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  • 1.
    Carlsson, Malin
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Kjällman Alm, Annika
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Rising, Malin Holmström
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    An evaluation of registered nurses’ experiences of person-centered care and competence after participating in a course in digital competence in care2022Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 21, nr 1, artikel-id 368Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Health care’s rapid transition from in-person visits to more digital care meetings has challenged nurses to find new, sustainable ways of using digital technology.

    Methods

    The aim was to describe registered nurses’(RN) experiences with person-centred care (PCC) and competence after participating in a course in Digital Competence in Care (DCC). In this study, a qualitative descriptive design was used, and 16 individual interviews were carried out with RNs. Data were analysed using qualitative content analysis. The COREQ checklist was used in this study.

    Results

    The results were presented in four categories: being open to change and new ways of working with patients; struggling to handle requirements; developing new ways of working and focusing on patients despite the distance.

    Conclusions

    The DCC course helped develop RNs' skills and practice of PCC in digital care meetings. Training in digital care theory increased RNs' competence and facilitated the creation of new knowledge. The RNs' professional role was strengthened by participating in the changing of work routines. Digital care meetings were shown to be distance bridging and complementary to physical care meetings contributing to PCC. The increased availability of health care via digital means has affected the consumption of care and tailored education needs for RNs must be met by nursing education programs. Digital care is accessible, efficient and enables care regardless of geographical conditions, its innovative development needs to be based on science and experience and RNs are key personnel in this process.

  • 2.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Kjällman Alm, Annika
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Rising Holmström, Malin
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Primary Healthcare Nurses’ Views on Digital Healthcare Communication and Continuity of Care: A Deductive and Inductive Content Analysis2022Ingår i: Nursing Reports, ISSN 2039-439X, E-ISSN 2039-4403, Vol. 12, nr 4, s. 945-957Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Primary healthcare in the Western world faces significant functional challenges, resulting in the implementation of digital communication tools. Nurses are key professionals in primary care and focusing on the impact of digital communication and continuity of care in primary care organisations is important. This qualitative descriptive study explores digital communication and continuity of care from primary healthcare nurses’ perspective. Data from individual semi-structured interviews with 12 nurses were collected; deductive and inductive content analyses were performed. Three descriptive categories emerged from the deductive (digital communication as interpersonal, information, and management continuities) and inductive (‘digital care does not suit everyone’, ‘new technology is contextually intertwined with daily work’, and ‘patient-positive aspects of digital information’) phases. Additionally, a structural risk of obscuration of patients’ needs by the contextual conditions emerged. To ensure digital communication-aligned continuity of care, compatible information technology systems should be developed. Allowing nurses to provide high-quality care based on their own values would enhance person-centred patient care.

  • 3.
    Kjällman Alm, Annika
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Enhancing transcultural awareness in nursing education - the impact of Rainbow Intensive Program2011Ingår i: 11th Iberoamerican Conference on Nursing Education of ALADEFE, Coimbra, 18-24 september / [ed] Fernando Henriques, 2011Konferensbidrag (Refereegranskat)
    Abstract [en]

    Enhancing transcultural awareness in nursing education - the impact of Rainbow Intensive Program

    Authors

    Ana Isabel Fernandes Querido*, Anouk Verburg**, Annika Elisabet Kjallman Alm***

    Presenters

    Ana Isabel Fernandes Querido*, Anouk Verburg**, Annika Elisabet Kjallman Alm***

    Introduction: Today’s globalization society makes transcultural nursing education, a priority. Leininger’s Transcultural nursing is the humanistic-scientific study of people from different cultures, so nurses can assist them in health and living needs. Rainbow Network - Sweden, Finland, Norway, Portugal, Netherlands, Belgium, Latvia, Lithuania partners, have operated Intensive programmes to explore contemporary nursing issues from transcultural perspective. Cultural/linguistic competence can reduce health care disparities, improving quality of care delivered to patients and nursing performance. We address nursing students´ transcultural awereness.

    Objectives: Analyze the impact of the IP “Preventing and Care for people in Chronic Conditions” on students Transcultural awareness; Explore IP pedagogical structure /methods; Characterize cultural attitudes and behaviors of students participating the IP; Identify areas of cultural consciousness (Personal Reflection) and cultural competence (Service Delivery) changed; Correlate students transcultural skills - values, attitudes, behaviors in caring for culturally diverse clients and families, before and after IP.

