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  • 1.
    Björklund, Margereth
    Kristianstad University, School of Health and Society.
    A health promotion perspective of living with head and neck cancer2012In: Head and neck cancer / [ed] Mark Agulnik, INTECH, 2012, p. 393-428Chapter in book (Other academic)
  • 2.
    Björklund, Margereth
    Kristianstad University, School of Health and Society.
    Health promotion and everyday living with head and neck cancer: a qualitative study2011Book (Other academic)
    Abstract [en]

    In society there is a growing awareness that a vital factor for patients with chronic diseases is how well they are able to function in their everyday lives. The aim was to reach a deeper understanding of living with head and neck cancer (HNC). Interviews were performed and critical incident technique, thematic and latent content, and interpretative descriptive analysis were used. Everyday living was expressed as living in captivity, in the sense that patients’ sometimes life-threatening symptoms were constant reminders of the disease. Patients struggled to find power and control from inner strength and other health resources, e.g. social networks, nature, hobbies, activity, and health professionals. Some patients were more vulnerable and felt lost and abandoned by health services, especially before and after treatment. A mutual working relationship during dialoguing and sensed co-operation and equality in encounters with competent health professionals could promote health and well-being. The findings highlight psychosocial rehabilitation in a patient-centred organisation when health professionals support patients’ inner strength and health resources.

  • 3.
    Björklund, Margereth
    Kristianstad University, School of Health and Society.
    Living with head and neck cancer: a health promotion perspective - a qualitative study2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background and aim: In society there is a growing awareness that a vital factor for patientswith chronic diseases, such as head and neck cancer (HNC), is how well they are able to function in their every day lives – a common, but often overlooked, public health issue. The overall aim of this thesis is to reach a deeper understanding of living with HNC and to identify the experiences that patients felt promoted their health and well-being. It also explores the patients' experiences of contact and care from health professionals and whether these encounters could increase their feelings of health and well-being; salutogenic approach.

    Methods: This thesis engages a qualitative data design. On three occasions, 35 purposivelyselected patients were interviewed (31 from Sweden and one from Denmark, Finland, Island, and Norway). The first study was conducted in the Nordic counties (I), and the remainingstudies were conducted in Sweden (II, III, IV). Interviews were performed on a single basis(I, II, III) and then repeated (IV). The individual, semi-structured qualitative interviews usedopen-ended questions (n=53). Three different forms of analyses were used: critical incident technique (I), thematic content analysis (II), latent content analysis (III), and interpretativedescriptive analysis (paper IV).

    Findings: Living with head and neck cancer was expressed as living in captivity, in the sensethat patients' sometimes life-threatening symptoms were constant reminders of the disease. The patients experienced a threat against identity and existence. Patients struggled to find power and control over everyday life, and if successful this appeared to offer them better health and well-being along with spiritual growth. The general understanding was that these patients had strong beliefs in the future despite living on a virtual rollercoaster. The patients went through a process of interplay of internal and external enabling that helped them acquire strength and feelings of better health and well-being. Consequently, they found power and control from inner strength and other health resources, e.g. social networks, nature, hobbies, activity, and health professionals. However, the findings also revealed the opposite; that some patients were more vulnerable and felt powerless and faced everyday life with emotional and existential loneliness. They were dependent on next of kin and health professionals. Having good interpersonal relationships and emotional support 24 hours a day from next of kin were crucial, as were health promoting contacts and care from health professionals. This health promoting contact and care built on working relationships with competent health professionals that were available, engaged, respectful, validating, and, above all experienced in the treatment phase. But many patients experienced not health promoting contact and care – and a sense of not being respected, or even believed. Added were the patients' experiences of inadequate coordination between phases of their lengthy illness trajectory. They felt lost and abandoned by health services, especially before and after treatment.

    Conclusions: Inner strength, good relationships with next of kin, nature, hobbies, andactivities could create strength and a sense of better health and well-being. Patients experienced a mutual working relationship during dialoguing and sensed co-operation and equality in encounters with competent health professionals. This could lead to enhanced power and control i.e. empowerment in a patient's everyday life. The findings highlight psychosocial rehabilitation in a patient-centred organisation when health professionals supportpatients' inner strength and health resources , and also offer long-term support to next of kin.Finally, this research suggests that if health professionals could gain a deeper understanding of the psychosocial, existential, social, and economic questions on patients' minds, they could better sense how patients feel and would be better equipped not only to offer greater support, but to raise their voices to improve health policy and health care for these patients. 

