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  • 1.
    Andersson, Bodil T.
    et al.
    Department of Health Sciences, Lund University.
    Fridlund, Bengt
    The School of Health Sciences and Social Work, Växjö University.
    Elgán, Carina
    Faculty of Health and Society, Malmö University.
    Axelsson, Åsa B.
    Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University.
    Radiographers' areas of professional competence related to good nursing care2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, p. 401-409Article in journal (Refereed)
    Abstract [en]

    Background: Radiographers’ ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer’s work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession.

    Aim: The aim was to describe the radiographer’s areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions.

    Method: A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden.

    Ethical issues: The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives.

    Results: The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers’ skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient’s immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient.

    Conclusions: The study highlights the different areas of the radiographer’s unique professional competence. The findings provide insight into the radiographer’s profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer’s work encompasses a variety of components – from caring for the patient to handling and checking the technical equipment.

  • 2.
    Andersson, Pia
    et al.
    Kristianstad University, Department of Health Sciences.
    Westergren, Albert
    Department of Nursing, Medical Faculty, Lund University.
    Karlsson, Siv
    North-east Skåne Health Care District, Central Hospital, Kristianstad.
    Rahm Hallberg, Ingalill
    Department of Nursing, Medical Faculty, Lund University.
    Renvert, Stefan
    Kristianstad University, Department of Health Sciences.
    Oral health and nutritional status in a group of geriatric rehabilitation patients2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 3, p. 311-318Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to evaluate the oral health status and nutritional status in a group of geriatric rehabilitation patients, and to analyse the relationship between these two parameters. Nurses at the ward performed structured assessments of oral and nutritional status using the Revised Oral Assessment Guide and the Subjective Global Assessment form in 223 newly admitted patients. Most oral health problems were found among patients who stayed longer at the hospital and were more dependent on help as compared with the healthier patients. Thirty-four per cent of the patients were either severely undernourished, at risk or suspected to be undernourished (UN). Oral health problems were more common among UN patients (p < 0.0005) compared with well-nourished patients. The most frequent oral health problem was found on teeth or dentures (48%). Problems related to the tongue and lips were also common among UN patients (56 and 44%, respectively). Oral health status was correlated (r = 0.32) to nutritional status. Problems with swallowing had the strongest association to the nutritional status (OR 6.05; 95% CI 2.41-15.18). This study demonstrated that poor oral health status was related to undernourishment.

  • 3.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health.
    Jakobsson, Ulf
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Applying a palliative care approach in residential care: effects on nurse assistants' experiences of care provision and caring climate2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, p. 830-841Article in journal (Refereed)
    Abstract [en]

    Background

    A palliative care approach aims to integrate psychosocial and existential as well as relationship aspects in the care and is an approach that can be used in residential care. Nurse assistants are the ones who are closest to the residents but have limited prerequisites for working in accordance with the palliative care approach. We aimed to investigate the effects on nurse assistants' experiences of care provision and the caring climate of an intervention applying a palliative care approach in residential care.

    Methods

    An intervention involving nurse assistants (n = 75) and their leaders (n = 9), in comparison with controls (n = 110), was evaluated using a questionnaire at three points in time.

    Results

    In the intervention group, positive effects were seen concerning the nurse assistants' reports of the care provision in that they focused more on the residents' stories about their lives and on communicating with the residents about what gave meaning to their lives. Also, negative effects were seen when the nurse assistants rated that the residents' needs for medical and nursing care had not been met at the facility directly after the intervention. No effects were seen concerning the caring climate or the prerequisites of providing more person-centred care.

    Conclusion

    The intervention seemed to have encouraged the nurse assistants to focus on relationship aspects with the residents. So as not to jeopardise the NAs' well-being and to support NAs in keeping themselves involved in existential issues, their support most certainly needs to be continuous and ongoing. However, in spite of the leaders' involvement, the intervention was not sufficient for changing the organisational prerequisites for more person-centred care.

  • 4.
    Behm, Lina
    et al.
    Lund University.
    Björkman, Eva
    Lund University.
    Ahlström, Gerd
    Lund University.
    Mental health and reactions to caregiving among next of kin of older people (65+) with multi-morbidity discharged home after hospitalization2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 4, p. 1458-1467Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Older people with multi-morbidity are major users of healthcare and are often discharged from hospital with ongoing care needs. This care is frequently provided by informal caregivers and the time immediately after discharge is challenging for caregivers with new and/or additional tasks, resulting in anxiety and stress.

    AIM: This study aimed to describe mental health, with particular reference to anxiety and depression and reactions to caregiving, and to investigate any associations between the two, in next of kin of older people with multi-morbidity after hospitalisation. It also aimed to explore the association between the demographic characteristics of the study group and mental health and reactions to caregiving.

    METHODS: This was a cross-sectional questionnaire study using the Hospital Anxiety and Depression Scale and the Caregiver Reaction Assessment. The study group consisted of 345 next of kin of older people (65+) with multi-morbidity discharged home from 13 medical wards in Sweden. Data were analysed using descriptive and analytical statistics. To identify whether reactions to caregiving and next of kin characteristics were associated with anxiety and depression, a univariate logistic regression analysis was performed.

    RESULTS: More than one quarter of respondents showed severe anxiety and nearly one in 10 had severe depressive symptoms. The frequencies of anxiety and depression increased significantly with increased negative reactions to caregiving and decreased significantly with positive reactions to caregiving. Regarding caregiving reactions, the scores were highest for the positive domain Caregiver esteem, followed by the negative domain Impact on health. Women scored significantly higher than men on Impact on health and spouses scored highest for Impact on schedule and Caregiver esteem.

    CONCLUSIONS: Nurses and other healthcare professionals may need to provide additional support to informal caregivers before and after discharging older people with significant care needs from hospital. This might include person-centred information, education and training.