    Methodology: Quasi-experimental study without group control correlates students’ cultural competence before/after Rainbow IP. IP consisted of pedagogical strategies combined with socio-cultural activities in an international environment. A convenience sample of 78 students from Rainbow partners participating in 2010 and 2011 IPs, consented to fill in a socio demographic questionnaire and cultural competence checklist (Goode, 2002) - self-assessment of cultural awareness: Personal Reflection (values/attitudes) - Lower scores mean better attitude; Service Delivery (behaviors) - Lower scores mean better skills caring for cultural different populations, applied before and after IPs.

    Results: Students were mostly women (91,0%), mean age 22,4 (+/-3,6) [19-42] years, from urban context (62,8%). During Rainbow, 44,2% attended 2nd year of nursing studies; 36,8% the 4th semester. 97,4% had clinical practice before attending the IP, Mean= 23,21 (+/-)15,56 [2; 61 weeks]. 67,9% learnt transcultural issues during nursing studies. Overall, students revealed good cultural values, attitudes and behaviors. After IP students improved respect for culture/language differences accepting clients decisions (p<0,01); showed better cultural sensibility being motivated to respond to insensitive comments/behaviors; recognized Family as decision maker (p<0,01); and revealed better understanding of communication disability and communication differences (p<0,05). They became more aware of culture background Impact in future expectations (p<0,01) and in daily living activities (p<0,05). Cultural skills improved by taking time to learn about behaviors/customs of clients culture (p<0,01), adopting strategies to overcome language barriers, providing clients written information to take home in their language (p<0,05); assessing clients linguistic ability using specific instruments (p<0,01).

    Conclusions: Study provided evidence supporting the positive effect of Rainbow IP in enhancing students’ transcultural awareness. By attending the IP, students became more aware of culture differences and the importance of language skills in a transcultural context. Gains were evident in both attitudes/values and behaviors. Pedagogical strategies and English interaction in multicultural groups may explain improvements achieved in transcultural awareness. Results might be due to the group work themes “client centered care”, “family oriented care”, “empowerment”, but also listening to families’ stories, visiting health care facilities, and discussing nursing ethics. This effect should be monitored over time complemented by qualitative research.

    Keywords: Cultural Competence, intensive programs, international cooperation, nursing education, pedagogy, students, transcultural nursing.

    * Escola Superior de Saúde do Instituto Politécnico de Leiria, Enfermagem

    ** Amsterdam School of Health Professions, Nursing

    *** Department of Health Sciences, Mid Sweden University

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    Rainbow IP
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    Rainbow IP Pedagogik
  • 4.
    Kjällman Alm, Annika
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Long-Term Ongoing Structured Support in Early Stage of Dementia: A Family Affair2014Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Demenssjukdomar drabbar mer än 35 miljoner människor världen över, en summa som kommer att fördubblas vart tjugonde år.

       Demens är en global störning av intellektuella funktioner: förmågan att minnas försämras, och förmågor som att orientera sig i tid och rum, språklig förmåga, tankeprocesser som att gå från tanke till handling, problemlösande, utföra saker praktiskt och känna igen föremål. Symtomen följs ofta av förändringar i beteende och personlighet, som låg initiativförmåga, irritation, grovt socialt beteende och humörsvängningar. I Sverige diagnostiseras 25 000 personer per år, totalt så lever 160 000 personer med sjukdomen i Sverige idag. I Sverige ställs diagnosen ofta utifrån blodprover, hjärnröntgen och Mini Mental Score Evaluation-Swedish Revision tillsammans med personens sjukdomshistoria.

     

    Efter diagnosen har ofta anhöriga många frågor om hur livet kommer att te sig framöver, är det bra att flytta eller ska man bo kvar? Hur kommer sjukdomen att förändra livet och personligheten hos den drabbade? Tidigare studier visar att dessa frågor ofta förblir obesvarade, det är svårt att få en uppföljning hos läkare och det finns få länder där stöd efter diagnosen är vanligt förekommande.

