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  • 1.
    Beck, Ingela
    et al.
    Lund University.
    Törnquist, Agneta
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Nurse assistants’ experience of an intervention focused on a palliative care approach for older people in residential care2012In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, no 2, p. 140-150Article in journal (Refereed)
    Abstract [en]

    Background.  Nurse assistants working in residential care facilities need support to ensure that they provide high-quality care for the residents and support for relatives, from admission to bereavement.

    Aim.  The aim was to describe the nurse assistants’ experience of how an intervention with a palliative care approach, had influenced them in their work in residential care for older people.

    Participants.  Fourteen nurse assistants working in three different municipal residential care facilities.

    Methods.  Data were collected by means of semi-structured individual interviews following an intervention consisting of study circles combined with workshops. The data were analysed using content analysis.

    Result.  The nurse assistants felt that, through the intervention, they had gained insight into their understanding of the importance of quality of care. This included an increased awareness of, and respect for, residents’ and relatives’ needs, and an increased understanding of the importance of the outcome of encounters with residents and their relatives. After the intervention, they also felt there was increased openness and understanding between colleagues. However, the nurse assistants also expressed frustration over obstacles to implementing a palliative care approach, such as lack of resources and supportive leadership.

    Conclusion.  The nurse assistants felt that the intervention was positive and encouraged them to provide more person-centred care within the framework of a palliative care approach. Although the intervention was intended to involve and support the management, it was not sufficient. Nurse assistants described lack of resources and supportive leadership. There is, therefore, a need to place greater emphasis on leadership and their support of nurse assistants so that they can provide high-quality care.

    Implications for practice.  To support nurse assistants in the provision of care, clear leadership and opportunities to discuss and reflect on issues associated with care, including systematic improvement work in practice, appear to be essential to ensure high-quality care.

  • 2.
    Bolmsjö, Ingrid
    et al.
    Department of Care Science, Faculty of Health and Society, Malmö University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Andersson, Petra Lilja
    The Swedish Institute for Health Sciences, Lund University.
    The use of drama to support reflection and understanding of the residents' situation in dementia care: a pilot study2014In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, no 3, p. 183-191Article in journal (Refereed)
    Abstract [en]

    Background.  One key aspect of person-centredness is striving to understand both the patients' experiences and behaviours from their perspective. These aspects are precisely those that staff in dementia care highlight as causing them most difficulty because the people in their care have major problems expressing themselves. There is thus a need to develop a method to help the staff to achieve interpretation through reflection.

    Aim.  The aim of this study was to explore the use of drama as a tool to support reflection among staff working in the residential care of people with dementia.

    Design.  A qualitative evaluation of a programme consisting of three drama sessions with staff working in residential care (n = 10 nurse assistants).

    Methods.  Data comprised observations and tape recordings of the sessions, the researchers' reflections after each session and a focus-group interview with the participants. The texts were analysed using qualitative content analysis.

    Results.  The analysis showed that: (i) the exercises stimulate reflection about daily caring practice; (ii) the participants must receive extensive information about the purpose of the sessions; (iii) the research team must secure the defined frames and conditions and have practical knowledge about caring for people with dementia and (iv) the management needs to be stable, committed and supportive.

    Conclusion.  Drama seems to be a valid tool to aid reflection, but several adjustments are needed concerning both the content of the sessions and the methodology. When designing a larger intervention study, it would be preferable to the sessions to be combined with staff support to effect changes in care provision resulting from their increased awareness of the residents' situation and experience.

    Implications for practice.  Our results showed that drama can be a means to enhance reflection among staff in residential care for people with dementia. Further research is however needed concerning the effects for the staff's situation and nursing care quality.

