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  • 1.
    Andersson, Ewa
    et al.
    Karolinska Institutet, Stockholm.
    Hildingsson, Ingegerd
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Uppsala University, Uppsala.
    Mother's postnatal stress: an investigation of links to various factors during pregnancy and post-partum2016Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 4, s. 782-789Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Higher levels of parental stress have long-term effects on children's health and could lead to dysfunction in the parent–child interaction. Different background factors can be predictors of high parental stress. Aim: The aim of this study was to examine parental stress among Swedish women and identify different factors linked to women's parental stress. Method: About 702 women were recruited to a clinical study and followed up six months after birth. Data were collected by two questionnaires, and 279 women completed the Swedish Parental Stress Questionnaire (SPSQ). Findings: Less than very good mental health and depressive symptoms after birth were strongly associated with parental stress, and the strongest association was found between post-partum depressive symptoms and high levels of stress in the subscale Incompetence. Multiparity was associated with high stress in two subscales, and lower level of education was a protective factor for stress in nearly all subscales. Conclusions: Depressive symptoms and perceived poor mental health post-partum are the most important factors related to high parental stress. The results point to the importance of identifying and supporting mothers with depressive symptoms, since these women have both mental illness and increased stress.

  • 2. Asplund, Kenneth
    et al.
    Norberg, Astrid
    Adolfsson, Rolf
    The Sucking Behaviour of Two Patients in the Final Stage of Dementia of the Alzheimer Type1991Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 5, nr 3, s. 141-147Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Two patients in the final stage of dementia of the Alzheimer type (DAT), who could no longer be given nutrition by assisted feeding, were given fluids by means of the sucking ability they still retained. They sucked more slowly under nutritive than under non-nutritive sucking conditions. The sucking efficiency of one of them improved during training. The status of the patients in the final stage of their dementia differed from one another, which might explain the difference in outcome. It is therefore suggested, that the use of the patients' sucking ability could serve as a complement and/or an alternative feeding technique when assisted spoon-feeding becomes extremely difficult or impossible. It is considered to be more gentle and natural than the present feeding techniques.

  • 3. Athlin, E
    et al.
    Norberg, Astrid
    Asplund, Kenneth
    Caregivers' perceptions and interpretations of severely demented patients during feeding in a task assignment system.1990Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 4, nr 4, s. 147-155Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Ninety-one focused interviews concerning the feeding of 23 severely demented patients were performed with 62 caregivers who fed the patients in a task assignment system. The aim was to increase the understanding about how caregivers perceive and interpret severely demented patients' behaviour and experiences during feeding. Content analysis showed that the caregivers' commitment or lack of commitment constituted a superior level that determined whether the patient was seen as a subject or as an object. Subcategories that were found were knowledge of the patient's disease and personal history, intuition, identification, empathy, generalisation and routinisation.

  • 4. Athlin, E
    et al.
    Norberg, Astrid
    Asplund, Kenneth
    Jansson, L
    Feeding problems in severely demented patients seen from task and relationship aspects1989Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 3, nr 3, s. 113-121Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study aimed at increasing the understanding of feeding problems in severely demented patients cared for in a task assignment system. Twenty-three video-recordings made during the feeding of 15 severely demented patients and 55 focused interviews with 45 caregivers, who fed the 15 patients during that period were analysed regarding the feeding problems seen from a task aspect and from a relationship aspect. The result indicated that the problems were partly of a more constant nature and partly fluctuated from meal to meal. Feeding problems regarding the task aspect were mentioned first by the caregivers in the interviews in spite of the fact that the patients had severe communication problems which could be expected to cause great problems in the relationship between the patient and his caregiver. Reasons for these findings are suggested.

     

  • 5. Berg, L
    et al.
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Patients' and nurses' experiences of the caring relationship in hospital: an aware striving for trust2007Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, nr 4, s. 500-506Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The phenomenon, caring relationship, has been widely studied in earlier research. Nevertheless, empirical studies in hospital, concerning patients and nurses experiences of the actual phenomenon caring relationship are rare. The aim was to illuminate patients with long-term illness and nurses' experiences of the caring relationship. The data were collected from 13 interviews, seven patients and six nurses, which were then analysed using an interpretive phenomenological method. This study shows patients' and nurses' view of the phenomenon. The findings concerning patients' view were identified in themes --'Maintaining dignity' with subthemes: using one's own competence and being cared for by the team as well as 'A feeling of vulnerability' with subthemes: being cared for in a strained situation and being exposed, inquiring personal caring relationship. The findings concerning nurses' view were identified in the following themes: 'A purposeful striving' with subthemes: using one's own competence and being aware of limitations as well as 'An arduous compassion' with subthemes: giving care in a strained situation and being aware of what is needed. These findings show that patients and nurses were aware in their striving for trust through forming a caring relationship. Their striving was not enough to result in trust. The findings in this study are understood as patients need a personal caring relationship which enables the possibility of trust.

