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  • 1.
    Audulv, Åsa
    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.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Being free of symptoms or experiencing mental wellbeing – different ways of understanding wellness among people living with chronic illness2009Conference paper (Refereed)
  • 2.
    Audulv, Åsa
    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.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The impact of illness - Various ways of perceiving illness influences on self-management among people living with chronic disease2010In: The impact of illness - Various ways of perceiving illness influences on self-management among people living with chronic disease, 2010Conference paper (Refereed)
  • 3.
    Audulv, Åsa
    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.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The influence of illness perspectives on self-management of chronic disease2011In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 3, no 2, p. 109-118Article in journal (Refereed)
  • 4.
    Audulv, Åsa
    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.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The integration of chronic illness self-management2012In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 22, no 3, p. 332-345Article in journal (Refereed)
    Abstract [en]

    Self-management is crucial for people living with chronic diseases, but the actual process of integrating self-management has not been explored in depth. In this article, we investigate the integration of self-management into the lives of people with chronic illness. In this longitudinal study, we used an interpretive description approach. Twenty-one individuals were interviewed regularly during the first 3 years after they were diagnosed with a chronic condition. We found self-management integration to be an ongoing process that included four phases: seeking effective self-management strategies, considering costs and benefits, creating routines and plans of action, and negotiating self-management that fits one's life. The participants managed the phases according to their context, e.g., illness experience, life situation, personal beliefs, and social support. Health care providers should therefore facilitate self-management integration by providing support that is adjusted to the person's phase of self-management integration and life context.

  • 5.
    Audulv, Åsa
    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.
    Norbergh, Karl-Gustaf
    Department of Public Health and Research, Sundsvall Hospital, Sweden.
    Who's in charge? The role of responsibility attribution in self-management among people with chronic illness2010In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 81, no 1, p. 94-100Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore how responsibility attribution influences self-management regimens among people with chronic illness. METHODS: This qualitative content analysis included 26 interviews with people living with chronic illness. RESULTS: The participants attributed responsibility to internal, external or a combination of these factors, meaning that they either assumed responsibility for self-management or considered other people or factors responsible. Internal responsibility was associated with a multifaceted self-management regimen, whereas external responsibility was related to "conventional" self-management such as taking medication, managing symptoms and lifestyle changes. CONCLUSION: How responsibility is attributed is vital for the way in which individuals perform self-management. In this study, those who attributed responsibility to external factors mainly performed recommended behaviours to control their illness. In contrast, to take charge of their illness and be an active participant in the care, individuals must take responsibility for themselves, i.e. internal responsibility. PRACTICE IMPLICATIONS: Health-care providers should acknowledge and support individuals' wishes about various levels of responsibility as well as different kinds of patient-provider relationships.

  • 6.
    Audulv, Åsa
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norbergh, Karl-Gustaf
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hörnsten, Åsa
    An ongoing inner negotiation process. A Grounded Theory study concerning self-management among people living with chronic illness.2009Conference paper (Refereed)
  • 7.
    Audulv, Åsa
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norbergh, Karl-Gustaf
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hörnsten, Åsa
    An ongoing process of inner negotiation – a Grounded Theory study of self-management among people living with chronic illness2009In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 1, no 4, p. 283-293Article in journal (Refereed)
    Abstract [en]

    Aim.  The aim of this study was to better understand the main concern of self-management processes among people with chronic illness.

    Background.  One aspect of living with chronic illness is self-management that can reduce the illness impact on daily life and promote future health. Although factors that influence self-management have been identified in previous research, little attention has been brought to the process of making self-management decisions. In clinical settings, use of a theory could facilitate patient-empowering approaches.

    Method.  The data collection for this Grounded Theory was mostly conducted in 2006. Data were collected by interviews with 26 adults with a variety of chronic illnesses, including rheumatoid arthritis, diabetes mellitus, inflammatory bowel syndrome, multiple sclerosis, ischaemic heart disease and chronic kidney failure.

    Results.  Individuals are conflicted by competing preferences when taking decisions about self-management. Consequently, the decision-making process can be understood as an ongoing inner negotiation between different incompatible perspectives, e.g. social needs vs. medical needs. The process of negotiating self-management starts with the individual’s considering beliefs about health and illness, which make the individual face illness threats and the need for self-management. Several aspects influence negotiating self-management namely, assessing effects of self-management; evaluating own capacity; perceiving normality or stigmatisation; and experiencing support and external resources. The process has been demonstrated in a model.

    Conclusions.  The process of negotiating self-management is an ongoing inner debate rather than a one-time decision. This opens up new ways of understanding, and communicating with, patients. The described model also links behavioural theories and research findings in a comprehensive understanding.

    Relevance to clinical practice.  This model could be applicable as a communication tool for health-care providers in identifying barriers to, and resources in, self-management behaviour among individuals with chronic illness.

  • 8.
    Hellzén, Ove
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norbergh, Karl Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Nurses' attitudes towards older residents with long-term schizophrenia.2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 43, no 6, p. 616-622Article in journal (Refereed)
    Abstract [en]

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

  • 9.
    Hellzén, Ove
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Being an outsider: nurses' statements about a vignette of an elderly resident with a schizophrenia diagnosis and dementia behaviour.2004In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 11, no 2, p. 213-220Article in journal (Refereed)
    Abstract [en]

    In an exploratory study of nurses' approach to elderly people with a diagnosis of long-term schizophrenia, the aim was to investigate nurses' views of the care of an elderly fictitious person with long-term schizophrenia. All the nurses in one municipality in northern Sweden working at seven different units were investigated. A vignette, which was based on a case description in a previous study of an 84-year-old woman with severe dementia and problematic behaviour, was used after a minor alteration. In this study, the woman's age in the case description was changed from 84 to 68 years and the diagnosis was changed from severe dementia to long-term schizophrenia; otherwise, the description was the same as in the original case. The main finding was the nurses' inability to see the resident as anything other than what the 'label', the diagnosis, said. The nurses are interpreted as being caught in a dilemma of loyalty - on the one hand, the loyalty to the organization with its traditional goals and means and, on the other hand, the loyalty to the resident with her wishes in the forefront of their minds.

  • 10.
    Hellzén, Ove
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Living in a group dwelling: how do residents spend their time in a psychiatric group dwelling?2004In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 41, no 6, p. 651-659Article in journal (Refereed)
    Abstract [en]

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

  • 11.
    Hellzén, Ove
    et al.
    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.
    Psykisk ohälsa hos äldre2013In: Omvårdnad på avancerad nivå: kärnkompetenser inom sjuksköterskans specialistområden / [ed] Anna-Karin Edberg, Anna Ehrenberg, Febe Friberg, Lars Wallin, Helle Wijk, Joakim Öhlen, Lund: Studentlitteratur AB, 2013, första, p. webb-Chapter in book (Other academic)
  • 12.
    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.

  • 13.
    Høgsnes, Linda
    et al.
    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.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Salhlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothanburg, Sweden .
    The existential life situations of spouses of persons with dementia before and after relocating to a nursing home2014In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 18, no 2, p. 152-160Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to describe the existential life situations of spouses who care for persons with dementia, before and after relocation to nursing homes.Method: This was a qualitative study among 11 spouses of persons with dementia, recruited via purposeful sampling. Data were collected through interviews and analysed with interpretive content analysis.Results: Before the relocation to nursing homes, the spouses' existential life situations were characterized by feelings of shame and guilt, being isolated in the home. Spouses were also exposed to psychological threats, physical violence, and had feelings of placing one's own needs last. After the relocation, spouses described feelings of guilt and freedom, living with grief and thoughts of death, feelings of loneliness in the spousal relationship, and striving for acceptance despite a lack of completion.Conclusion: The existential life situation of spouses of persons with dementia is about being in limit situations which changes when the ill person relocates to a nursing home. This is important knowledge for health care staff to bear in mind at nursing homes when encountering spouses.