  • 5. Bengtsson Tops, Anita
    et al.
    Brunt, David
    Rask, Mikael
    The structure of Antonovsky's sense of coherence in patients with schizophrenia and its relationship to psychopathology2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 3, p. 280-287Article in journal (Refereed)
    Abstract [en]

    The main aim of the study was to investigate whether the three hypothesized subscales of Antonovsky's sense of coherence (SOC) scale: comprehensibility, meaningfulness and manageability, can be found when measuring SOC in a sample of patients with schizophrenia living in the community. A further aim was to study the relationship between SOC and psychopathology. The concept of SOC has been proposed to explain successful coping with life stressors. A total of 120 patients completed the SOC scale and the Brief Psychiatric Rating Scale (BPRS) was used to assess the psychopathology of the patients. The SOC scale was analysed by means of a factor analysis with a varimax rotation and the Spearman rank correlation test was used to test for associations between subscales, factors and psychiatric symptoms. A four-factor model presented the best solution and explained 48% of the total variation in SOC. The first factor, which included 12-items of the SOC scale, turned out to be the most salient factor explaining 29% of the total variation. All factors displayed some overlapping between items. Affective symptoms were negatively related to all the three subscales and the four factors of SOC, while positive symptoms were similarly related to two of the subscales and two of the factors while negative symptoms were not associated with any of the factors or subscales. The findings in this study corroborate those in studies with other patient groups and indicate that the theoretical framework of SOC should not be adopted uncritically. Furthermore, the use of the three subscales in the SOC scale in studies of patients with a severe mental illness is questioned and a further investigation of the relationship between SOC and psychopathology is proposed.

  • 6.
    Bengtsson Tops, Anita
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Hansson, Lars
    Lunds universitet.
    Clinical and social changes in severely mentally ill individuals admitted to an outpatient psychosis team: an 18-month follow-up study2003In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, no 1, p. 3-11Article in journal (Refereed)
    Abstract [en]

    Aim: The study investigated clinical and social changes during an 18-month follow-up period in a group (n = 76) of schizophrenic outpatients admitted to a newly implemented outpatient psychosis team. Changes related to level of contact with the psychosis team were also examined as well as aspects of the content of the treatment interventions and work situation from a staff perspective. Methods: Structured face-to-face interviews with the patients were performed at baseline and after 18 months. The Camberwell Assessment of Need instrument, the Lancashire Quality of Life Profile and the Interview Schedule for Social Interaction were used on both interview occasions along with Global Assessment of Functioning Scale and Brief Psychiatric Rating Scale. Thematic open-ended questions were used in staff interviews. Results: Psychiatric symptoms, number of needs and number of met needs decreased, and perceived quality of life improved for the total sample during the follow-up period. Patients only in contact with a psychiatrist in the psychosis team improved more in symptoms and spent fewer days in hospital during follow-up time compared with those who had combined psychiatric and supportive contacts, and were also more satisfied with their medication. Patients with a combined contact deteriorated in psychosocial functioning compared with the group only in contact with a psychiatrist. Some of the elements in treatment interventions and work situation as well as hindrances in providing community-based care adapted to the patients' needs were identified. Conclusions: Community-based psychiatric services, to a larger extent, need to embrace evidence-based interventions and to perform regular, structured and comprehensive need assessments in order to ensure the effectiveness of interventions. Attention should be paid to staff motivation and education as well as to providing practical guidelines, supervision and support.

  • 7.
    Benzein, Eva
    et al.
    Department of Health and Behavioural Sciences, Kalmar University.
    Berg, Agneta
    Kristianstad University, Department of Health Sciences.
    The Swedish version of Herth Hope Index: an instrument in palliative care2003In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, no 4, p. 409-415Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to assess the reliability and validity of the Swedish version (HHI-S) of the Herth Hope Index (HHI), developed by K. Herth. The HHI-S is a 12-item Likert scale, arranged with scores from 1 to 4, where 1 is 'strongly disagree' and 4 is 'strongly agree'. The HHI-S together with the Miller Hope Scale (TMHS) and Beck's Hopelessness Scale (HS-S) were distributed to 85 adults, 40 patients with cancer in palliative care and 45 family members to patients with cancer in palliative care, recruited from four different in- and out-patient oncology clinics. The result showed an internal consistency alpha coefficient of 0.88 for the HHI-S. Concurrent criterion-related validity was assessed by correlating the HHI-S with the TMHS (r = 0.82) and the discriminant validity was assessed by correlating the HHI-S with the HS-S (r = −0.69). A varimax-rotated principal component factor analysis was performed and identified two factors; reconciliation with life situation and religiosity. Although the instrument shows sound reliability and validity, it should be used with care in clinical palliative care settings, because of linguistic, conceptual and cultural difficulties when transferring the instrument into Swedish. The result demands the work of developing an instrument measuring hope, based in the Swedish culture.

  • 8.
    Blomqvist, Kerstin
    et al.
    Department of Nursing, University of Lund.
    Hallberg, Ingalill R.
    Department of Nursing, University of Lund.
    Managing pain in older persons who receive home-help for their daily living: perceptions by older persons and care providers2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 3, p. 319-328Article in journal (Refereed)
    Abstract [en]

    Pain is a common problem for older persons who need professional help for their daily living. In this study 94 older persons (75+) in persistent pain were compared with 52 care providers concerning the pain management methods they had used/administered during the previous week and how helpful they perceived these methods to be. Interviews were based on 16 items from the original version of the pain management inventory (PMI). Both groups perceived prescribed medication, rest and distraction as the most frequently utilized methods. Specific methods such as transcutaneous electrical nerve stimulation (TENS) or bracing/splinting or bandaging the affected body part were seldom employed, although most users perceived these methods as helpful. Care providers perceived most methods for managing pain as more effective than older persons did. The results imply that care providers need skills in a variety of pharmacological and nonpharmacological methods to manage pain and a need to evaluate effectiveness of the methods in a systematic way.