     

  • 6.
    Bäckström, Britt
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Sundin, Karin
    Department of Nursing, Umeå University, Campus Örnsköldsvik..
    The experience of being a middle-aged close relative of aperson who has suffered a stroke – six months after discharge from a rehabilitation clinic2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 1, s. 116-124Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The experience of being a middle-aged close relative of a person who has suffered a stroke - six months after discharge from a rehabilitation clinicBeing a close relative brings with it a large number of consequences, with the life situation changing over time. The aim of this study was to illuminate the experiences of being a middle-aged close relative of a person who has suffered a stroke 6 months after being discharged from a medical rehabilitation clinic. Narrative interviews were conducted with nine middle-aged close relatives and analysed using a content analysis with a latent approach. The analysis revealed that being close to someone who had suffered a stroke 6 months after discharge meant; a struggling for control and a renewal of family life in the shadow of suffering and hope. The middle-aged close relatives began to perceive the changed reality. They were struggling to take on something new, become reconciled and find a balance in their family life. Their ability to work, relief from caring concerns and having support and togetherness with others seemed to be essential for the close relatives in their efforts to manage their life situation and maintain their well-being. Having reached the 'halfway point' in their lives and still with half of their life in front of them created worries. They felt dejected about their changed relationships and roles, experience a sense of loss of shared child responsibilities, a negative impact on their marital relationships and sexual satisfaction. They felt trapped in a caring role and they worried about how to endure in the future. The middle-aged close relatives' experiences were of being alone and neglected, in an arduous and complex life situation filled with loss and grief. The findings highlights that health professionals need to see and listen to the close relatives' experiences of transition in order to provide appropriate support adjusted to their varying needs during a time of renewal.

  • 7.
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Reflections about publications during doctoral education in health care sciences: Editorial2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 2, s. 209-210Artikkel i tidsskrift (Annet vitenskapelig)
  • 8. Edwall, Lise-Lotte
    et al.
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Öhrn, Ingbritt
    The meaning of a consultation with the diabetes nurse specialist2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 2, s. 341-348Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The meaning of a consultation with the diabetes nurse specialist Objective: The aim of this study was to elucidate the essential meaning of a consultation between diabetes nurse specialists and patients to gain a deeper understanding of the patients' experiences. Methods: Twenty patients with type 2 diabetes were interviewed about their experience of a consultation at an annual check-up with the diabetes nurse specialist. A phenomenological hermeneutic method was used in the analysis and interpretation of the text. Results: The patient's experience of a consultation was interpreted as manifestation of hold on the disease control. This means a safeguard to continue daily life shown in the four themes being controlled, feeling exposed, feeling comfortable, and feeling prepared. Conclusion: The patients' experiences of a consultation with the diabetes nurse specialist became the basis for a health maintenance process in dealing with critical health-disease aspects. Implications to practice: In a consultation, professionals have to take into account the potential emotional turbulence that disease progression can mean to a patient. Diabetes care implies patient dependence on support to avoid a potential self-management insufficiency and call attention to professionals' time for listening to patients' perceptions.

  • 9.
    Eriksson, Monica
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Hochwälder, Jacek
    Department of Public Health Sciences, Karolinska Institutet.
    Svedlund, Marianne
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Changes in hope and health-related quality of life in couples following acute myocardial infarction: A quantitative longitudinal study2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 2, s. 295-302Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:  Acute myocardial infarction (AMI) is a life-changing event that affects both the patient and the family and can have an influence on hope as well as HRQoL during the recovery period.

    Aims:  To compare self-rated scores of hope and health-related quality of life (HRQoL) 1, 7, 13 and 25 months, after an AMI with regard to (i) differences across time, and (ii) differences between patients and their partners.

    Design:  Explorative and longitudinal study.

    Methods:  In this nonrandomized study, Short Form 36 Health Questionnaire (SF-36) and Herth Hope Index-Swedish (HHI-S) questionnaires were completed by thirteen post-AMI patients and their partners. Data were collected on four occasions.

    Results:  In general, hope as well as HRQoL scores increased over time. A 2 (groups) × 4 (times) anova for mixed design showed significant changes in mental as well as in physical health over time but no significant effect of group on mental or physical health. Calculation of the minimum detectable change (MDC-index) for HHI-S and SF-36 revealed that scores between data collection points were not stable.

    Conclusion:  Our results show that although hope and HRQoL scores increased, only a few of the changes were statistically significant. Neither HHI-S nor SF-36 seems to measure stable states. Changes in hope and HRQoL levels may be due to participants striving to adapt to the current situation.

    Relevance to clinical practice:  These results can be used in the training of nursing staff to enhance their understanding of the significance of a family-centred approach after an AMI.

