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  • 1.
    Andreassen Devik, Siri
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Centre for Care Research Mid-Norway, Steinkjer, Norway .
    Enmarker, I.
    Centre for Care Research Mid-Norway, Steinkjer, Norway .
    Wiik, G. B.
    Nord Trøndelag University College, Namsos, Norway.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Centre for Care Research Mid-Norway, Steinkjer, Norway .
    Meanings of being old, living on one's own and suffering from incurable cancer in rural Norway2013Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, nr 6, s. 781-787Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim of this study was to explore and understand the lived experience of older people living alone and suffering from incurable cancer in rural Norway. Methods and sample: Narrative interviews were conducted with five older people with incurable cancer (three women and two men, aged 71-79), receiving outpatient and life-prolonging chemotherapy and living alone in their homes in rural areas. A phenomenological hermeneutical approach was used to interpret the meaning of the lived experience. Key results: Four main themes were found: enduring by keeping hope alive, becoming aware that you are on your own, living up to expectations of being a good patient and being at risk of losing one's identity and value. Enduring this situation means struggling with terminal illness and facing death in a brave manner, and replacing former ways of living. The process of providing treatment may threaten dignity and cause additional distress. Conclusions: These results show a complex and comprehensive situation where physical symptoms and emotions are interwoven. Further the results describe how the ways of suffering caused by the manner in which care is delivered, suffering related to the cancer disease and existential suffering, may increase each other's impact. The social and rural context calls for special attention as the patients may lack recourses to gain sufficient care. Their comfort depends to a large extent on the health professionals' sensitivity. © 2013 Elsevier Ltd.

  • 2.
    Andreassen Devik, Siri
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Ctr Care Res, Steinkjer, Mid Norway, Norway.
    Enmarker, Ingela
    Ctr Care Res, Steinkjer, Mid Norway, Sweden.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    When expressions make impressions-Nurses' narratives about meeting severely ill patients in home nursing care: A phenomenological-hermeneutic approach to understanding2013Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, s. Art. no. 21880-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Registered nurses (RNs) working in homecare encounter severely ill and palliative patients whose expressions may cause ethical challenges and influence their daily work. The aim of this qualitative study was to illuminate and interpret the meaning of nurses' lived experiences when meeting these patients. Narrative interviews were conducted with 10 RNs working in home nursing care. These interviews were audiotaped and transcribed verbatim to a text and interpreted by a phenomenological-hermeneutic method inspired by Ricoeur. The meaning of the RNs' lived experience of patients' expressions was formulated into four themes. The first theme, Being open for the presence of the Other, includes two subthemes: "Sensing vulnerability" and "Empathizing with." The second theme, Being satisfied, entails the subthemes, "Feeling exceptional" and "Being trusted." The third theme, Being frustrated, contains the subthemes, "Being disappointed" and "Being angry." The fourth and final theme, Being ambivalent, includes one subtheme: "Being generous or reserved." Patients' expressions that make impressions on nurses create emotional waves. Expressions leave impressions that call upon the nurse, and confront her with taking the risk of letting intuition and pre-reflexive feelings gain entry to her care. Allowing for the Other's presence is seen as a precondition, which means facing humanity and sensing a vulnerability in herself as well as in the Other. Understanding and balancing this emotional dimension in care seems to cause confusion and distress within the nurses. Realizing how their feelings may lead to either generosity or aloofness towards the patient is upsetting. Our interpretation suggests that these impressions echo confusion according to the role of being a professional nurse. There is a need to pay more attention to how the emotional dimension in care is understood and impacts the way nurses perform their professional role.

  • 3.
    Andreassen Devik, Siri
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Enmarker, Ingela
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Perceptions of suffering in older persons receiving palliative home nursing care: Bereaved family members' perspectiveManuskript (preprint) (Övrigt vetenskapligt)
  • 4.
    Andreassen Devik, Siri
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Midnorway, Ctr Care Res, Steinkjer, Norway..
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Enmarker, Ingela
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Midnorway, Ctr Care Res, Steinkjer, Norway..
    "Picking up the pieces'' - Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area2015Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, artikel-id 28382Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients' strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context.

  • 5.
    Björk, Annette
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Rönngren, Ylva
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Selander, John
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Vinberg, Stig
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Perspectives on Everyday Suffering among People with Adult Attention Deficit Hyperactivity Disorder and Concurrent Mental Disorders2017Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, s. 583-598Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to describe the perceptions of everyday suffering among adults with attention deficit hyperactivity disorder (ADHD) and comorbid mental disease. Directed content analysis guided by Eriksson’s theory on human suffering was performed on data from 20 individual interviews. Expressions of both suffering and well-being were identified; the former centred on loneliness and related to life, illness, and care, which supported Eriksson’s theory, whereas expressions of well-being related to ADHD diagnosis and supportive social relationships. Nevertheless, results indicate the need to expand those expressions in order to better contribute to developing a supportive rehabilitation regimen that can provide more interpersonal care.

  • 6.
    Björk, Annette
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Rönngren, Ylva
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Selander, John
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Vinberg, Stig
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Olofsson, Niclas
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. County Council of Västernorrland, Sundsvall.
    Health, lifestyle habits, and physical fitness among adults with ADHD compared with a random sample of a Swedish general population2018Ingår i: Society, health and vulnerability, E-ISSN 2002-1518, Vol. 9, nr 1, artikel-id UNSP 1553916Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Persons with Attention Deficit Hyperactive Disorder (ADHD) represent a high-risk population according to health and lifestyles. In the present study, 48 adults with ADHD were recruited to a forthcoming lifestyle intervention. The ADHD sample was matched to a random sample of 42 persons from a Swedish general population that was selected from LIV (a Lifestyle-Performance-Health project).

    Objective: To identify potential differences in health, lifestyle habits, and physical fitness between adults with and without ADHD.