  • 9.
    Bolejko, Anetta
    et al.
    Department of Health Sciences, Lund University.
    Wann-Hansson, Christine
    Department of Caring Sciences, Malmö University.
    Zackrisson, Sophia
    Diagnostic Centre of Imaging and Functional Medicine, Skåne University Hospital, Malmö.
    Brodersen, John
    Research Unit and Section for General Practice, Institute of Public Health, University of Copenhagen.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Adaptation to Swedish and further development of the ‘Consequences of Screening – Breast Cancer’ questionnaire: a multimethod study2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 475-486Article in journal (Refereed)
    Abstract [en]

    Rationale:  Experiencing a false-positive screening mammography can cause considerable psychosocial distress. The Consequences of Screening – Breast Cancer questionnaire (COS-BC parts 1 and 2), recently developed in Denmark, is the only condition-specific questionnaire for measuring short- and long-term psychosocial consequences of false-positive mammographic screening. Additional studies are needed to further test the COS-BC before use across cultures. Furthermore, studies have suggested that the consequences of false-positive screening results are partly common across cancer screening settings, although this hypothesis remains largely untested.

    Objectives:  This study (i) assesses content validity of a Swedish version of the COS-BC, (ii) tests whether items expressing long-term consequences of false-positive lung cancer screening results are relevant in a breast cancer screening context and (iii) explores the usefulness of taking results from Rasch analyses of the source version as an aid in questionnaire translation and adaptation.

    Methods:  Following dual-panel translation, content validity was assessed through qualitative interviews with representatives of the target population and the content validity index (CVI). Item locations and Rasch model fit of the source questionnaires were considered in the translation and assessment process.

    Results:  The COS-BC items were generally found relevant and provided coverage of the target construct. Content validity was supported also for nine of 10 lung cancer screening items. Scale CVI values were ≥0.81. Previous Rasch data were useful in facilitating translation and assessing item content validity. The resulting Swedish version of the COS-BC parts 1 and 2 consists of 34 and 23 items, respectively.

    Conclusion:  This study illustrates the value of methodological triangulation and use of data from previous Rasch analyses in questionnaire translation and adaptation. We found support for the hypothesis that consequences of false-positive screening are common across cancer screening settings. Psychometric properties of the Swedish COS-BC remain to be established.

  • 10.
    Carlsson, Margareta
    et al.
    Department of Geriatric and Long-term Care Medicine, Gothenburg University.
    Berg, Stig
    Department of Geriatric and Long-term Care Medicine, Gothenburg University.
    Wenestam, Claes-Göran
    Department of Educational Research, Gothenburg University.
    The oldest old: patterns of adjustment and dependence1991In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 5, no 2, p. 93-100Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate how dependence was experienced by 129 non-institutionalized 85-year-old persons, who previously had been categorized into seven different patterns of adjustment. The participants' subjective experiences of dependence were expressed in in-depth interviews and additionally, mobility, self-maintenance and need of help in daily living was conventionally assessed. When the results from these two methods were compared, it was found that subjectively experienced dependence did not generally correspond with the scorings on dependence. The in-depth interviews revealed that subjects with poorer adjustment could be most affected by minor impairments, while physical impairments were of a subordinate importance to those who were better adjusted. For appropriate caring interventions, it is therefore suggested that conventionally assessed dependence needs to be supplemented with documented subjective experiences of dependence.

  • 11.
    Carlsson, Margareta
    et al.
    Department of Geriatric and Long-term Care Medicine, Gothenburg University.
    Berg, Stig
    Department of Geriatric and Long-term Care Medicine, Gothenburg University.
    Wenestam, Claes-Göran
    Department of Educational Research, Gothenburg University.
    The oldest old: patterns of adjustment and life experiences1991In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 5, no 4, p. 203-210Article in journal (Refereed)
    Abstract [en]

    A qualitative method was used to study the life experiences and the adjustment to very old age of a non-institutionalized population of 129 85-year-olds living in Gothenburg, Sweden. In-depth interviews were analyzed and categorized and seven patterns of adjustment emerged: Self-Realizing, Mature Aging, Adapting, Dependent, Resignedly Accepting, Despairing and Withdrawing. Additionally, a coping strategy—ritualization of time and occupations—was revealed in the interviews. These results reflect the heterogeneity among this age group and indicate that the subjective reality should be seriously considered both in further research and in the care of the elderly.

  • 12.
    Clausson, Eva
    et al.
    Kristianstad University, Department of Health Sciences.
    Petersson, Kerstin
    Lund University, Department of Nursing, Faculty of Medicine.
    Berg, Agneta
    Kristianstad University, Department of Health Sciences.
    School nurses' view of schoochildren's health and their attitudes to document it in the school health record: a pilot study2003In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, no 4, p. 392-398Article in journal (Refereed)
    Abstract [en]

    This study highlights school nurses' view of schoolchildren's health and their attitude to document it in the school health records. A strategic sample of 12 school nurses was interviewed. The interviews were semistructured and analysed with qualitative content analysis. The findings showed that the school nurses' viewed schoolchildren as physical healthy although they called attention to growing problems related to a changed lifestyle. Psychosocial ill-health was however increasing and the most common reason for visiting the school nurse was psychosomatic expressions. According to the nurses' descriptions, health was related to the individual, the school and the family situation. The family situation was mentioned as one of the most important factors of schoolchildren's health. The nurses described no problem to document schoolchildren's physical health. Ethical consideration, tradition, lack of time and the structure of the record were however factors that were said to hinder the documentation of the psychosocial health. In order to promote, protect and recover schoolchildren's health, more research is needed about how beliefs, experience, ethical consideration and resources influence the school nurse's daily work with schoolchildren's health.

  • 13.
    Condelius, Anna
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University.
    Edberg, Anna-Karin
    Department of Health Sciences, Faculty of Medicine, Lund University.
    Hallberg, Ingalill Rahm
    Department of Health Sciences, Faculty of Medicine, Lund University.
    Jakobsson, Ulf
    Department of Health Sciences, Faculty of Medicine, Lund University.
    Utilization of medical healthcare among people receiving long-term care at home or in special accommodation2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 404-413Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate the utilization of medical healthcare, hospital care and outpatient care, during a 1-year period in relation to informal care, multimorbidity, functional status and health complaints and to long-term care at home or in special accommodation among people aged 65+, with one or more hospital admissions and receiving long-term care.

    METHOD: A total of 694 people receiving long-term care during the year 2001 were studied. Data were collected by means of the administrative registers Patient Administrative Support in Skåne and PrivaStat and through the study Good Ageing in Skåne. Those at home and those in special accommodation were compared regarding utilization of medical healthcare, informal care, multimorbidity, functional status and health complaints. Multiple logistic regression analysis was performed using at home vs. in special accommodation as the dependent variable and also two multiple linear regression analyses using the number of hospital stays and the number of contacts with the physician in outpatient care separately as dependent variables.

    FINDINGS: Those at home were significantly younger (mean age: 81 vs. 84 years) and less dependent in personal and instrumental activities of daily living (PADL/IADL) than those in special accommodation. A larger proportion of those at home was admitted to hospital three times or more (21 vs. 14%) and they had significantly more contacts with physicians in outpatient care (md: 10 vs. md: 7). Informal care was associated with care at home (OR = 0.074) and with utilization of outpatient care (B = 2.045). Dependency in PADL was associated with care in special accommodation (OR = 1.375) and with utilization of hospital care (B = -0.060) and outpatient care (B = -0.581).

    CONCLUSION: Medical healthcare seems more accessible to those who live at home are younger, less dependent and who have access to informal caregivers.

  • 14.
    Edberg, Anna-Karin
    Centre for Caring Sciences, Lund University.
    Assessment by nurses of mood, general behaviour and functional ability in patients with dementia receiving nursing home care2000In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, no 1, p. 52-61Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the reliability of the Patient Mood Assessment Scale (PMAS), the General Behaviour Assessment Scale (GBAS) and the Gottfries Bråne Steen scale and to investigate mood, general behaviour, degree of dementia and symptoms for patients with dementia living permanently in nursing home care (n = 75). Interviews were conducted with the contact nurses, focussing on their view of the patients during the preceding week, based on the above-mentioned assessment scales. In 29 cases a second interview was conducted with another nurse in order to investigate the inter-rater reliability. The inter-rater reliability was high for items associated with ADL and intellectual functions, but low for items associated with emotional aspects. The nurses' difficulties in assessing the patients' emotional state could arise because these matters are not regularly discussed among the staff or could reflect the nurse's inner state rather than that of the patient. The varying understanding that the nurses had of the patients raises the question of whether the care provided is based on the nurses' opinions rather than on the patients' needs. There is a need for continuous and reflective discussions in the staff group, focusing on the patients' physical as well as emotional needs.

  • 15.
    Ekström, Kajsa
    et al.
    Lund University.
    Spelmans, Sanna
    Lund University.
    Ahlström, Gerd
    Lund University.
    Nilsen, Per
    Linköping University.
    Alftberg, Åsa
    Malmö University.
    Wallerstedt, Birgitta
    Linnaeus University.
    Behm, Lina
    Lund University.
    Next of kin's perceptions of the meaning of participation in the care of older persons in nursing homes: a phenomenographic study.2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 2, p. 400-408Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Being involved in the care of a loved one is a desire of many next of kin. However, according to several studies of the perceptions of nursing home staff, the involvement of next of kin is not an obvious part of care. To be able to involve next of kin in care at nursing homes, the perceptions of what participation means are an important piece of knowledge. The aim of this study was therefore to describe variations in next of kin's perceptions of the meaning of participation in the care of older persons living in nursing homes.

    METHODS: Eighteen next of kin of older persons living in ten nursing homes in Sweden were recruited for interviews. The study design was based on a phenomenographic approach, focusing on the qualitatively different ways in which a person perceives, experiences or conceptualises a phenomenon or certain aspect of reality.

    RESULTS: Five categories emerged from analysis of the interviews, representing the next of kin's perceptions of the meaning of participation in the care of older persons in nursing homes: be present; communicate; monitor; do practical tasks; and to represent. The next of kin expressed meanings that belonged to more than one category, and the categories were interdependent.

    CONCLUSIONS: Our results indicate that there are several meanings of next of kin's perceptions of participation at nursing homes. Nursing home staff's knowledge of these perceptions is important to enable next of kin to participate according to their own preferences.

  • 16.
    Elgán, Carina
    et al.
    Department of Health Sciences, Lund University.
    Axelsson, Åsa
    Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg.
    Fridlund, Bengt
    School of Health Sciences, Jönköping University.
    Being in charge of life: perceptions of lifestyle among women of retirement age2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 4, p. 730-735Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to describe the perceptions of lifestyle among women of retirement age. BACKGROUND: Women go through many transitions during their lives, which impact on their lifestyle and possibly their outlook on life. Family circumstances such as motherhood and marital status change over time and the menopause is also likely to influence their view of life. METHOD: Data were collected through interviews with 20 women, aged 61-70, selected by means of strategic sampling. The interviews were analysed using a phenomenographic approach. FINDINGS: Three structural aspects emerged: being healthy as life turns out, living life in their own way, and taking care of everyday life. The women described lifestyle as a means of being healthy, having an active role in society, being content with what one has and the need to adapt oneself to limiting circumstances. Lifestyle was also associated with being in charge and making one's own choices in life based on one's own values. They reported that they were independent and made decisions about their life. The informants considered that lifestyle was an asset that helped them to cope with everyday life and to make the most of each day. CONCLUSION: Lifestyle is a tool that requires independence, the right to self-determination over everyday life and adjustment to limitations in order to ensure the psychological well-being of women of retirement age. Further research is needed in order to delineate the possible association between lifestyle and psychological well-being.

  • 17.
    Elgán, Carina
    et al.
    Department of Nursing, Lund University.
    Dykes, Anna-Karin
    Department of Nursing, Lund University.
    Samsioe, Göran
    Obstetrics and Gynaecology, Lund University Hospital.
    Fridlund, Bengt
    Department of Nursing, Lund University.
    Young women's lifestyle behaviours and their bone mineral density changes: a grounded theory analysis2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 1, p. 39-45Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Only limited information is available on healthy young women's perspective of their own lifestyle behaviours. By lifestyle behaviours, e.g. smoking and physical activity, individuals have the possibility to influence bone mineral density (BMD). The aim of this study was to generate a theoretical model of lifestyle behaviours among young women with different BMD changes. METHODS: Data were collected by interviewing with 11 women, and the material was analysed by means of the grounded theory. FINDINGS: Two core categories were generated: (i) the respondents' outlook on life and (ii) their life situation. The respondents' outlook on life was either 'rigid' or 'relaxed'. Respondents who had a rigid outlook on life adjusted with others and had a decreased BMD while those with a relaxed outlook on life were doing things for fun and had an increased BMD level. Life situation also consisted of two categories: 'stagnation' and 'development'. Respondents in a static life situation did not pursue any active actions while in a developing life situation, the respondents were actively striving towards a goal. Four dimensions which characterized the respondents' outlook on life in relation to their life situation emerged: subordinating and enduring with a decreased BMD level or compromising and discerning with an increased BMD level. CONCLUSION: It seems as if the outlook on life has a greater influence than the acted lifestyle behaviour for bone development. Further research is needed to generalize the findings of this study and to explore the importance of the outlook on life among women of all ages.

  • 18.
    Hedov, Gerth
    et al.
    Unit of Paediatrics, Department of Woman and Child Health, Uppsala University.
    Annerén, Göran
    Unit of Clinical Genetics, Department of Genetics and Pathology, Uppsala University.
    Wikblad, Karin
    Department of Welfare and Care, Faculty of Health Sciences, Linköping University.
    Swedish parents of children with Down's syndrome: parental stress and sense of coherence in relation to employment rate and time spent in child care2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 4, p. 424-430Article in journal (Refereed)
    Abstract [sv]

    Becoming parents of a child with Down's syndrome (DS) challenges the adjustment ability in parenthood. Individuals with higher sense of coherence (SOC) are supposed to manage stressors better than those with lower SOC. The aims of this study were to investigate parental self-perceived stress, SOC, frequency of gainful employment and amount of time spent on child care in Swedish DS parents (165 parents; 86 mothers, 79 fathers) and to compare those with control parents of healthy children (169 parents; 87 mothers, 82 fathers). The mean age of the children was 4.7 years. Parents responded to questionnaires separately including Hymovich's Parent Perception Inventory as stress measurement and Antonovsky's short version of the Orientation to Life. No differences concerning total employment rate were observed, but the DS mothers were more often employed part-time than control mothers. The DS parents did not spend more time on child care than the control parents and they did not differ in mean SOC score, but the DS parents perceived greater stress. The differences in stress, particularly between the DS and control mothers, were related to time-demanding areas. Parents with high SOC scores experienced significantly less self-perceived stress.

  • 19.
    Jakobsson, Liselotte
    Kristianstad University, Department of Health Sciences.
    Indwelling catheter treatment and health-related quality of life in men with prostate cancer in comparison with men with benign prostate hyperplasia2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 3, p. 264-271Article in journal (Refereed)
    Abstract [en]

    Experiences from indwelling urinary catheter treatment periods were studied. Little is known of what is felt from a male perspective although catheter treatment is a common pre- and postoperative measure for men with prostate cancer and benign prostatic hyperplasia (BPH). Also studied were health-related quality of life (HRQOL) and sense of coherence (SOC). Men with catheter experience (prostate cancer n = 71, BPH n = 37) were selected from a larger questionnaire study. Assessment was made with study-specific questions together with the QLQ C-30 assessing HRQOL and the SOC questionnaire measuring sense of coherence. Data reduction method was applied to study specific variables to determine problem patterns. Correlation between HRQOL and SOC was determined. Results showed similar problem patterns in men with prostate cancer and BPH: discomfort in wearing catheter (e.g. uneasiness 48.2%), practical and psychosocial difficulties in handling and wearing catheter (e.g. attaching catheter 32.4%) and discomfort at installation (e.g. pain 29.7%). There was lack of knowledge about wearing and practical handling of the catheter. Having a cancer diagnosis did not add to uneasiness or practical problems. Life quality was correlated to SOC (p ≤ 0.001).

  • 20.
    Jakobsson, Ulf
    et al.
    Lund University.
    Westergren, Albert
    Lund University.
    Statistical methods for assessing agreement for ordinal data2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 427-431Article in journal (Refereed)
    Abstract [en]

    Evaluation of various methods in clinical practice is often based on interpretations by two or more observers. Such data need to be analysed with correct statistics, or the results and conclusions may be misleading. In this study, the use of measures of agreement for ordinal data in five international nursing journals is reviewed and various methods for measuring agreement are presented and discussed. Analyses of agreement did not seem to be very common in nursing research, but a great variation was found regarding the choice of method for analysing agreement. Both acceptable and unacceptable methods were found in the articles reviewed. When choosing among various methods for agreement the weighted κ-coefficient is probably the most useful for ordinal data, but several issues of concern arise and need to be taken into consideration when using these types of analyses.

  • 21.
    Janlöv, Ann-Christin
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Johansson, Linda
    Kristianstad University, School of Health and Society.
    Clausson, Eva
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Mental ill-health among adult patients at healthcare centres in Sweden: district nurses experiences2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 987-996Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Mental ill-health among the general population is increasing in Sweden. Primary Health Care (PHC) and Healthcare Centres (HCC), where district nurses (DNs) work, bear the basic responsibility for treatment of mental ill-health, while severe mental ill-health fall under the responsibility of psychiatric specialist care. The increased prevalence of mental ill-health in the community means that DNs increasingly encounter people with mental health problems - not least as a comorbidity. How well DNs are equipped to deal with mental ill-health is currently unclear.

    AIM: The purpose of this study was to explore district nurses' experience of encountering and dealing with mental ill-health among adult patients at healthcare centres.

    DESIGN: A qualitative explorative approach was used to capture the experiences of the phenomena under study.

