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  • 1. Abrahamsson, Caroline
    et al.
    Eek, Nina
    Jönsson, Marie
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Beck, Ingela
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Att drabbas av sorg i samband med vuxen närståendes död: En allmän litteraturöversikt om anhörigas upplevelser av sorg och vad som förvärrar och lindrar sorgen2021Rapport (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Bakgrund: Sorg är en normal reaktion i samband med närståendes död. Sorg är inteen sjukdom men kan ge besvär som liknar dem som uppkommer vid sjukdom. Om sorgeninte kan hanteras av personen som drabbas av sorg kan den leda till kompliceradsorg och sorgeprocessen förlängs. Sjuksköterskor som arbetar inom vård och omsorgmöter anhöriga som upplever sorg i samband med närstående döende och död ochbehöver ha kunskap och förståelse för hur deras situation kan vara för att kunna geadekvat stöd för anhöriga i sorg.

    Syfte: Syftet var att beskriva anhörigas upplevelser av sorg i samband med vuxen närståendesdöd.

    Metod: En allmän litteraturöversikt baserad på vetenskapliga artiklar med kvalitativstudiedesign. Vetenskapliga artiklar söktes fram i databaserna Cinahl Complete, Pub-Med och PsycINFO. Artiklarna kvalitetsgranskades utifrån kvalitativa kvalitetskriterieroch analysen av studiernas resultat genomfördes utifrån Fribergs analysmetod för litteraturöversikter.

    Resultat: Upplevelsen av sorg delas in i två kategorier och tio underkategorier. En känslomässigbelastning och att känna sig vilsen och oviss med underkategorierna Chockoch oförmåga att minnas, Smärta, Ångest och ledsenhet, Skuld och lättnad, Ensamhetoch saknad, Ovisshet samt Vilsenhet. Omgivningens agerande förvärrar och lindrarsorgen med underkategorierna Att mötas av personer som inte förstår, Att få informationsom ger förståelse samt Att få känslomässigt stöd.

    Diskussion: Studiens kvalitet diskuteras utifrån trovärdighetsbegreppen tillförlitlighet,verifierbarhet, pålitlighet och överförbarhet. I resultatdiskussionen diskuteras de trecentrala fynden: upplevelser av skuld, ovisshet och betydelsen av känslomässigt stödvid sorg. Fynden diskuteras i relation till personcentrerad vård och sjuksköterskorsbehov av kunskap för att kunna möta personer i sorg.

    Fulltekst (pdf)
    Att drabbas av sorg isamband med vuxennärståendes död: En allmän litteraturöversiktom anhörigas upplevelserav sorg och vad somförvärrar och lindrar sorgen
  • 2.
    Adam, Christina
    et al.
    Grekland.
    Patiraki, Elisabeth
    Grekland.
    Lemonidou, Chryssoula
    Grekland.
    Radwin, Laurel
    USA.
    Charalambouss, Andreas
    Cypern; Finland.
    Charalambous, Melanie
    Cypern.
    Berg, Agneta
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Sjövall, Katarina
    Skånes universitetssjukhus; Lunds universitet.
    Katajisto, Jouko
    Finland.
    Stolti, Minna
    Finland.
    Suhonen, Riitta
    Finland.
    Quality of nursing care as perceived by cancer patients: a cross-sectional survey in four European countries2017Inngår i: Balkan Union of Oncology. Journal, ISSN 1107-0625, Vol. 22, nr 3, s. 777-782Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To explore and compare cancer patients' perceptions on the quality of nursing care in four European countries. Methods: Data were collected in Cyprus, Finland, Greece and Sweden. The sample comprised 596 hospitalized cancer patients. The quality of nursing care was measured using the "Oncology Patients' Perceptions of the Quality of Nursing Care Scale" (OPPQNCS). Patient characteristics were also collected. Analysis of variance was used to examine the effects of country on the perceptions of the quality of nursing care. Results: Patients' age ranged from 18 to 86 years, and 58% were male. The comparison of cancer patients' perceptions regarding the quality of nursing care between the four countries showed a statistically significant difference in the total OPPQNCS scores (p <0.001) as well as in the subscales responsiveness (p <0.001), individualization (p<0.001), co ordination (p<0.001) and proficiency (p<0.001). The Cronbach's alpha coefficient for the OPPQNCS ranged between 0.89 and 0.95. A multivariate analysis of variance for the OPPQNCS controlled by respondents' demographic characteristics revealed that only the patient's country was significantly related with the patients' perceptions of quality care. Conclusion: Quality of nursing care as perceived by cancer patients was high, but differed between the four countries. The impact of the clinical status of cancer patients on the quality of nursing care and managerial factors such as staffing/nursing care delivery models that influence the ability of nurses to offer high quality care should also be explored by more focused studies.

  • 3. Alam, Farzana
    et al.
    Nilsson, Annika
    Petersson, Pia
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Trygghet och delaktighet: vård- och omsorgspersonalens syn på närståendes behov av stöd vid palliativ vård av äldre2019Rapport (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    När äldre inte klarar av att bo hemma längre flyttar de ofta till ett vård-och omsorgs-boende, lever den sista tiden där och är i behov av palliativ vård. Palliativ vård är ett förhållningssätt som kännetecknas av en helhetssyn på människan utifrån individens behov. De som arbetar nära den äldre och den närstående är vård- och omsorgsperso-nalen och det är distriktssköterskan som har det övergripande ansvaret för omvårdna-den. Stöd till den närstående är av största vikt inom den palliativa vården. Syftet med studien var att beskriva vård- och omsorgspersonalens erfarenheter av att uppmärk-samma och stödja närstående till den äldre på vård- och omsorgsboende utifrån ett palliativt förhållningssätt. Datainsamlingarna gjordes i två omgångar, en fokusgrupp-sintervju 2017 och genomförda diskussionsgrupper 2010, analyserades med hjälp av kvalitativ innehållsanalys och tolkades med hjälp av Dosseys "Theory of integral nur-sing". I resultatet framkom kategorierna att skapa trygghet för den närstående, önskan att göra den närstående delaktig och att få kunskap om palliativ vård. Kategorierna utmynnade i temat: I ett palliativt förhållningssätt stöds närstående genom att de får känna trygghet och delaktighet. Slutsatsen är att vård- och omsorgspersonalens in-tention är att stödja de närstående men behöver arbeta mer i ett partnerskap med de närstående för att de ska känna en helhet och därmed trygghet och delaktighet.

    Fulltekst (pdf)
    fulltext
  • 4. Andersen, Anna-Eva
    et al.
    Moberg, Catherine
    Bengtsson-Tops, Anita
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Garmy, Pernilla
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Children's and Young People's Health in Social Context (CYPHiSCO). Lund University.
    Lesbian, gay and bisexual parents' experiences of nurses' attitudes in child health care: a qualitative study2017Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, nr 23-24, s. 5065-5071Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe lesbian, gay and bisexual parents' experiences of nurses' attitudes in child health care.

    BACKGROUND: Lesbian, gay and bisexual people are often reluctant to disclose their gender identity for fear of discrimination. This fear may lead to avoidance of healthcare for themselves or their children and may negatively affect families' health and well-being.

    DESIGN: A qualitative inductive design was employed.

    METHODS: Semi-structured interviews were conducted with 14 lesbian, gay or bisexual parents (11 mothers and 3 fathers) with child health care experiences in southern Sweden. Interviews were analysed using qualitative content analysis.

    RESULTS: Two themes were identified. One, a 'sense of marginalization', included lesbian, gay and bisexual parents' experiences of heteronormative attitudes among child health care nurses which led them to feel alienated and questioned as parents. Another, 'being respected for who you are', included experiences of being respected and included at child health care appointments.