  • 10.
    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
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    A second chance at life: People's lived experiences of surviving out-of-hospital cardiac arrest2017Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, nr 4, s. 878-886Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 11.
    Hansen, Elisabeth
    et al.
    Department of Neuroscience, The Norwegian University of Science and Technology, Trondheim, Norway.
    Landstad, Bodil J
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Svebak, Sven
    Department of Neuroscience, The Norwegian University of Science and Technology, Trondheim, Norway.
    Motivation for lifestyle changes to improve health in people with impaired glucose tolerance2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 3, s. 484-490Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 12. Hedman Ahlström, Britt
    et al.
    Skarsäter, Ingela
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Living with major depression: experiences from families' perspectives2009Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, nr 2, s. 309-316Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe the ways of living with major depression in families. Seven families with an adult member who suffered major depression participated, in all 18 participants. Data were collected from seven narrative group interviews, one with each family. A qualitative thematic content analysis was used and the text was coded according to its content and further interpreted into themes. Findings consist of five themes: 'Being forced to relinquish control of everyday life'; during depression the family members lost their energy and could not manage everyday life. 'Uncertainty and instability are affecting life'; everyday life in the families was unstable and emotions influenced the atmosphere. 'Living on the edge of the community': the families periodically lived in seclusion. 'Everyday life becomes hard'; everyday life was demanding for everyone in the family and the responsibility shifted between family members. 'Despite everything a way out can be found'; the families as a unit as well as individually had their own ways of coping and finding some kind of satisfaction within the bounds of possibility. The families' experiences were demanding. Children were aware of their parent's depression and were involved in managing everyday life and emotionally affected by the situation. This legitimates the need for nurses and other healthcare professionals to have a family's perspective on the whole situation and to include partners as well as children and take their experiences seriously when supporting and guiding a family. It is important to develop strategies which in particular include children in the planning, provision and receiving of care as well as unburden them with the responsibility. It is also important to support the family in their own coping strategies with a major depressive episode.

  • 13. Hellzén, Maria
    et al.
    Lind, Ingbritt
    Dahl, Annika
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Psychiatric nurses attitudes towards identified in-patients as measured by the semantic differential technique2005Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 1, s. 12-19Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 14.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Nurses' personal statements about factors that influence their decisions about the time they spend with residents with long-term mental illness living in psychiatric group dwellings2004Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, nr 3, s. 257-263Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 15.
    Hellzén, Ove
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Sandman, Per-Olof
    Norberg, Astrid
    Umeå universitet.
    The meaning of caring as described by nurses caring for a person who acts provokingly:: an interview study2004Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, nr 1, s. 3-11Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 16.
    Häggström, Marie
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    To reduce technology prior discharge from intensive care –important but difficult?: A grounded theory2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 3, s. 506-515Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to provide a deeperunderstanding of the experience of intensive care staffregarding the reduction in the use of medical technologyprior to patients’ transfer from the ICU.Background: The goal of ICU transitional care, provided forintensive care patients before, during and after the transferfrom the ICU to another care unit, is to ensure minimaldisruption and optimal continuity of care for the patient.To smooth this transition, there is a need to prepare for aless technological environment and therefore also a needfor a gradual reduction in the use of monitoring equipment.Method: Group interviews and individual interviews, togetherwith participant observations, were conducted withICU staff in two hospitals in Sweden. The data wereanalysed using classic grounded theory.Results: The main concern was the ICU staff’s ambiguityregarding whether and how to reduce the use of medicaltechnology devices. Insecurity about weaning patientsfrom medical equipment combined with a lack of standardizedroutines made it difficult for staff to reduce thetechnical support. The core category describes how theambiguity was solved primarily by ’prioritizing control’.However, this often caused the ICU staff to use advancedtechnology while the patients were in the ICU until theward staff arrived, even if this should have been handledotherwise. Why and how the ICU staff used the strategy of’prioritizing control’ is further explained in the categories’being affected by cultural/contextual aspects’, ’searching forguidance and a shared understanding’ and ’weighing advantageswith more v s less technology’.Conclusion: It is important to consider ICU staff ambiguityconcerning the reduction in technology and to establishstrategies for a safe and structured transitional phase withstep-down procedures in which technology and monitoringis gradually reduced prior to transfer from ICU.

  • 17.
    Jong, Mats
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Lundqvist, Veronica
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Jong, Miek C
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Louis Bolk Institute Driebergen The Netherlands .
    A cross-sectional study on Swedish licensed nurses’ use, practice, perception and knowledge about Complementary and Alternative Medicine2015Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 4, s. 642-650Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Only a few and relatively outdated population studies with respect to CAM use among the general population in Sweden exists. Those who has been made indicates that CAM usage is relatively high where 30-39% reports lifetime use and 20% use the last year, with massage, Naprapathy and Chiropracy being most common. Nurses are often involved in direct patient care and hold a unique role where issues of CAM can be communicated, but little is known about them as a group on the topic of CAM.Objective: The objective of this cross-sectional study was to describe licensed nurses’ use, practice, attitudes and knowledge about CAM. Method: In a web based survey Licensed Nurses were invited for participation through two different approaches: firstly from the member register of Vårdförbundet (the Swedish Association of Health Professionals), and secondly via a general invitation to formal and informal nursing associations, web communities and workplaces. A total number of 960 nurses responded to the survey, 83% were female and the mean age of the respondents were 46 years (±10.8).Results: Among the respondents, 83.4% reported to have used at least one CAM method within the last two years. The most prevalently used methods are within the categories of massage and Dietary supplements/probiotics/herbal remedies and Mind-Body therapies. Fifteen percent of respondents are practicing some form of CAM method; 69% of those among family and friends, 25% in a private business, and 37% (n=52) within the public health care (mostly different form of massage and mind-body practices). Of the respondents, 11.7% express that they ask patients about CAM use, the most common reason 38% (n=366) not to is lack of knowledge about CAM (and their legal position with respect to CAM). A high proportion (66%) agrees that healthcare personnel should inform clients about CAM treatments when asked about it.Conclusion: Swedish nurses do to a very high extent use different CAM methods for themselves, and also practice it to some degree. In spite of this, due to lack of knowledge, they do not regularly ask or inform patients about CAM methods. From the results of the study we can see that nurses are in need of better training and education about CAM, both in order to be able to meet the needs of the patients, but also for reasons of safety since interactions exist between dietary supplements/probiotics/herbal remedies and conventional drugs.

