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  • 1. Andersson, G.
    et al.
    Engström, Å
    Söderberg, Siv
    A chance to live: Women's experiences of living with a colostomy after rectal cancer surgery2010In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 16, no 6, p. 603-608Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe women's experience of living with a colostomy after rectal cancer surgery. Interviews with five women about their experiences were subjected to thematic content analysis. The findings showed that receiving a cancer diagnosis gave rise to thoughts about life and death. For the women to feel comfortable, the information and health-care measures need to focus on supporting them through the entire process, also when the treatment is completed. After the surgery, the women adjusted to living with colostomy and carried on as before the cancer diagnosis, but they constantly worried about leakage or flatulence. The women were happy to have survived the cancer and this realization helped them to accept and have a good life with colostomy. In conclusion, women with colostomy because of rectal surgery need specific rehabilitation and nursing care that focuses on adjustment to temporary or permanent changes in life. © 2010 Blackwell Publishing Asia Pty Ltd.

  • 2.
    Carlsund, Åsa
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Daily Life with Type 1 Diabetes from the Perspectives of Young Adults and Their Close Relatives2018In: American Journal of Nursing Science, ISSN 2328-5745, Vol. 7, no 4, p. 115-120Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to enhance a deeper understanding of daily life as experienced by young adults with Type 1 Diabetes and their close relatives. Young adulthood is commonly considered as an amendment to adult roles. Increased responsibility, such as a long-term illness in young adulthood, might lead to increased stress and anxiety. Type 1 Diabetes involves large obligations related to self-care, and close relatives might play an important role in managing daily life. A hermeneutic study involving interviews with a narrative approach with couples. The hermeneutic analysis revealed that T1D is always unconditionally present in daily life for young adults and their close relatives. Close relatives are important supporters, they have an understanding based on sharing daily life with the young adults with T1D. Young adults and their close relatives highlighted the experiences of being questioned, which in turn threatens the young adults’ integrity.

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

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

  • 4. Engström, A.
    et al.
    Andersson, S.
    Söderberg, Siv
    Re-visiting the ICU. Experiences of follow-up visits to an ICU after discharge: A qualitative study2008In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 24, no 4, p. 233-241Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to describe how people who have been critically ill, and their close relatives experience a post-discharge, follow-up visit to the intensive care unit (ICU) that provided the care. There is a lack of studies from such a standpoint. The study design is qualitative. A total of 18 adults participated; nine had been critically ill and nine were close relatives, all made a post-discharge follow-up visit to an ICU in the northern part of Sweden. The study data was collected through personal interviews, conducted after the follow-up visit, using a narrative approach. The data were then subjected to qualitative thematic content analysis which resulted in four themes: receiving strength from returning together; making sense of the critical-illness experience; feeling grateful to have survived and the possibility of improving the care. People who had been critically ill and close relatives felt that returning together was valuable. Meeting the staff, with whom participants felt they had developed a relationship, made it possible for them to express their gratitude for the treatment and nursing care received, and to suggest improvements. The interviews revealed that the follow-up visit was seen as an important way of learning what had happened and why during the period of critical illness. © 2008 Elsevier Ltd. All rights reserved.

  • 5. Engström, A.
    et al.
    Söderberg, Siv
    Luleå University of Technology.
    Transition as experienced by close relatives of people with traumatic brain injury2011In: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 43, no 5, p. 253-260Article in journal (Refereed)
    Abstract [en]

    When someone is afflicted by a traumatic brain injury (TBI), it entails a sudden change in the lives of their close relatives. Relatives provide the primary support system for the person with TBI, and new living patterns have to be developed by the family to achieve balance in the new situation. There is an absence of studies focusing on the process of transition for people living close to a person with TBI, especially in a long-term relationship. The aim of this study, therefore, was to describe such transitions experienced by the close relatives of people with TBI. Five close relatives, all women, who lived with or close to a person with TBI in the northern part of Sweden, were interviewed. The data were analyzed in accordance with the qualitative interpretive method and performed in a series of steps to arrive at a description of the transition. The findings of the analysis are presented in 4 categories: the starting point of the transitions, transitions in pattern of daily life, transitions in relationship, and transitions in social life. The transitions of daily life for close relatives began suddenly as the person with TBI was injured unexpectedly. The relatives could feel lonely as former friends were gone or avoided them. How the person with TBI was met by other people strongly affected how the close relatives felt. Although they struggled to lessen the dependence of the person with TBI on them, they also felt anxious about how things would be if close relatives were no longer there for that person. The findings are discussed with reference to works by the philosophers Buber, Lévinas, and Lögstrup and theories of transition. © 2011 American Association of Neuroscience Nurses.

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

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

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

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

  • 8. Engström, Å
    et al.
    Söderberg, Siv
    The experiences of partners of critically ill persons in an intensive care unit2004In: Intensive and Critical Care Nursing, ISSN 0964-3397, Vol. 20, no 5, p. 299-308Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe partners' experiences when their spouses received care in an intensive care unit (ICU). Seven partners were interviewed using a narrative approach. The interview texts were subjected to qualitative thematic content analysis. The analysis resulted in three themes; being present, putting oneself in second place and living in uncertainty. It was a shocking experience for the partners to see their critically ill spouse in the ICU. It was important to be able to be present; nothing else mattered. Showing respect, confirming the integrity and dignity of their critically ill spouse were also essential for partners. Receiving support from family and friends was important, as were understanding and accepting what had happened, obtaining information and the way in which this was given. The state of uncertainty concerning the outcome for the critically ill person was difficult to cope with. The partners wanted to hope, even though the prognosis was poor. © 2004 Elsevier Ltd. All rights reserved.

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

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

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

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

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

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

  • 10. Forsberg, A.
    et al.
    Engström, A.
    Söderberg, Siv
    Luleå University of Technology.
    From reaching the end of the road to a new lighter life - People's experiences of undergoing gastric bypass surgery2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 2, p. 93-100Article in journal (Refereed)
    Abstract [en]

    Objectives: It is limited research that focuses on people's experiences from prior to surgery to the postoperative period after a gastric bypass. The aim of this retrospective study was to describe people's experiences of undergoing gastric bypass surgery. Method: A qualitative approach was used. Interviews with ten participants were subjected to qualitative content analysis. Results: The analysis of the interviews resulted in one theme: from reaching the end of the road to a new lighter life. Prior to surgery participants described a sense of inferiority and that they were not able to 'take any more'. Shortly after surgery participants felt both vulnerable and safe in the unknown environment and expressed needs of orientation and to have the staff close. Despite information prior to surgery it was difficult to imagine ones' situation after homecoming, thus it was worth it so far. Conclusion: The care given in the acute postoperative phase for people who undergo gastric bypass surgery, should aim to provide predictability and management based on individual needs. Being treated with respect, receiving closeness, and that the information received prior to surgery complies with what then happens may facilitate postoperative recovery after a gastric bypass surgery. © 2013 Elsevier Ltd.

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

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

  • 12. Forsberg, Angelica
    et al.
    Engström, Åsa
    Söderberg, Siv
    Luleå University of Technology.
    From reaching the end of the road to a new lighter life – People's experiences of undergoing gastric bypass surgery2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 2, p. 93-100Article in journal (Refereed)
    Abstract [en]

    SummaryObjectives It is limited research that focuses on people's experiences from prior to surgery to the postoperative period after a gastric bypass. The aim of this retrospective study was to describe people's experiences of undergoing gastric bypass surgery. Method A qualitative approach was used. Interviews with ten participants were subjected to qualitative content analysis. Results The analysis of the interviews resulted in one theme: from reaching the end of the road to a new lighter life. Prior to surgery participants described a sense of inferiority and that they were not able to ‘take any more’. Shortly after surgery participants felt both vulnerable and safe in the unknown environment and expressed needs of orientation and to have the staff close. Despite information prior to surgery it was difficult to imagine ones’ situation after homecoming, thus it was worth it so far. Conclusion The care given in the acute postoperative phase for people who undergo gastric bypass surgery, should aim to provide predictability and management based on individual needs. Being treated with respect, receiving closeness, and that the information received prior to surgery complies with what then happens may facilitate postoperative recovery after a gastric bypass surgery.

  • 13. Forslund, A. S.
    et al.
    Lundblad, D.
    Jansson, J. H.
    Zingmark, K.
    Söderberg, Siv
    Luleå University of Technology.
    Risk factors among people surviving out-of-hospital cardiac arrest and their thoughts about what lifestyle means to them: A mixed methods study2013In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 13, article id 62Article in journal (Refereed)
    Abstract [en]

    Background: The known risk factors for coronary heart disease among people prior suffering an out-of-hospital cardiac arrest with validated myocardial infarction aetiology and their thoughts about what lifestyle means to them after surviving have rarely been described. Therefore the aim of the study was to describe risk factors and lifestyle among survivors. Methods: An explanatory mixed methods design was used. All people registered in the Northern Sweden MONICA myocardial registry between the year 1989 to 2007 who survived out-of-hospital cardiac arrest with validated myocardial infarction aetiology and were alive at the 28th day after the onset of symptoms (n = 71) were included in the quantitative analysis. Thirteen of them participated in interviews conducted in 2011 and analysed via a qualitative manifest content analysis. Results: About 60% of the people had no history of ischemic heart disease before the out-of-hospital cardiac arrest, but 20% had three cardiovascular risk factors (i.e., hypertension, diabetes mellitus, total cholesterol of more or equal 5 mmol/l or taking lipid lowering medication, and current smoker). Three categories (i.e., significance of lifestyle, modifying the lifestyle to the new life situation and a changed view on life) and seven sub-categories emerged from the qualitative analysis.Conclusions: For many people out-of-hospital cardiac arrest was the first symptom of coronary heart disease. Interview participants were well informed about their cardiovascular risk factors and the benefits of risk factor treatment. In spite of that, some chose to ignore this knowledge to some extent and preferred to live a " good life" , where risk factor treatment played a minor part. The importance of the support of family members in terms of feeling happy and having fun was highlighted by the interview participants and expressed as being the meaning of lifestyle. Perhaps the person with illness together with health care workers should focus more on the meaningful and joyful things in life and try to adopt healthy behaviours linked to these things. © 2013 Forslund et al.; licensee BioMed Central Ltd.

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

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

  • 15. Forslund, A. S.
    et al.
    Söderberg, Siv
    Jansson, J. H.
    Lundblad, D.
    Trends in incidence and outcome of out-of-hospital cardiac arrest among people with validated myocardial infarction2013In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 20, no 2, p. 260-267Article in journal (Refereed)
    Abstract [en]

    To describe trends in incidence, outcome, and background characteristics among people who suffered an out-of-hospital cardiac arrest with validated myocardial infarction aetiology (OHCA-V). People from the northern Sweden MONICA myocardial registry (1989-2007) with OHCA-V (n = 2977) were divided in two age groups (25-64 and 65-74 years). Both those who were resuscitated outside hospital and those who died before resuscitation was started were included in the study. The younger age group was studied during 1989-2007 and the older group during 2000-2007. The incidence of OHCA-V decreased in both the younger group (men p < 0.0001, women p = 0.04) and the older group (men p < 0.0001, women p < 0.0007, respectively). The proportion with a history of ischaemic heart disease prior to the event decreased (p < 0.0001). The proportion of previous myocardial infarction decreased (p < 0.0001), diabetes mellitus increased (p = 0.001), coronary interventions increased (p < 0.0001), and survival after OHCA-V increased (p < 0.0001) in the younger group but not in the older group. Long-term survival after OHCA-V was better in the younger than in the older group (p = 0.026). The incidence of OHCA-V decreased in both sexes. The proportion surviving after OHCA-V was small but increased, and long-term survival (≥ 28 days) was better in the younger age group. Primary preventive measures may explain most of the improvements. However, the effects of secondary preventive measures cannot be excluded.

  • 16. Forslund, A. S.
    et al.
    Zingmark, K.
    Jansson, J. H.
    Lundblad, D.
    Söderberg, Siv
    Luleå University of Technology.
    Meanings of people's lived experiences of surviving an out-of-hospital cardiac arrest, 1 month after the event2014In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 29, no 5, p. 464-471Article in journal (Refereed)
    Abstract [en]

    Background: The out-of-hospital cardiac arrest (OHCA) survival rate has been poor and stable for a long time, but more recent studies describe its increase. However, there are few studies in which people narrate their experiences from surviving. Objective: The aim of this study was to elucidate meanings of people's lived experiences of surviving an OHCA with validated myocardial infarction (MI) etiology, 1 month after the event. Methods: A purposive sample of 2 women and 9 men was interviewed between February 2011 and May 2012. A phenomenological hermeneutical method was used for analysis, which involved 3 steps: naive reading and understanding, structural analysis, and comprehensive understanding. Results: There were 2 themes, (1) returning to life and (2) revaluing life, and five subthemes, (1a) waking up and missing the whole picture, (1b) realizing it was not time to die, (2a) wondering why and seeking explanations, (2b) feeling ambiguous in relations, and (2c) wondering whether life will be the same. All were constructed from the analysis. Conclusions: Surviving an OHCA with validated MI etiology meant waking up and realizing that one had experienced a cardiac arrest and had been resuscitated. These survivors had memory loss and a need to know what had happened during the time they were dead/unconscious. They searched for a reason why they experienced an MI and cardiac arrest and had gone from being "heart-healthy" to having a lifelong illness. They all had the experience of passing from life to death and back to life again. For the participants, these differences led to a revaluation of what is important in life. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

  • 17.
    Forslund, Ann-Sofie
    et al.
    The Northern Sweden MONICA Myocardial Registry, Department of Research, Norrbotten County Council, Luleå.
    Jansson, Jan-Håkan
    Umeå Universitet.
    Lundblad, Dan
    Umeå Universitet.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    A second chance at life: People's lived experiences of surviving out-of-hospital cardiac arrest2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 4, p. 878-886Article in journal (Refereed)
    Abstract [en]

    Background

    There is more to illuminate about people's experiences of surviving out-of-hospital cardiac arrest (OHCA) and how such an event affects people's lives over time.

    Aims

    This study aimed to elucidate meanings of people's lived experiences and changes in everyday life during their first year after surviving OHCA.

    Methods

    A qualitative, longitudinal design was used. Eleven people surviving OHCA from northern Sweden agreed to participate and were interviewed 6 and 12 months after the event. A phenomenological hermeneutic interpretation was used to analyse the transcribed texts.

    Findings

    The structural analysis resulted in two themes: (i) striving to regain one's usual self and (ii) a second chance at life, and subthemes (ia) testing the body, (ib) pursuing the ordinary life, (ic) gratitude for help to survival, (iia) regaining a sense of security with one's body, (iib) getting to know a new self, and (iic) seeking meaning and establishing a future.

    Conclusion

    To conclude, we suggest that people experienced meanings of surviving OHCA over time as striving to regain their usual self and getting a second chance at life. The event affected them in many ways and resulted in a lot of emotions and many things to think about. Participants experienced back-and-forth emotions, when comparing their present lives to both their lives before cardiac arrest and those lives they planned for the future. During their first year, participants’ daily lives were still influenced by ‘being dead’ and returning to life. As time passed, they wanted to resume their ordinary lives and hoped for continued lives filled with meaning and joyous activities.

  • 18. Gard, G.
    et al.
    Söderberg, Siv
    How can a work rehabilitation process be improved? - A qualitative study from the prespective of social insurance officers2004In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, no 5, p. 299-305Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study is to describe social insurance officers' experiences of a work rehabilitation process at a rehabilitation centre in the northern parts of Sweden. In Sweden the social insurance company has a key role to coordinate all efforts concerning work rehabilitation planning between all rehabilitation actors. Method: Ten social insurance officers at the social insurance company in a city in northern Sweden were interviewed using a narrative approach about their experiences of work rehabilitation processes in general. The interviews were analysed by qualitative content analysis with a focus on their experiences of goals, content and results of a work rehabilitation process. Results: The social insurance officers' experiences of how a work rehabilitation process could be improved were described in six categories; (1) Early identification of problems, needs and interventions (2) clear goal formulations, (3) a focus on psychosocial factors (4) a greater variety of possible interventions, (5) activating employers to a higher extent in work rehabilitation and (6) a closer cooperation and information exchange with other rehabilitation actors. Conclusions: It is possible to improve a work rehabilitation process by focusing on early identification of problems, needs and interventions, with a variety of interventions to choose between and with clear goal formulations and recognizing psychosocial factors in the process. To activate employers to a higher extent in work rehabilitation and to make the information exchange between rehabilitation actors more frequent may also improve work rehabilitation processes. © 2004 Taylor & Francis Ltd.

  • 19. Jacobsson, L. J.
    et al.
    Westerberg, M.
    Söderberg, Siv
    Lexell, J.
    Functioning and disability 6-15 years after traumatic brain injuries in northern Sweden2009In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 120, no 6, p. 389-395Article in journal (Refereed)
    Abstract [en]

    Objectives-To assess long-term functioning and disability after traumatic brain injury (TBI). Material and methods-Individuals (n = 88) in Norrbotten, northern Sweden, who had been transferred for neurosurgical care were assessed with internationally established TBI outcome measures 6-15 years post-injury. Results-There was an improvement in overall outcome from discharge from inpatient rehabilitation to follow-up. Many individuals had a high degree of motor and cognitive functioning, which enabled them to live independently in their own home without assistance, but there remained a disability related to community reintegration and social participation. This affected their productivity and to some degree their marital stability. The remaining disability and reduced productivity were related to the age at injury and the injury severity. Conclusions-Our data showed that individuals with a TBI can achieve and maintain a high degree of functioning many years after the injury. Increasing age and a greater injury severity contributed to their long-term disability. © 2009 Blackwell Munksgaard.

  • 20. Johansson, A. M.
    et al.
    Lindberg, I.
    Söderberg, Siv
    Luleå University of Technology.
    Patients' experiences with specialist care via video consultation in primary healthcare in rural areas2014In: International Journal of Telemedicine and Applications, ISSN 1687-6415, E-ISSN 1687-6423, Vol. 2014, article id 143824Article in journal (Refereed)
    Abstract [en]

    Introduction. Video consultation (VC) can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients' experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme "confident with the technology" was constructed from the categories "possibilities and obstacles in using VC encounters" and "advantages and disadvantages of the technology." The theme "personal satisfaction with the VC encounters" was constructed from the categories "support from the healthcare personnel," "perceived security," and "satisfaction with the specialist consultation." Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients' perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient's perception of security during the VC encounter. © 2014 Annette M. Johansson et al.

  • 21. Johansson, A. M.
    et al.
    Lindberg, I.
    Söderberg, Siv
    Luleå University of Technology.
    The views of health-care personnel about video consultation prior to implementation in primary health care in rural areas2014In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 15, no 2, p. 170-179Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to describe the views of health-care personnel about video consultation (VC) prior to implementation in primary health care in rural areas. BACKGROUND: For people living in rural areas, it is often a long distance to specialist care, and VC could be an opportunity for increased access to care. Therefore, this study was to investigate what views primary health-care personnel had on VC as a working method in the distance between primary and specialist care. The development of technology in society and the introduction of technology in health care mean that the working methods must be adapted to a new approach. It is therefore important that in the initial phase of the introduction of new working methods to capture the personnel views regarding this. METHODS: Focus group (FG) discussions with health-care personnel from five primary health-care centres in northern Sweden. The transcribed FG discussions were analysed with qualitative content analysis. FINDINGS: The analysis revealed four main categories: a patient-centred VC; the importance of evaluating costs and resources; new technology in daily work; technology gives new possibilities in future health care.

  • 22. Johansson, A. M.
    et al.
    Söderberg, Siv
    Luleå University of Technology.
    Lindberg, I.
    Views of residents of rural areas on accessibility to specialist care through videoconference2014In: Technology and Health Care, ISSN 0928-7329, E-ISSN 1878-7401, Vol. 22, no 1, p. 147-155Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Accessibility to specialized health care is important for residents in rural areas. Videoconsultation can provide increased accessibility to health care. Before implementation of new technologies, it is important to study residents' views. OBJECTIVE: This study describes views of residents of rural areas on accessibility to specialist care and the use of videoconsultation as tool to increase accessibility. METHOD: A questionnaire was distributed via the primary health care centres in rural areas of northern Sweden. Data was analysed with both quantitative and qualitative methods. RESULTS: The quantitative analysis revealed three main areas: savings in time, environmental damage and cost of not having to travel were important; security of information must be coupled with increased availability of specialist care; responses depended on an individual's specific health care needs. The open-ended answers resulted into two categories: 1) experiences related to availability of specialist care and 2) views on participating in VC. CONCLUSION: Despite the fact that rural residents considered the distance as important factor in access to care, there was uncertainty regarding videoconsultation as solution. Although respondents were familiar with different types of communication technologies, they probably hesitated because they did not have information on what videoconsultation would mean to them. © 2014 - IOS Press and the authors.

  • 23.
    Johansson, Annette
    et al.
    Luleå University of Technology, Luleå.
    Lindberg, Inger
    Luleå University of Technology, Luleå.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Healthcare personnel's experiences using video consultation in primary healthcare in rural areas2017In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 18, no 1, p. 73-83Article in journal (Refereed)
    Abstract [en]

    Background Patients living in rural areas often need to travel long distances for access to specialist care. To increase access to specialist care, video consultation between patients in primary healthcare and specialist care has been used. In order for this new method to be developed and used to the fullest, it is important to understand healthcare personnel's experiences with this intervention. Objective The aim of this study was to describe healthcare personnel's experiences using video consultation in their work in primary healthcare. Method A mixed methods design was used, and the data were analysed using qualitative and quantitative analysis methods. Interviews were conducted with eight general practitioners and one district nurse, all of whom had conducted a video consultation with a patient and a specialist physician or a cardiac specialist nurse. After each video consultation, the participants completed a consultation report/questionnaire. Results Healthcare personnel considered video consultation to provide quicker access to specialist care for the patient, and greater security when the video consultation encounter was conducted at their own primary healthcare centre. They considered video consultation an opportunity to provide education and for the patients to ask questions. Conclusion Video consultation is a satisfactory tool for healthcare personnel, and the technology is a new, useful method, especially for the district nurses. Further, video consultation is an opportunity for healthcare personnel to learn. However, for it to work as an accepted method, the technology must function well and be user friendly. It must also be clear that it is beneficial for the patients and the healthcare personnel.

  • 24. Jumisko, E.
    et al.
    Lexell, J.
    Söderberg, Siv
    Living with moderate or severe traumatic brain injury: The meaning of family members' experiences2007In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 13, no 3, p. 353-369Article in journal (Refereed)
    Abstract [en]

    Traumatic brain injury (TBI) has long-lasting consequences not only for the individual with the injury but also for family members. The aim of this study is to elucidate the meaning of family members' experiences of living with an individual with moderate or severe TBI. The data have been collected by means of qualitative research interviews with 8 family member participants. A phenomenological hermeneutic interpretation (Ricouer, 1976) of the data reveal that family members struggle with their own suffering while showing compassion for the injured person. Their willingness to assume care for the injured person is derived from their feeling of natural love and the ethical demand to be responsible for the other. Hope and natural love from close relatives, the afflicted person, and other family members give the family members strength. It is important that professionals pay more attention to the suffering of close relatives.

  • 25.
    Jumisko, E.
    et al.
    Luleå University of Technology.
    Lexell, J.
    Luleå University of Technology, Lund University Hospital.
    Söderberg, Siv
    Luleå University of Technology.
    The experiences of treatment from other people as narrated by people with moderate or severe traumatic brain injury and their close relatives2007In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 29, no 19, p. 1535-1543Article in journal (Refereed)
    Abstract [en]

    Purpose. The aim of this study was to describe the treatment from other people as experienced by people with moderate or severe traumatic brain injury (TBI) and their close relatives. Method. Twelve people with moderate or severe TBI and eight of their close relatives were interviewed. The interviews were analysed using thematic content analysis. Results. The results were described by the means of two themes: being excluded and missing confirmation. People with TBI and their close relatives had experiences of being avoided, being ruled by the authorities, being met with distrustfulness and being misjudged. They also searched for answers and longed for the right kind of help. People who listened to them, believed them and tried to understand and help them were appreciated. Conclusions. This study showed a lack of treatment which promotes well-being of the people with TBI and their close relatives. They experienced bad treatment also from authorities. Therefore, we emphasize that authorities should continuously reflect on how to make their practice a place which promotes dignity. Treatment of people with TBI and close relatives may be improved by increased knowledge about TBI, living with it and being a close relative to a person with TBI. This is a challenge to health care and rehabilitation professionals.

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

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

  • 27. Jumisko, E.
    et al.
    Lexell, J.
    Söderberg, Siv
    The meaning of living with traumatic brain injury in people with moderate or severe traumatic brain injury2005In: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 37, no 1, p. 42-50Article in journal (Refereed)
    Abstract [en]

    A traumatic brain injury (TBI) extensively affects the injured person's daily life. Research based on the perspectives of people with TBI can increase understanding of the challenges they face and the possibility of supporting them in managing their lives. The aim of this study was to elucidate the meaning of living with TBI as narrated by the people with moderate or severe TBI. The data were collected by means of qualitative research interviews with 12 participants who had lived with TBI for 4-13 years. A phenomenological hermeneutic method was used to interpret the transcribed interviews. The study showed that people with TBI had lost their way and struggled to achieve a new normalcy. Losing one's way included experiences of waking up to unknown, missing relationships and experiencing the body as an enemy. Participants' struggles to attain a new normalcy included searching for an explanation, recovering the self, wishing to be met with respect, and finding a new way of living. Living with TBI seems to mean living with a perpetually altered body that changed the whole life and caused deep suffering, where feelings of shame and dignity competed with each other. Participants seem to be quite alone in their suffering and need more support from healthcare professionals.

  • 28. Juuso, P.
    et al.
    Skär, L.
    Olsson, M.
    Söderberg, Siv
    Luleå University of Technology.
    Living with a double burden: Meanings of pain for women with fibromyalgia2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 3, article id 7184Article in journal (Refereed)
    Abstract [en]

    Living with fibromyalgia (FM) means living with a chronic pain condition that greatly influences daily life. The majority of people with FM are middle-aged women. The aim of this study was to elucidate meanings of pain for women with FM. Fifteen women with FM were interviewed about their pain experiences and a phenomenological hermeneutic interpretation was used to analyse the interview texts. The findings show that meanings of pain for women with FM can be understood as living with a double burden; living with an aggressive, unpredictable pain and being doubted by others in relation to the invisible pain. The ever-present pain was described as unbearable, overwhelming, and dominated the women's whole existence. Nevertheless, all the women tried to normalize life by doing daily chores in an attempt to alleviate the pain. In order to support the women's needs and help them to feel well despite their pain, it is important that nurses and health care personnel acknowledge and understand women with FM and their pain experiences. © 2011 P. Juuso et al.

  • 29. Juuso, P.
    et al.
    Skär, L.
    Olsson, M.
    Söderberg, Siv
    Luleå University of Technology.
    Meanings of being received and met by others as experienced by women with fibromyalgia2014In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 24, no 10, p. 1381-1390Article in journal (Refereed)
    Abstract [en]

    Fibromyalgia (FM) is a common chronic pain syndrome that mostly affects middle-aged women. Our aim with this study was to elucidate meanings of being received and met by others as experienced by women with FM. Interviews with a narrative approach were conducted with 9 women. We analyzed the transcribed interviews with a phenomenological hermeneutical interpretation. The findings revealed two themes: being seen as a malingerer and being acknowledged. Meanings of being received and met by others, as experienced by women with FM, can be understood as a movement between the two perspectives. When they were acknowledged, their feelings of security and trust increased, but the women could not rely on this because others received and met them in such an unpredictable manner. © The Author(s) 2014.

  • 30. Juuso, P.
    et al.
    Skär, L.
    Olsson, M.
    Söderberg, Siv
    Luleå University of Technology.
    Meanings of Feeling Well for Women With Fibromyalgia2013In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 34, no 8, p. 694-706Article in journal (Refereed)
    Abstract [en]

    The researchers' focus in this study was to elucidate meanings of feeling well for women with fibromyalgia (FM). We obtained narrative interviews with 13 women with FM and used a phenomenological-hermeneutic interpretation to analyze the interview texts. Our interpretation of the findings shows that for women with FM meanings of feeling well can be understood as having strength to be involved. The women's experiences of feeling well meant being in control, having power, finding one's own pace, and experiencing feelings of belonging. © 2013 Copyright Taylor and Francis Group, LLC.

  • 31. Juuso, P.
    et al.
    Söderberg, Siv
    Luleå University of Technology.
    Olsson, M.
    Skär, L.
    The significance of FM associations for women with FM2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 21, p. 1755-1761Article in journal (Refereed)
    Abstract [en]

    Purpose: Living with fibromyalgia (FM) means living with a long-term pain syndrome that is invisible to others. Support and understanding from others seem to be important to managing the affected daily life. The aim of this study was to describe the significance of FM associations for women with FM. Methods: Data collection was carried out through focus group discussions with seventeen women with FM. Data were analyzed through thematic content analysis. Results: The findings show that women experienced associations for people with FM as important as they gave access to contacts with others with similar experiences. Their need of togetherness was fulfilled at the association and they described being strengthened by the support received. Because of the lack of information and knowledge about FM, the association was described as an important venue for getting and mediating information about the illness. Conclusions: At the association the women seem to be empowered, which increases their ability to manage their daily lives despite the limitations imposed by FM. Healthcare personnel could not satisfy the women's needs and to manage to support women with FM. There is a need for communication based on a shared understanding between the women and healthcare personnel.Implications for RehabilitationThis study highlighted the need for communication based on a shared understanding between people with chronic illness and healthcare personnel to support and strengthen women with FM in their daily lives.The FM associations meet the needs for togetherness, confirmation, and information that the women with FM in this study described and healthcare personnel could not satisfy.Healthcare personnel can learn from FM associations how to empower women with FM in their everyday lives. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.