    Method: Self-reported questionnaires and physical fitness tests.

    Results: The ADHD group show worse health outcomes with higher odds ratios for bad general health (OR;13 CI; (3,4–50)), and poorer lifestyle habits with higher odds ratios for low weekly exercise (OR; 3,8 CI; (1,2–13)). When adjusting for education, employment status, and cash margin, the ADHD sample did not show decreased aerobic fitness (OR; 0,9 CI; (0,8–1,0), but lower odds ratios for doing less sit-ups (OR; 0,6 CI; (0,4–0,9)) compared to the general population group.

    Conclusion: It is not possible to prove that the ADHD diagnosis itself cause the worse health and lifestyle. Other lifestyle factors may have negative consequences of adult ADHD, such as lower levels of education, less succeed in working life, and minor financial margins.

  • 7.
    Brodin, Kerstin
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Häggström, Marie
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Intraoperative Care of the Conscious Patient from the Perspective of the Operating Theatre Nurse: A Grounded Theory2017Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, nr 9, s. 1086-1099Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Intraoperative care includes a unique knowledge of how to

    perform a safe and effective surgery procedure. Surgery performed under regional

    or local anaesthesia allows the patient to remain conscious during the

    procedure and is rather common in Swedish healthcare today. Aim: The aim

    was to obtain a deeper understanding of the main concerns of operating theatre

    nurses (OTN) when caring for conscious patients during the intraoperative

    phase. Methods: Interviews were conducted with 23 OTNs from five different

    hospitals in Sweden and analysed according to grounded theory. Findings:

    The main concern among the OTNs was to take the patient in consideration.

    The core category “achieve and maintain ethical treatment of patients”

    in the operating theatre (OT) was a strategy used throughout the intraoperative

    process. Ethical treatment was described as moral behaviour at

    different levels and included the team’s behaviour, respectful and individualised

    patientcare, and the working-morale of the professionals. Being vigilant

    and being flexible were the categories related to the core category. The OTNs

    constantly assessed where to pay most attention as they balanced between the

    needs of the patient, the team, and the surgery procedure. Conclusion: It is

    important that every patient is taken into consideration and that ethical principles

    are held to the highest standards in the OT. A familiar team can facilitate

    that. The complex skills that operating theatre nurses develop can be

    added to explain important competencies within the profession.

  • 8.
    Brodin, Kerstin
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Häggström, Marie
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Patients´ experiences of being conscious during surgery – an interview studyManuskript (preprint) (Övrigt vetenskapligt)
  • 9.
    Devik Andreasen, Siri
    et al.
    Nord Universitetet, Norge.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Enmarker, Ingela
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Nord Univ, Dept Hlth Sci, Ctr Care Res, Steinkjer, Norway; Högskolan i Gävle.
    Bereaved family members' perspectives on suffering among older rural cancer patients in palliative home nursing care: A qualitative study2017Ingår i: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 26, nr 6, artikel-id e12609Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Little is known about experiences with receiving home nursing care when old, living in a rural area, and suffering from end-stage cancer. The aim of this study was thus to investigate bereaved family members' perceptions of suffering by their older relatives when receiving palliative home nursing care. Qualitative semi-structured interviews were conducted with 10 family members, in Norway during autumn 2015, and directed content analysis guided by Katie Eriksson's theoretical framework on human suffering was performed upon the data. The two main categories identified reflected expressions of both suffering and well-being. Expressions of suffering were related to illness, to care and to life and supported the theory. Expressions of well-being were related to other people (e.g. familiar people and nurses), to home and to activity. The results indicate a need to review and possibly expand the perspective of what should motivate care. Nursing and palliative care that become purely disease and symptom-focused may end up with giving up and divert the attention to social and cultural factors that may contribute to well-being when cure is not the goal.

  • 10.
    Devik, S.A.
    et al.
    Centre for Care Research Mid-Norway, Norway; Nord University, Norway.
    Enmarker, Ingela
    Högskolan i Gävle.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad.
    Nurses’ experiences of compassion when giving palliative care at home2019Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Compassion is seen as a core professional value in nursing and as essential in the effort of relieving suffering and promoting well-being in palliative care patients. Despite the advances in modern healthcare systems, there is a growing clinical and scientific concern that the value of compassion in palliative care is being less emphasised. Objective: This study aimed to explore nurses’ experiences of compassion when caring for palliative patients in home nursing care. Design and participants: A secondary qualitative analysis inspired by hermeneutic circling was performed on narrative interviews with 10 registered nurses recruited from municipal home nursing care facilities in Mid-Norway. Ethical considerations: The Norwegian Social Science Data Services granted permission for the study (No. 34299) and the re-use of the data. Findings: The compassionate experience was illuminated by one overarching theme: valuing caring interactions as positive, negative or neutral, which entailed three themes: (1) perceiving the patient’s plea, (2) interpreting feelings and (3) reasoning about accountability and action, with subsequent subthemes. Discussion: In contrast to most studies on compassion, our results highlight that a lack of compassion entails experiences of both negative and neutral content. Conclusion: The phenomenon of neutral caring interactions and lack of compassion demands further explorations from both a patient – and a nurse perspective.

  • 11.
    Eivergård, Kristina
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Enmarker, Ingela
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Högskolan i Gävle.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    The Talk About the Psychiatric Patient2016Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, nr 10, s. 756-764Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Essential to psychiatric nursing practice and care, verbal handovers and ward rounds are reporting systems for communication that shapes psychiatric staff's ability to recognize, understand, and construct patients, as well as patients' ability to construct themselves. Given the centrality of such language in psychiatric practice, the aim of this study was to describe how psychiatric staff talk about patients in psychiatric wards, what their talk encompasses, and what consequences it might pose for patient care. Empirical data were collected from audio recordings of staff discussions of patients during nine verbal handovers and three ward rounds in six different general psychiatric wards in mid and southern Sweden. Findings showed that to describe patients' mood, characteristics, and behavior, nurses used culturally common words and concepts related to three themes-good patients, bad patients, and to stay or be discharged-and six subthemes-looking well, looking poorly, desirable patients, undesirable patients, continuing work, and being discharged. However, since assessments of and decisions about patients' conditions and care used everyday language and did not involve patients' participation, opportunities for patients to participate in their own care were rare.