    CONCLUSIONS: Findings paint a complex picture of lesbian, gay and bisexual parents' interactions with child health care nurses in that they experienced both positive and negative attitudes. Knowledge gaps about lesbian, gay and bisexual families within the child health care field must be filled.

    RELEVANCE TO CLINICAL PRACTICE: Child health care nurses should work with the entire family to provide the best care for the child; however, discrimination in health care is common and often caused by a lack of knowledge. The number of children living with same-sex parents has increased more than ten-fold since the end of the 1990s. It is therefore important to explore lesbian, gay and bisexual parents' experiences with child health care nurses' attitudes to improve quality of care.

    Fulltekst (pdf)
    fulltext
  • 5.
    Andersson, Anders-Petter
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Cappelen, Birgitta
    The Oslo School of Architecture and Design.
    Musical interaction for health improvement2014Inngår i: Oxford handbook of interactive audio / [ed] Karen Collins, Bill Kapralos, Holly Tessler, Oxford: Oxford University Press , 2014, s. 247-262Kapittel i bok, del av antologi (Fagfellevurdert)
    Abstract [en]

    During the past decade, tangible sensor technologies have matured and become less expensive and easier to use, leading to an explosion of innovative musical designs within video games, smartphone applications, and interactive art installations. Interactive audio has become an important design quality in commercially successful games like Guitar Hero , and a range of mobile phone applications motivating people to interact, play, dance, and collaborate with music. Parallel to the game, phone, and art scenes, an area of music and health research has grown, showing the positive results of using music to promote health and wellbeing in everyday situations and for a broad range of people, from children and elderly to people with psychological and physiological disabilities. Both quantitative medical and ecological humanistic research show that interaction with music can improve health, through music’s ability to evoke feelings, motivate people to interact, master, and cope with difficult situations, create social relations and experience shared meaning. Only recently, however, the music and health field has started to take interest in interactive audio, based on computer-mediated technologies’ potential for health improvement. Here, we show the potential of using interactive audio in what we call interactive musicking in the computer-based interactive environment Wave. Interactive musicking is based on musicologist Christopher Small’s concept “musicking”, meaning any form of relation-building that occurs between people, and people and things, related to activities that include music. For instance, musicking includes dancing, listening, and playing with music (in professional contexts and in amateur, everyday contexts). We have adapted the concept of "musicking" on the design of computer-based musical devices. The context for this chapter is the research project RHYME. RHYME is a multidisciplinary collaboration between the Centre for Music and Health at the Norwegian Academy of Music, the Oslo School of Architecture and Design (AHO), and Informatics at the University of Oslo. Our target group is families with children with severe disabilities. Our goal is to improve health and wellbeing in the families through everyday musicking activities in interactive environments. Our research approach is to use knowledge from music and health research, musical composition and improvisation, musical action research, musicology, music sociology, and soundscape studies, when designing the tangible interactive environments. Our focus here is interaction design and composition strategies, following research-by-design methodology, creating interactive musicking environments. We describe the research and design of the interactive musicking environment Wave, based on video documentation, during a sequence of actions. Our findings suggest some interactive audio design strategies to improve health. We base the design strategies on musical actions performed while playing an instrument, such as impulsive or iterative hitting, or sustainable stroking of an instrument. Musical actions like these can also be used for musicking in everyday contexts, creating direct sound responses to evoke feelings that create expectations and confirm interactions. In opposition to a more control-oriented, instrument and interface perspective, we argue that musical variation and narrative models can be used to design interactive audio, where the audio is seen as an actor taking many different roles, as instrument, co-musician, toy, etc. In this way, the audio and the interactive musicking environments will change over time, answering with direct response, as well as nose-thumbing and changing response, motivating creation, play, and social interaction. Musical variation can also be used to design musical backgrounds and soundscapes that can be used for creating layers of ambience. These models create a safe environment and contribute to shared meaning.

  • 6.
    Andersson, Anders-Petter
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Cappelen, Birgitta
    Oslo School of Architecture and Design.
    Vocal and tangible interaction in RHYME2014Inngår i: Music, Health, Technology and Design / [ed] Stensæth, Karette, Oslo: Norwegian Academy of Music , 2014, s. 21-38Kapittel i bok, del av antologi (Fagfellevurdert)
    Abstract [en]

    Our voice and body are important parts of our self-expression and self-experience for all of us. They are also essential for our way to communicate and build relations cross borders such as abilities, ages, locations and backgrounds. Voice, body and tangibility gradually become more important for Information and Communication Technology (ICT), due to increased development of tangible interaction and mobile communication. The voice and tangible interaction therefore also become more important for the fields of Assistive Technology, Health Technology and Universal Design. In this paper we present and discuss our work with voice and tangible interaction in our on-going research project RHYME. The goal is to improve health for families, adults and children with disabilities through use of collaborative, musical, tangible and sensorial media. We build on use of voice in Music Therapy, knowledge from multi-sensory stimulation and on a humanistic health approach. Our challenge is to design vocal and tangible interactive media that are sensorially stimulating. Interactive media that through use, can reduce isolation and passivity and increase empowerment for all the users. We use sound recognition, generative sound synthesis, vibrations and cross-media techniques, to create rhythms, melodies and harmonic chords to stimulate voice-body connections, positive emotions and structures for actions.

  • 7.
    Andersson, Anders-Petter
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Cappelen, Birgitta
    The Oslo School of Architecture and Design.
    Vocal and tangible technology for music and health2013Inngår i: Book of abstracts: setting the tone: cultures of relating and reflecting in music therapy / [ed] Gro Trondalen, Oslo: The Norwegian Academy of Music , 2013, s. 24-24Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Our voice and body are important parts of our self-expression and self-experience. They are also essential for our way to communicate and build relations cross borders like abilities, ages, locations, backgrounds and cultures. Voice and tangibility gradually become more important when developing new music technology for the Music Therapy and the Music and Health fields, due to new technology possibilities that have recently arisen. For example smartphones, computer games and networked, social media services like Skype. In this paper we present and discuss our work with voice and tangible interaction in our ongoing research project. The goal is to improve health for families, adults and children with severe disabilities through use of collaborative, musical, tangible sensorial media. We build on use of voice in Music Therapy and studies by Lisa Sokolov, Diane Austin, Kenneth Bruscia and Joanne Loewy. Further we build on knowledge from Multi-sensory stimulation and on a humanistic health approach. Our challenge is to design vocal and tangible, sensorially stimulating interactive media, that through use reduce isolation and passivity and increase empowerment for all the users. We use sound recognition, generative sound synthesis, vibrations and cross- media techniques, to create rhythms, melodies and harmonic chords to stimulate body- voice connections, positive emotions and structures for actions. The reflections in this paper build on action research methods, video observations and research-by-design methods. We reflect on observations of families and close others with children with severe disabilities, interacting in three vocal and tangible installations.

  • 8.
    Andersson, Anders-Petter
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Cappelen, Birgitta
    Oslo School of Architecture & Design.
    Olofsson, Fredrik
    Designing sound for recreation and well-being2014Inngår i: Proceedings of the International Conference on New Interfaces for Musical Expression (NIME 2014) / [ed] Baptiste Caramiaux, Koray Tahiroğlu, Rebecca Fiebrink, Atau Tanaka, 2014, s. 529-532Konferansepaper (Fagfellevurdert)
    Abstract [en]

    In this paper we explore how we compose sound for an interactive tangible and mobile interface, where the goal is to improve health and well-being for families with children with disabilities. We describe the composition process of how we decompose a linear beat-based and vocal sound material and recompose it with real-time audio synthesis and composition rules into interactive Scenes. Scenes that make it possible for the users to select, explore and recreate different sound worlds. In order to recreate, the users interact with the tangible interface in different ways, as instrument, play with it as a friend, improvise and create music and relax with it as ambient sounding furniture. We discuss composition techniques for mixing sound, tangible-physical and lighting elements in the Scenes. Based on observations we explore how a diverse audience in the family and at school can recreate and improvise their own sound experience and play together in open and non-therapeutic everyday situations. We conclude by discussing the possible impact of our findings for the NIME-community; how the techniques of decomposing, recomposing and recreating sound, based on a relational perspective, could contribute to the design of new instruments for musical expression.