  • 18.
    Junehag, Lena
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Svedlund, Marianne
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Perceptions of illness, lifestyle and support after an acute myocardial infarction2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 2, s. 289-296Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    After an acute myocardial infarction (AMI), people are encouraged to adopt a healthy lifestyle. But they are not always motivated to maintain the necessary lifestyle changes and need the right support to do it. In sparsely populated areas, people afflicted by an AMI have difficulty in finding standard rehabilitation programmes near their homes during the recovery, so they need alternative forms of support. The aim was to describe individual perceptions of their lifestyle and support, 1year after an AMI, with or without mentorship. This study has a qualitative, descriptive design with data collected in individual interviews. Twenty men and women were interviewed 1year after their first AMI, and 11 had been offered contact with mentors who had had an AMI. Content analysis was used to analyse the data. Those with and without mentors had similarities and tendencies to variation in their perceptions, with both a positive and negative view of life. The participants were aware of the necessity of living a healthy lifestyle but some resisted doing so. They wished to live as before, and all saw the future positively. Having a mentor with the same experience could be valuable for some people, but more research is needed to understand the lack of motivation to make beneficial lifestyle changes after a serious health event as AMI.

  • 19.
    Kristiansen, Lisbeth
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Hellzén, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Left alone - Swedish nurses' and mental health workers' experiences of being care providers in a social psychiatric dwelling context in the post-health-care-restructuring era. A focus-group interview study2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 3, s. 427-435Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The professional role of nurses and mental health workers in social psychiatry is being re-defined towards a recovery, client-focused perspective. Approximately 0.7 percent of the adult population in Sweden suffers from severe mental illness leading to a need for community services. The primary aims of the Mental Health Reform in 1995 in Sweden were to improve the quality of life for people with severe, long-term mental illness and, through normalization and integration, enhancing their opportunities to communicate with and participate in society. This study examines nurses' and mental health workers' views and experiences of being care providers in a municipal psychiatric group dwelling context when caring for clients suffering from severe mental illness. Three focus group interviews were made and thematic content analysis was conducted. Four themes were formulated: 'Being a general human factotum not unlike the role of parents', 'Having a complex and ambiguous view of clients', 'Working in a mainly 'strangled' situation', and 'Feeling overwhelming frustration'. The staff, for instance, experienced a heavy workload that highly involved themselves as persons and restricted organization. The individual relational aspects of the nursing role, the risk of instrumentalizing the staff due to an organizational economical teleopathy (meaning a pathological desire to react goals), and the high societal demands on accomplishing the Mental Health Reform goals are discussed. To redefine the professional role of nurses and mental health workers in the community, in Sweden known as municipality, they need support in the form of continuously education, supervision, and dialogue with politicians as well as the public in general.

  • 20.
    Kvamme, Brita Odland
    et al.
    Univ Hosp North Norway, Div Addict & Specialized Psychiat, N-9291 Tromso, Norway..
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Mid Sweden Univ, Dept Nursing Sci, Sundsvall, Sweden..
    Bjerke, Trond Nergaard
    Univ Hosp North Norway, Psychiat Res Ctr Northern Norway, N-9291 Tromso, Norway..
    Drinking resumption: problematic alcohol use relapse after rehabilitation. A phenomenological hermeneutical perspective2015Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 4, s. 716-723Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The majority of patients being treated for alcohol abuse disorders experience one or more relapses after treatment. The fact that people use this inebriant in a way leading to so much harm and suffering might seem a conundrum. Therapists, family and others might find the person's relapse to be dramatic and upsetting, and one might question whether the person has the sufficient will or motivation to change. However, few previous studies have explored relapse from the patient's perspective. The aim of this study was to illuminate the patient's lived experience of relapse and to develop a deeper understanding of this phenomenon. The study consisted of qualitative interviews using a phenomenological hermeneutical approach. Three main themes emerged from the analyses: 'craving', 'self-image' and 'time'. The findings were discussed in the context of phenomenological literature. Cravings could occur unpredictably; nevertheless, craving was a common experience for the patients and signified a risk of relapse. Bodily experiences of craving were frequently mentioned, and alcohol addiction could be understood as to be a disease or a learned habit. Self-image was, at times, adversely affected by relapse episodes. Therefore, feelings of shame, self-respect and recognition were significant concepts. This study found that the perception of time as past, present and future greatly influenced the participants' experiences of relapse and rehabilitation. Thus, relapse was an upsetting and dramatic experience that could cause great discomfort and sometimes life-threatening situations. However, relapse could also be viewed as a planned event. This study highlights important truth and reality about alcoholism and relapse grounded in people's lived experience.