    METHODS: Individual interviews were conducted with 10 DNs working at six HCCs. The interviews were transcribed and analysed by qualitative content analysis.

    RESULTS: The result emerged as several subcategories captured by three categories: (i) having competence - a prerequisite for feeling confident; (ii) nursing mental ill-health requires time and commitment; and (iii) working in an organisation without preparedness, encompassed by the synthesising theme; nursing mental ill-health requires specific competence and organisational support.

    CONCLUSION: Working as a DN requires formal and informal competence when encountering patients with complex health needs. The findings revealed that the DNs could feel insecure regarding how to deal with patients with mental ill-health due to lack of knowledge. Assessment of patients with mental ill-health is time- and energy-consuming and calls for improved teamwork at HCCs as well as effective collaboration with psychiatric specialist care and other care givers. The DNs responsibility to fulfil their work considering the increasing number of mental ill-health among people that seeks help at HCCs needs to be acknowledged and met by the PHC organisation.

  • 22.
    Janlöv, Ann-Christin
    et al.
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Rahm Hallberg, Ingalill
    Department of Health Sciences, Faculty of Medicine, Unit of Caring Sciences, Lund University.
    Petersson, Kerstin
    Department of Health Sciences, Faculty of Medicine, Unit of Caring Sciences, Lund University.
    Care managers' view of family influence on needs assessment of older people2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 2, p. 243-252Article in journal (Refereed)
    Abstract [en]

    Research has shown that families experience poor involvement in needs assessment of older people while little is known about municipal care managers' views of family participation. The aim was to explore how municipal care managers view families' participation in and influence on needs assessment of older people receiving public home help. Individual interviews (n = 26) were conducted with care managers (n = 5) about their previously conducted needs assessments (n = 5-6). As a complement, a focus group interview with care managers (n = 9) from nine different municipalities was conducted. All interviews were analysed using a qualitative content analysis. The results revealed the overarching category, 'Having to establish boundaries towards family influence and at the same time use them as a resource', which encompassed five principal categories. How family participation was viewed and handled during the needs assessment process seemed determined by the way care managers set boundaries for their professional responsibility. Their views revealed both distancing and strengthening attitudes. The distancing attitude dominated, in particular towards family members who were not perceived as having any legal rights to be considered, even though their participation was an important resource. To follow legislation and municipal guidelines of allocation of public home help to avoid reprimands caused a need for self-protection. The care managers seemed pressed by demands from organizations and families, and in this competition, the family lost out. Adherence to organizational developed patterns of handling legislation and guidelines were prioritized. Because family members often are older and assist in providing care, family participation in the needs assessment of older help recipients needs further societal support.

  • 23.
    Karlsson, Staffan
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University.
    Edberg, Anna-Karin
    Department of Health Sciences, Faculty of Medicine, Lund University.
    Westergren, Albert
    Department of Health Sciences, Faculty of Medicine, Lund University.
    Hallberg, Ingalill Rahm
    Department of Health Sciences, Faculty of Medicine, Lund University.
    Functional ability and health complaints among older people with a combination of public and informal care vs. public care only2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 1, p. 136-148Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate functional ability and health complaints of people, 65+, living in special accommodation (equivalent to nursing home) and their counterparts who live at home and receive municipal care or a combination of municipal and informal care. Persons (n = 1958) receiving municipal care were assessed in terms of functional ability, health complaints, and level of informal and municipal care and services. The results showed that more home care, services and help with Instrumental Activities of Daily Living (IADL) were provided to those receiving only municipal care at home, while more home care and services associated with Personal Activities of Daily Living (PADL) as well as nursing care were provided to those receiving informal care in addition to formal care. Cohabitation was a predictor of a combination of municipal and informal care in the home (OR: 5.935), while assistance with IADL provided by municipal home care and services predicted municipal care only (OR: 0.344). Care in special accommodation was predicted by advanced age (OR: 1.051), dependency in IADL (OR: 19.883) and PADL (OR: 2.695), and impaired cognitive ability (OR: 3.849) with receiving municipal care only as a reference. Living alone (OR: 0.106), dependency in IADL (OR: 11.348) and PADL (OR: 2.506), impaired cognitive ability (OR: 3.448), impaired vision or blindness (OR: 1.812) and the absence of slowly healing wounds (OR: 0.407) were predictors of special accommodation with a combination of informal and municipal care at home as a reference. The distribution of municipal care divided older people into three distinct groups. The most frail and elderly people who had no cohabitants received care in special accommodation, determined by their level of physical and cognitive dependency. The frailest individuals living at home were cohabiting and received a combination of municipal and informal care, while those who were less dependent mainly had help with IADL from municipal care only. The results indicate that there is a shift from the substitution to the complementary model and highlights that attention to the family carers is needed.

  • 24.
    Larsen, Anne
    et al.
    Karolinska Institutet.
    Broberger, Eva
    Karolinska Institutet.
    Petersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health.
    Complex caring needs without simple solutions: the experience of interprofessional collaboration among staff caring for older persons with multimorbidity at home care settings2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 2, p. 342-350Article in journal (Refereed)
    Abstract [en]

    Background: Older persons with multimorbidity being cared for at home often have complex needs which can´t be met by one player. Interprofessional collaboration is therefore considered necessary if care is to be organised according to the needs of the elderly. To achieve coherent healthcare, municipalities and regions need to develop this area.

    Aim: The aim of the study was to illustrate how various professionals belonging to homemaker services, home care services in municipality and Hospital-Based Home Care Services experience their collaboration in caring for older persons with multimorbidity.

    Method: Eleven informants took part in the study and individual interviewed. The material was analysed using a hermeneutic data analysis.

    Result: The result shows that collaboration between players contains various types of experiences which influence not only the staff who are involved in collaboration but also the result of the collaboration itself. The informants´ experience of collaboration was defined by trust and distrust and by security and insecurity. These influenced both the staff who were involved in collaboration and the result of collaboration itself.