       Sverige har sen 2009 lagstiftat om rätten till stöd till anhöriga och närstående med demenssjukdom eller andra kroniska sjukdomar med funktionshinder. Typen av stöd som ges skiljer sig däremot åt, Socialstyrelsen kom därför hösten 2013 ut med riktlinjer för hur stödet bör se ut för att vara effektivt: 8-10 träffar under 3-6 månader med information och socialt stöd till anhöriga.

    En kommun i norra delen av Sverige har gett långvarigt stöd till personer med demenssjukdom och deras anhöriga sen 2006.

    Ett nära samarbete med Landstinget i regionen och på senare tid även privata vårdcentraler i området har lett till att stöd kan erbjudas i direkt samband med diagnostillfället. Personerna deltar ofta i stödgrupp inom ca 4-6 veckor efter sin diagnos. Avhandlingens syfte var att fördjupa kunskapen om personernas upplevelse av att vara i stödgrupp under lång tid; den längsta i 4 år. Intervjuer gjordes med anhöriga och personer med demenssjukdom.

    Resultaten visade att de par som varit med längst i stödgrupp kände sig trygga, de upplevde att de fick god kunskap om demens och var förberedda på den förändring som skulle komma. Resultaten visade också att vara vuxet barn till en person med demens innebar att vara tyngd av ansvar för att agera i den sjuka förälderns intresse trots en djup känsla av sorg of förlust vilket ofta leder till frustration med situationen. Relationerna inom familjen kan förändras efter demens diagnosen både till det bättre; att man sluter upp kring den demenssjuke föräldern men också till det sämre; att familjen splittras då relationerna utsätts för påfrestningar. Personerna med demenssjukdom som deltog i stödgrupperna upplevde och skattade sin känsla av sammanhang högt; att livet var meningsfullt, begripligt och hanterbart. Deras friska partner upplevde mindre begriplighet och hanterbarhet och de vuxna barnen mer meningsfullhet.

    Avhandlingens resultat har legat till grund för en modell för stöd till personer med demenssjukdom och deras anhöriga kallat PER-modellen®; Pedagogisk, Emotionell och Relationsbaserad modell för stöd.

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  • 5.
    Kjällman Alm, Annika
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Long-term ongoing structured support in early stage of dementia: PER-model2014Ingår i: 2nd International Conference on Alzheimer's Disease and Dementia September 23-25, 2014 Valencia, Spain / [ed] OMICS Group Conference, 2014Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Dementia is a global disruption of intellectual functioning; there is a decrease of memory ability and other intellectual abilities. About 25, 000 persons are diagnosed with dementia each year in Sweden. In 2009, the Swedish Parliament passed a new law that stated that support should be given to persons caring for people with chronic illnesses, elderly people, or people with functional disabilities. A municipality in northern Sweden have a long term ongoing support to persons with dementia and their next of kin since 2006. A close collaboration with the geriatric clinic and private health centers has resulted in support being offered within 4-6 weeks after diagnose.  The overall aim of the thesis was to explore experiences of living with dementia both as a sufferer and as a next of kin; and being part of a long-term ongoing support group. Results showed that couples who had been the longest in a support group felt great comfort and support. They experienced that their knowledge about the disorder was good and that they could prepare for the changes to come. Persons with dementia who participated in the support groups experienced a great sense of coherence and felt that life was manageable, comprehensible and meaningful. The results have founded a model for support called PER-model®; Pedagogical, Emotional and Relationship based model of support.  The PER model ® focuses on creating and supporting relationships between participants and moderators, pedagogical information about dementia and supporting emotions as a means making the best of what is.

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  • 6.
    Kjällman Alm, Annika
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Danielsson, Sandra
    Region Jämtland/Härjedalen.
    Porskrog-Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Non-Pharmalogical Interventions towards Behavioural and Psychological Symptoms of  Dementia—An Integrated Literature Review2018Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, nr 8, s. 434-447Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective of this integrated literature review was to identify and examine

    effectiveness of non-pharmacological interventions towards BPSD. Database

    searches were documented following the PRISMA flow diagram and included

    papers were judged by the researchers using the SAHTAASS protocol. Coding

    of the papers was carried out using Polit and Beck matrix for literature review.

    It was concluded that several non-pharmacological interventions showed a

    positive influence on BPSD such as stimulating interventions, social and personalized

    activities and physical exercise. Also, education/training of healthcare

    professionals and equipment in form of a structured BPSD protocol resulted

    in decreased BPSD.

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  • 7.
    Kjällman Alm, Annika
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hagglund, Per
    Härnösands kommun.
    Norbergh, Karl-Gustav
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Sense of Coherence in Persons with Dementia and Their Next of Kin: A Mixed-Method Study2015Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, s. 490--499Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Indications of dementia disease include deterioration of memory, thinking, behaviour, and the

    ability to perform everyday activities. Any of these symptoms can lead to stress and difficulties

    organizing everyday life. As a way to view factors that support human health and well-being despite

    stressful situations, Antonovsky introduced a salutogenic model. This model proposes that

    sense of coherence primarily determines physical and mental health i.e. psychological well-being.

    Having a sense of coherence in everyday life can reduce the impact of stress on the individual in

    everyday life. The study’s aim of this study was to explore how participants in existing support

    groups scored on the Sense of Coherence Scale (SOC), and what they perceived as contributory

    factors to a meaningful, manageable, and comprehensible everyday life in the presence of dementia

    using a mixed method. Persons with dementia had the highest scores on the SOC scale and their

    partners the lowest. Persons with dementia expressed that being with others who understood

    them made their everyday life comprehensible and manageable. Their partners expressed that

    learning about dementia was helpful in managing and comprehending everyday situations. The

    adult children expressed that it was meaningful to care for their parents and they scored slightly

    higher than the partners on the SOC scale. Long-term ongoing support supplemented with information

    and social support can contribute to the sense of coherence in persons with dementia and

    their next of kin.

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  • 8.
    Kjällman Alm, Annika
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Experiences of Family Relationships when a Family Member Has Dementia2014Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, s. 520-527Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Approximately 66 million people worldwide will suffer from dementia in 2030. The dementia’s impact affects people with the disorder and those in their social networks, most notably, their families. This study’s aim was to explore the experiences of family relationships when a family member has dementia. We conducted semi-structured interviews with people diagnosed with dementia, their spouses and adult children. Seventeen participants were interviewed. All participants were recruited in open-ended ongoing structured support groups provided by a Swedish municipality in order to elicit the participants’ subjective experiences on family relationships after the dementia diagnosis. Researchers used content analysis to examine the transcripts. Two main themes were identified, one relating to changed relationships where the participants experienced longing, lost closeness, loneliness and changed sibling relationships. The second theme related to supporting relationships within the family with experiences such as kinship, shared responsibilities and love and appreciation. Support should therefore focus on creating relationships and giving opportunities for conversations about changes within the families and difficult decisions, creating family or team support for those who need it.

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  • 9.
    Kjällman Alm, Annika
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Experiences of long-term ongoing structured support in early stage of dementia – a case study2014Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, nr 4, s. 289-297Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The prevalence of dementia diseases is increasing worldwide with advancing age and growing populations. In Sweden alone, which currently has a population of approximately 9 million, there are about 25, 000 persons diagnosed each year with a dementia disease. Consequently, after such a diagnosis there is a tremendous need for support not only in Sweden but other countries as well. The recipients of that support include next of kin who seek all sorts of information including conversations about upcoming lifestyle changes and ways to handle personality changes in their loved one who is suffering from dementia. The aim of this study was to explore four couples´ experiences in structured support groups. A single case study with multiple data collection methods was used. Semi-structured interviews were analyzed by content analysis, which revealed three main categories representing the findings in four cases: Kinship through shared experiences, Knowledge about the disease, and Sense of comfort and support. One category, Longing for kinship was created exclusively for one of the couples. Viewing the emerging categories from a healthy aging perspective, both comfort and support and kinship through shared experiences can be considered as components of larger themes of support and social interaction. Findings suggest that structured support groups are a good way to encourage discussions, allow persons with dementia to express themselves, and support healthy aging in partners. Facilitators, regardless of whether they are social workers or registered nurses, should be trained in the group process to enable the individuals in the group to communicate and find meaning in their experiences.