  • 21. Lawoko, S
    et al.
    Soares, Joaquim JF
    Satisfaction with care: A study of parents of childrenwith congenital heart disease and parents of children with other diseases2004Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, nr 1, s. 90-102Artikkel i tidsskrift (Fagfellevurdert)
  • 22.
    Menckel, Ewa
    et al.
    National Institute for Working Life.
    Viitasara, Eija
    National Institute for Working Life and Karolinska Institutet.
    Threats and violence in Swedish care and welfare--magnitude of the problem and impact on municipal personnel.2002Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, nr 4, s. 376-85Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The problem of threats and violence at work has received increasing attention in Sweden in recent years. Exposure is especially high among health-care personnel in social services. A nationwide survey of prevalence, work environment and risk situations was conducted. A questionnaire was sent to a stratified sample of 2800 local government employees in the care and welfare sector, working mainly with the elderly or persons with developmental impairments. Seven occupational groups, including supervisors, specialists and other categories of carers, were included, and represented a population of more than 170 000 employees. The response rate was 85%. The results indicated that as many as 51% of the population had been affected by threats/violence, either verbally or physically, over the previous year. Moreover, the results suggest that over 9% of the employees in the care sector experienced acts of violence or threats on a daily basis, and several times a month by 67%. The most vulnerable groups were assistant nurses and direct carers. Verbal threats appear more common (79%), but 66% appear to have experienced physical assaults. Stratified estimates suggest that feelings of anger (41%) and helplessness (31%), but also minor physical injuries (18%), are frequent reactions. Organizational change in the workplace and high workload entailed increased risk. Threats and violence in health-care settings are a major work-environment issue. Greater knowledge of consequences for organization, work situation and health of personnel is needed.

  • 23.
    Ness, Tove M.
    et al.
    Nord University, Namsos, Norway.
    Söderberg, Siv
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad.
    Hellzèn, Ove
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för omvårdnad.
    ‘The same care providers over time who make individual adjustments and have competence’ Older South Sami People in Sweden's expectations of home nursing care2019Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study is part of a larger research project designed to examine the view of home nursing care from the perspective of older South Sami people in Sweden. In the present study, we present findings from the point of view of their expectations of home nursing care. The Sami are an indigenous population living in northern Sweden, Norway, Finland and the Kola Peninsula, and consist of different Sami people, of which the South Sami population is one. This population consists of approximately 2000 persons living in the central regions of Sweden and Norway. Fifty-six older South Sami people participated in the study. Semi-structured interviews were conducted over the telephone and were analysed using latent content analysis. The main findings show how older South Sami people's expectation for home nursing care contains the same care providers over time, individual adjustments and competent care providers and do not differ from the general Swedish population. Interpersonal interaction is a hallmark of nursing care and other healthcare disciplines. Ideally, interpersonal care is achieved when individual care providers have few care receivers, which promote continuity in care, individual adjustments based on the care receivers individual needs and care providers with professional and relational competence. 

  • 24. 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 study2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 2, s. 259-265Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 25.
    Norbergh, Karl-Gustaf
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Rasmussen, B.H.
    Nordahl, G.
    Sandman, Per-Olof
    How patients´ with dementia spend their time in a psycho-geriatric unit2001Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, nr 3, s. 215-221Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 26. Nygren Zotterman, A.
    et al.
    Skär, L.
    Olsson, M.
    Söderberg, Siv
    Luleå University of Technology.
    District nurses' views on quality of primary healthcare encounters2015Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 3, s. 418-425Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 27.
    Olsson, Helen
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Strand, Susanne
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för samhällsvetenskap.
    Kristiansen, Lisbeth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Reaching a turning point – how patients in forensic care describe trajectories of recovery2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 3, s. 505-514Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Sweden, the duration of treatment is increasing for patients admitted to forensic psychiatric care. To reduce the length of stay it is important for the forensic rehabilitation and recovery process to be effective and safe. Not much is known about how the process of recovery and transition begins and how it is described by the forensic patients. The purpose of this study was to explore how forensic patients with a history of high risk for violence experienced the turn towards recovery. A qualitative content analysis was used to analyze interviews with 10 patients who had decreased their assessed risk for violence on the risk assessment instrument HCR-20, and who were successfully managed a lower level of security. Three themes were identified: (1) the high risk phase; facing intense negative emotions and feelings (2) the turning point phase; reflecting on and approaching oneself and life in a new way (3) the recovery phase; recognizing, accepting and maturing. In the high risk phase chaotic and overwhelming feelings were experienced. The turning point phase was experienced as a sensitive stage and it was marked by being forced to find a new, constructive way of being. The recovery phase was characterized by recognizing personal circumstances in life, including accepting the need for structure, a feeling of maturity and a sense of responsibility for their own life. In order to ensure a successful recovery, the forensic nursing staff needs to recognize and support processes related to treatment motivation and turning points. Recommendations for best nursing practice are given accordingly.