  • 12.
    Eivergård, Kristina
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad. Ersta Sköndal .
    Enmarker, Ingela
    Högskolan i Gävle.
    Livholts, Mona
    Linköpings Universitet.
    Aléx, Lena
    Umeå Universitet.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad.
    The Importance of Being Acceptable: Psychiatric Staffs’ Talk about Women Patients in Forensic Care2019Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, nr 2, s. 124-132Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Currently, women comprise about ten percent of those sentenced to psychiatric forensic clinics in Sweden. Those who are sentenced to forensic care because of offending and violent behaviour have already taken a step away from the usually expected female behaviour. On the other hand, there are many women in forensic care who have not committed crimes, but who instead selfharm. Studies have identified a gender bias in diagnosing and care in psychiatric settings, but there are few studies conducted on women in forensic care. The present study therefore examined how the situation of women patients and female norms are expressed in the staff’s talk about these women during verbal handovers and ward rounds at a forensic clinic in Sweden. The aim was to explore how psychiatric staff, in a context of verbal handovers and ward rounds, talk about women who have been committed to forensic psychiatric care, and what consequences this might have for the care of the patients. The content of speech was examined using audio recordings and a method of analysis that was inspired by thematic analysis. The analysis identified that the staff talked about the women in a way that indicates that they expected the women to follow the rules and take responsibility for their bodies in order to be regarded as acceptable patients.                        

  • 13.
    Enarsson, Per
    et al.
    Umeå University.
    Sandman, P O
    Umeå University.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    The preservation of order: The use of common approach among staff toward clients in long-term psychiatric care2007Ingår i: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 17, nr 6, s. 718-729Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The authors performed this grounded theory study to gain a deeper understanding of the kinds of social processes that lead to a need among psychiatric nursing staff to reach a common approach on how to act toward individual clients in long-term psychiatric care. They present a theory about the development of such common approaches among staff. The main findings were that in psychiatric group dwellings, when the internal order is perceived as having been disturbed, the staff preserve or restore the internal order by formulating and reaching a common approach. The staff negotiated with each other to achieve an agreement on how to act and behave toward the individual client. The authors isolate and describe different types of order-disturbing incidents and the common approaches taken by the staff in dealing with them. However, their data also show that staff often had difficulties in maintaining a common approach over time.

  • 14.
    Enarsson, Per
    et al.
    Linné universitetet.
    Sandman, Per Olof
    Umeå Universitet.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    'There should be something gained': Carers ethical reasoning about a common staff approach in psychiatrich in-care2017Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 37, nr 4, s. 217-225Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Thirteen carers were interviewed about their ethical reasoning when using a common staff approach to restricting smoking for a psychiatric in-patient. A constructed case structure and a vignette method were used in the interviews, and manifest content analysis of the texts exposed five ethical positions adopted by the carers: ‘best for the person’, ‘best for the patient’, ‘best for others involved with the person/patient’, ‘best for me as a carer’, and ‘best according to rules and regulations’. A second manifest content analysis of language showed terms that expressed value judgments in regard to the carers’ personal experiences. Some carers argued at first from one ethical position, but when the question was changed, they argued from an opposite ethical position. Results may be understood in light of dialog philosophy; ethical reasoning during use of a common staff approach tends to focus either on relations with others or with oneself.

  • 15. Engström, J.
    et al.
    Bruno, E.
    Holm, B.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Palliative sedation at end of life - A systematic literature review2007Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 11, nr 1, s. 26-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Palliative sedation at the end of life to handle unmanageable symptoms has been much debated. A systematic literature review in three phases including a content analysis of 15 articles published between the years 1990 and 2005 has been conducted. The aim was to describe the phenomenon of 'palliative sedation at the end of life' from a nursing perspective. The results can be summarised in three themes: 'Important factors leading to the patient receiving sedation at the end of life', 'Attitudes to palliative sedation at the end of life' and 'Nurses' experience of palliative sedation at the end of a patient's life'. Together, the themes show that palliative sedation is a phenomenon that could be described as sedation given to fewer than 40% of dying patients during their Last 4 days of life. It is usually given because of the patient's pain, agitation and/or dyspnoea. Professionals usually have positive attitudes towards it and their view differs from that of the public's view regarding it as continuously deep sedation, whereas the public regards it as being close to euthanasia. Studies focusing on nursing care during palliative sedation are hard to find and this underlines the importance of further research in this area to elucidate the nurses' role during palliative sedation.