  • 10.
    Kjällman Alm, Annika
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Rising Holmström, Malin
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Creating a Dementia-Friendly Community2023Ingår i: World Academy of Science, Engineering and Technology: International Journal of Medical and Health Sciences, 2023, Vol. 17Konferensbidrag (Refereegranskat)
    Abstract [en]

    The concept of dementia‐friendly communities focuses on the lived experience of people who have dementia and is most relevant to addressing their needs and the needs of those people who live with and provide support for them. The goal of communities becoming dementia‐friendly is for dementia to be normalized and recognized as a disabling condition. People with dementia find being connected to self, to others, and to the environment by meaningful activities as important. According to the concept underlying dementia-friendly communities, people with dementia or cognitive decline can continue to live in the community if their residential community has sufficiently strong social capital. The aim of this study is to explore staff and leaders’ experiences in implementing interventions to enhance a more inclusive dementia-friendly community. A municipality in northern Sweden with a population of approx. 100 000 inhabitants decided to create a dementia friendly municipality. As part of the initiative, a Centre for support was established. The Centre offered support for both individuals and groups, did home visits, and provided information about Dementia. Interviews were conducted with staff who had undergone training in a structured form of multidimensional support, the PER-model®, and worked at the Centre for support. The staff consisted of registered nurses, occupational therapists, and specialized nurses who had worked there for more than five years, and all had training in dementia. All interviews were audio-recorded and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results suggest that implementing the PER-model® of support for persons in the early stages of dementia and their next of kin added a much-needed form of support and perceived possibilities to enhance daily life in the early stages of dementia. The staff appreciated that the structure of PER-model® was evidenced based. They also realized that they never even considered that the person with dementia also needed support in the early stages but that they now had tools for that as well. Creating a dementia friendly municipality offering different kinds of support for all stages of dementia is a challenge. However, evidence-based tools and a broad spectrum of different types of support, whether individual or group, are needed to tailor to everyone’s needs. A conviction that all citizens are equal and should all be involved in the community is a strong motivator.

  • 11.
    Kjällman Alm, Annika
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Rising Holmström, Malin
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Sense of Involvement and Support in Persons with Cognitive Decline in Ordinary Dwelling2023Ingår i: World Academy of Science, Engineering and Technology: International Journal of Medical and Health Sciences, 2023, Vol. 17Konferensbidrag (Refereegranskat)
    Abstract [en]

    Worldwide, the number of people who are living with dementia is increasing because of an aging population, which leads to increased financial and social costs, including reduced quality of life for people with dementia and their care partners. Most people who have dementia reside in the community. Aging in place could be described as having the health and social supports and services you need to live safely and independently in your home or your society for as long as you wish and are able. People with dementia are not different than people without dementia where they want to remain at home, if possible, with a sense of familiarity and engagement in typical everyday activities. So how do persons with dementia or cognitive decline see their possibilities to be socially involved and experience support? The aim of this study was to explore persons with cognitive decline's sense of involvement and support living in the ordinary dwelling. The study was approved by the Ethical Review Authority in Sweden prior to the interviews. Interviews were conducted with 20 persons living at home, either alone or in a relationship. The persons had perceived cognitive decline; some were under investigation or already had a diagnose of early dementia. Thematic analysis was used to identify, analyze, and report patterns within the data. Researchers extracted three main themes through participants’ interviews: a) Importance of social involvement with family and friends. b) Hindrances for social involvement. c) Struggling mentally with a new life situation. Results found that going to activity centers, staying involved, and meeting friends and family enhanced the sense of involvement and support. There were also hindrances to a sense of involvement and support as they struggled with the diagnose and the changes in daily life, such as physical problems, mental problems, or economic issues. The mental struggle of accepting the cognitive decline and the changes in daily life it brought was also an issue for some of the participants. A multidimensional support should be provided by the community to enable persons with cognitive decline to stay involved in family and community in the comfort of their own homes.