  • 14.
    Høgsnes, Linda
    et al.
    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.
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Melin Johansson, Christina
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    The Shift in Existential Life situation of Adult Children to Parents with Dementia Relocated to Nursing Homes2016In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 10, p. 122-130Article in journal (Refereed)
    Abstract [en]

    Background:

    Previous research describes spouses and adult children of people with dementia as a homogeneous group using one term: family caregivers. Recent research shows that the needs and experiences of spouses and adult children differ, therefore they cannot be studied as a homogeneous group.

    Aims:

    The aim of the study was to describe the shift in existential life situations of adult children of a parent with dementia relocated to nursing homes.

    Design:

    This is a qualitative study with an interpretive approach.

    Methods:

    Face-to-face interviews were held with 11 adult children aged 48-65 years. The interviews lasted 30–60 minutes and data were analysed using interpretive content analysis.

    Findings:

    The adult children described how they experienced their life situation before and after their parents’ relocation. Before relocation they described feelings of powerlessness, loneliness in their responsibilities, loss and guilt. After relocation they had feelings of freedom, ongoing responsibility, living with loss and having a new relationship with death.

    Conclusion:

    The most important finding in our study was that adult children developed a different relationship with death than before the parent became affected by dementia. It is essential that healthcare staff understand and address the adult children’s existential life situations and the suffering they are experiencing. Healthcare staff need to be conscious about adult children’s needs for support to address their existential life situations before and after their parents relocate to nursing homes.

  • 15.
    Høgsnes, Linda
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Norbergh, Karl-Gustav
    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. Ersta Sköndal Bräcke Univ Coll.
    "Being in Between" Nurses' Experiences When Caring for Individuals With Dementia and Encountering Family Caregivers' Existential Life Situations2019In: Research in Gerontological Nursing, ISSN 1940-4921, E-ISSN 1938-2464, Vol. 12, no 2, p. 91-98Article in journal (Refereed)
    Abstract [en]

    The focus of the current study was to explore nursing home staff's understanding and how they approach family caregivers' existential life situations when caring for individuals with dementia. A qualitative interview study was conducted with 20 nursing staff in two nursing homes in northern Sweden. Face-to-face interviews were analyzed using interpretive content analysis. One overarching theme with three themes and nine subthemes comprised the findings. The themes describe how nursing staff were "in between" when they cared for individuals with dementia and encountered family caregivers' existential life situations. Nurses acted as advocates and safeguarded family caregivers via dialogues and interactions. Nurses were supporters and by"being in between"they eased family caregivers'feelings of powerlessness in relation to dying and death."Being in between" may give nurses a deeper understanding of family caregivers'existential needs, thus increasing family caregivers' well-being.

  • 16.
    Karlström, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Engström-Olofsson, Regina
    Norbergh, Karl-Gustaf
    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.
    Postoperative pain after cesarean birth affects breastfeeding and infant care2007In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 36, no 5, p. 430-440Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study women's experience of postoperative pain and pain relief after cesarean birth and factors associated with pain assessment and the birth experience. DESIGN: Descriptive patient survey. Data were collected through a questionnaire. The outcome variables were assessments of pain using a Visual Analog Scale and women's birth experience measured on a seven-point Likert scale. SETTING: Central Swedish county hospital, maternity unit. PATIENTS/PARTICIPANTS: The sample consisted of 60 women undergoing cesarean birth. RESULTS: Women reported high levels of experienced pain during the first 24 hours. Seventy-eight percent of the women scored greater than or equal to 4 on the Visual Analog Scale, which can be seen as inadequately treated pain. There was no difference between elective and emergency cesarean births in the levels of pain. In spite of high levels of pain, women were pleased with the pain relief. The risk of a negative birth experience was 80% higher for women undergoing an emergency cesarean birth compared with elective cesarean birth. Postoperative pain negatively affected breastfeeding and infant care. CONCLUSIONS: There is a need for individual and adequate pain treatment for women undergoing cesarean birth, as high levels of pain interfere with early infant care and breastfeeding.