  • 28.
    Paulson, Margareta
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Larsson, Kenneth
    Östersund. Reumatikersjukhuset.
    Norberg, Astrid
    Umeå universitet. Institutionen för omvårdnad.
    Men's descriptions of their experience of nonmalignant pain of fibromyalgia type2001Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, nr 1, s. 54-59Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to gather men's descriptions of their experience of nonmalignant pain of fibromyalgia (FM) type in order to to gain a deeper understanding of this phenomenon. Fourteen men participated in the study. A qualitative method with narrative interviews and content analysis were used. The findings showed that the men's experience of pain fell within two major themes: "perceptions of diversified bodily pain" and "perceptions of fluctuating pain". The pain had progressed from being local to being widespread. Characteristic was that the men described both pain that worried them and pain that did not worry them and also that the pain passed through both calm and difficult phases. This study highlights the importance of acknowledgement that men had specific experiences and used metaphorical expressions to make the pain visible. The clinical indication in this study is that health care staff need to listen intently to each man's experience of long-term pain that involve a great variety of both bodily and emotional symptoms. These findings are a crucial prerequisite for the health care staff's possibility to offer support and relief to men with pain of FM type.

  • 29.
    Rejnö, A.
    et al.
    Institute of Health and Care Sciences, University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden .
    Berg, L.
    Institute of Health and Care Sciences, University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden .
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Institute of Health and Care Sciences, University of Gothenburg, The Sahlgrenska Academy, Gothenburg, Sweden .
    The narrative structure as a way to gain insight into peoples' experiences: One methodological approach2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 3, s. 618-626Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The narrative method is used in healthcare research, mostly in data collection but also in the analysis. Narrative approaches draw attention to how people tell about and create meaning of experiences. The aim of the article was to examine the narrative structure, the elements in the structure and their function and how these can be used in research to gain insights into experiences. Examples are taken from a material of narratives from a study where next of kin were asked to narrate their experiences of sudden and unexpected death from stroke. The narratives had a clear beginning, midpoint and ending. In the beginning, orientation of the narrated events was given. The narrated events were told to have a turning point constituted of complicating actions that lead to a resolution that solved the narrated event. The narratives were built up by multiple recaps into the narrated events and also consisted of asides - side narratives and flashbacks - events back in time. Use of a narrative structure can contribute with valuable information that might be missed with other analysis. The analysis can be used on its own, as a complement to other narrative analysis or even as a complement to other qualitative analysis. © 2013 Nordic College of Caring Science.

  • 30.
    Rejnö, Åsa
    et al.
    The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Göteborg, Sweden.
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    von Post, Irene
    Åbo Academy University, Faculty of Caring Sciences, Vasa, Finland.
    The unexpected force of acute stroke leading to patients' sudden death as described by nurses2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 1, s. 123-130Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Stroke occurs suddenly and unexpectedly and its consequences can mean the difference between life and death. Research into stroke is extensive but largely focused on patients who survive. The aim of the study was to describe how nurses experience the patient's death and dying, when patients are afflicted by acute stroke and whose lives cannot be saved. The study had a descriptive design with a hermeneutical approach. Interviews were carried out with ten nurses in stroke units at three hospitals. Data were interpreted using hermeneutic textual interpretation based on Gadamer's philosophy. The study shows that sudden death, when unexpected forces intervene in the lives of patients afflicted by acute stroke, was described by the main theme sudden death - the unexpected force and the following three sub-themes: death comes unexpectedly and without warning to the patient; the relatives are at the mercy of the unexpected and the nurses find themselves in demanding situations. The new understanding emphasizes that the unexpected and demanding situations the nurses are put in can be understood as ethical dilemmas and value conflicts because they are not free to give their time to preserving the dying patient's dignity and are not able to give the good care they wish to. A more flexible organization could support the nurses in making use of the creative forces in the unexpected event which an acute stroke that leads to death constitutes.

  • 31. Skär, L.
    et al.
    Söderberg, Siv
    Luleå University of Technology.
    Complaints with encounters in healthcare - men's experiences2012Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, nr 2, s. 279-286Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Good encounters within healthcare are important for the manner in which ill people facilitate their health and their perception of quality of care. Research about quality of care are important, but point out that dissatisfaction with healthcare may in the future be even more common regarding the demands for a more effective healthcare. The aim of this study was therefore to describe experiences of dissatisfaction with encounters in healthcare among men who personally filed a complaint to the Patients' Advisory Committee in the county council. Qualitative data were collected in semi-structured interviews with a purposive sample of nine men who have filed a complaint to the Patients' Advisory Committee. The analysis resulted in two categories: being met with a disrespectful manner and not receiving a personal apology. The results in the first category describe that the men were treated with disrespect and suspicions by healthcare professionals. This was related to lack of communication which made the men sensitive to negative attitudes on the part of professionals. The results in the second category show that the men expected amends to be made in form of a personal apology about the dissatisfaction. The men were given no opportunities to influence the encounters and the professionals were unconscious of their behaviour in form of bad treatment. In conclusion, the results indicate the importance of meeting patients and their relatives with respect and dignity, listening to their experiences and proceeding with the treatment without insulting anyone as a person. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  • 32. Soares, Joaquim
    et al.
    Grossi, G
    Stockholm University.
    The Experience of Musculoskeletal Pain: A Comparison between Immigrant and Swedish Patients1999Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 13, nr 4, s. 254-266Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We explored differences regarding several psychosocial constructs (e.g. coping with pain) between immigrant (n = 140) and Swedish (n = 446) patients seeking treatment for pain at health and physiotherapy centres. A cross-sectional study design was used. The findings showed that, compared with Swedes, immigrants more often relied on benefits for their support and were more concerned with their financial situation. They also had longer periods of sick-leave. In addition, immigrants felt more disabled, reported more job strain and relied more on passive coping strategies for pain. Finally, they were more emotionally distressed, as they showed more symptoms of burnout, anxiety, depression and post-traumatic stress reactions, and lower self-confidence. Multivariate analyses performed separately for immigrant and Swedish patients showed differential patterns of associations between sociodemographic variables, financial strain, emotional distress, perceived disability, passive coping and job strain. We conclude that immigrant patients live under more strained psychosocial conditions and experience a deeper impact of pain than do their Swedish counterparts.