    Fulltekst (pdf)
    fulltext
  • 9.
    Andersson, Ann-Christine
    et al.
    Jönköping University.
    Ainalem, Ingrid
    Region Skåne.
    Berg, Agneta
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Janlöv, Ann-Christin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Challenges to Improve Inter-Professional Care and Service Collaboration for People Living With Psychiatric Disabilities in Ordinary Housing2016Inngår i: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 25, nr 1, s. 44-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking back--evaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved.

  • 10.
    Andersson, Ann-Christine
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Melander, Katarina
    Blomqvist, Kerstin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Kvinnors upplevelse av att leva med diabetes typ 22013Rapport (Annet vitenskapelig)
    Abstract [sv]

    Bakgrund: Diabetes typ 2 är en kronisksjukdom som ökar på grund av förändrade kostvanor och minskad fysisk aktivitet. Det är en sjukdom som ställer stora krav på individen eftersom det är viktigt med välfungerande egenvård för att må bra. Att drabbas av en kronisk sjukdom upplevs oftast negativt samtidigt som det är viktigt att få ett namn på sjukdo- men. Det finns studier som tyder på att kvinnor verkar må psykiskt sämre och har sämre reglerad diabetes än män. För att kunna stödja kvinnorna i egenvården behövs kunskap om hur de upplever det att leva med diabetes. Syfte: Undersöka kvinnors upplevese av att leva med typ 2 diabetes. Metod: Litteraturstudie som bygger på nio kvalitativa artiklar. Resultat: Fyra teman hittades; besvikelse och svek, kluvenhet, skuld och skam samt oro för framtiden. Diskussion: Det är svårt att vara kvinna och leva med diabetes typ 2. Sjukdomen kräver daglig egenvård och kombinerat med andra roller som kvinnan har i sitt dagliga liv kan kraven upplevas som stressande för en del av kvinnorna. Många kvinnor med diabetes typ två upplevde att de var i behov av bättre stöd och information för att kunna leva med sin sjukdom. Slutsats: Vårdpersonal behöver mer utbildning och ha med ett genusperspektiv för att förstå kvinnornas behov. Diabetesutbildningen behöver utveckas till att omfatta hela familjen, men samtidigt måste den vara individanpassad.

    Fulltekst (pdf)
    fulltext
  • 11. Andersson, Martina
    et al.
    Cronvall, Caroline
    Beck, Ingela
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Erfarenhet av att bedöma äldre personers problem i livets slutskede: en fokusgruppsstudie ur ett sjuksköterskeperspektiv2020Rapport (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Andelen äldre personer i Sverige ökar och en del äldre personer drabbas av en eller flera kroniska sjukdomar. Allt fler personer önskar att vårdas hemma vid livets slut och kan då vara i behov av allmän palliativ vård. Vid palliativ vård i livets slutskede är det en eftersträvan att lindra lidande och förbättra livskvaliteten genom att tidigt uppmärksamma och lindra personers fysiska, psykiska, sociala och existentiella problem. Äldre personer i livets slutskede har ofta flera komplexa problem som påverkar varandra. För att lindra lidande behöver sjuksköterskor kunna bedöma och tolka olika problem som äldre personer kan uppleva i livets slutskede. Syftet med studien var att beskriva sjuksköterskors erfarenhet av att bedöma problem som äldre personer besväras av i livets slutskede inom kommunal hemsjukvård. En kvalitativ metod har använts. Data samlades in med fyra fokusgruppsintervjuer. Totalt deltog 13 sjuksköterskor verksamma inom hemsjukvård från tre olika kommuner i studien. Data analyserades med Kvalitativ innehållsanalys. I resultatet framkom ett övergripande tema: strävan efter kontinuitet för att lära känna personen genom återkommande hembesök underlättar bedömning av problem som behöver tillgodoses i livets slutskede samt kategorierna; att bygga en relation underlättar bedömningen, att samtala för att erhålla information, att observera kroppsspråket skapar en bild och att ta del av andras iakttagelser som stöd. Resultatet visade att relationen till den äldre var viktig för att bedöma den äldres problem och att sjuksköterskor till stor del förlitade sig på sin kliniska blick vid bedömningen. Vidare framkom att sjuksköterskorna sällan använde sig av skattningsinstrument, vilket de uttryckte en önskan att bli bättre på. Slutsatsen är att en ökad användning av skattningsinstrument skulle kunna förenkla bedömning av problem hos äldre personer som sjuksköterskorna inte sedan tidigare har någon relation till. Detta skulle kunna skapa en känsla av trygghet för sjuksköterskorna och stärka dem i deras professionella roll. Användningen av skattingsinstrument skulle kunna öka kvaliteten på den allmänna palliativa vården som utförs i kommunal hemsjukvård. För att sjuksköterskorna ska få stöd i att öka användningen av skattningsinstrument har organisationen en viktig roll för att skapa rutiner och se till att etablerade arbetsformer utvecklas.

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  • 12.
    Andersson, Pia
    et al.
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa.
    Kragh Ekstam, Annika
    Region Skåne Koncernkontoret - Regionhuset.
    Impaired oral health in older orthopaedic in-care patients: The influence of medication and morbidity2021Inngår i: Clinical Interventions in Aging, ISSN 1176-9092, E-ISSN 1178-1998, Vol. 16, s. 1691-1702Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Fall-related injuries are prevalent in older patients and often lead to increased morbidity, medication, and impaired functions. We studied older trauma patients with the aim to describe their oral health in comparison to morbidity and medication.

    Material and Methods: The study included 198 patients, ≥65 years, admitted with an orthopedic trauma. Oral examinations included number of natural teeth, dental implants, missing, decayed and restored teeth, root remnants, and pocket depth. Data on comorbidities and medication were assembled. Statistical analyses were carried out with logistic regression models, adjusted for age, gender, comorbidity, and polypharmacy.

    Results: Overall, 198 patients participated, 71% women, mean age 81 years (±7.9), 85% resided in their own homes, 86% had hip fractures. Chronic diseases and drug use were present in 98.9%, a mean of 6.67 in Charlson comorbidity index (CCI), 40% heart diseases, 17% diabetes, and 14% dementia. Ninety-one percent were dentate (181), mean number of teeth 19.2 (±6.5), 24% had decayed teeth, 97% filled teeth, 44% <20 teeth, and 26% oral dryness. DFT (decayed, filled teeth) over mean were identified in patients with diabetes (p=0.037), COPD (p=0.048), polypharmacy (p=0.011), diuretics (p=0.007), and inhalation drugs (p=0.032). Use of ≥2 strong anticholinergic drugs were observed in patients with <20 teeth and DFT over mean (p=0.004, 0.003). Adjusted for age, gender, CCI, and polypharmacy.

    Conclusion: The study showed that impaired oral health was prevalent in older trauma patients and that negative effects on oral health were significantly associated with chronic diseases and drug use. The results emphasize the importance of identifying orthogeriatric patients with oral health problems and to stress the necessity to uphold good oral care during a period when functional decline can be expected.

