbilical cord and the base deficit were higher in the group which were augmented during the second stage of labour (P = 0.02 and P = 0.06 respectively). Women describing their impression of the experience as a whole generally gave it a high rating, but women who were augmented during the second stage of labour gave the experience a significantly lower score (P = 0.01). CONCLUSION: Augmentation is used in unusually prolonged deliveries. We did not find that augmentation involved a higher frequency of perineal trauma, although it was correlated with a higher frequency of operative deliveries. There was no correlation between the oxytocin infusion and the primiparas' descriptions of the strength of contractions, pain and fatigue, although greater use of epidurals was observed in women with augmented labour. The number of nulliparas in this study was too small to analyse the incidence of ruptures in the sphincter or draw conclusions about differences between the groups with regard to Apgar scores or metabolic acidosis. RELEVANCE TO CLINICAL PRACTICE: In clinical practice, good routines concerning oxytocin augmentation are crucial. Interventions as oxytocin augmentation seem to cause harm to mother and child. To evaluate interventions continuously in obstetric care is therefore important.

  • 37. Söderberg, Siv
    et al.
    Lundman, B.
    Norberg, A.
    The meaning of fatigue and tiredness as narrated by women with fibromyalgia and healthy women2002In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 2, p. 247-255Article in journal (Refereed)
    Abstract [en]

    • The aim of this study was to elucidate the meaning of fatigue and tiredness as narrated by women with fibromyalgia (FM) and healthy women. Twenty-five women with FM were interviewed with a narrative approach about the meaning of the lived experience of fatigue and tiredness. A reference group of 25 healthy women was interviewed about the same topic. • A phenomenological-hermeneutic method inspired by the French philosopher Ricoeur was used to interpret the interview text. • The meaning of fatigue and tiredness was related differently by women with FM and healthy women. The findings are presented in four major themes for women with FM - the body as a burden, an absent presence, an interfering obstacle and being in hope of alleviation - and in one major theme for healthy women: needing recovery. • Women with FM narrated fatigue as making it obvious that I have a body, instead of I am my body; the lived body becomes urgently present, as an 'it'. Healthy women narrated tiredness as a natural phenomenon when they need recovery and time to rest. • The findings are interpreted in the light of the phenomenological work on the lived body by Leder, Toombs and Merleau-Ponty. © 2002 Blackwell Science Ltd.

  • 38. Öhman, M.
    et al.
    Söderberg, Siv
    District nursing - Sharing an understanding by being present. Experiences of encounters with people with serious chronic illness and their close relatives in their homes2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 7, p. 858-866Article in journal (Refereed)
    Abstract [en]

    Background. In the homecare setting, district nurses assume a heavy responsibility and are involved in a variety of care activities. They view themselves as having a central role in care at home that centres on the development of a relationship with those who are ill and their families. Aim. The aim of this study was to elucidate the meaning of district nurses experiences of encounters with people with serious chronic illness and their close relatives in their homes. A purposive sample of 10 district nurses (female) was interviewed using a narrative approach. Method. To achieve the aim, a phenomenological hermeneutic interpretation inspired by the philosophy of Ricoeur was used to interpret the interview text. Results. This study proposes that district nurses' experiences of encounters with people with serious chronic illness and their close relatives in their homes can be understood as district nurses being welcomed into the ill people's privacy, to share their intimacy and their understanding of being ill. This close relationship enables them to alleviate and to console the suffering and loneliness caused by illness. This is expressed in the three themes: being in a close relationship, sharing an understanding and weaving a web of protection. Conclusion. It seems that by being entirely present, in a close relationship, district nurses share the experiences of illness and through interpretation of the whole persons' expressions; they share an understanding of this illness experience. In this close relationship, at the home of the ill people and their close relatives, district nurses are available to alleviate people's suffering and loneliness caused by illness. Relevance to clinical practice. This study reveals the need to be entirely present in encounters between the district nurses and people with serious chronic illness and their close relatives. This relation makes it possible to establish a shared understanding of the illness experience. Being aware of the importance of this shared understanding within a relationship, will increase the health care personnel's possibility to alleviate and console those suffering of illness. This proposed interpretation could be useful for reflection of care interventions, in education and supervision of district nurses.

1 - 38 of 38
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf