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  • 1.
    Andreassen Devik, Siri
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Perceptions of suffering in older persons receiving palliative home nursing care: Bereaved family members' perspectiveManuscript (preprint) (Other academic)
  • 2.
    Andreassen Devik, Siri
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Midnorway, Ctr Care Res, Steinkjer, Norway..
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. 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 area2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, article id 28382Article in journal (Refereed)
    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.

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  • 3.
    Bell, Hege T.
    et al.
    Nord Univ NTNU, Trondheim, Norway.
    Granas, Anne Gerd
    HiOA, Oslo, Norway.
    Omli, Ragnhild
    Nord Univ, Namsos, Norway.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Steinsbekk, Aslak
    NTNU, Trondheim, Norway.
    Nurses' and pharmacists' learning experiences from participating in inter professional medication reviews in primary health care: a qualitative study2017In: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 39, no 1, p. 218-219, article id CP-PC004Article in journal (Refereed)
  • 4.
    Bell, Hege Therese
    et al.
    Nord Trondelag Univ Coll, Fac Hlth Sci, Dept Pharm, Namsos, Norway.;Norwegian Univ Sci & Technol, Dept Publ Hlth & Gen Practice, N-7034 Trondheim, Norway..
    Omli, Ragnhild R.
    Nord Trondelag Univ Coll, Fac Hlth Sci, Dept Nursing, Namsos, Norway.;Ctr Care Res, Steinkjer, Norway..
    Granas, Anne Gerd
    Oslo & Akershus Univ Coll, Dept Life Sci & Hlth, Fac Hlth Sci, Oslo, Norway..
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Ctr Care Res, Steinkjer, Norway.;Nord Trondelag Univ Coll, Dept Hlth Sci, Namsos, Norway.
    Steinsbekk, Aslakk
    Norwegian Univ Sci & Technol, Dept Publ Hlth & Gen Practice, N-7034 Trondheim, Norway..
    Interdisciplinary and structured drug reviews in primary health care-health personnel's perceived value of participation2015In: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 37, p. 11-11Article in journal (Other academic)
  • 5.
    Bell, H.T.
    et al.
    Nord University, Namsos, Norway; Norwegian University of Science and Technology, Trondheim, Norway.
    Granas, A.G.
    University of Oslo, Oslo, Norway.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Centre for Care research Mid-Norway, Steinkjer, Norway.
    Omli, R.
    Centre for Care research Mid-Norway, Steinkjer, Norway; Nord University, Namsos, Norway.
    Steinsbekk, A.
    Norwegian University of Science and Technology, Trondheim, Norway.
    Nurses’ and pharmacists’ learning experiences from participating in interprofessional medication reviews for elderly in primary health care: a qualitative study2017In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 18, no 1, p. 30-Article in journal (Refereed)
    Abstract [en]

    Background: Traditionally, drug prescription and follow up have been the sole responsibility of physicians. However, interprofessional medication reviews (IMRs) have been developed to prevent drug discrepancies and patient harmespecially for elderly patients with polypharmacy and multimorbidity. What participating nurses and pharmacists learnfrom each other during IMR is poorly studied. The aim of this study was to investigate nurses’ and pharmacists’ perceived learning experience after participating in IMRs in primary health care for up to two years.

    Methods: A qualitative study with semi-structured focus group interviews and telephone interviews with nurses and pharmacists with experience from IMRs in nursing homes and home based services. The data was analysed thematically by using systematic text condensation.

    Results: Thirteen nurses and four pharmacists were interviewed. They described some challenges concerning how to ensure participation of all three professions and how to get thorough information about the patient. As expected, both professions talked of an increased awareness with time of the benefit of working as a team and the perception of contributing to better and more individual care. The nurses’ perception of the pharmacist changed from being a controller of drug management routines towards being a source of pharmacotherapy knowledge and a discussant partner of appropriate drug therapy in the elderly. The pharmacists became more aware of the nurses’ crucial role of providing clinical information about the patient to enable individual advice. Increasingly the nurses learned to link the patient’s symptoms of effect and side effect to the drugs prescribed.

    Conclusions: Although experiencing challenges in conducting IMRs, the nurses and pharmacists had learning experiences they said improved both their own practice and the quality of drug management. There are some challenges concerning how to ensure participation of all three professions and how to get thorough information about the patient.

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  • 6.
    Devik Andreasen, Siri
    et al.
    Nord Universitetet, Norge.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. 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 study2017In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 26, no 6, article id e12609Article in journal (Refereed)
    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.

  • 7.
    Eivergård, Kristina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Högskolan i Gävle.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    The Talk About the Psychiatric Patient2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 10, p. 756-764Article in journal (Refereed)
    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.

  • 8.
    Mentsen Ness, Tove
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hellzen, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    The Experience of Nurses Providing Home Nursing Care to Oldest Old Persons Living Alone in Rural Areas—An Interview Study2015In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 5, no 4, p. 336-344Article in journal (Refereed)
    Abstract [en]

    The rapidly increasing population of older persons worldwide, and the fact that the majority of them want to continue living in their own homes, mean there is a growing focus on home based care. Because of this, it is necessary to increase the number of studies, including rural areas, as earlier studies are sparse. Rural areas cannot be seen as a homogeneous phenomenon, meaning more research is needed to increase knowledge about cultural differences in rural areas. The aim of this study was therefore to describe registered nurses’ experiences of providing home nursing care to oldest old persons living alone in rural areas. A sample of 15 registered nurses in rural South Sami areas was chosen for this study, 13 women and 2 men. Narrative interviews were conducted, and qualitative content analysis was used to interpret the data. The analysis revealed four themes and eight subthemes in addition to a core-theme. The latent meaning of the themes “Feeling responsible”, “Trying to accommodate”, “Being challenged” and “Feeling significant” formed the core-theme: contradictions between nurses’ ideals of being professional and the reality faced in rural home nursing care with close social relationships. The findings in this study showed that the experiences of providing home nursing care in rural areas to oldest old persons were multifaceted and altering, as well as emotionally and socially contradictory.

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  • 9.
    Rönngren, Ylva
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Björk, Annette
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Audulv, Åsa
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Högskolan i Gävle; Center for Care Research, Steinkjer, Norway.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Haage, David
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Educational nurse-led lifestyle intervention for persons with mental illness.2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 3, p. 1022-1031Article in journal (Refereed)
    Abstract [en]

    Although persons with severe mental illness face an increased risk of mortality and of developing negative health outcomes, research has shown that lifestyle interventions can sufficiently support their health. In response, this study examined a nurse-led lifestyle intervention developed in cooperation with members of municipal and county councils to gauge its impact on the quality of life, cognitive performance, walking capacity, and body composition of persons with severe mental illness. Lasting 26 weeks and involving 38 persons with severe mental illness, the intervention prioritised two components: the interpersonal relationships of persons with severe mental illness, staff, and group leaders and group education about physical and mental health. Pre-post intervention measurements of quality of life collected with the Manchester Short Assessment of Quality of Life, cognitive performance with the Frontal Systems Behaviour Scale, walking capacity with a 6-min walk test, and body composition in terms of waist circumference and body mass index were analysed using a nonparametric test Wilcoxon signed-rank test. Results suggest that the intervention afforded significant improvements in the health-related variables of quality of life, cognitive performance, walking capacity, and waist circumference for persons with severe mental illness. However, long-term studies with control groups and that examine parameters related to cardiovascular risk factors are essential to ensure the sustained impact of the intervention.

  • 10.
    Rönngren, Ylva
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Björk, Annette
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Haage, David
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Univ Gävle; Mid Norway, Steinkjer, Norway.
    Audulv, Åsa
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Meeting the needs? Perceived support of a nurse-led lifestyle programme for young adults with mental illness in a primary health-care setting2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 1, p. 390-399Article in journal (Refereed)
    Abstract [en]

    Being a young adult with mental illness challenges all aspects of health, including an increased risk for developing lifestyle-related diseases. There is a lack of lifestyle programmes in primary health care that target physical, mental, and social needs for young adults with mental illness. The aim of the present study was to describe the experiences of young adults with mental illness receiving support from a nurse-led lifestyle programme, and how this support was related to their life context, including challenges and coping strategies. Two focus groups and six individual interviews were performed with 13 young adults (16–25 years), and analysed using a qualitative content analysis. The findings showed that the young adults experienced challenges in their daily lives, including psychiatric symptoms, lack of social understanding, and loneliness. The study indicated that the programme could support lifestyle habits with its components of supportive interpersonal relationships, awareness of coping strategies, understanding of health and illness, and cognitive support (e.g. schedules and reminders). However, the programme could not meet everyone's needs for new social relationships or more comprehensive support. Even so, this nurse-led programme provides health information-management strategies that could easily be integrated in a primary health-care setting.

  • 11.
    Voraroon, Supaporn
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Boromarajonani College of Nursing, Suphanburi, Thailand.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Meebunmak, Yaowaluck
    Boromarajonani College of Nursing, Ratchaburi, Thailand.
    Enmarker, Ingela
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Högskolan i Gävle; Centre for Care Research Mid-Norway, Steinkjer, Norway..
    Older People’s Lived Experiences with Participation in Shareholding Networks for the Care of Older People in Rural Areas of Thailand: A Phenomenological Hermeneutic Study2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 7, no 7, p. 875-892Article in journal (Refereed)
    Abstract [en]

    Background: Older people participating in shareholding networks are ex-posed to diverse situations, which may be associated with dignity. Aims: This study aimed to illuminate the meaning of lived experiences when participating in shareholding networks for the care of older people in rural areas. Methods: This qualitative study is based on individual interviews. Ten older Thai per-sons with at least 12 months of lived experiences participating in shareholding networks for older people in rural areas were interviewed. A phenomenologi-cal-hermeneutic approach, inspired by Ricoeur, was used to understand the meaning of the narrated text. Findings: The structural analysis resulted in four themes: 1) being satisfied with activities, 2) being valued as important, 3) being frustrated and feeling sad, and 4) being bored and feeling disinterest. The meaning of participation in a shareholding network for the elderly can be understood as a pathway to feelings of confidence and presence of others. Confidence and allowing the presence of others mean facing humanity and sensing vulnerability, because in a trusting relationship the person who gives confidence is susceptible to the other’s betrayal. Conclusion: An individual’s dignity should be a high priority in health and social care strategies. There-fore, it is important for healthcare professionals to initiate a dialogue with the shareholding participants for support and information. The narrations in this study can be used as a basis for developing cooperating care with older people in shareholding network focusing on their needs and dignity.

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  • 12.
    Voraroon, Supaporn
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Boromarajonani College of Nursing, Suphanburi, Thailand.
    Meebunmak, Yaowaluck
    Boromarajonani College of Nursing, Ratchaburi, Thailand.
    Enmarker, Ingela
    University of Gävle; Centre for Care Research Mid-Norway, Steinkjer, Norway.
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Shareholding Networks for Care in Rural Thailand: Experiences of Older Persons and Their Family Members2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 07, no 02, article id 74497Article in journal (Refereed)
    Abstract [en]

    Most  members  of  the  older  population  in  Thailand  live  in  rural  areas  while  their  children  live  in  cities.  With  the  joint  family  system  separated,  elderly  Thai persons often have to care for themselves, and opportunities for them to get  involved  in  community  care  remain  limited.  In  response,  the  aim  of  this  study  was  to  describe  olderpersons’  and  their  family  members’  experiences  with  shareholding  networks  for  the  care  of  older  people  in  rural  Thailand.  Paired  interviews  with  five  older  persons  and  five  of  their  family  members  were conducted, and collected data were subjected to content analysis, which yielded  results  organized  around  two  themes: older  persons’  outsider  status  and disregard for older persons’ individuality.Whereas the theme of outsider status  describes  shortcomings  in  healthcare  encounters,  the  theme  of  disre-gard for individuality describes the lack of engagement of authorities and ca-regivers  in  older  persons’  care.  In  that  sense,  the  concept of  participation  emerged  as  a  framework  for  understanding  interviewees’  experiences.  Given  findings  from  local  authorities,  older  individuals  and  theirfamily  members  should engage in dialogue in order to support healthcare based on shared un-derstanding.

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