  • 16.
    Enmarker, Ingela
    et al.
    Nord Trondelag Univ Coll, Dept Hlth Sci, Steinkjer, Norway.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Nord Trondelag Univ Coll, Dept Hlth Sci, Steinkjer, Norway.
    Ekker, Knut
    Nord Trondelag Univ Coll, Dept Agr & Informat Technol, Steinkjer, Norway.
    Berg, Anne-Grethe
    Univ Bergen, Dept Clin Med, Vivarium Haukeland Sykehus, Bergen, Norway.
    Depression in older cat and dog owners: the Nord-Trondelag Health Study (HUNT)-32015Ingår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 19, nr 4, s. 347-352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Depression constitutes a major health problem for older people, in this study defined as people 65 years of age and older. Previous studies have shown that mental health among older people who live with animals could be improved, but contrary results exist as well. Therefore, the objective of the present population study was to compare the self-rated depression symptoms of both female and male non-pet owners, cat owners, and dog owners. Method: The participants in this cross-sectional population study included 12,093 people between the ages of 65 and 101. One thousand and eighty three participants owned cats and 814 participants owned dogs. Self-rated depression symptoms were measured using HADS-D, the scale of self-administered depression symptoms in HADS (Hospital Anxiety and Depression Scale). Results: The main results showed higher mean values on the HADS-D for cat owners than for both dog and non-pet owners. The latter group rated their depression symptoms the lowest. When dividing the ratings into low- and high-depression symptoms, the logistic regression analysis showed that it was more likely that males who owned cats perceived lower depression symptoms than females who owned cats. No interactions were recognized between pet ownership and subjective general health status, loneliness, or marital status. Conclusions: Our results provide a window into the differences in health factors between older females and males who own cats and dogs in rural areas. Results from population studies like ours might increase the available knowledge base when using cats and dogs in clinical environments such as nursing homes.

  • 17.
    Enmarker, Ingela
    et al.
    Högskolen i Nord Trndelag.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Ekker, Knut
    Hgskolen i Nord Tröndelag.
    Berg, Anne-Grethe
    Norwegian Food Safety Authority, Steinkjer, Norway.
    Personalities and health in older cat and dog owners: A HUNT-study2013Ingår i: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 5, nr 9, s. 1449-1454Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this population study was to identify personality traits among older (>65 years) male and female owners of cats and dogs and to com- pare their general health status in relation to their personality. Further, the aim was to exa- mine whether current cat and dog ownership could be predicted by the owners’ personality and health. Data were collected from the North- Trøndelag Health Study (HUNT) in Norway. In- cluded were a total of 1897 cat or dog owners between the ages of 65 years and 101 years. The results showed that there were a higher propor- tion of introverted male cat owners than extra- verted ones. Moreover, a majority of women with cats reported that their health was not good. Furthermore, female cat owners who displayed higher scores on neurotic traits experienced sig- nificantly poorer health compared to those female cat owners that experienced good health. The same was true for female cat owners who con- sidered themselves to be introverted. Neither per- sonality nor health could predict pet-ownership, but it was more likely for older individuals (80 - 101 years) to own a cat than a dog. This study has shown that human personality is associated with cat and dog ownership, but there are other fac- tors connected with pet ownership as well. 

  • 18.
    Enmarker, Ingela
    et al.
    Faculty of Health Sciences, Nord-Trøndelag University College, Namsos, Norway .
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Ekker, Knut
    Faculty of Agriculture and Information Technology, Nord-Trøndelag University College, Steinkjer, Norway .
    Berg, Ann-Grethe
    Norwegian Food Safety Authority, Steinkjer, Norway .
    Health in older cat and dog owners: The Nord-Trondelag Health Study (HUNT)-3 study.2012Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, nr 8, s. 718-724Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The main objective was to compare older male and female cat, dog, and non-owners with regard to demographic and health-related characteristics. Method: Data in the present cross-sectional population study were drawn from HUNT-3 in Norway. A total of 12,297 persons (5631 men; 6666 women) between the ages of 65 and 101 years were included, of whom 2358 were pet owners. Results: The main finding was that owning a dog demonstrated several health-related characteristics to a higher positive degree than both non-pet and cat ownership among the participants. Cat owners showed higher body mass index values and higher systolic blood pressure, and reported worse general health status. They also exercised to a lower degree than the others. Conclusions: As the result implies that older cat owners are negatively outstanding in many aspects of health compared with the dog owners, in the future, more focus must be put on the worse health of those. Further, there were more married male than female cat and dog owners. This probably depends on traditional cultural thinking; the man is the owner of the pet even if the woman lives with and cares about it. It is important to point out that different groups in the population might select different pets. Consequently, the findings showing a correlation between pet ownership and health may be owing to unrelated confounding factors.

  • 19.
    Enmarker, Ingela
    et al.
    Högskolan i Nord-Tröndelag.
    Olsen, Rose-Marie
    Högskolen i Nord-Tröndelag.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Management of person with dementia with aggressive and violent behaviour: a systematic literature review.2011Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 6, nr 2, s. 153-162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    Studies indicate that physical and pharmacological restraints are still often in the frontline of aggression management in a large number of nursing homes. In the present literature review the aim was to describe, from a nursing perspective, aggressive and violent behaviour in people with dementia living in nursing home units and to find alternative approaches to the management of dementia related aggression as a substitute to physical and chemical restraints.

    METHODS:

    A systematic literature review in three phases, including a content analysis of 21 articles published between 1999 and August 2009 has been conducted.

    RESULTS:

    The results could be summarised in two themes: 'origins that may trigger violence' and 'activities that decrease the amount of violent behaviour'. Together, the themes showed that violence was a phenomenon that could be described as being connected to a premorbid personality and often related to the residents' personal care. It was found that if the origin of violent actions was the residents' pain, it was possible to minimise it through nursing activities. This review also indicated that an organisation in special care units for residents who exhibit aggressive and violent behaviour led to the lesser use of mechanical restraints, but also an increased use of non-mechanical techniques.

    CONCLUSION:

    The optimal management of aggressive and violent actions from residents with dementia living in nursing homes was a person-centred approach to the resident. Qualitative studies focusing on violence were sparsely found, and this underlines the importance of further research in this area to elucidate how violence and aggressiveness is experienced and understood by both staff and patients.

    RELEVANCE TO CLINICAL PRACTICE:

    To communicate with people with dementia provides a challenge for nurses and other health caregivers. To satisfy the needs of good nursing care, an important aspect is therefore to get knowledge and understanding about aggressive and violent behaviour and its management.