    Fulltekst (pdf)
    fulltext
  • 13.
    Andersson, Pia
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Renvert, Stefan
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Oral hälsa och folkhälsovetenskap. Högskolan Kristianstad, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Blekinge Institute of Thechology & Trinity College, Dublin.
    Sjögren, P
    Oral Care.
    Zimmerman, M
    Karolinska Institutet.
    Dental status in nursing home residents with domiciliary dental care in Sweden2017Inngår i: Community Dental Health, ISSN 0265-539X, Vol. 34, nr 4, s. 203-207Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To describe the dental health status of elderly people in nursing homes receiving domiciliary dental care.

    DESIGN: Case note review.

    CLINICAL SETTING: Nursing homes in 8 Swedish counties.

    PARTICIPANTS: Care dependent elderly people (≥65 years).

    METHODS: Clinical data, including the number of remaining natural teeth, missing and decayed teeth (manifest dental caries) and root remnants, recorded by dentists according to standard practices. Medical and dental risk assessments were performed.

    RESULTS: Data were available for 20,664 patients. Most were women (69.1%), with a mean age of 87.1 years (SD 7.42, range 65-109). The mean age for men was 83.5 years (SD 8.12, range 65-105). Two or more medical conditions were present in most of the population. A total of 16,210 individuals had existing teeth of whom 10,974 (67.7%) had manifest caries. The mean number of teeth with caries was 5.0 (SD 5.93) corresponding to 22.8% of existing teeth. One in four individuals were considered to have a very high risk in at least one professional dental risk assessment category.

    CONCLUSIONS: Care dependent elderly in nursing homes have very poor oral health. There is a need to focus on the oral health-related quality of life for this group of frail elderly during their final period of life.

  • 14. Andrisan, Loredana
    et al.
    Molin, Klara
    Beck, Ingela
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Att uppmärksamma och tillgodose äldre personers behov utifrån ett palliativt förhållningssätt på vård och omsorgsboende: omvårdnadspersonals perspektiv2018Rapport (Annet vitenskapelig)
    Abstract [sv]

    Bakgrund: Äldre personer som bor på vård- och omsorgsboende befinner sig i livetsslut och är ofta svårt sjuka. Palliativ vård är ett förhållningssätt som syftar till att förbättralivskvaliteten för patienter och deras familjer i samband med livshotande sjukdom.Förhållningssättet lämpar sig väl att använda vid vård- och omsorgsboende. Syfte:Syftet med studien var att beskriva omvårdnadspersonalens uppfattningar om vad de gör och kan göra för att uppmärksamma och tillgodose äldres behov på vård- ochomsorgsboende utifrån ett palliativt förhållningssätt. Metod: Sju fokusgruppdiskussioner som representerades av omvårdnadspersonal på fyra olika vård- och omsorgsboende genomfördes, sex fokusgruppdiskussioner genomfördes 2010 och en 2017. Intervjuerna analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultat:Genom analysen framträdde ett övergripande tema Att möta den äldre utifrån dennes tankar, känslor och värderingar och tre huvudkategorier Att lära känna den äldre, Att sörja för den äldres angelägenheter och Att den äldre ges valmöjligheter. Slutsats: Föratt kunna tillgodose äldre personers behov utifrån ett palliativt förhållningssätt behöver omvårdnadspersonal möta den äldre personen utifrån dennes tankar, känslor och värderingar vilket kräver resurser i form av tid men också handledning i att samtala omexistentiella frågor.

    Fulltekst (pdf)
    fulltext
  • 15.
    Angsmo, Ewa
    et al.
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Clausson, Eva
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Children's and Young People's Health in Social Context (CYPHiSCO). Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Teider, Karin
    Vänersborgs kommun.
    Dokumentation av hälsobesök: epikriser2020Inngår i: Skolsköterskans dokumentation / [ed] Eva K. Clausson, Stockholm: Gothia fortbildning , 2020, s. 40-60Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 16.
    Angsmo, Ewa
    et al.
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Clausson, Eva
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Children's and Young People's Health in Social Context (CYPHiSCO). Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Teider, Karin
    Vänersborgs kommun.
    Exempel på hälsoplaner2020Inngår i: Skolsköterskans dokumentation / [ed] Eva K. Clausson, Stockholm: Gothia fortbildning , 2020, s. 62-77Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 17.
    Argento, Daniela
    et al.
    Högskolan Kristianstad, Fakulteten för ekonomi, Forskningsmiljön Governance, Regulation, Internationalization and Performance (GRIP). Högskolan Kristianstad, Fakulteten för ekonomi, Avdelningen för ekonomi.
    Einarson, Daniel
    Högskolan Kristianstad, Fakulteten för naturvetenskap, Avdelningen för datavetenskap. Högskolan Kristianstad, Fakulteten för naturvetenskap, Forskningsmiljön för datavetenskap (RECS).
    Mårtensson, Lennart
    Högskolan Kristianstad, Fakulteten för naturvetenskap, Forskningsmiljön Man & Biosphere Health (MABH). Högskolan Kristianstad, Fakulteten för naturvetenskap, Avdelningen för miljö- och biovetenskap.
    Persson, Christel
    Högskolan Kristianstad, Fakulteten för lärarutbildning, Forskningsmiljön Learning in Science and Mathematics (LISMA). Högskolan Kristianstad, Fakulteten för naturvetenskap, Avdelningen för miljö- och biovetenskap.
    Wendin, Karin
    Högskolan Kristianstad, Fakulteten för naturvetenskap, Forskningsmiljön Food and Meals in Everyday Life (MEAL). Högskolan Kristianstad, Fakulteten för naturvetenskap, Avdelningen för mat- och måltidsvetenskap. Danmark.
    Westergren, Albert
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Lunds universitet.
    Integrating sustainability in higher education: a Swedish case2020Inngår i: International Journal of Sustainability in Higher Education, ISSN 1467-6370, Vol. 21, nr 6, s. 1131-1150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose – This paper aims to unveil how sustainability is integrated into the courses/programmes ofhigher education institutions. The research question addressed is: how do academics representing differentdisciplines cooperate and engage in the work of integrating sustainability into their teaching programmes.Design/methodology/approach – This paper draws upon the notions of practise variation andinstitutional work from institutional theory and empirically focusses on the case of Kristianstad University(Sweden). This case is based on an autoethnographic approach and illustrates the experiences shared by sixcolleagues, representing different disciplines, engaged in implementing sustainability in their courses/programmes.Findings – The findings highlight how academics representing different disciplines, with specific traditionsand characteristics, face the sustainability challenge. Despite being bound by similar sustainable developmentgoals, differences across disciplines need to be acknowledged and used as an asset if trans-disciplinarity is theultimate goal.Research limitations/implications – Although the intrinsic motivation of individuals to work withsustainability might be a strong driver, the implementation of sustainability within courses/programmes andacross disciplines requires joint efforts and collective institutional work.Practical implications – By highlighting how academics engage in the work of integratingsustainability, this study emphasizes that managers of higher education institutions need to account for thetime and additional resources needed to ensure that academics effectively cope with sustainability. Intrinsicmotivation may not last if organizational structures and leadership are not supportive on a practical level andin the long run.