  • 12.
    Kjällman Alm, Annika
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Nurses' opinions of pain and the assessed need for pain medication for the elderly2013Ingår i: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 14, nr 2, s. e31-e38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The undertreatment of pain in the elderly living in nursing homes is a significant problem. In Swedish nursing homes, the registered nurse on duty is often responsible for 20-40 patients during the day with no daily contact from attending physicians. The aim of this study was to investigate the opinions of registered nurses regarding pain and the assessed need for pain medication for elderly patients using patient scenarios. Two patient scenarios were used in this study; a questionnaire and background information was provided. The scenarios consisted of one smiling patient and one grimacing patient, both with the same numeric rating scale value of pain, blood pressure, pulse rate, and respiration rate. Three questions regarding pain assessment and management followed the scenarios. The questionnaire was sent to all 128 registered nurses working daytime in elderly care in both municipal nursing homes and municipal home care in the mid-Sweden region. A total of 56 nurses participated, providing an answering frequency of 45%. Results showed that registered nurses with more experience did not have the same opinion about pain as the smiling patient and gave inadequate medication, which was not in accordance with recommendations from the county hospital and the World Health Organization. © 2013 American Society for Pain Management Nursing.

  • 13.
    Kjällman Alm, Annika
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    What it means to be an adult child of a person with dementia2013Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, s. Art. no. 21676-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The prevalence of dementia as a disease has increased worldwide with advancing age and growing population numbers, affecting whole families. However, most previous research does not separate the spouses or cohabitants from the adult children, but instead regards all next of kin involved in the everyday care of the person suffering from dementia as caregivers. This has made it difficult to find previous research regarding what it means to be an adult child of a person with dementia, and as such, the aim of this study is to explore that topic. The method used was narrative interviews analysed using phenomenological hermeneutics. Our comprehensive understanding showed that to be an adult child of a person with dementia means being burdened with the responsibility to act on behalf of the diseased parent despite a deep sense of grief and loss, which leads to frustration and despondence. The adult children’s existence and reality are threatened not only by the loss of the parent but also by the possibility that one day they too may inherit the disease. This could be compared to a psychic crisis, which is defined as a situation that leads to radical changes in the afflicted person’s relationship to life and reality, or, simply, ‘‘an upset in a steady state’’. The findings suggest that adult children of people with dementia are in need of support for a substantial period of time in order to adapt to the fact that they have lost a parent who is still alive. They also need information about the disease and the process of diagnosis and treatment to feel more a part of the process, as well as understand the behavior and needs of their parent.

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  • 14.
    Larsson Gerdin, Anna
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Kjällman Alm, Annika
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Rising Holmström, Malin
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Encountering patients in their homes: A qualitative study of home care nurses’ experiences2023Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 43, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Many ill people want to be cared for at home, and home care nurses face an infinite number of encounters when providing that service. Despite the rising prominence of home care organizations worldwide, little research has been conducted on the encounters between home care nurses and patients and how encounters influence the nursing care provided. The aim of the present study was to describe home care nurses’ experiences of encounters with patients in their homes. In total, 11 home care nurses were selected through purposive sampling. The data consisted of individual interviews, which were analyzed through qualitative content analysis, and reported using COREQ reporting guidelines. The results were based on two categories describing the importance of adapting to each patient's needs and collaborating with the person being cared for. Implementing the findings could enable nurses to care for the patients without reducing them to recipients of objectified care.

  • 15.
    Larsson Gerdin, Anna
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Kjällman Alm, Annika
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Rising Holmström, Malin
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskaper (HOV).
    Older persons' experiences of care encounters in their home: A multiple-case study2024Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, s. 1-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    To explore and describe older persons' unique experiences of care encounters with home care nurses in a real-life context.

    Background

    The increasing number of older persons in society contributes to increases in age-related impairments compromising their quality of life. Future care consists of “hospitals at home” where care encounters occur in a person's private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted.

    Design

    Multiple-case study.

    Methods

    The cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated.

    Findings

    The cross-analysis emerged in three categories: “Nursing routine rules the care encounters”, “Lack of knowledge and information” and “Dependency on support from others”.

    Conclusions

    Our research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person-centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time-sensitive care encounters.

    Reporting Method

    Findings were reported using COREQ guidelines.

    Patient or Public Contribution

    Patients were interviewed and contributed with data for this study.

    Implications for the Profession and Patient Care

    This study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality.

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