  • 17.
    Kjällman Alm, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hagglund, Per
    Härnösands kommun.
    Norbergh, Karl-Gustav
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Sense of Coherence in Persons with Dementia and Their Next of Kin: A Mixed-Method Study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, p. 490--499Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    their next of kin.

  • 18.
    Kjällman Alm, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Experiences of Family Relationships when a Family Member Has Dementia2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, p. 520-527Article in journal (Refereed)
    Abstract [en]

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

  • 19.
    Kjällman Alm, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Experiences of long-term ongoing structured support in early stage of dementia – a case study2014In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, no 4, p. 289-297Article in journal (Refereed)
    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.

  • 20.
    Kjällman Alm, Annika
    et al.
    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.
    Nurses' opinions of pain and the assessed need for pain medication for the elderly2013In: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 14, no 2, p. e31-e38Article in journal (Refereed)
    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.

  • 21.
    Kjällman Alm, Annika
    et al.
    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.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    What it means to be an adult child of a person with dementia2013In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, p. Art. no. 21676-Article in journal (Refereed)
    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.

  • 22.
    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.

  • 23.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Care of people with dementia: patients' characteristics, organisational climate and staff attitudes2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [sv]

    Syftet med denna avhandling var att undersöka funktionsförmågor hos personer med demens vid inflyttning till gruppboende under olika tidsperioder, hur personer med demens tillbringar sin tid i olika vårdformer samt strukturen i vårdares attityder till personer med demens. Data baseras på: 1) retrospektiva data av funktionell förmåga bland personer med demens vid inflyttning till gruppboende; 2) icke-deltagande observationer av patienters aktiviteter (2024 observationer) på en psykogeriatrisk avdelning; 3) icke-deltagande observationer av patienters aktiviteter i gruppboende skattade som ett ”kreativt organisationsklimat” (3061 observationer) och i gruppboende skattade som ett ”mindre kreativt organisationsklimat” (3399 observationer); 4) semantisk differentialteknik för att identifiera strukturen i vårdares attityder till personer med demens (1237 skattningar). Resultatet visar att vid jämförelse av patienternas funktionsförmågor vid inflyttning till gruppboende har beroendet av assistans för att klara dagligt liv ökat dessutom har möjligheten att bo kvar i gruppboende ökat över tid (β= -0.3134; p< 0.001) (I). Studien av personer med demens på en psykogeriatrisk avdelning (II) visar att 31,1 procent av tiden tillbringades med vårdare och 50,3 procent av tiden i ensamhet. De patienter med försämrad kommunikationsförmåga erhöll mindre tid från vårdare (p< 0.001). Jämförelse mellan gruppboendeenheter med ett kreativt organisationsklimat och enheter med ett mindre kreativt klimat (III) visade att i enheter med ett kreativt organisationsklimat tillbringade personerna med demens 45,2 procent av tiden med vårdare och i det mindre kreativa klimatet 25,6 procent (p< 0.001). Den tid som tillbringades i ensamhet var nästan densamma i både det kreativa och mindre kreativa klimatet (39,1% och respektive 38,8%, ns). Fyra dimensioner framkom vid analysen av vårdares attityder till personer med demens, vilka relateras till vårdarnas uppfattning om patienterna utifrån a) en etisk/estetisk dimension, b) förmågan att förstå, c) förmågan att uppleva och d) deras förmåga till sociala interaktioner. På ett positivt till negativt attitydkontinuum visar sig vårdarnas attityder ligga mellan positiva till neutrala attityder. Sammanfattningsvis så har personer med demens förändrats speciellt med avseende på funktionell förmåga vid inflyttning till gruppboende, dessutom har möjligheten att bo kvar ökat. I gruppboende med ett kreativt organisationsklimat tillbringade patienterna mindre tid i ensamhet och patient-vårdar interaktionen ökade. Vidare så är vårdarnas attityder överlag positiva till neutrala på ett positivt till negativt attitydkontinuum och den mest positiva och generella attityden kan ses i den etiska/estetiska dimensionen. Keywords: dementia, group-dwelling, work sampling, patients activities classification, organisational climate, attitudes, semantic differential.