  • 20.
    Grav, Siv
    et al.
    Nord-Trøndelag University College, Norway.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Stordal, Eystein
    Sykehuset, Namsos, Norway.
    Romild, Ulla
    Sykehuset Levanger, Norway.
    Enmarker, Ingela
    Nord-Trøndelag University College, Norway.
    The prevalence of recovered and new cases of depressionin relation to social support and temperament in an 11-year follow-up; The HUNT studyArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims.

    This study aimed to describe changes in the prevalence of depression in relation to

    social support and temperament, in an 11-year follow-up study.

    Background.

    Lack of social support is a risk factor for depression. Understanding the role of

    temperament and social support in relation to development of, and recovery from, depression

    may help nurses to intervene early with high-risk patients in order to prevent depression and

    promote health.

    Design.

    Longitudinal design was used.

    Methods.

    In total, 26,709 men (42.8%) and women (57.2%) aged 20-89 years from Nord-

    Trøndelag County in Norway participated. Those who had a valid rating on the depression

    subscale of the Hospital Anxiety and Depression Scale (HADS) from The Nord-Trøndelag

    Health Study (HUNT) wave 2 (1995-97) and wave 3 (2006-08), including a complete

    response to the Eysenck Personality Questionnaire (EPQ) and questions regarding social

    support, were included.

    Results.

    The prevalence of new cases of depression was higher than the prevalence of

    recovery from depression. There was a significant association between the sub-groups of

    depression and temperament, changes in health, and social support. The risk factors for new

    cases had a greater causal influence on depression than risk factors for recovery.

    Conclusions.

    Prevention of depression seems to be more effective than treatment. Older

    people and males are the most frequent new cases. Nurses should emphasize the interpersonal

    process to meet the needs of an individual patient and his or her social network that provides

    social support, especially among older people and males.

  • 21.
    Grav, Siv
    et al.
    Department of Health Science, Nord-Trøndelag University College.
    Hellzèn, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Romild, Ulla
    Swedish Natl Inst Publ Hlth, Ostersund, Sweden.
    Stordal, Eystein
    Norwegian Univ Sci & Technol, Fac Med, Dept Neurosci, N-7034 Trondheim, Norway.
    Association between social support and depression in the general population: the HUNT study, a cross-sectional survey.2012Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 1-2, s. 111-120Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 22.
    Grav, Siv
    et al.
    Trondelag Univ Coll, Dept Hlth Sci, N-7800 Namsos, Norway.
    Stordal, Eystein
    Norwegian Univ Sci & Technol, Fac Med, Dept Neurosci, N-7034 Trondheim, Norway.
    Romild, Ulla
    Swedish Natl Inst Publ Hlth, Ostersund, Sweden.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Trondelag Univ Coll, Dept Hlth Sci, N-7800 Namsos, Norway.
    Association of personality, neighbourhood, and civic participation with the level of perceived social support: the HUNT study, a cross-sectional survey2013Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 6, s. 579-586Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim:

    The aim of the current study was to examine the association of personality,

    neighbourhood, and civic participation on the level of perceived social support if needed.

    Methods:

    The sample consists of a total of 35,797 men (16,035) and women (19,762) drawn

    from the Nord-Trøndelag Health Study 3 (HUNT3), aged 20-89, with a fully completed short

    version of the Eysenck Personality Questionnaire (EPQ) including a complete response to

    questions regarding perceived social support. A multinomial logistic regression model was

    used to investigate the association between the three-category outcomes (high, medium, and

    low) of perceived social support.

    Results: The Chi-square test detected a significant (p <

    0.001) association between personality, sense of community, civic participation, self-rated

    health, living arrangement, age groups, gender, and perceived social support except between

    perceived social support and loss of social network in which no significance was found. The

    crude and adjusted multinomial logistic regression models shows relation between medium

    and low scores on perceived social support, personality, and sources of social support.

    Interactions were observed between gender and self-rated health.

    Conclusions: There is an

    association between the level of perceived social support and personality, sense of

    community in the neighbourhood, and civic participation. Even if the interaction

    between men and self-reported health decreases the odds for low and medium social

    support, health professionals should be aware of men with poor health and their lack of

    social support.

  • 23.
    Hammarström, Lars
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad.
    Häggström, Marie
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad.
    Devik, Siri Andreassen
    Nord University, Namsos, Norway.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad.
    Controlling emotions - nurses’ lived experiences caring for patients in forensic psychiatry2019Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 14, nr 1, artikel-id 1682911Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Nurses working in forensic psychiatry often encounter offenders who have a severe mental illness, which may cause ethical challenges and influence nurses’ daily work. This study was conducted to illuminate the meaning of nurses’ lived experiences of encounters with patients with mental illnesses in forensic inpatient care. Methods: This qualitative study employed narrative interviews with 13 nurses. Interviews were audiotaped and transcribed verbatim and analysed following a phenomenological-hermeneutic approach. Results: Four key themes were revealed: “Being frustrated” (subthemes included “Fighting resignation” and “Being disappointed”), “Protecting oneself” (subthemes included “To shy away,” “Being on your guard,” and “Being disclosed”), “Being open-minded” (subthemes included “Being confirmed,” “Developing trust,” and “Developing compassion”), and “Striving for control” (subthemes included “Sensing mutual vulnerability” and “Regulating oneself”). Further, working in forensic psychiatry challenged nurses’ identity as healthcare professionals because of being in a stressful context. Conclusions: Dealing with aggressive patients with severe mental illnesses threatens nurses’ professional identity. Nurses must attempt to empathize with patients’ experiences and respond accordingly. Utilizing strategies rooted in compassion such as self-reflection, emotional regulation, and distancing themselves when necessary may enable nurses to more effectively respond to patients’ needs. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