  • 32.
    Juuso, Päivi
    et al.
    Luleå Univ Technol, Div Nursing, Dept Hlth Sci, Luleå.
    Skär, Lisa
    Blekinge Inst Technol, Dept Hlth, Karlskrona.
    Sundin, Karin
    Umeå Univ, Dept Nursing, Umeå.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    The Workplace Experiences of Women with Fibromyalgia2016In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 14, no 2, p. 69-76Article in journal (Refereed)
    Abstract [en]

    Purpose: Fibromyalgia (FM) is a common pain syndrome that mostly affects women. Chronic pain and other symptoms often chalenge work for women with FM. This study aimed to explore how women with FM experience their work situations. Method: A purposive sample of 15 women with FM was interviewed with in-depth qualitative interviews. Data were analysed using a hermeneutic approach. Results: The results revealed that women with FM experienced incapacity to work as they had previously and eventually accepted that their work life had changed or reached its end. Since their work had great significance in their lives, feelings of loss and sorrow were common. Women who were working, unemployed, or on sick leave described feelings of fear for their future work situations. Conclusions: Women with FM greatly value their work. Their wish to perform work as before is however, not consistent with their abilities. As such, women with FM need support in continuing to work for as long as possible, after which they need support in finding new values in life.

  • 33. Lindberg, B.
    et al.
    Nilsson, C.
    Zotterman, D.
    Söderberg, Siv
    Luleå University of Technology.
    Skär, L.
    Using information and communication technology in home care for communication between patients, family members, and healthcare professionals: A systematic review2013In: International Journal of Telemedicine and Applications, ISSN 1687-6415, E-ISSN 1687-6423Article in journal (Refereed)
    Abstract [en]

    Introduction. Information and communication technology (ICT) are becoming a natural part in healthcare both for delivering and giving accessibility to healthcare for people with chronic illness living at home. Aim. The aim was to review existing studies describing the use of ICT in home care for communication between patients, family members, and healthcare professionals. Methods. A review of studies was conducted that identified 1,276 studies. A selection process and quality appraisal were conducted, which finally resulted in 107 studies. Results. The general results offer an overview of characteristics of studies describing the use of ICT applications in home care and are summarized in areas including study approach, quality appraisal, publications data, terminology used for defining the technology, and disease diagnosis. The specific results describe how communication with ICT was performed in home care and the benefits and drawbacks with the use of ICT. Results were predominated by positive responses in the use of ICT. Conclusion. The use of ICT applications in home care is an expanding research area, with a variety of ICT tools used that could increase accessibility to home care. Using ICT can lead to people living with chronic illnesses gaining control of their illness that promotes self-care. © 2013 Birgitta Lindberg et al.

  • 34.
    Lindberg, Birgitta
    et al.
    Luleå tekniska universitet.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Standing on their own feet: Experiences of young people living with type 1 diabetes when entering adulthood – a qualitative study.2016In: International Diabetes Nursing, ISSN 2057-3316, Vol. 12, no 3, p. 79-85Article in journal (Refereed)
    Abstract [en]

    Type 1 diabetes can complicate the lives of young people. The aim was to describe the experiences of young people living with Type 1 diabetes when entering adulthood. Nine young people were interviewed. The general principles of interpretative descriptions were used in the analysis. Results showed that young people with Type 1 diabetes lived a life like other young people, but they often had to face a lack of knowledge and understanding. Although they knew how to live, it was not easy to be in control. Even if they took responsibility for their illness, support was critically important. They did not think so much about how their illness might impact their future life. Overall, young people described their life situation positively and dealt with their diabetes naturally. To better support and facilitate the transition to adulthood, health care professionals who are engaged with young people living with Type 1 diabetes need to have better insight into how they experience their life.

  • 35.
    Lindberg, Inger
    et al.
    Luleå University of Technology.
    Lindberg, Birgitta
    Luleå University of Technology.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Patients' and healthcare personnels' experiences of health coaching with on-line self-management in the ReNewing health project2017In: International Journal of Telemedicine and Applications, ISSN 1687-6415, E-ISSN 1687-6423, article id 9306192Article in journal (Refereed)
    Abstract [en]

    Background. Telehealth applications have shown positive effects for people with chronic conditions and their awareness of health. Objective. To describe patients’ and healthcare personnel’s experiences of using health coaching with online self-management in primary health care. Method. A pragmatic randomised controlled trial was conducted. Patients in the intervention group measured and reported medical parameters such as blood pressure, blood glucose, prothrombin complex (PK) values, and 2-channel ECG. Data were collected through a questionnaire, individual interviews with patients, and focus group discussions with healthcare personnel. The questionnaire was analysed using statistics; texts from interviews and focus groups were analysed using content analysis. Findings. Patients were satisfied and believed that the intervention had enhanced their care and increased accessibility without causing concerns about privacy. Although being positive, patients commented the lack of support and feedback from healthcare personnel. Healthcare personnel regarded the intervention valuable for the patients’ abilities to perform self-management healthcare tasks but preferred that patients did so without them supporting the patients. Conclusion. Patients expressed satisfaction and acceptance regarding the use of the application. It seems that healthcare personnel are convinced about the benefits for patients and the potential for the intervention but are not convinced about its benefits for healthcare organisations.

  • 36.
    Lindberg, Inger
    et al.
    Luleå Tekniska Universitet.
    Torbjörnsen, Astrid
    University of Oslo; Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Ribu, Lis
    Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
    Telemonitoring and health counseling for self-management support of patients with type 2 diabetes: A randomized controlled trial2017In: JMIR Diabetes, ISSN 2371-4379, Vol. 2, no 1Article in journal (Refereed)
    Abstract [en]

    Background: The prevalence of diabetes is increasing among adults globally, and there is a need for new models of health care delivery. Research has shown that self-management approaches encourage persons with chronic conditions to take a primary role in managing their daily care.

    Objective: The objective of this study was to investigate whether the introduction of a health technology-supported self-management program involving telemonitoring and health counseling had beneficial effects on glycated hemoglobin (HbA1c), other clinical variables (height, weight, body mass index, blood pressure, blood lipid profile), and health-related quality of life (HRQoL), as measured using the Short Form Health Survey (SF-36) version 2 in patients with type 2 diabetes.

    Methods: This was a pragmatic randomized controlled trial of patients with type 2 diabetes. Both the control and intervention groups received usual care. The intervention group also participated in additional health promotion activities with the use of the Prescribed Healthcare Web application for self-monitoring of blood glucose and blood pressure. About every second month or when needed, the general practitioner or the diabetes nurse reviewed the results and the health care activity plan.