  • 24.
    Norbergh, Karl-Gustaf
    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.
    Rasmussen, B.H.
    Nordahl, G.
    Sandman, Per-Olof
    How patients´ with dementia spend their time in a psycho-geriatric unit2001In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 3, p. 215-221Article in journal (Refereed)
    Abstract [en]

    This paper presents the findings of a work sampling study conducted at an assessment unit for patients with dementia at a university hospital in Nothern Sweden. The aim of the study was to describe the activity of the demented patients´day at apsycho-geriatric unit, and to investigate the correlation between the patients´ characteristics and time provided by nursing staff, in order to increase our knowledge of institutionalized demented patients situation. The sample consited of 24 patients with dementia. The activities of patients were monitored at 10-min interval between 7.00 a.m. and 9.10 p.m. In total, 2024 activities were recorded. The findings showed that being demented and placed in a psycho-geriatric unit is a life in solitude for most of the time. The variationin time patients spent in solitude could partly be explanied by their communication abilities. For patients with dementia, communication is essential for their well-being. It seems important to enhance our knowledge about the reasons, that influence the nursing staffs' perceptions of patients with dementia, to decrease their time in solitude.

  • 25.
    Norbergh, Karl-Gustaf
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Helin, Yvonne
    Department of Social Services, Sundsvall.
    Dahl, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hellzén, Ove
    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' attitudes towards people with dementia: the semantic differential technique2006In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 3, p. 264-274Article in journal (Refereed)
    Abstract [en]

    One important aspect of the nurse-patient relationship is the nurses' attitudes towards their patients. Nurses' attitudes towards people with dementia have been studied from a wide range of approaches, but few of them have focused on the structure in nurses' attitudes. This study aimed to identify a structure in licensed practical nurses' attitudes towards people with dementia. Twenty-one group dwelling units for people with dementia at eleven nursing homes participated in the study. In all, 1,577 assessments of 178 patients were sent out to 181 respondents and 1,237 answers were returned. The semantic differential technique was used. The scale has 57 bipolar pairs of adjectives, which estimate an unknown number of dimensions of nurses' attitudes towards an identified patient. The assessments were analysed using entropy-based measures of association combined with structural plots. The analysis revealed four dimensions. These four dimensions related to licensed practical nurses' opinion of the patients; from an ethical and aesthetic dimension; their ability to understand; their ability to experience; their ability for social interaction. The study indicates that, on the positive to negative attitude continuum, attitudes fall at the positive to neutral end of the continuum. This is an important finding due to the personhood perspective. From this perspective, it is reasonable to assume that with a more positive attitude to people with dementia, the prerequisites for person-centred care will improve.

  • 26.
    Norbergh, Karl-Gustaf
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Mittuniversitetet.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Mittuniversitetet.
    Omvårdnad på avancerad nivå: kärnkompetenser inom sjuksköterskans specialistområden2013In: Omvårdnad på avancerad nivå: kärnkompetenser inom sjuksköterskans specialistområden, Lund: Studentlitteratur, 2013, 1:1, p. webb artiklar-Chapter in book (Other (popular science, discussion, etc.))
  • 27.
    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.