  • 18.
    Aronsen Torp, Jenny
    et al.
    Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Berggren, Vanja
    Erlandsson, Lena-Karin
    Westergren, Albert
    Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Weight status among Somali immigrants in Sweden in relation to sociodemographic characteristics, dietary habits and physical activity2015Konferansepaper (Annet vitenskapelig)
  • 19.
    Arvidsson, Andreas
    et al.
    Osby kommun.
    Skog, Therese
    Region Skåne Hässleholm.
    Palmquist, Eva-Lott
    Kristianstads Kommun.
    Pajalic, Zada
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    ”Risk för undernäring”2013Annet (Annet (populærvitenskap, debatt, mm))
    Fulltekst (pdf)
    fulltext
  • 20.
    Augustinsson, Sören
    et al.
    Högskolan Kristianstad, Fakulteten för ekonomi, Forskningsmiljön Governance, Regulation, Internationalization and Performance (GRIP). Högskolan Kristianstad, Fakulteten för ekonomi, Avdelningen för arbetsliv. Högskolan Kristianstad, Forskningsmiljön Arbete i skolan (AiS).
    Ericsson, Ulf
    Högskolan Kristianstad, Fakulteten för ekonomi, Forskningsmiljön Governance, Regulation, Internationalization and Performance (GRIP). Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för ekonomi, Avdelningen för arbetsliv. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Nilsson, Henrik
    Linnaeus University.
    Making sense of assignment: on the complexity of being a school leader2018Inngår i: Nordic journal of comparative and international education (NJCIE), ISSN 2535-4051, Vol. 2, nr 2-3, s. 149-164Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    he primary aim of this paper is to narrow down the description of how school leaders interpret the assignment (the task) and identify the markers for how they look upon the conditions of doing a good job in Sweden. The aim is in the context of practice-based and process-oriented research. We use complexity and complexity theories to frame the emerging practice of leading and organizing. This is in contrast to technocratic homogenization—that is, law texts, steering documents, documentation, standardized methods, planning, and ceremonies. A questionnaire was conducted with three open questions (n=363 out of a possible 548 participants) and four focus groups (n=21). Complexity, dilemmas, and inconsistency emerge in the respondents’ answers the closer they are to everyday action. The results show that complexity theories put focus on a conflict between the image of schools as complicated and complex. Complicated is accompanied by generalizing and weak contextualizing of control systems, standardized methods, planning, law texts, and evidence-based education—that is, the concept of technocratic homogenization. Complexity theories emphasize the life in organizations, everyday practice as leaders, and a conflict between weak and robust contextualizing from the perspective as practice-based and process-oriented research.

    Fulltekst (pdf)
    fulltext
  • 21.
    Augustinsson, Sören
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Samhällsvetenskap. Högskolan Kristianstad, Forskningsmiljön Governance, Regulation, Internationalization and Performance (GRIP).
    Petersson, Pia
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    On discharge planning  : dynamic complex processes – uncertainty, surprise and standardisation2015Inngår i: Journal of Research in Nursing, ISSN 1744-9871, E-ISSN 1744-988X, Vol. 20, nr 1, s. 39-53Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    How can discharge planning (DP) for patients who require care in the home following a period in hospital be understood and developed through the lenses of complexity theory? With the help of complexity theory and practice-based narrative research this study discloses the formal routines and complex dynamic practices that are associated with DP. A study of the literature established that there was an almost total absence of complexity-theoretical perspectives on interpreting and developing DP.                 

    The researchers collected narratives about the DP processes using qualitative interviews with the nurses responsible for this in a hospital ward: these were audio-recorded and transcribed verbatim. They also participated in and documented meetings where these nurses, as a group, discussed DP.                 

    The findings show that nurses have to continuously deal with uncertainty, surprises and the unknown. They have to make sense and take charge of dynamic complex events and new knowledge, and manage complex relations and information. The researchers argue that looking upon practice from the lenses of complexity theory, and therefore accepting the complexity of practice, could facilitate the development of nurses' skills in order to guarantee good quality in DP.

  • 22.
    Axelsson, Malin
    et al.
    Malmö University.
    Persson, Lena
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna.
    Höglund Nielsen, Birgitta
    Danmark.
    Living in the wake of Chronic Obstructive Pulmonary Disease and Long-Term Oxygen Therapy2016Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, s. 376-385Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the world. COPD is a progressive disease that could lead to chronic hypoxemia, which requires treatment as domiciliary Long-Term Oxygen Therapy (LTOT). There is a need for increased knowledge about self-care strategies used by individuals living with COPD and LTOT. Objective: The aim was to explore experiences and self-care strategies in patients living with both COPD and LTOT. Sample: The sample consisted of five men and five women diagnosed with COPD being prescribed LTOT for more than one year. Method: Ten interviews were undertaken and analyzed for both manifest and latent content. Results: Living with COPD and LTOT was associated with experiences of guilt although there were doubts about what had caused the lung disease. Both the lung disease and the oxygen therapy had a negative impact on their self-image. Anxiety was expressed when thoughts about the remaining time occurred. There was a constant balance between diminishing abilities and increasing restrictions related to the lung disease and the therapy. In order to compensate for arising imbalance, self-care strategies had been initiated aimed at preserving the present state of health, enabling and facilitating physical activity and promoting a positive attitude. Conclusion: The current study suggests that individuals living with COPD and LTOT are encouraged to adopt self-care strategies directed towards maintaining stability with regard to the lung disease, the oxygen therapy, physical capability and emotional reactions.

    Fulltekst (pdf)
    fulltext
  • 23.
    Bala, Sidona-Valentina
    et al.
    Lund University.
    Forslind, Kristina
    Lund University.
    Fridlund, Bengt
    Jönköping University.
    Hagell, Peter
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Measuring person-centred care in nurse-led outpatient rheumatology clinics2018Inngår i: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, nr 2, s. 296-304Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Measurement of person-centred care (PCC) outcomes is underdeveloped owing to the complexity of the concept and lack of conceptual clarity. A framework conceptualizing outpatient PCC in rheumatology nurse-led clinics has therefore been suggested and operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum).

    OBJECTIVE: The aim of the present study was to test the extent to which the PCCoc/rheum represents the underpinning conceptual outpatient PCC framework, and to assess its measurement properties as applied in nurse-led outpatient rheumatology clinics.

    METHODS: The 24-item PCCoc/rheum was administered to 343 persons with rheumatoid arthritis from six nurse-led outpatient rheumatology clinics. Its measurement properties were tested by Rasch measurement theory.

    RESULTS: Ninety-two per cent of individuals (n = 316) answered the PCCoc/rheum. Items successfully operationalized a quantitative continuum from lower to higher degrees of perceived PCC. Model fit was generally good, including lack of differential item functioning (DIF), and the PCCoc/rheum was able to separate individuals with a reliability of 0.88. The four response categories worked as intended, with the exception of one item. Item ordering provided general empirical support of a priori expectations, with the exception of three items that were omitted owing to multidimensionality, dysfunctional response categories and unexpected ordering. The 21-item PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories and no DIF, and its reliability was 0.86.

    CONCLUSION: We found general support for the appropriateness of the PCCoc/rheum as an outcome measure of patient-perceived PCC in nurse-led outpatient rheumatology clinics. While in need of further testing, the 21-item PCCoc/rheum has the potential to evaluate outpatient PCC from a patient perspective.

  • 24.
    Bala, Sidona-Valentina
    et al.
    Lund University.
    Forslind, Kristina
    Lund University.
    Fridlund, Bengt
    Jönköping University.
    Samuelson, Karin
    Lund University.
    Svensson, Björn
    Lund University.
    Hagell, Peter
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Person-centred care in nurse-led outpatient rheumatology clinics: conceptualization and initial development of a measurement instrument2018Inngår i: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, nr 2, s. 287-295Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Person-centred care (PCC) is considered a key component of effective illness management and high-quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics.

    METHODS: A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person-centredness principles and existing PCC frameworks. The resulting framework was operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum), which was tested for acceptability and content validity among 50 individuals with RA attending a nurse-led outpatient clinic.

    RESULTS: The conceptual framework focuses on the meeting between the person with RA and the nurse, and comprises five interrelated domains: social environment, personalization, shared decision-making, empowerment and communication. Operationalization of the domains into a pool of items generated a preliminary PCCoc/rheum version, which was completed in a mean (standard deviation) of 5.3 (2.5) min. Respondents found items easy to understand (77%) and relevant (93%). The Content Validity Index of the PCCoc/rheum was 0.94 (item level range, 0.87-1.0). About 80% of respondents considered some items redundant. Based on these results, the PCCoc/rheum was revised into a 24-item questionnaire.