    Results: A total of 166 patients with type 2 diabetes were randomly assigned to the intervention (n=87) or control (n=79) groups. From the baseline to follow-up, 36 patients in the intervention group and 5 patients in the control group were lost to follow-up, and 2 patients died. Additionally, HbA1c was not available at baseline in one patient in the intervention group. A total of 122 patients were included in the final analysis after 19 months. There were no significant differences between the groups in the primary outcome HbA1c level (P=.33), and in the secondary outcome HRQoL as measured using SF-36. A total of 80% (67/87) of the patients in the intervention group at the baseline, and 98% (47/50) of the responders after 19-month intervention were familiar with using a personal computer (P=.001). After 19 months, nonresponders (ie, data from baseline) reported significantly poorer mental health in social functioning and role emotional subscales on the SF-36 (P=.03, and P=.01, respectively).

    Conclusions: The primary outcome HbA1c level and the secondary outcome HRQoL did not differ between groups after the 19-month follow-up. Those lost to follow-up reported significantly poorer mental health than did the responders in the intervention group.

  • 37. Lindgren, E.
    et al.
    Söderberg, Siv
    Luleå University of Technology.
    Skär, L.
    Swedish Young Adults' Experiences of Psychiatric Care during Transition to Adulthood2015In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 36, no 3, p. 182-189Article in journal (Refereed)
    Abstract [en]

    The number of young adults with mental illness and the need of psychiatric care has increased during the last decades. The aim of the study was to explore young adults' experiences of psychiatric care during transition to adulthood. Individual interviews were conducted with 11 young adults and analysed according to Grounded Theory. The analyses results showed that support was a prerequisite for transition to adulthood and striving to reach recovery. By being encountered as a person and with a supportive environment, young adults can be motivated to continue care and be encouraged to express feelings. © 2015 Informa Healthcare USA, Inc.

  • 38. Lindgren, E.
    et al.
    Söderberg, Siv
    Luleå University of Technology.
    Skär, L.
    The gap in transition between child and adolescent psychiatry and general adult psychiatry2013In: Journal of Child and Adolescent Psychiatric Nursing, ISSN 1073-6077, E-ISSN 1744-6171, Vol. 26, no 2, p. 103-109Article in journal (Refereed)
    Abstract [en]

    Background: During transition from child and adolescent psychiatry (CAP) to general adult psychiatry (GenP) young adults with mental illness face multilevel transitions along with a risk for disruption in continuity of care. The aim of this study was to describe professionals' experiences and views of the transition process from CAP to GenP. Method: Data were collected through six focus group discussions with professionals from both CAP and GenP and analyzed by content analysis. Results: The results showed a gap in transition between CAP and GenP when different perspectives and care cultures meet in a complex process. Conclusions: Cooperation, transition planning, and a mutual understanding of care can support young adults in transition from CAP to GenP. © 2013 Wiley Periodicals, Inc.

  • 39.
    Lindgren, Eva
    et al.
    Lulea University of Technonogy, Department of Health Science, Lulea, Sweden .
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Skär, Lisa
    Blekinge Institute of Technology, Department of Health, Karlskrona, Sweden.
    Being a parent to a young adult with mental illness in transition to adulthood2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 2, p. 98-105Article in journal (Refereed)
    Abstract [en]

    Parents of young adults with mental illness may face a continued demand for support, even though their children have reached the age of majority. The aim of this study was to explore relatives experiences of parenting a young adult with mental illness in transition to adulthood. Individual interviews were conducted and analysed according to Grounded Theory. The results showed that relatives experienced powerlessness and a sense of inescapable duty with limited possibilities to be relieved. With a family nursing approach, relatives can be supported and, when the young adults needs of care are met, they can be relieved from their burden of responsibility.

  • 40.
    Lindgren, Eva
    et al.
    Luleå University of Technology.
    Söderberg, Siv
    Luleå University of Technology.
    Skär, Lisa
    Luleå University of Technology.
    Managing Transition with Support: Experiences of Transition from Child and Adolescent Psychiatry to General Adult Psychiatry Narrated by Young Adults and Relatives2014In: Psychiatry Journal, ISSN 2314-4327, E-ISSN 2314-4335, Vol. 2014, article id 457160Article in journal (Refereed)
  • 41. McMillen, A. M.
    et al.
    Söderberg, Siv
    Disabled person's experience of dependence on assistive devices2002In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 9, no 4, p. 176-183Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate disabled persons' experience of dependence on assistive devices. Fifteen persons were interviewed with a narrative approach. A qualitative thematic content analysis was used to analyse the interview text. The analysis resulted in four themes with nine sub-themes. The study shows that the participants' experience of being dependent on assistive devices included possibilities such as gaining a better quality of life and being able to live a normal life. The dependence also led to obstacles like a fear of injuring oneself when utilizing assistive devices, difficulties in accepting them and worry about future needs for devices. The participants experienced a changed reception from other people and problems imposed by society or the community. They felt that they were treated in a different way and were in the way. A lack of access to public places and a feeling of helplessness when faced with the power of the authorities were other experiences of the participants. The relationship between the approach that people take to their illness and the acceptance of using assistive technology needs further study. Further research concerning the way in which people handle their dependence on assistive devices needs to be conducted.

  • 42. Nilsson, C.
    et al.
    Skär, L.
    Söderberg, Siv
    Swedish District Nurses' experiences on the use of information and communication technology for supporting people with serious chronic illness living at home - a case study2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 259-265Article in journal (Refereed)
    Abstract [en]

    The aim of this case study was to describe two District Nurses' (DN) experiences of using information and communication technology (ICT) to communicate with chronically ill people in their homes. An electronic messaging program via computers and mobile phones with an Internet connection was used, enabling DNs and the ill people to exchange messages to and from anywhere. The program comprised different virtual rooms, and communication was via text messages. The DNs in this study used the program two to four times each week from November 2003 to March 2004. Semi-structured interviews were performed before, during and after the implementation of the new technology and were analysed using thematic content analysis. The results showed that the DNs felt that the technology increased accessibility to nursing care through a more direct communication with the ill person meaning that a more trusting relationship could be created. The DNs also experienced that the use of ICT saved working time. This study indicates that the use of ICT for communication allowed the DN to better support a chronically ill person at home leading to improved home nursing care. This method of communication cannot replace physical presence, but can be seen as a complement to nursing care at home. © 2009 The Authors. Journal compilation © 2009 Nordic College of Caring Science.