  • 28.
    Norbergh, Karl-Gustaf
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Nordahl, G.
    Sandman, Per-Olaf
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    A retrospective study of functional ability among people with dementia when admitted to group-dwelling2001In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 19, no 1, p. 39-42Article in journal (Refereed)
    Abstract [en]

    Objective - To describe functional ability among people with dementia when admitted to group-dwelling (GD) during different time periods, and the probability of their remaining in these units for the rest of their lives. Design - Retrospective study of functional ability and likelihood of staying in GD. Setting - Thirteen GD units in the Sundsvall region, Sweden. Subjects - One-hundered-and-forty-two demented people admitted to GD in the period 1986-1996. Main outcome measures - Ability to manage personal care and somatic and psychiatric status were measured with the use of a rating scale. Result - On comparing people over the years, a significant increase was found in the need of assistance to manage everyday life on admission to GD. The likelihood of living the rest of life in GD has increased over time. Conclusions - Increasing dependency and increasing probability óf remaining in GD may influence the intention of GD as a unique way of caring for people with dementia. It is crucial to consider these changes in order to to encourage the development of GD.

  • 29.
    Norbergh, Karl-Gustaf
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Paulson, Margareta
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Pejlert, Anita
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Avancerad Specialistsjuksköterska - en förstudie inför planerad utbildning2003Report (Other academic)
  • 30.
    Palm, Anna
    et al.
    Uppsala University.
    Danielsson, Ingela
    Umeå University.
    Högberg, Ulf
    Uppsala University.
    Norbergh, Karl-Gustav
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    How do youth with experience of violence victimization and/or risk drinking perceive routine inquiry about violence and alcohol consumption in Swedish youth clinics?: A qualitative study2017In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 13, p. 51-57Article in journal (Refereed)
    Abstract [en]

    Objective: To explore perceptions and experiences among youth who underwent structured questions about violence victimization and alcohol consumption when visiting Swedish youth clinics.

    Methods: This study is part of a larger research project examining the effect of including routine inquiry about violence victimization and alcohol consumption for youth visiting youth clinics. Fifteen youth with experiences of victimization and/or risk drinking (AUDIT-C >= 5) were interviewed. Content analysis was used.

    Results: The findings were grouped into three main categories: The first; "Disclosure talking about violence" reflected the participants' experiences of being asked about victimization. Participants were in favor of routine inquiry about violence victimization, even when questions caused distress. The questions helped participants reflect on prior victimization and process what had happened to them. The second; "Influence on the life situation" demonstrated that many of the participants still were effected by prior victimization, but also how talking about violence sometimes led to the possibility of initiating change such as leaving a destructive relationship or starting therapy. In the third; "One's own alcohol consumption in black and white" participants considered it natural to be asked about alcohol consumption. However, most participants did not consider their drinking problematic, even when told they exceeded guidelines. They viewed risk drinking in terms of immediate consequences rather than in quantity or frequency of alcohol intake.

    Conclusion: Routine inquiry about violence victimization and risk drinking at youth clinics was well received. Questions about violence helped participants to interpret and process prior victimization and sometimes initiated change.

  • 31.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Malker, Hans
    Landstinget Västernorrland.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    What information do patients waiting for and undergoing arthroplastic surgery want? Their side of the story2006In: Journal of Orthopaedic Nursing, ISSN 1361-3111, E-ISSN 1873-4839, Vol. 10, no 1, p. 5-14Article in journal (Refereed)
    Abstract [en]

    This nurse-led focus-group study investigated information needs of patients waiting for arthroplastic surgery – how did they obtain the information and advice they needed? The content analysis of the interview transcripts revealed two main categories – ways of obtaining information and advice and what is needed – what patients want. In the picture emerging from the findings, it is evident that the content of the information that is given does not solely determine whether the respondents’ information needs are met. The way the information is given and whether the respondent is confirmed as a human being and taken seriously by the staff, is believed to be more important in the mutual process of communicating information. On a concrete level, respondents ask for information and advice on what they can do to manage their present life situation while waiting for surgery; this includes pain management, advice on self-training and contact with physiotherapists. They want to know “when” surgery will be performed and to be given opportunities to ask questions. This study serves as another piece in the puzzle investigating patients’ information needs. Implications for nursing are discussed, together with suggestions for future areas of research.

1 - 31 of 31
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