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  • 1.
    Clausson, Eva K.
    et al.
    Kristianstad University, Department of Health Sciences.
    Köhler, Lennart
    Nordic School of Public Health, Göteborg.
    Berg, Agneta
    Kristianstad University, Department of Health Sciences.
    Ethical challenges for school nurses in documenting schoolchildren's health2008In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 15, no 1, p. 40-51Article in journal (Refereed)
    Abstract [en]

    This study explored Swedish school nurses' experiences of school health record documentation. Fifty per cent of a representative sample of Swedish school nurses (n = 129) reported difficulties with documenting mental and social health problems in family relationships, schoolchildren's behaviour, and school situations. Ethical considerations concerning fears of misinterpretation and practical barriers to documentation were expressed as reasons for their worries. Mental and social ill health is an increasing and often dominating problem among schoolchildren, thus proper documentation is a basic issue, both for individuals and for the population as a whole. School nurses obviously need professional guidance regarding documentation and ethical challenges. Systematic effort should be directed towards recognition and support of these nurses' unique opportunities to consider, follow and promote all aspects of schoolchildren's health.

  • 2.
    Khalaf, Atika
    et al.
    University Hospital, Malmö.
    Berggren, Vanja
    Kristianstad University, School of Health and Society.
    Westergren, Albert
    Kristianstad University, School of Health and Society.
    Caring for undernourished patients in an orthopaedic setting2009In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 16, no 1, p. 5-18Article in journal (Refereed)
    Abstract [en]

    This study elucidates the nursing of undernourished patients as experienced by eight registered clinical nurses and five nursing assistants by using content analysis. The participants' narratives describe the inner perspective of caring for undernourished patients, known in Sweden as `the thin ones'. Categories identified were: frustration in nursing, joy in nursing and that undernourishment is taboo. The taboo was narrated as feelings of guilt and shame. Frustration in nursing could be seen as feeling stressed, exposed, lonely, powerless, helpless, and being torn between demands and needs. Joy in nursing was experienced when creating a trusting relationship, promoting pleasure in the meal situation and working with respect for each individual's life-style and context of life. Understanding staff members' views is important when implementing guidelines as well as in the teaching situation in order to identify where staff stand with regard to knowledge and attitudes.

  • 3.
    Larsson, Helena
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health. Malmö University.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Bolmsjö, Ingrid
    Malmö University.
    Rämgård, Margareta
    Malmö University.
    Contrasts in older persons' experiences and significant others' perceptions of existential loneliness2018In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As frail older people might have difficulties in expressing themselves, their needs are often interpreted by others, for example, by significant others, whose information health care staff often have to rely on. This, in turn, can put health care staff in ethically difficult situations, where they have to choose between alternative courses of action. One aspect that might be especially difficult to express is that of existential loneliness. We have only sparse knowledge about whether, and in what way, the views of frail older persons and their significant others concerning existential loneliness are in concordance.

    OBJECTIVE: To contrast frail older (>75) persons' experiences with their significant others' perceptions of existential loneliness.

    METHODS: A case study design was chosen for this study. Individual interviews with frail older persons (n = 15) and interviews with their significant others (n = 19), as well as field notes, served as a basis for the study. A thematic analysis was used to interpret data. Ethical considerations: This study was conducted in accordance with the principles of research ethics.

    FINDINGS: The findings showed three themes: (1) Meaningless waiting in contrast to lack of activities, (2) Longing for a deeper connectedness in contrast to not participating in a social environment and (3) Restricted freedom in contrast to given up on life.

    DISCUSSION: Knowledge about the tensions between older persons' and their significant others' views of existential loneliness could be of use as a basis for ethical reflections on the care of older people and in the encounter with their significant others.

    CONCLUSION: It is of importance that health care professionals listen to both the frail older person and their significant other(s) and be aware of whose voice that the care given is based on, in order to provide care that is beneficial and not to the detriment of the older person.

  • 4.
    Lilja Andersson, Petra
    et al.
    Lund University.
    Juth, Niklas
    Karolinska Institute.
    Petersén, Åsa
    Lund University.
    Graff, Caroline
    Karolinska Institute.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Ethical aspects of undergoing a predictive genetic testing for Huntington’s disease2013In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 20, no 2, p. 189-199Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the experiences of undergoing a presymptomatic genetic test for the hereditary and fatal Huntington’s disease, using a case study approach. The study was based on 18 interviews with a young woman and her husband from the decision to undergo the test, to receiving the results and trying to adapt to them, which were analysed using a life history approach. The findings show that the process of undergoing a presymptomatic test involves several closely connected ethical and medical questions, such as the reason for the test, the consequences of the test results and how health-care services can be developed to support people in this situation.

  • 5.
    Lilja Andersson, Petra
    et al.
    Lund University.
    Petersén, Åsa
    Lund University.
    Graff, Caroline
    Karolinska Institutet, Stockholm.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Ethical aspects of a predictive test for Huntington’s Disease: a long term perspective2016In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 23, no 5, p. 565-575Article in journal (Refereed)
    Abstract [en]

    Background: A predictive genetic test for Huntington’s disease can be used before any symptoms are apparent, but there is only sparse knowledge about the long-term consequences of a positive test result. Such knowledge is important in order to gain a deeper understanding of families’ experiences.

    Objectives: The aim of the study was to describe a young couple’s long-term experiences and the consequences of a predictive test for Huntington’s disease.

    Research design: A descriptive case study design was used with a longitudinal narrative life history approach.