  • 24.
    Hansen, Elisabeth
    et al.
    Department of Neuroscience, The Norwegian University of Science and Technology, Trondheim, Norway.
    Landstad, Bodil J
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Svebak, Sven
    Department of Neuroscience, The Norwegian University of Science and Technology, Trondheim, Norway.
    Motivation for lifestyle changes to improve health in people with impaired glucose tolerance2011Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 3, s. 484-490Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Motivation for lifestyle changes to improve health in people with impaired glucose tolerance Aim:  To identify factors that could have motivational significance for lifestyle change to facilitate the reduction of Impaired Glucose Tolerance (IGT) and, consequently, the risk of having type 2 diabetes. Methods:  Eighteen people living in a municipality in central Norway participated in the study. A large-scale public health screening study had defined them as people with IGT. The participants took part in a semi-structured interview that focused on four aspects of everyday lifestyle: (1) structure and rhythm, (2) physical health, (3) physical activity and (4) social relations. Results:  The interviews showed that the participants in the study changed their priorities regarding daily living. Results indicated four domains of motivational factors that appeared as significant for lifestyle changes. The participants attributed great significance to their physical health and were strongly motivated to prevent disease development by improvement of everyday structure and rhythm, reduction of sickness risk, activity level and social relation. Research indicates, however, that lasting lifestyle changes take time and that health care support must be adapted to the individual in light of their social setting. Conclusion:  Persons with IGT appear to benefit from lifestyle changes along four dimensions of motivational significance: Structure and rhythm, Sickness concerns, Activity levels, Social relations. This means that attention needs to be more carefully tailored the individual along these four dimensions than has been the case in traditional health care.

  • 25.
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Omvårdnad vid psykisk ohälsa2014Ingår i: När omvårdnad blev vetenskap: De första decennierna 1970-2000 / [ed] Elisabeth Hamrin, Mona Kihlgren, Alice Rinell Hermansson, Gerthrud Östlinder, Stockholm: Liber, 2014, första, s. 184-188Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 26.
    Hellzen, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Andreassen Devik, Siri
    Centre for Care Research Mid-Norway, Steinkjer, Norway.
    Velferdsteknologi og hjemmeboende eldre : hvilke gevinster er oppnådd med velferdsteknologi som kommunikasjonsstøtte for hjemmeboende eldre i kommunehelsetjenesten? - Og hva kan påvirke utbyttet? En systematisk litteraturstudie.2012Rapport (Övrigt vetenskapligt)
  • 27.
    Hellzen, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Brataas, Hildfrid
    Högskolan i Nord-Tröndelag.
    Undervisning og veiledning for hjemmeboende eldre2011Ingår i: Sykepleiepedagogisk praksis: Pasientsentrert sykepleie på ulike arenaer / [ed] Hildfrid Brataas, Oslo: Gyldendal Akademisk, 2011, första, s. 136-156Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 28.
    Hellzen, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Lilja, Lars
    Högskolan i Nord-Tröndelag.
    Vårdares attityder och stigmatisering2010Ingår i: Omvårdnad vid psykisk ohälsa: på grundläggande nivå / [ed] Ingela Skärsäter, Lund: Studentlitteratur AB, 2010, 1:1, s. 383-400Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 29.
    Hellzen, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Rasmussen, Hege
    Helse Nord-Tröndelag, Namsos Sykehus.
    The meaning of care giving for patients with Frontal Lobe Dementia in a long-term care unit2012Konferensbidrag (Övrigt vetenskapligt)
  • 30.
    Hellzen, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Sjöblom, Lena-Mari
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Lilja, Lars
    Nord-Trøndelag University College.
    “I screamed for help”: A single case study of one sister’s experiences with formal psychiatric care when her brother became mentally ill2013Ingår i: Health, ISSN 1949-5005, Vol. 5, nr 3, s. 417-425Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Studies have shown that the quality of the relationship between siblings has great significance for the mentally ill sibling’s overall quality of life. Sibling relationships may be particularly impor- tant because few adults with severe mental illness have children. As parents grow older, adult children are expected to support their sibling with mental illness when their parents are no longer able to do so. The sibling relationship has the potential to be one of the most significant relationships for adults with schizophrenia. The aim of this paper is to present a case study of a sister’s experiences and needs in her contact with psychiatric care. This single case study was designed and the informant was recruited be- cause of her value in maximizing what we can learn about being a sibling to a person with mental illness. Data were collected through four in-depth, semi-structured, repeated interviews during a two-year period, and were interpreted and analyzed through content analysis. Three major topics were discussed: 1) Anna’s brother’s time with formal psychiatric care; 2) Anna’s feel- ings and emotions; and 3) Anna’s view of her contact with psychiatric care. The findings indicated a sibling’s need for attention, support, and understanding from the formal caregivers. Participation in our study was one of the first opportunities she had to talk about her relationship with formal psychiatric care. An open dialogue may help siblings to manage their situations. 

  • 31.
    Hellzen, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Stordal, Eystein
    Hospital Namsos, Namsos, Norway and Norwegian University of Science and Technology, Trondheim, Norway.
    Grav, Siv
    Nord-Trøndelag Univercity College, Namsos, Norway.
    Romild, Ulla Kristina
    Levanger Hospital, Health Trust Nord-Trøndelag, Levanger, Norway, and Swedish National Institute of Public Health, Östersund, Sweden.
    The relationship among neuroticism, extraversion, and depression in the HUNT Study: in relation to age and gender.2012Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 33, nr 11, s. 777-785Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was to examine the relationship between personality and depression in a general population in relation to gender and age. The Nord-Trøndelag Health Study (2006–2008), a large cross-sectional survey, was used. The sample consists of 35,832 men (16,104) and women (19,728) aged 20–89 years, living in the Nord-Trøndelag County of Norway, with valid ratings on the depression subscale of the Hospital Anxiety and Depression Scale (HADS) and Eysenck Personality Questionnaire (EPQ). This study demonstrates a relationship between depression and both neuroticism and extraversion in a general population. Older people score low more often on Extraversion (E) than younger people. Interactions were observed between neuroticism and age, gender, and extraversion with depression. The interaction term indicates a high score on Neuroticism (N) enhanced by introversion, older age, and being a male with depression. The findings suggest that health professionals may need to put extra effort into the care of patients with low extraversion and high neuroticism, in order to help those patients avoid depression.