    CONCLUSIONS: A conceptual outpatient PCC framework and a 24-item questionnaire intended to measure PCC in nurse-led outpatient rheumatology clinics were developed. The extent to which the questionnaire represents a measurement instrument remains to be tested.

  • 25.
    Bala, Sidona-Valentina
    et al.
    Helsingborg Central Hospital.
    Forslind, Kristina
    Helsingborg Central Hospital.
    Samuelson, Karin
    Lund University.
    Svensson, Björn
    Lund University, Helsingborg.
    Fridlund, Bengt
    Jönköping University.
    Hagell, Peter
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Measuring person-centered care in nurse-led outpatient rheumatology clinics2018Inngår i: International Conference on Probabilistic Models for Measurement, 2018Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    BACKGROUND: Person-centered care (PCC) is a key component to effective illness management and high-quality care but conceptually underdeveloped in outpatient care settings for long-term disorders such as rheumatoid arthritis (RA), and there is a lack of instruments measuring patient perceived PCC.

    AIM: To conceptualize and operationalize outpatient PCC as a basis for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics.

    DESIGN: A conceptual outpatient PCC framework was developed based on theory and patient experiences.The resulting framework was operationalizedinto items that were tested regarding their accordancewith the theoretical framework and their measurement properties according to Rasch measurement theory (RMT) using the RUMM2030 software. 

    RESULTS: The conceptual framework comprised five intermingled domains (personalization, shared decision-making, empowerment, communication, and social environment) that were operationalized into a 24-item PCC instrument for outpatient care in rheumatology (PCCoc/rheum). RMT analyses found items to successfully map out a quantitative continuum from lower to higher PCC levels, with generally acceptable model fit and a reliability of 0.88. Three items exhibiting multidimensionality, dysfunctional response categories, and/or unexpected hierarchical ordering were omitted. The revised PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories, and no DIF; reliability was 0.86.

    SUMMARY AND IMPLICATIONS: We found support for the PCCoc/rheum as a conceptually based outcome measure of patient perceived PCC. Results implied minor theoretical reconsiderations, and related scale revisions improved theoretical and clinical clarity. While in need of further testing, the PCCoc/rheum has great potential as a measure of outpatient PCC from a patient perspective.

  • 26.
    Bala, Sidona-Valentina
    et al.
    Lund University & Helsingborg Hospital.
    Samuelson, Karin
    Lund University.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Fridlund, Bengt
    Lund University & Jönköping University.
    Forslind, Kristina
    Helsingborg Hospital & Lund University.
    Svensson, Björn
    Lund University.
    Thomé, Bibbi
    Lund University.
    Living with persistent rheumatoid arthritis: a BARFOT study2017Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, nr 17-18, s. 2646-2656Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM AND OBJECTIVE: To describe and understand the meaning of living with persistent rheumatoid arthritis.

    BACKGROUND: A considerable number of patients with rheumatoid arthritis live with an ongoing active and symptomatic illness despite access to potent antirheumatic treatment. There is, however, a lack of knowledge about the meaning of living with this severe long-term illness, defined as persistent rheumatoid arthritis.

    DESIGN: A descriptive design based on a hermeneutic phenomenological method was used.

    METHODS: Ten adults with persistent rheumatoid arthritis and at least five years disease duration were interviewed. The interviews were analysed according to van Manen's method.

    RESULTS: Living with persistent rheumatoid arthritis revealed four overall themes: an existence dominated by painful symptoms and treatment, radical changes and limitations in one's life, a continual struggle to cope with one's life and to master the illness, and a dependency on those who are close by and the world around. The lifeworld was affected to a varying extent and in various ways by the illness but also by the dependence on its treatment and care that was not experienced as sufficiently meeting needs in terms of security, access to and coordination of care as well as team and rehabilitation services.

    CONCLUSIONS: Persistent rheumatoid arthritis and its treatment entail a radical effect on the person's life and quality of life. Current ordinary rheumatology care does not seem to meet the individual needs of the person with persistent rheumatoid arthritis in an optimal way.

    RELEVANCE TO CLINICAL PRACTICE: A greater knowledge about and understanding of the person who lives with persistent rheumatoid arthritis is important for facilitating the development of care and the relief of suffering. A holistic alternative to conventional clinical practice, such as person-centred care, could be tested as an innovative model of care. Our findings might serve as material for educational and counselling purposes for healthcare professionals.

  • 27.
    Bala, V.
    et al.
    Lund University.
    Fridlund, B.
    Jönköping University.
    Forslind, K.
    Lund University.
    Svensson, B.
    Lund University.
    Hagell, Peter
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Towards measurement of person-centered care outcomes in outpatient nurse-led clinics2017Inngår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, s. 1520-1520Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Person-centered care (PCC) is increasingly emphasized as a key component of effective illness management and of developing high quality of care. Despite considerable progress of PCC in many areas of care there is currently a gap and a need for means to assess PCC practice in outpatient care. In rheumatology, PCC is considered an unmet need and further development and evaluation of this approach to care is thus of high priority.

    Objectives To develop an instrument for measuring person-centered care from the perspective of the person with rheumatoid arthritis (RA) in nurse-led outpatient clinics.

    Methods A conceptual framework of PCC in the outpatient context and focusing on the meeting between the person with RA and the nurse and on the patient as an active care partner was undertaken. Based on this framework, qualitative interviews (1,2) and a literature review, a 35-item questionnaire was proposed and qualitatively tested regarding acceptability and content validity among 50 persons with RA attending a nurse-led outpatient clinic. Two versions of the questionnaire were tested: one using four response categories (0 = Totally disagree; 3 = Completely agree), and one using two response categories (0 = Disagree; 1 = Agree). Content validity was estimated by calculating Content Validity Index of the individual items (I-CVI) and of the overall instrument (S-CVI).

    Results Respondents found the items easy to understand (77%) and relevant (93%). Seventy-three percent of the respondents preferred the questionnaire version with four response categories. This version took a mean (SD) of 5.3 (2.5) minutes to complete. I-CVI values ranged from 0.87 to 1.00 and S-CVI was 0.94. About 80% of the respondents considered some items to be redundant. This resulted in a reduced 24-item draft questionnaire that yield a total score between 0–72.

    Conclusions A preliminary 24-item patient-reported PCC questionnaire was developed. Psychometric testing is needed for validation of this tool before implementation.

  • 28.
    Beck, Ingela
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    An intervention applying a palliative care approach in residential care: influences on nurse assistants' work situation2013Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Introduction

    Palliative care is an approach characterized by a holistic view of the person, which supports the individual for living with dignity and with the best possible level of wellbeing until the end of life. Those who, in practice, provide care in Swedish residential care facilities for older people (RCFs) are nurse assistants (NAs), a work group with limited education. They also often stand alone with difficult decisions with regards to the care provision, as the registered nurse has the role of consultant rather than leader. In an explorative qualitative study we found that NAs experienced that it was difficult to focus on relationship aspects in their work, as the main discourse in the residential care focused on tasks. Palliative care was described as something that was applied only during a short define phase i.e. last days of the residents’ life. These results were used as a basis for development of an intervention focus on a palliative care approach in RCFs. The intervention consisted of study circles with NAs, and workshops together with their leaders, focusing on improvement work.

    Aim

    To investigate how an intervention focusing on a palliative care approach in RCFs influenced the NAs and their work.