  • 3.
    Hovde, Boel
    et al.
    Lunds universitet.
    Hallberg, Ingalill R.
    Lunds universitet.
    Edberg, Anna-Karin
    Department of Health Sciences, Faculty of Medicine, Lund University.
    Older immigrants' experiences of their life situation in the context of receiving public care in Sweden2008In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, no 2, p. 104-112Article in journal (Refereed)
    Abstract [en]

    Objectives.  The aim of this study was to illuminate older immigrants' experience of their life situation in the context of receiving public care in Sweden. Background.  To meet the varying needs from the growing number of older immigrants, more knowledge about the experience of their life situation, health, illness and family ties is needed, especially in the context of receiving public health care and service. Methods.  Data were collected through interviews with sixteen immigrants aged 65 years and older, originally from nine different countries, living in Southern Sweden and receiving continuous care and service. The texts were analysed using qualitative content analysis. Results.  The overall impression from the texts was that the informants expressed a debt of gratitude to Swedish society. Their experience could be understood as - being burdened with health complaints; experiencing painful losses; wanting to manage by oneself and feeling exposed and deserted. Conclusions.  The results show that older immigrants are vulnerable when receiving public care. This was related to previous life events, cultural differences as well as communication difficulties. When planning for and providing care for older immigrants, it is important to be aware of their exposed situation and to acknowledge their life history and family context.

  • 4.
    Petersson, Pia
    et al.
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Blomqvist, Kerstin
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Sense of security: searching for its meaning by using stories: a participatory action research study in health and social care in Sweden2011In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 6, no 1, p. 25-32Article in journal (Refereed)
    Abstract [en]

    Background. In Sweden, attempts to implement core values to ensure high quality health and social care for older people are given high priority and concepts such as security and dignity are often used. As concepts are abstract they are difficult to transform into practical work. 

    Aim: The aim of this study was to make sense of the Swedish concept ‘trygghet’ by using stories from daily life in a participatory action research project. Design: One group of six assistant nurses and one group of five registered nurses working in municipality participated in Story Dialogue Method and four older women were interviewed. Result: ‘Trygghet’ was found to be an internal sense – an intrinsic state based on faith and trust in oneself and others called security were situations Sense of security. External factors that strengthened Sense ofto be part of a community, to recognise and be familiar with things andand to use various kinds of aids. Conlusion and Relevance to Clinical Practice: A prerequisite for the professionals being able to support the care receivers adequately is that they have a sense of security themselves, and that they are allowed to operate in a system that facilitates for the care receivers to maintain trustworthy and reliable relations over time.

  • 5.
    Sjöberg, Marina
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Rasmussen, Birgit H
    Malmö universitet.
    Beck, Ingela
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Being acknowledged by others and bracketing negative thoughts and feelings: frail older people's narrations of how existential loneliness is eased.2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 14, no 1Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of this study was to describe how EL was eased, as narrated by frail older people.

    BACKGROUND: Existential loneliness (EL) is an unavoidable part of the human condition. It is a complex phenomenon that has been described as disconnection from life. If EL is acknowledged in the care of older people, the experience of EL can be reduced.

    DESIGN: In this qualitative study, we used an exploratory and descriptive design.

    METHODS: The study was based on 22 narrative interviews with frail older people, 76 to 101 years old, who were receiving long-term care and services. We analysed the data using conventional content analysis.

    RESULTS: Being acknowledged by others, that is, being the focus of others' concern, eased the experience of EL, as did encountering intimacy and having meaningful exchanges of thoughts and feelings. Further, EL was pushed into the background and eased when participants could bracket negative thoughts and feelings, that is, when they could adjust and accept the present situation, view life in the rear-view mirror, be in contact with spiritual dimensions and withdraw and distract themselves.

    CONCLUSION: Existential loneliness can be eased by experiencing meaningful togetherness with others and oneself when something else comes to the forefront, pushing EL to the background. Frail older peoples' opportunities to ease EL may be facilitated by health care staff (HCS) providing person-centred care and create possibilities for solitary time and meaningful togetherness.