    Read More: http://informahealthcare.com/doi/abs/10.3109/01612840.2012.713082

  • 32. Hellzén, Maria
    et al.
    Lind, Ingbritt
    Dahl, Annika
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Psychiatric nurses attitudes towards identified in-patients as measured by the semantic differential technique2005Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 1, s. 12-19Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Nursing care can figuratively be described as a gift that is given by the nurse in the nurse-patient relationship where attitudes play an important role for the gift's appearance. Sometimes patients are unwilling to or incapable of accepting the gift and this can lead to situations in which nurses are not able to handle their situation in a professional manner. This research survey aimed to investigate nurses' attitudes and find a structure in nurses' attitudes towards their patients. Six psychiatric group dwellings and six acute psychiatric hospital wards participated in the study. In all, 2700 assessments of 163 patients were sent out to 160 respondents and 2436 answers were returned. The semantic differential technique was used. The scale has 57 bipolar pairs of adjective, which estimate an unknown number of dimensions of nurses' attitudes towards an identified patient. The respondents' answers were analysed through factor analysis rotated using the Varimax method and etropy-based measures of association combined with structural plots were also used. Both the factor analysis and the entropy revealed three factors, which were interpreted as being of evaluative type. Factor 1 was interpreted as describing nurses' answers mainly as a combination of an ethical and aesthetic evaluation of the patients. Factor 2 was interpreted as being of an empathetic type and factor 3 as nurses' experiences of the patients' cognitive capacity. The study indicates that the dominant aspect of nurses' attitudes in a psychiatric context is the ethical/aesthetic dimension, which is an important finding for the understanding of nurses' attitudes and actions towards their patients.

  • 33.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Nurses' personal statements about factors that influence their decisions about the time they spend with residents with long-term mental illness living in psychiatric group dwellings2004Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, nr 3, s. 257-263Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    One seldom-discussed issue is the factors that influence nurses' decisions about the time they spend with residents in psychiatric care. This study uses a qualitative naturalistic approach and consists of an analysis of focus-group interviews with nurses, which aimed to identify factors affecting nurses' decisions about being with or being nonattendant in their relationship with their residents. Two series of focus-group interviews were conducted, interpreted and analysed through content analysis. The study included all the staff (n=32) at two municipal psychiatric group dwellings housing residents mainly with a diagnosis of long-term schizophrenia. This study revealed that the main factor that determined nurses' nurse/resident time together or nonattendance time was whether they liked or disliked the individual resident. One possible explanation is the carers' change from a perspective in which the nursing care was given on the basis of each resident's needs and rights, based on the individual nurse's professional judgement, to a consumer perspective, which leads to a change in responsibility from themselves to the individual residents.

  • 34.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Being in a fragmented and isolated world: Iinterviews with carers working with a person with severely autistic disorder. An interview study2002Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 37, nr 4, s. 346-354Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 35.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Nurses' narratives about their residents when caring for people with long-term mental illness in municipal group dwellings2006Ingår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 15, nr 1, s. 60-69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Nurses working in community psychiatric care are expected to spend time with the residents, in a genuine, professional way, irrespective of their own feelings towards them. Fourteen nurses at two group dwellings in Sweden were interviewed about their experiences when caring for people with long-term mental illness. Narrative interviews were conducted and interpreted using a method inspired by Ricoeur. The analyses were performed in two steps: the first shows that residents could be divided into four different typologies or patterns--the good, the disabled, the invisible, and the bad residents, of which the nurses liked the first two and disliked the last two. In the second analysis, two themes were formulated to describe the nurses' experiences of 'replenishing one's self-worth and self-esteem' and 'giving up the caring role'. These results were interpreted and reflected on in the light of a theoretical framework in order to obtain a deeper understanding of the text. The study indicates that the question of whether nurses liked or disliked the residents appears to be closely related to whether or not the individual resident confirmed the nurse. Residents who confirmed nurses were liked and given attention, whereas those who did not were disliked and given a minimum of time together with the nurse.

  • 36.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Gilje, Fredricka
    Sandman, Per-Olof
    Norbergh, Astrid
    From optimism to pessimism: A case study of a psychiatric patient1998Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 7, nr 4, s. 360-370Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 37.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Sandman, Per-Olof
    Norberg, Astrid
    Umeå universitet.
    The meaning of caring as described by nurses caring for a person who acts provokingly:: an interview study2004Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, nr 1, s. 3-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Nurses working with people with learning disabilities are sometimes exposed to provoking behaviour such as unpredictable and violent actions, spitting and sexual harassment. Eight nurses at a group dwelling in Sweden were interviewed about their experiences when caring for a person who acts provokingly. Narrative interviews were conducted and interpreted using a method inspired by Ricoeur. Three themes were formulated which describe nurses' feelings of being tormented, disrupted and helpless. Nurses describe themselves as being deeply humiliated by physical violence, spittle, sexual invective and actions on the part of the patient. They respond more to being spat on and the sexual invective than to the patient's physical violence. The frequent humiliations could be seen as a symbolic language connected to defilement and 'evil' and therefore as having a deep symbolic meaning for the nurses. These results were interpreted and reflected on in the light of a theoretical framework from an affliction perspective in order to achieve a deeper understanding of the text. This paper shows that an affliction perspective is important when searching for the meaning of caring for a patient who acts provokingly. The study indicates that the goal in a provoking care situation must be to see the provoking patient, as he appears to the nurses in order to glimpse the goodness concealed behind the provoking facade.