  • 33.
    Sundin, Karin
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Axelsson, K
    Jansson, L
    Norberg, Astrid
    Suffering from care as expressed in the narratives of former patients in somatic wards2000Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, nr 1, s. 16-22Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To illuminate patients' experiences of suffering from care, ten former patients in somatic wards narrated a desirable care episode (n = 39) and an undesirable care episode (n = 51). The interviews were analysed using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. Four themes were found: having a good rest, suffering through, searching for autonomy and being cared for by attentive and committed staff. The findings were interpreted in light of Eriksson's description of suffering, which describes three kinds of suffering: 'suffering of life', 'suffering of illness' and 'suffering of caring'. Although not mentioned explicitly, it was evident that cases of suffering from care were indicated in the patients' narratives. The themes were related to the patients' states of health, their experience of the care situation and their descriptions of themselves, and could be understood as related to the acts of the 'drama of suffering' described by Eriksson. The study highlights the need for the patient to find a co-actor in the drama of suffering in order to prevent suffering from care, i.e. prevent hindrance to the patient in her/his struggle against the 'suffering of illness' and the 'suffering of life'. The patients must be seen as the directors of their own dramas of suffering.

  • 34. Söderberg, Siv
    et al.
    Norberg, A.
    Metaphorical pain language among fibromyalgia patients1995Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 9, nr 1, s. 55-59Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Fourteen women with fibromyalgia described their pain experiences using words indicating a model of pain that presented pain as an aggressive physical deformation and a torture-like experience. Metaphorical expressions were used which was seen as a means for enabling the patients to disclose tacit knowledge. The pain experience was narrated as being steady and without any distinct bodily location. Only causes explaining the present aggravation of the pain and treatment leading to a temporary relief were related.

  • 35.
    Söderberg, Siv
    et al.
    Luleå University of Technology.
    Olsson, M.
    Skär, L.
    A hidden kind of suffering: Female patient's complaints to Patient's Advisory Committee2012Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, nr 1, s. 144-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe female patients' experiences of dissatisfaction with healthcare. People who have been treated with dignity during healthcare encounters are more prone to report better adherence to treatment and higher satisfaction with their care. Good quality care is commonly described as individualized and related to individual needs. This study has a qualitative approach, as the aim was to describe female patients' experiences of dissatisfaction with healthcare from a first person perspective. A purposive sample of fourteen women was interviewed about their experiences of dissatisfaction with healthcare. The interviews were subjected to a qualitative content analysis. The findings show that the women were treated with indifference when they were being withheld information, felt distrusted, and when they were treated badly they did not receive an apology. The findings also show that the women experienced that they did not feel safe when they had no one liable to turn to within the healthcare when the encounter did not correspond to the women's needs and expectations. The women's experiences of being withheld explanations can be seen as a violation of their dignity and a hidden suffering from care. In conclusion, the study shows the importance of receiving a personal explanation after filing a complaint about healthcare and recommends that clinics that receive a complaint from a patient should contact that patient and provide an individualized explanation. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  • 36.
    Thomas, Jan
    et al.
    Department of Sociology, Kenyon college, Gambier, USA.
    Bonér, Ann-Katrine
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Hildingsson, Ingegerd
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Fathering in the First Few Months2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 3, s. 499-509Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Fathering in the first few months Becoming a parent is a major event in life. Pregnancy is a time when both physical and emotional changes affect the lives of expectant parents as they prepare for parenthood. The aim of this study was to focus on fathers during and shortly after pregnancy. A prospective longitudinal study was conducted in all hospital prenatal clinics in the county council of Västernorrland, Sweden. Participating were 827 partners of women who had been pregnant and given birth during the period of June 2007 to June 2008. Data were collected using three questionnaires. Regression analysis showed that fathers who were most concerned about their new role were those that were university educated, first-time fathers, and those with financial worries. Support from the midwife or others close to the father did not impact fathers' thoughts about the difficulties of being a parent during pregnancy, but lack of support from the partners after the birth increased fathers' concern. This study suggests that more research is needed on fathers' own needs for support in parenting.

  • 37.
    Wennerberg, M M
    et al.
    Institute of Health and Care Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
    Eriksson, M
    Center on Salutogenesis Department of Health Sciences University West Trollhättan Sweden.
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Institute of Health and Care Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
    Lundgren, S M
    Institute of Health and Care Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
    Unravelling Swedish informal caregivers' Generalised Resistance Resources2016Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 3, s. 602-613Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Interlinked aspects, as demographic changes, accentuation on home-based community care, increase the amount of informal caregivers to older adults. To preserve and enhance their health are subsequently essential and a reoccurring topic on political agendas. How this may be achieved is vividly debated and mainly focused on elimination of risks and stresses associated with caregiving. Within health promotion, the salutogenic approach focusing on resources to health is recognised and this approach was used to acquire necessary knowledge to enhance caregivers' health ‘the salutogenic way’.