    Participants and research context: The study was based on 18 interviews with a young couple, covering a period of 2.5 years; starting 6 months after the disclosure of the test results showing the woman to be a carrier of the gene causing Huntington’s disease.

    Ethical considerations: Even though the study was extremely sensitive, where potential harm constantly had to be balanced against the benefits, the couple had a strong wish to contribute to increased knowledge about people in their situation. The study was approved by the ethics committee.

    Findings: The results show that the long-term consequences were devastating for the family. This 3-year period was characterized by anxiety, repeated suicide attempts, financial difficulties and eventually divorce.

    Discussion: By offering a predictive test, the healthcare system has an ethical and moral responsibility. Once the test result is disclosed, the individual and the family cannot live without the knowledge it brings. Support is needed in a long-term perspective and should involve counselling concerning the families’ everyday life involving important decision-making, reorientation towards a new outlook of the future and the meaning of life.

    Conclusion: As health professionals, our ethical and moral responsibility thus embraces not only the phase in direct connection to the actual genetic test but also a commitment to provide support to help the family deal with the long-term consequences of the test.

  • 6.
    Lindh, Inga-Britt
    et al.
    Kristianstad University, School of Health and Society.
    Barbosa da Silva, Antonio
    Ansgar College and Theological Seminary, Norway.
    Berg, Agneta
    Kristianstad University, School of Health and Society.
    Severinsson, Elisabeth
    Vestfold University College, Norway.
    Courage and nursing practice: a theoretical analysis2010In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 17, no 5, p. 551-565Article in journal (Refereed)
    Abstract [en]

    This article aims to deepen the understanding of courage through a theoretical analysis of classical philosophers’ work and a review of published and unpublished empirical research on courage in nursing. The authors sought answers to questions regarding how courage is understood from a philosophical viewpoint and how it is expressed in nursing actions. Four aspects were identified as relevant to a deeper understanding of courage in nursing practice: courage as an ontological concept, a moral virtue, a property of an ethical act, and a creative capacity. The literature review shed light on the complexity of the concept of courage and revealed some lack of clarity in its use. Consequently, if courage is to be used consciously to influence nurses’ ethical actions it seems important to recognize its specific features. The results suggest it is imperative to foster courage among nurses and student nurses to prepare them for ethical, creative action and further the development of professional nursing practices.

  • 7.
    Lindh, Inga-Britt
    et al.
    Kristianstad University, Department of Health Sciences.
    Severinsson, Elisabeth
    University of Stavanger.
    Berg, Agneta
    Kristianstad University, Department of Health Sciences.
    Moral responsibility: a relational way of being2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 2, p. 129-140Article in journal (Refereed)
    Abstract [en]

    This article reports a study exploring the meaning of the complex phenomenon of moral responsibility in nursing practice. Each of three focus groups with a total of 14 student nurses were conducted twice to gather their views on moral responsibility in nursing practice. The data were analysed by qualitative thematic content analysis. Moral responsibility was interpreted as a relational way of being, which involved guidance by one's inner compass composed of ideals, values and knowledge that translate into a striving to do good. It was concluded that, if student nurses are to continue striving to do good in a way that respects themselves and other people, it is important that they do not feel forced to compromise their values. Instead they should be given space and encouragement in their endeavours to do good in a relational way that advances nursing as a moral practice.

  • 8.
    Sandman, Lars
    et al.
    University College of Borås.
    Agren Bolmsjö, Ingrid
    Lund University.
    Westergren, Albert
    Kristianstad University College, School of Health and Society.
    Ethical considerations of refusing nutrition after stroke2008In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 15, no 2, p. 147-59Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to analyse and discuss the ethically problematic conflict raised by patients with stroke who refuse nutritional treatment. In analysing this conflict, the focus is on four different aspects: (1) Is nutritional treatment biologically necessary? (2) If necessary, is the reason for refusal a functional disability, lack of appetite or motivation, misunderstanding of the situation or a genuine conflict of values? (3) If the latter, what values are involved in the conflict? (4) How should we deal with the different kinds of refusal of nutritional treatment? We argue that patients' autonomy should be respected as far as possible, while also considering that those who have suffered a stroke might re-evaluate their life as a result of a beneficial prognosis. However, if patients persist with their refusal, health care professionals should force nutritional treatment only when it is clear that the patients will re-evaluate their future life.

  • 9.
    Werntoft, Elisabet
    et al.
    Lund University.
    Hallberg, Ingalill R.
    Lund University.
    Edberg, Anna-Karin
    Lund University.
    Older people's reasoning about age-related prioritization in health care2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 3, p. 399-412Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the reasoning of people aged 60 years and over about prioritization in health care with regard to age and willingness to pay. Healthy people (n = 300) and people receiving continuous care and services (n = 146) who were between 60 and 101 years old were interviewed about their views on prioritization in health care. The transcribed interviews were analysed using manifest and latent qualitative content analysis. The participants' reasoning on prioritization embraced eight categories: feeling secure and confident in the health care system; being old means low priority; prioritization causes worries; using underhand means in order to be prioritized; prioritization as a necessity; being averse to anyone having precedence over others; having doubts about the distribution of resources; and buying treatment requires wealth.

  • 10.
    Ågren Bolmsjö, Ingrid
    et al.
    Vårdalsinstitutet.
    Edberg, Anna-Karin
    Vårdalsinstitutet.
    Sandman, Lars
    Högskolan i Borås.
    Everyday ethical problems in dementia care: a teleological model.2006In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 4, p. 340-359Article in journal (Refereed)
    Abstract [en]

    In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and nurses' ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses' everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care.

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