  • 43. Nilsson, C.
    et al.
    Öhman, M.
    Söderberg, Siv
    Information and communication technology in supporting people with serious chronic illness living at home - An intervention study2006In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 12, no 4, p. 198-202Article in journal (Refereed)
    Abstract [en]

    We studied the experiences of two people with serious chronic illness who used information and communication technology (ICT) to communicate with their district nurse. The study was a qualitative case study. The intervention was performed using an electronic messaging program. The program was accessible to any computer with an Internet connection. The programme consisted of different virtual rooms, where people could communicate using text messages. The participants used the program 2-4 times each week from the beginning of November 2003 to February 2004. Semistructured interviews were performed before, during and after the intervention and were analysed using thematic content analysis. The results showed that the participants' communication with the district nurse was improved because of easy accessibility and that they felt increased security. They also felt there were fewer limitations and that their everyday life was improved, which can also be seen as an improvement in care.

  • 44.
    Nilsson, Carina
    et al.
    Luleå University.
    Lindberg, Birgitta
    Luleå University.
    Skär, Lisa
    BTH.
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Meanings of balance for people with long-term illnesses2016In: British Journal of Community Nursing, ISSN 1462-4753, E-ISSN 2052-2215, Vol. 21, no 11, p. 563-567Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate meanings of balance in everyday life for people with long-term illnesses living at home. People living with long-term illnesses are in need of help and support to manage their daily lives. Twelve adults with extensive needs for help and support were interviewed. A phenomenological hermeneutic interpretation was used to analyse the interview texts. The findings show that balance in everyday life for people with long-term illnesses means striving for independence through care and support in their surroundings. It was also important to be able to choose how their lives would be and to be with others who listened and understood them for who they are. By building a relationship with patients at an early stage of their illnesses, nursing staff have an opportunity to understand what people who are living at home with long-term illnesses need in order to achieve balance in their everyday lives.

  • 45. Nilsson, Carina
    et al.
    Skär, Lisa
    Söderberg, Siv
    Luleå University of Technology.
    Swedish district nurses’ attitudes to implement information and communication technology in home nursing2008In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 2, p. 68-72Article in journal (Refereed)
  • 46.
    Nilsson, Åsa
    et al.
    Luleå University of Technology.
    Skär, Lisa
    Luleå University of Technology.
    Söderberg, Siv
    Luleå University of Technology.
    Nurses' views of shortcomings in patent care encounters in one hospital in Sweden2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 19-20, p. 2807-2814Article in journal (Refereed)
    Abstract [en]

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

  • 47. Nordmark, S.
    et al.
    Söderberg, Siv
    Luleå University of Technology.
    Skär, L.
    Information exchange between registered nurses and district nurses during the discharge planning process: Cross-sectional analysis of survey data2015In: Informatics for Health and Social Care, ISSN 1753-8157, E-ISSN 1753-8165, Vol. 40, no 1, p. 23-44Article in journal (Refereed)
    Abstract [en]

    Objectives: Discharge planning is an important care process for managing transitions from the hospital to the community. It has been studied for >20 years, but few studies clarify the information exchanged between healthcare providers. This study aimed to describe nurses' experiences and perceptions of information exchange during the discharge planning process, focused on what, when and how information is exchanged between the hospital and primary healthcare. Method: A web-based census survey was used to collect data; the data were analyzed using descriptive statistics and chi-squared test. A questionnaire was distributed to 194 registered nurses (129 respondents) from a central county hospital and 67 district nurses (42 respondents) working in 13 primary healthcare centres. Results: The results show a significant difference between given and received information between the two groups. Both groups thought the information exchange worked best when all participants met at the discharge planning conference and that the electronic information system was difficult to use. Conclusion: This study shows difficulties knowing what patient-related information needs to give and not receiving the expected information. These results can be used to develop knowledge about roles, work tasks and needs to enhance the outcome of the process and the information exchanged. © 2015 Informa UK Ltd. All rights reserved.

  • 48. Nygren Zotterman, A.
    et al.
    Skär, L.
    Olsson, M.
    Söderberg, Siv
    Luleå University of Technology.
    District nurses' views on quality of primary healthcare encounters2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 3, p. 418-425Article in journal (Refereed)
    Abstract [en]

    Good encounters are fundamental for good and professional nursing care, and can be described as treating patients with respect and protecting their integrity and autonomy. This study describes district nurses' views on quality of healthcare encounters in primary healthcare. A purposive sample of 27 district nurses participated in five focus group interviews. The focus groups interviews were digitally recorded and transcribed verbatim. The interview texts were analysed using a thematic content analysis. The analysis resulted in four themes, including being aware of the importance and difficulties during encounters, being the patient's advocate, being attentive to the unique person and being informed when a meeting turned out poorly. The results show that district nurses believed that encounters formed the basis of their work and it was vital for them to be aware of any difficulties. District nurses found that acting in a professional manner during encounters is the most significant factor, but this type of interaction was sometimes difficult because of stress and lack of time. The district nurses considered themselves to be the patients' advocate in the healthcare system; in addition, the acts of seeing, listening, believing and treating the patient seriously were important for providing good quality care. If a poor encounter occurred between the district nurse and the patient, the district nurses found that it was necessary to arrange a meeting to properly communicate what problems arose during the interaction. The district nurses highlighted that providing an apology and explanation could improve future encounters and establish a better nurse-patient relationship. In conclusion, this study shows the importance of confirming and respecting patients' dignity as the fundamental basis for a good quality encounter in primary healthcare. Copyright © 2015 Nordic College of Caring Science.

  • 49.
    Nygren Zotterman, Anna
    et al.
    Division of Nursing Department of Health Science, Luleå University of Technology Luleå.
    Skär, Lisa
    Department of Health Blekinge Institute of Technology, Karlskrona .
    Olsson, Malin
    Division of Nursing Department of Health Science, Luleå University of Technology, Luleå .
    Söderberg, Siv
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Being in togetherness: Meanings of encounters within primary healtcare setting for patients living with long-term illness2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 19-20, p. 2854-2862Article in journal (Refereed)
    Abstract [en]

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

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

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

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