    Method

    Two quantitative studies, based on a questionnaire, including several measurements, that was answered pre-, and post- intervention and one qualitative study based on individual interviews after the intervention. A total of 75 nurse assistants participated in the intervention and answered the questionnaire at baseline and at two follow-ups, in comparison with 110 nurse assistants who served as controls. 

    Results

    The evaluation of the intervention showed that the NAs, after the intervention, had increased their focus on the residents’ situation and to a greater extent stated that they focused on the residents’ life stories and on aspects that brought meaning to their lives. The NAs also stated that they experienced less criticism from their superiors as well as from the residents after the intervention. However, the evaluation also showed that the NAs had a more negative view of the leadership, were more critical to the medical and the nursing care, and that their job satisfaction had decreased after the intervention. Interviews after the intervention showed that they, as a result of the intervention, had not only gained increased insight into their own significance in their encounter with residents and their relatives, but also an increased awareness of the needs of the residents and their relatives. The intervention also contributed to an increased openness in the workgroup. However, the nurse assistants also expressed frustration over barriers, primarily in the form of a lack of resources and limited leadership, standing in the way of the implementation of changes.

    Conclusion

    The results indicate that the NAs, through discussions and reflections over praxis in their ordinary work group, developed an increased awareness about, and focus on relationship aspects. However, in spite of the leaders’ involvement, the intervention was not sufficient for changing the organizational prerequisites for working in line with the palliative care approach. When implementing a palliative care approach in RCFs, more focus on support to the leaders in needed in order to maintain sustainable changes.

  • 29.
    Beck, Ingela
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Increasing nurse assistants' focus on residents' situation and needs by applying a palliative care approach in residential care facilities2014Konferansepaper (Fagfellevurdert)
  • 30.
    Beck, Ingela
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna.
    IPOS - meningsfull skattning av palliativa vårdbehov2016Konferansepaper (Annet vitenskapelig)
  • 31.
    Beck, Ingela
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Palliativ vård2017Inngår i: Omvårdnad & äldre / [ed] Kerstin Blomqvist, Anna-Karin Edberg, Marie Ernsth Bravell, Helle Wijk, Lund: Studentlitteratur, 2017, s. 509-526Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 32.
    Beck, Ingela
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Palliativ vård efter kurativt syftande kirurgi på grund av matstrupscancer2016Konferansepaper (Fagfellevurdert)
  • 33.
    Beck, Ingela
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
    Stödet till personalen vid vård- och omsorgsboende är avgörande för deras möjlighet att möta äldre personers situation och behov2013Inngår i: Tidningen Ä, en tidning för Riksföreningen Sjuksköterskan inom Äldrevård, nr 4, s. 16-19Artikkel i tidsskrift (Annet vitenskapelig)
  • 34.
    Beck, Ingela
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna.
    Validering av Svenska Palliativregistert ur patienters och närståendes pespektiv2016Konferansepaper (Fagfellevurdert)
  • 35.
    Beck, Ingela
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna.
    Översättning och kulturell anpassning av IPOS för användning i Sverige2016Konferansepaper (Fagfellevurdert)
  • 36.
    Beck, Ingela
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Blomqvist, Kerstin
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna.
    Teori och modeller som stöd för personcentrerade möten2017Inngår i: Omvårdnad & Äldre / [ed] Kerstin Blomqvist, Anna-Karin Edberg, Marie Ernsth Bravell, Helle Wijk, Lund: Studentlitteratur, 2017, s. 49-60Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 37.
    Beck, Ingela
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan. Vårdalinstiutet.
    Jakobsson, Ulf
    Lunds universitet.
    Edberg, Anna-Karin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan. Vårdalinstitutet.
    An intervention applying a palliative care approach in residential care-effects on care provision and caring climate2013Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction: The palliative care approach aims to integrate psychosocial and existential aspects as well as relationship aspects in the care and can be used in all care contexts. In residential care, nurse assistants (NAs) are the ones who are closest to the residents, but have limited prerequisites to work in accordance with the palliative care approach. We aimed to investigate the effects of an intervention applying a palliative care approach in residential care, on NAs experience of care provision and caring climate.

    Method: In this quasi-experimental study we evaluated the intervention involving NAs (n=75) and their leaders (n=9), focusing on emotional, existential and relationship aspects within the palliative care approach, in comparison with controls (n=110). Data consisted of a questionnaire that the NAs answered at three time points.

    Results: In the intervention group, effects were seen concerning the NAs reports of the care provision in that they focused more on to ease for residents to narrate about their lives, and on communication with residents in what gives them meaning in life. In the intervention group effects were also seen in that the NAs rated the residents medical and nursing care needs being less met at the facility after the intervention. No effects were seen concerning the caring climate or the possibilities to provide a more person-centered care.

    Conclusion: The intervention seemingly facilitated for the NAs to focus on relationship aspects with the residents. But the intervention was not sufficient to change the organizational prerequisites for the staff to provide a more person-centered care.

  • 38.
    Beck, Ingela
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Jakobsson, Ulf
    Lund University.
    Edberg, Anna-Karin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Applying a palliative care approach in residential care: effects on nurse assistants' experiences of care provision and caring climate2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 4, s. 830-841Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 39.
    Beck, Ingela
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Jakobsson, Ulf
    Lund University.
    Edberg, Anna-Karin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Applying a palliative care approach in residential care: effects on nurse assistants' work situation2015Inngår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, nr 3, s. 543-553Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership.

    Method: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110).

    Results: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased.

    Significance of results: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.

  • 40.
    Beck, Ingela
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Olsson Möller, Ulrika
    Lund University.
    Malmström, Marlene
    Lund University.
    Klarare, Anna
    Ersta Sköndal Bräcke University College.
    Samuelsson, Henrik
    Palliative Care Unit, Ystad.
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Rasmussen, Birgit
    Lund University .
    Fürst, Carl Johan
    Lund University .
    Translation and cultural adaptation of the Integrated Palliative care Outcome Scale including cognitive interviewing with patients and staff2017Inngår i: BMC Palliative Care, E-ISSN 1472-684X, Vol. 16, nr 1, artikkel-id 49Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: To expand our clinical and scientific knowledge about holistic outcomes within palliative care, there is a need for agreed-upon patient-reported outcome measures. These patient-reported outcome measures then require translation and cultural adaptation, either from country-specific languages to English, or the other way around. The aim of this study was to translate and cross-culturally adapt the Integrated Palliative care Outcome Scale (IPOS) to the Swedish care context.

    METHODS: Swedish versions of IPOS Patient and IPOS Staff were developed and culturally adapted using recommended guidelines including cognitive interviews with patients (n = 13) and staff (n = 15) from different care contexts including general and specialised palliative care.

    RESULTS: The comprehension and judgement difficulties identified in the pre-final patient and staff versions were successfully solved during the cognitive interviewing process. IPOS was well accepted by both patients and staff, none of the questions were experienced as inappropriate, and all questions were judged important.

    CONCLUSIONS: In this study, we translated and culturally adapted the patient and staff versions of IPOS, and demonstrated face and content validity and acceptability of the scale through cognitive interviewing with patients and staff within residential care facility, surgical and specialised palliative home care units. Cognitive interviewing in parallel with patients and staff in rounds, with tentative analysis in between, was a suitable method for identifying and solving challenges with comprehension and evaluation in the pre-final version of IPOS. The Swedish IPOS is now available for use in a variety of clinical care settings.

    Fulltekst (pdf)
    fulltext
  • 41.
    Beck, Ingela
    et al.
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Pålsson, Christina
    Bengtsson-Tops, Anita
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Upholding an ideal image of palliative work in the face of obstacles2018Inngår i: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 24, nr 12, s. 611-617Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Homecare workers play a pivotal role in palliative care, but research on their experiences is limited. The aim of this study was to describe how homecare workers in Sweden experience their work in palliative homecare.