    Conlusion: Complex situations could not be solved with simple models. Instead a flexible approach appears necessary with focus shifted from structures to interpersonal relations and interactions. Therefor the different professions have to work as a transprofessional team where close interactions, flexibility and improvisation is a key to success.   

    Relevance to clinical practice: A transprofessional approach to teamwork collaboration can blur professional boundaries and take the competence of all staff into account when home health care to older people with multimorbidity is to be provided by multiple caregivers. This is suggested as an approach with potential to provide high quality and safe care to a vulnerable population.

  • 25.
    Lethin, Connie
    et al.
    Lund University.
    Hallberg, Ingalill Rahm
    The Pufendorf Institute of Advanced Studies, Lund.
    Karlsson, Staffan
    Lund University.
    Janlöv, Ann-Christin
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Family caregivers experiences of formal care when caring for persons with dementia through the process of the disease2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 3, p. 526-534Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Family caregivers' experiences of formal care when caring for persons with dementia through the process of the disease is sparsely investigated.

    AIMS: To investigate family caregivers' experiences of formal care when caring for a person with dementia, through the stages of the disease.

    DESIGN: A qualitative approach with focus group interviews.

    METHODS: Four focus group interviews were conducted in October 2011 with 23 spouses and adult children of persons with dementia and analysed with content analysis.

    RESULTS: The participants' experiences of formal care when caring for a person with dementia were captured in the theme 'Family caregiving requires collaboration with formal care to get support adjusted to needs specific to the stages of dementia'. This can be broken down into the categories 'The dementia diagnosis - entry into formal care as a novice family caregiver', 'Needing expanded collaboration with formal care to continue care at home' and 'Being dependent on a nursing home and trying to maintain involvement'.

    CONCLUSION: Family caregiving requires collaboration with formal care to get support adjusted to the individual's needs, specific to the stages of dementia. Caregivers experience a transition process with three main turning points: the dementia diagnosis; when they realise increased need for formal care to continue caring at home; and when the person with dementia is moved into a nursing home. The interviewed caregivers experience formal care reactive to their needs and this often promoted unhealthy transitions. Formal care needs to be proactive and deliver available care and support early on in the dementia trajectory. Interventions should focus on facilitating a healthy transition for family caregivers through the trajectory of the dementia disease to ensure their well-being.

  • 26.
    Persson, Lena
    et al.
    Kristianstad College for Health Professions.
    Hallberg, Ingalill R.
    Kristianstad College for Health Professions.
    Athlin, Elsie
    College of Health and Caring Sciences, Umeå.
    Nurse turnover with special reference to factors relating to nursing itself1993In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 7, no 1, p. 29-36Article in journal (Refereed)
    Abstract [en]

    Nurse turnover may decrease the quality of nursing care due to the loss of knowledge. It also results in high costs for the employer. Hence, the factors contributing to nurse turnover, if correctly understood, are important in order to know how to reduce it. This study aimed at exploring what contributing factors nurses who had decided to leave referred to concerning their decision to resign. A questionnaire was posted to all nurses who had left within one county council and 142 nurses responded. The most important factors behind the decision to leave turned out to be the following: difficult to implement changes, lack of influence and recognition, to much weekend and evening duty as well as the psychological burden inherent in nursing. The importance of the first three factors became significantly more important when those who remained in the geographical area were compared with those who moved or started to study. The findings support the idea that job satisfaction indirectly influences nurses turnover. However, it also points to the fact that what increases job satisfaction in nursing may need further research. Psychological burden for instance has not been taken into consideration before. In order to increase job satisfaction, thereby reducing nurse turnover, influence and recognition, lessening of the psychological burden and individually planned work schedules seem to be the most important factors.

  • 27.
    Samarasinghe, Kerstin
    et al.
    Kristianstad University, Department of Health Sciences.
    Arvidsson, Barbro
    School of Social and Health Sciences, University of Halmstad.
    "It is a different war to fight here in Sweden": the impact of involuntary migration on the health of refugee families in transition2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 3, p. 292-301Article in journal (Refereed)
    Abstract [en]

    Involuntary migration and adaptation to a new cultural environment is known to be a stress factor. The aim of the study was to explore the impact of involuntary migration on the family health in order to identify specific health care issues related to refugee families in transition living in Sweden. Data was collected through interviews with 16 members of 10 different refugee families from Balkan countries, Kurdistan and Africa for which permission was obtained from the chairman of the local ethnic organizations in a municipality in the southern part of Sweden. In interpreting the material, analysis was made using a contextual approach with reference to phenomenography. The analysis resulted in four qualitatively different descriptive categories characterizing the health of the families: a distressed family living under prolonged tension; a contented family who leads a satisfactory life; a frustrated family who cannot lead a fully satisfactory life and a dejected family who feels deserted. Stressors seeking asylum, facing unemployment and changed roles, interacted negatively within the family. A friendly and understanding attitude from the host country was the main factor in promoting the health of the refugee families. Nursing interventions should therefore assist the families accordingly in order to promote the stability of the family system.

  • 28.
    Suhonen, Riitta
    et al.
    Department of Nursing Science, University of Turku.
    Berg, Agneta
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Idvall, Ewa
    University of Linköping.
    Kalafati, Maria
    University of Athens, Faculty of Nursing.
    Katajisto, Jouko
    University of Turku, Department of Statistics.
    Land, Lucy
    Birmingham City University.
    Lemonidou, Chryssoula
    University of Athens, Faculty of Nursing.
    Schmidt, Lee A.
    Niehoff School of Nursing, Loyola University Chicago.
    Välimäki, Maritta
    University of Turku, Department of Nursing Science.
    Leino-Kilpi, Helena
    University of Turku, Department of Nursing Science.
    Adapting the Individualised Care Scale for cross-cultural comparison: an international study2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 392-403Article in journal (Refereed)
    Abstract [en]

    Rationale:  Cross-cultural comparative studies using reliable and valid instruments can increase awareness of the differences and similarities between health worker’s ability to respond to patients’ individual needs within different health systems. This will enable a better understanding of cultural perspectives in individualized nursing care.