  • 4.
    Björklund, Margereth
    et al.
    Kristianstad University, School of Health and Society.
    Sarvimäki, Anneli
    The Nordic School of Public Health, Gothenburg.
    Berg, Agneta
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Health promotion and empowerment from the perspective of individuals living with head and neck cancer2008In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 12, no 1, p. 26-34Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to shed light on health promotion from the perspective of individuals living with head and neck cancer. Eight informants were interviewed and latent content analysis was used. Individuals living with head and neck cancer experienced many problems that had a negative impact on their health. One overarching main theme was demonstrated; the ability to regain control and empower oneself. Three themes emerged: (1) Being enabled by dialogue with one's inner self, including three sub-themes: transformed and improved self-esteem, recognising and embracing existentiality, and increased self-determination. (2) Being enabled by means of contact with a social network, including two sub-themes: emotional support and practical support. (3) Being enabled by means of contact with and a passion for the environment, including two sub-themes: nature, hobbies and activities. Empowerment, the goal of health promotion, was understood as an ongoing process, and the ability to promote health varied and was dependent on internal and external enabling of acting and doing. The interpretation of this ongoing process demonstrates interplay assisted by a dialogue with one's inner self, contact with a social network and a passion for the environment. Altogether, these findings may inspire nurses and other health care professionals to support the individual's empowerment process and pose non-pathology-oriented questions such as "what improves your health?" or "what makes you feel good?"

  • 5.
    Björklund, Margereth
    et al.
    Kristianstad University, School of Health and Society.
    Sarvimäki, Anneli
    The Nordic School of Public Health, Gothenburg.
    Berg, Agneta
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Living with head and neck cancer: a profile of captivity2010In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 2, no 1, p. 22-31Article in journal (Refereed)
    Abstract [en]

    Aim. To illuminate what it means to live with head and neck cancer.

    Background. Patients could experience head and neck cancer as more emotionally traumatic than other cancers because of visible disfigurement and its life-threatening impact on vital functions. This long-term illness often leads to lifestyle changes such as to physical function, work and everyday tasks, interpersonal relationships and social functioning.

    Design. This study used a qualitative and explorative longitudinal and prospective design with semi-structured interviews and open-ended questions. Twenty-one interviews were conducted with six participants with newly diagnosed or newly recurrent head and neck cancer. The analysis was descriptive and interpretive.

    Findings. The participants were living 'in captivity' in the sense that their symptoms were constant reminders of the disease. Our findings also revealed existential loneliness and spiritual growth, as interpreted within six themes: altered sense of affiliation; hostage of health care; locked up in a broken body, but with a free spirit; confined in a rogue body, forced dependency on others, and caught up in a permanent illness trajectory.

    Conclusions. Living with head and neck cancer involves emotional and existential vulnerability. The participants and their next of kin experienced insufficient support from health services and inadequate coordination between phases of their lengthy illness trajectory. These findings call for changes in oncological rehabilitation and management. Patient care must take a holistic view of everyone involved, centring on the individual and the promotion of health. A care coordinator could navigate between the individual patient needs and appropriate health services, hopefully with results that lessen the individual's emotional and existential confinement.

  • 6.
    Dimenäs, Jörgen
    et al.
    Institutionen för pedagogik, Högskolan i Borås.
    Björklund, Margereth
    Kristianstad University, School of Health and Society.
    Häggkvist, Kristin
    Högskolan i Borås.
    Larsson, Ingamay
    Högskolan i Borås.
    Malm, Annika
    Högskolan i Borås.
    Rundgren, Monica
    Högskolan i Borås.
    Welin Mod, Agneta
    Högskolan i Borås.
    Retorikens beprövande erfarenhet ur yrkesverksamma lärar- och sjuksköterskehandledares perspektiv2012In: Utbildning & Lärande, ISSN 2001-4554, Vol. 6, no 1, p. 98-116Article in journal (Refereed)
    Abstract [en]

    This study aims to investigate the concept of proven experience, which is being increasingly used and emphasised in documents relating to the education of student teachers and nurses as well as in the training of these two professions. The study is aimed at academic vocational training (AVT) and is based upon interviews with the tutors of student teachers and nurses during their periods of AVT. The purpose of this study is to understand what constitutes the essence of proven experience, arising from the verbal statements given by AVT tutors in the field. The conclusion of this study is that the concept of proven experience should be considered at three levels: experience, tested experience and proven experience. Furthermore, those who use it without further consideration should understand the complexity of the concept. From a critical perspective it seems that government agencies use a concept that we assume is more characterised by ideological rhetoric than by conceptual preciseness.

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