  • 38.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Sandman, Per-Olof
    Norberg, Astrid
    Unwillingness to be violated: Carers' experiences of caring for a person acting in a disturbing manner. An interview study1999Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 8, nr 6, s. 653-662Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 39.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Centre of Care Research, Steinkjer, Norway.
    Haugenes, Marit
    Nord University, Namsos, Norway.
    Ostby, May
    Molde University College, Molde, Norway.
    'It's my home and your work': the views of a filmed vignette describing a challenging everyday situation from the perspective of people with intellectual disabilities2018Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, nr 1, artikel-id 1468198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Examining everyday challenges in the interactions between people with intellectual disabilities and their staff, as seen from the user's perspective, is an important perspective in health care research. Involving people with intellectual disabilities as so-called co-researchers is a relatively unexplored research strategy. In this paper, co-researchers participated in all the steps of the research process, from planning to reporting, in addition to the written reporting of the findings. The aim of this study was to explore how people with intellectual disabilities experienced a filmed vignette of an everyday situation. Method: Based on audio-recorded and transcribed individual and focus-group interviews with people with intellectual disabilities, performed by co-researchers with intellectual disabilities together with researchers, qualitative content analysis was used. Results: The analysis reveals three themes: "being emotionally touched", "being aware of the other", and "being unclear". Conclusions: The results are discussed in light of normalization and participation in society with independence and one's own decision-making. Regarding the care of people with intellectual disabilities, the main finding is the need to focus not only on greater involvement of this population in their own daily lives, but also to teach self-determination skills. Another finding is the importance of involving people with intellectual impairment as co-researchers.

  • 40.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Johansson, Anneth
    Pejlert, Anita
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Evidence Based Nursing - Caring for Persons With Schizophrenia2001Bok (Övrigt vetenskapligt)
  • 41.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Johansson, Anneth
    Pejlert, Anita
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Evidensbaserad omvårdnad vid behandling av personer med schizofreni1999Bok (Övrigt vetenskapligt)
  • 42.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    En studie i kvantitetssäkring av omvårdnad – En möjlig metod att fokusera kvaliteten?2003Ingår i: Incitament : för en hälso- & sjukvård i förvandling, ISSN 1103-503X, Vol. 12, nr 7, s. 638-640Artikel i tidskrift (Övrigt vetenskapligt)
  • 43.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Norbergh, Karl Gustaf
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Nurses' attitudes towards older residents with long-term schizophrenia.2003Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 43, nr 6, s. 616-622Artikel i tidskrift (Refereegranskat)
    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.

  • 44.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Being an outsider: nurses' statements about a vignette of an elderly resident with a schizophrenia diagnosis and dementia behaviour.2004Ingår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 11, nr 2, s. 213-220Artikel i tidskrift (Refereegranskat)
    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.

  • 45.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Living in a group dwelling: how do residents spend their time in a psychiatric group dwelling?2004Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 41, nr 6, s. 651-659Artikel i tidskrift (Refereegranskat)
    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

  • 46.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Norbergh, Astrid
    Sandman, Per Olof
    Schizophrenic patients´ image of their carers and the carers´ image of their patients: An interview study.1995Ingår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, Vol. 2, nr 5, s. 279-285Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In order to gain a deeper understanding of how long-term adult schizophrenic patients perceive themselves, their carers and the care they receive in relation to how the carers perceive their patients, themselves and the care they provide, a narrative interview study, analysed using a method inspired by Ricoeur´s philosophy, was performed. The main findings of this study were that both patients and carers who saw the patients as a subject, stressed the confirming relation between the parties as an essential element of the care. The carers who saw the patient as an object did not share this opinion. They had a more restricted point of view, seeing their goal only as providing a variety of care-activities and keeping the schizophrenics at the hospital. This study also points out that confirmation is provided in the meeting between patient and carers.

  • 47.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Psykisk ohälsa hos äldre2013Ingår i: 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, s. webb-Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 48.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Wiik, Guri
    Högskolan i Nord-Tröndelag, Avdelning for Helsefag.
    Andreassen Devik, Siri
    Senter for Omsorgsforskning, Midt-Norge.
    Vill ikke klage, vill ikke plage2012Ingår i: Kreftsykepleien, ISSN 0804-0567, Vol. 4, s. 10-17Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [no]

    Hvordan er det for enslige eldre i distriktene å ha uhelbredelig kreft?

    De fem som er intervjuet i denne studien har alle kjent på hvordan

    det er å leve i spenning, føle seg utmattet og å måtte gjennomføre slitsomme reiser for å få behandling.

  • 49. Holm, Birgitta
    et al.
    Mesch, L
    Hellzen, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Importance of nutrition for elderly persons with pressure ulcers or a vulnerability for pressure ulcers: a systematic literature review2007Ingår i: Australian journal of advanced nursing, ISSN 0813-0531, Vol. 25, nr 1, s. 77-84Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The number of elderly people, usually with multiple illnesses, is increasing in our society. In the public debate, many scientists predict that this could lead to a considerable increase in pressure ulcers. Since elderly care was reorganised in Sweden in 1993, the situation for older people has changed. In many cases, access to geriatric expertise and nurses has been reduced and the mortality rate among patients with pressure ulcers is increasing. A literature review, including a content analysis of 16 peer-reviewed articles published between 1995 and 2005, was conducted. The aim was to describe the importance of nutrition in reducing the risk of pressure ulcers and to focus on nursing interventions. The result shows that the analysis can be summarised around four areas: nutrition, prevention, nursing and economic aspects, which elucidate the importance of ensuring that an elderly person's need for energy is met and that nutritional supplements are effective for this group of patients. Early nursing intervention and the use of questionnaires are also stressed as being important. The economic aspects of pressure ulcers are also discussed.

  • 50.
    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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