    Aim:  To describe the translation and adaptation process of the Individualized Care Scale (ICS) and examine its reliability and validity in a cross-cultural study.

    Design:  A cross-sectional comparative study.

    Settings:  Twenty-seven orthopaedic and trauma in-patient units at 14 hospitals in 5 countries.

    Participants:  A total of 1126 patients were included in the study: Finland (n = 425), Greece (n = 315), Sweden (n = 218), UK (n = 135) and USA (n = 33).

    Methods:  A systematic forward- and back-translation procedure using bilingual techniques, a committee approach, pretest techniques and pilot testing were used with a convenience sample to produce a valid ICS for each participating group. Psychometric evaluation of the adapted ICS was based on means, SD, missing data analysis, Cronbach’s alpha coefficients and average inter-item correlations. Construct validity was examined using sub-scale correlations to total scales and principal components analysis.

    Results:  The use of the range of options and the sub-scale mean scores ranging from 2.72 to 4.30 demonstrated the sensitivity of the scale. Cronbach’s alpha coefficients (0.77–0.97) and average inter-item correlations (0.37–0.77) were acceptable. The sub-scale correlations to total scales were high (0.83–0.97). The underlying theoretical construct of the ICS was demonstrated by the explained variances ranging from 58% to 79%.

    Conclusions:  The ICS shows promise as a tool for evaluating individualized care in European cultures. The international expansion of an existing instrument developed for one country facilitates comparative studies across countries. There is a need to further test the construct validity and appropriateness of the ICS in different settings in European and nonwestern cultures.

  • 29.
    Sundström, Malin
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Petersson, Pia
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Rämgård, Margareta
    Malmö University.
    Varland, Linda
    The Municipality of Kristianstad.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Health and social care planning in collaboration in olderpersons’ homes: the perspectives of older persons, familymembers and professionals2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 147-156Article in journal (Refereed)
    Abstract [en]

    Providing health and social care to older persons is challenging, since older persons often have multiple diseases and a complex health situation. Hence many professions and organisations are involved. Lack of interprofessional and interorganisational collaboration leads to fragmented care. Care planning meetings before hospital discharge have long been used to overcome this fragmentation, but meetings conducted at the hospital have limitations in identifying long-term needs at home. A new model for health and social care planning in collaboration (HSCPC) in older persons' homes was introduced in two Swedish municipalities. The aim of this study was to gain a deeper understanding of the HSCPC-meeting from the perspectives of older persons, family members, and professionals. Ten care planning meetings from two municipalities were consecutively included. Interviews in retrospect with ten older persons, eight family members, and ten groups of professionals who had attended the HSCPC-meeting at home were analysed with a hermeneutic approach. Four themes emerged: unspoken agendas and unpreparedness, security and enhanced understanding, asymmetric relationships, and ambiguity about the mission and need for follow-up. The comprehensive interpretation is that the professionals handled the HSCPC-meeting mainly as a routine task, while the older persons and family members viewed it as part of their life course. Older persons are in an inferior institutional, cognitive and existential position. However, meeting together in the home partly reduced their inferior position. Findings from this study provide some general suggestions for how HSCPC-meetings should be designed and developed: attention of power relations, the importance of meeting skills and follow-up.

  • 30. Thurang, Anna
    et al.
    Fagerberg, Ingegerd
    Palmstierna, Tom
    Bengtsson Tops, Anita
    Växjö universitet.
    Women's experiences of caring when in treatment for alcohol dependency2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 700-706Article in journal (Refereed)
    Abstract [en]

    Despite the fact of increased levels of alcohol dependency in women and gender differences in how the disease affects men and women, the research on alcohol dependency continues to have a dominating perspective on men. The meaning of the phenomenon of caring in formal care for women with alcohol dependency is not well known. Thus, formal caregivers may find it problematic to know what is caring for women with alcohol dependency. The aim of the study was to illuminate the meaning of caring in formal care for women with alcohol dependency, as narrated by the women. The study was performed using a phenomenological-hermeneutic method. Data were collected in ten in-depth interviews with alcohol-dependent women. The themes presented are availability, being a patient and being a learner. The findings reveal that the women with alcohol dependency receiving a mandate from formal care, experience the relation between them and their caregiver as a mutual transformation. Within the mutual transformation, the participants experienced being respected as a responsible human being which renders possibilities for the women with alcohol dependency to continue in formal care even when the struggle against the disease became hard. Continual meetings with the caregiver allowed the women to gain structure in their daily life as well as allowing the women and their caregivers to develop mutual transformation, which both relieved the women's suffering and increased their experience of being involved in the care process.

  • 31.
    Törnquist, Agneta
    et al.
    The Swedish Institute for Health Sciences, Lund University.
    Andersson, Magdalena
    The Swedish Institute for Health Sciences, Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    In search of legitimacy – registered nurses’ experience of providing palliative care in a municipal context2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 651-658Article in journal (Refereed)
    Abstract [en]

    Background:  The palliative care approach was originally developed for hospice care and for persons with cancer diseases, but has gradually expanded to embrace other contexts and people of all ages, with various life-threatening diseases. The palliative care concept thus also applies to older people and the context of municipal care, where Registered Nurses (RNs) hold key care provision positions. The municipal context is not, however, focused primarily on advanced nursing care, and it is important to highlight RNs’ prerequisites for care provision. Aim:  The study’s aim was to describe RNs’ experience of providing palliative care for older people in a municipal context. Data were collected through focus group discussions with 20 RNs from four different municipalities in southern Sweden and were analysed using conventional content analysis. Findings:  The results showed that the nurses experienced that it was they who cushioned the effects of unclear responsibilities between different organizations, but had limited legitimacy in the municipal context and in relation to other care providers. The results also showed that nurses lacked proper support and prerequisites for providing high-quality palliative care to older dying patients. Conclusion:  The results pinpoint the importance of increased acknowledgement of nurses’ knowledge and skills and a critical view on the effects of moving towards an organization composed of different consultants, which can lead to even more unclear responsibility for nursing care provision.

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