    Aim

    To present Generalised and Specific Resistance Resources (GRRs/SRRs) described by caregivers as stemming from themselves and their carerecipients.

    Methodology

    To unravel caregivers' GRRs/SRRs, a theory-driven, explorative design guided by definitions of GRRs/SRRs was utilised. Data were collected through salutogenically guided interviews with 32 Swedish caregivers in one municipality. Inductively, data were analysed using content analysis to identify each caregiver's SRRs and thereafter deduction to identify the population's GRRs.

    Findings

    The synthesis of findings, caregivinghood, encompasses several domains of GRRs seemingly involved in caregivers' movements towards health. In the caregiver domain, ‘Being someone significant in my own eyes’ unites the essence of having access to GRRs stemming from oneself and ‘Being “blessed” with a co-operative co-worker’ that of having access to GRRs stemming from the carerecipient. This may be the core in an orientation to life which creates positive life experiences, since it enables caregivers to find a ‘fit’ between the possible and desired when resolving challenges.

    Conclusion and implications

    Health-promoting initiatives should be conducted as partnerships between formal and informal sources due to the versatility of GRRs. It also seems essential to empower both parties so that they may make sense of their situation and use their available GRRs/SRRs in this ‘joint venture’ of managing. Thereby, their motivation to continue the journey through Caregivinghood may be enhanced.

  • 38.
    Wennerberg, Mia M.T.
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Eriksson, Monica
    Center on Salutogenesis, Department of Health Sciences, University West, Trollhättan.
    Lundgren, Solveig M.
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Unravelling Swedish informal caregivers' Generalised Resistance Deficits2018Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, nr 1, s. 186-196Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In salutogenic theory, individual/contextual, immaterial/material characteristics enabling movements towards health are labelled Specific and Generalised Resistance Resources, SRRs/GRRs, and characteristics counteracting such movements Specific and Generalised Resistance Deficits, SRDs/GRDs. The aim of this paper was to present SRDs and GRDs described by caregivers as stemming from themselves and their care recipient. Guided by salutogenic theory, an explorative design was used to collect data through interviews with 32 Swedish informal caregivers. During the theory-driven analysis, SRDs were unravelled using within-case approaches. To be able to unite them as GRDs across cases, a serviceable GRD definition was developed from the existing theoretical GRR definition. In findings, SRDs are visualised in citations and GRDs described in detail. Caregivers' experiences of SRDs/GRDs are presented as themes: 'Experiencing personal deficiencies', when stemming from themselves; and 'Struggling with an uncooperative co-worker', when stemming from their care recipients. Findings indicate that if these themes dominate a caregiver's view of life, she/he seems to have reached the 'breaking point' when caregiving ends due to lack of usable SRRs/GRRs. To prolong the time until this occurs, support, making otherwise unusable SRRs/GRRs usable, is needed. When designing this type of 'salutogenic' support, it seems essential to involve the target group (e.g. caregivers, care recipients), to ascertain what their SRRs/GRRs and SRDs/GRDs may consist of. Such knowledge regarding SRRs/SRDs could be used to design individualised support, and regarding GRRs/GRDs to design generalised support at group level. This study suggests how such new knowledge regarding resistance resources and deficits could be acquired.

  • 39.
    Östlund, U.
    et al.
    Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden .
    Bäckström, Britt
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Lindh, V.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Sundin, K.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Saveman, B. .-I.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Nurses' fidelity to theory-based core components when implementing Family Health Conversations - a qualitative inquiry2015Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 3, s. 582-590Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and aim: A family systems nursing intervention, Family Health Conversation, has been developed in Sweden by adapting the Calgary Family Assessment and Intervention Models and the Illness Beliefs Model. The intervention has several theoretical assumptions, and one way translate the theory into practice is to identify core components. This may produce higher levels of fidelity to the intervention. Besides information about how to implement an intervention in accordance to how it was developed, evaluating whether it was actually implemented as intended is important. Accordingly, we describe the nurses' fidelity to the identified core components of Family Health Conversation. Intervention and research methods: Six nurses, working in alternating pairs, conducted Family Health Conversations with seven families in which a family member younger than 65 had suffered a stroke. The intervention contained a series of three-1-hour conversations held at 2-3 week intervals. The nurses followed a conversation structure based on 12 core components identified from theoretical assumptions. The transcripts of the 21 conversations were analysed using manifest qualitative content analysis with a deductive approach. Results and conclusion: The 'core components' seemed to be useful even if nurses' fidelity varied among the core components. Some components were followed relatively well, but others were not. This indicates that the process for achieving fidelity to the intervention can be improved, and that it is necessary for nurses to continually learn theory and to practise family systems nursing. We suggest this can be accomplished through reflections, role play and training on the core components. Furthermore, as in this study, joint reflections on how the core components have been implemented can lead to deeper understanding and knowledge of how Family Health Conversation can be delivered as intended. © 2015 Nordic College of Caring Science.

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