    IMPLICATIONS FOR PRACTICE: If frail older people's ongoing processes of adjusting and accepting their situation are understood and confirmed by people in their environment, for example, by nurses, family and friends, the experience of living a meaningful life can be supported, which, in turn, can ease EL.

  • 6.
    Sundström, Malin
    et al.
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Rämgård, Margareta
    Malmö Universitet.
    The context of care matters: older people’s existential loneliness from the perspective of healthcare professionals: a multiple case study2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 14, no 3Article in journal (Refereed)
    Abstract [en]

    AIM:

    To explore existential loneliness among older people in different healthcare contexts from the perspective of healthcare professionals.

    BACKGROUND:

    Professionals meet and care for older people in most care contexts and need to be prepared to address physical, psychological, social and existential needs. Addressing existential loneliness can be both challenging and meaningful for professionals and is often not prioritised in times of austerity.

    DESIGN:

    A multiple case study design was used.

    METHODS:

    Focus group interviews were conducted with healthcare professionals (n = 52) in home, residential, hospital and palliative care settings. The analysis was performed in two steps: firstly, a within-case analysis of each context was conducted, followed by a cross-case analysis.

    FINDINGS:

    Differences and similarities were observed among the care contexts, including for the origin of existential loneliness. In home care and residential care, the focus was on life, the present and the past, compared to hospital and palliative care, in which existential loneliness mainly related to the forthcoming death. The older person's home, as the place where home care or palliative care was received, helped preserve the older person's identity. In hospital and palliative care, as in institutional care, the place offered security, while in residential care, the place could make older people feel like strangers. Creating relationships was considered an important part of the professionals' role in all four care contexts, although this had different meanings, purposes and conditions.

    CONCLUSIONS:

    The context of care matters and influences how professionals view existential loneliness among older people and the opportunities they have to address existential loneliness.

    IMPLICATIONS FOR PRACTICE:

    Support for professionals must be tailored to their needs, their education levels and the context of care. Professionals need training and appropriate qualifications to address existential loneliness related to existential aspects of ageing and care.

  • 7.
    Wijesiri, H S Maliga S K
    et al.
    Sri Lanka.
    Samarasinghe, Kerstin
    Kristianstad University, Faculty of Health Science.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Loneliness among older people living in care homes in Sri Lanka2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743Article in journal (Refereed)
    Abstract [en]

    AIM AND OBJECTIVES: The aim of this study was to explore loneliness in older people (aged 65+) living in care homes in Colombo, Sri Lanka.

    BACKGROUND: Loneliness, defined as the subjective, unwelcome feeling of the lack or loss of companionship, is known to be associated with old age, especially among older people living in care homes. Although several studies have shown that loneliness is highly prevalent, we lack knowledge about older people's personal experience of loneliness when residing in a care home and the strategies that older people use by themselves on a day-to-day basis to alleviate loneliness.

    METHODS: The participants (n = 75) were randomly selected from three different types of care homes: governmental, non-governmental and private, and loneliness was screened using the Revised University of California-Los Angeles (R-UCLA) Loneliness Scale. The 15 participants with the highest score on the loneliness scale were purposively selected for individual interviews.

    RESULTS: The median loneliness score was 45 (range 20-80); no significant differences concerning loneliness were found between the care homes. No differences concerning loneliness were found for any demographic variable except marital status. Loneliness was experienced as coping with inner pain, which older people described as emotional suffering caused by feeling abandoned from the family network and fettered to the care home, anxious about their future and depressed. Participants managed their loneliness by accepting their loneliness, practising religion, staying in touch with family, engaging in daily activities and participating in social activities.

    CONCLUSION: Reliable and socio-culturally validated tools for screening loneliness and culturally applicable interventions targeting factors associated with loneliness are necessary in the care of older people residing in care homes. A person-centred approach involving family or significant others is recommended in clinical practice, and an increase in the number of nurses with specialist education in geriatric nursing seems urgent.

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