    METHOD:This qualitative study used open-ended interviews with a purposive sample of 15 homecare workers. The data was analysed by means of qualitative content analysis.

    RESULTS: One main theme emerged from the analysis: upholding an ideal image of palliative work. This had four subthemes: doing good; doing their best work; feeling work satisfaction; and facing difficulties.

    CONCLUSION: Palliative care performed by homecare workers is demanding. Homecare workers need more practical support and would benefit from a care model that involves working with registered nurses, as a team, to provide humanistic care to dying patients and their relatives.

  • 42.
    Beck, Ingela
    et al.
    Lund University.
    Törnquist, Agneta
    Lund University.
    Broström, Linus
    Lund University.
    Edberg, Anna-Karin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Having to focus on doing rather than being: nurse assistants' experience of palliative care in municipal residential care settings2012Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 49, nr 4, s. 455-464Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Palliative care should be provided, irrespective of setting to all patients facing a life-threatening illness and to their families. The situation and needs of older people differ from those of younger people since they often have several co-existing diseases and health complaints. This implies an extensive need for care and for longer periods of palliative care. The main providers of palliative care for older people are nurse assistants, who are also those with the shortest education. AIM: The aim of this study was to illuminate nurse assistants' experience of palliative care for older people in residential care. DESIGN: The study had an explorative, descriptive design. SETTINGS: Thirteen residential care units in three different districts in a large city in southern Sweden. PARTICIPANTS: Twenty-five nurse assistants selected to represent variations in age, gender workplace and work experience. METHODS: Data were collected from six focus-group interviews and subjected to content analysis to gain an understanding of the phenomenon. RESULTS: The nurse assistants described palliative care as a contrast to the everyday care they performed in that they had a legitimate possibility to provide the care needed and a clear assignment in relation to relatives. Palliative care also meant having to face death and dying while feeling simultaneous that it was unnatural to talk about death and having to deal with their own emotions. They emphasised that they were in need of support and experienced leadership as invisible and opaque, but gained strength from being recognized. CONCLUSION: In order to support nurse assistants in providing high quality end-of-life care, more focus is needed on the trajectory of older peoples' dying, on the importance of involving relatives throughout the period of care provision, and on support when encountering death and dying. There is also a need for engaged care leaders, both registered nurses and managers, to recognize the work of nurse assistants and to support care provision for older people within the framework of palliative care philosophy.

    Fulltekst (pdf)
    fulltext
  • 43.
    Beck, Ingela
    et al.
    Lund University.
    Törnquist, Agneta
    Lund University.
    Edberg, Anna-Karin
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Nurse assistants’ experience of an intervention focused on a palliative care approach for older people in residential care2012Inngår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, nr 2, s. 140-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

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

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

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

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

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

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

  • 44.
    Bellander, Lisa
    et al.
    Göteborgs universitet, Folktandvården Västra Götaland.
    Andersson, Pia
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet (OHAL). Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för oral hälsa.
    Nordvall, Dennis
    Qulturum, Region Jönköpings län.
    Hägglin, Catharina
    Göteborgs universitet, Folktandvården Västra Götaland.
    Oral health among older adults in nursing homes: a survey in a national quality register, the senior alert2021Inngår i: Nursing Open, E-ISSN 2054-1058Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To investigate the extent to which the Revised Oral Assessment Guide–Jönköping (ROAG-J) is used by nursing staff routinely in nursing homes in Swedenand to describe oral health status of the residents.

    Design: An observational, retrospective register-based study.

    Methods: Data from different validated health assessments instruments, includingROAG-J, for the period 2011–2016 were obtained from the Web-based nationalquality register Senior Alert. The basis for the analyses was 190,016 assessments.

    Results: About half of all residents had underwent at least one annual ROAG-J assessment (2014–2016). During the period 2011–2016, 42% of the residents (n = 92,827) were registered to have oral health problems. Significantly more oral health problemswere found for men and for those with younger age, poorer physical condition, neurophysiological problems, underweight, impaired mobility and many medications. Inconclusion, poorer oral health was found for more care-dependent individuals, whichshows a need of preventive actions.

    Fulltekst (pdf)
    fulltext
  • 45.
    Bengtsson Tops, Anita
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Behov av vård och stöd2014Inngår i: Att leva med psykisk funktionsnedsättning: livsssituation och effektiva vård- och stödinsatser / [ed] David Brunt & Lars Hansson, Lund: Studentlitteratur AB, 2014, 2, s. 153-170Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 46.
    Bengtsson Tops, Anita
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Hot och våld mot personer med psykisk funktionsnedsättning2014Inngår i: Att leva med psykisk funktionsnedsättning: livsssituation och effektiva vård- och stödinsatser / [ed] David Brunt & Lars Hansson, Lund: Studentlitteratur AB, 2014, 2, s. 207-216Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 47.
    Bengtsson Tops, Anita
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Ericsson, Ulf
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Samhällsvetenskap. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Ehliasson, Kent
    Högskolan Kristianstad, Sektionen för hälsa och samhälle.
    Living in supportive housing for people with serious mental illness: a paradoxical everyday life2014Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 23, nr 5, s. 409-418Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Since the closure of large psychiatric institutions, various types of community-based supportive housing for people with serious mental illness (SMI) have been developed. There is currently limited knowledge about users' experiences of living in supportive housing. The aim of the present study was to describe user experiences of living in supportive housing for people with SMI. Twenty-nine people living in such facilities participated in open, qualitative interviews. Data were subjected to latent content analysis. Three main themes emerged from this analysis: (i) having a nest, which included the subthemes of a place to rest and having someone to attach to; (ii) being part of a group, with the subthemes of being brought together and a community spirit; and (iii) leading an oppressive life, including the subthemes of questioning one's identity, sense of inequality, and a life of gloom. It could be concluded that user experiences of living in supportive housing are complex and paradoxical. In order to provide supportive housing, staff need to recognize and work within social group processes, and perform continual and structural evaluations of users' social and emotional needs.

  • 48.
    Bengtsson Tops, Anita
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
    Hansson, L.
    Lund University.
    Landlords’ experiences of housing tenants suffering from severe mental illness: a Swedish empirical study2014Inngår i: Community mental health journal, ISSN 0010-3853, E-ISSN 1573-2789, Vol. 50, nr 1, s. 111-119Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this Swedish study was to describe landlords' experiences of having tenants suffering from severe mental illness. Sixteen landlords working in private and public housing agencies participated in open in-depth interviews. Data were subjected to a thematic latent content analysis. The results showed that having tenants with severe mental illness entails being confronted with various difficult circumstances, ranging from mismanagement of apartments to sensitivity among neighbours as well as issues regarding provocative behaviour. It involved providing assistance that was far beyond their professional obligations and to be neglected by the community-based psychiatric service system when in need of help. In order to support landlords and to prevent evictions of individuals with severe mental illness, community-based psychiatric services need to be more pro-active in their attempts to achieve collaboration with the parties at hand.

  • 49.
    Bengtsson-Tops, Anita
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Schmidt, Manuela
    Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Sektionen för hälsa och samhälle. Lund University.
    Development and implementation of a need-based care model for persons who frequently visit psychiatric emergency rooms2017Konferansepaper (Annet vitenskapelig)
    Fulltekst (pdf)
    fulltext
  • 50.
    Berg, Agneta
    et al.
    Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
    Clausson, Eva
    Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Children's and Young People's Health in Social Context (CYPHiSCO). Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Yrkesmässig handledning för skolsköterskor2019Inngår i: Skolsköterskans hälsofrämjande arbete / [ed] Clausson, EK & Morberg, S., Lund: Studentlitteratur AB, 2019, 2, s. 267-281Kapittel i bok, del av antologi (Annet vitenskapelig)
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