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  • 101.
    Lilja Andersson, Petra
    et al.
    Kristianstad University, School of Health and Society.
    Edberg, Anna-Karin
    Department of Health Sciences, Lund University.
    The transition from rookie to genuine nurse: narratives from Swedish nurses 1 year after graduation2010In: Journal of Continuing Education in Nursing, ISSN 0022-0124, Vol. 41, no 4, p. 186-192Article in journal (Refereed)
    Abstract [en]

    This article describes nurses' experiences during their first year after graduation, based on the qualitative content analysis of eight interviews. The results show that the nurses experienced a transition from "being a rookie," including being accepted as a member of the team and respected as a colleague, to "becoming a genuine nurse," including the feeling of being able to shoulder responsibility, prioritize tasks, and convey confidence to patients. This transition seems to occur regardless of support, and it is important to be aware of nurses' level of maturity and to adjust the degree of responsibility given to them because they may not be comfortable revealing their limitations to others. J Contin Educ Nurs 2010;41(4):186-192.

  • 102.
    Lilja Andersson, Petra
    et al.
    Lund University.
    Juth, Niklas
    Karolinska Institute.
    Petersén, Åsa
    Lund University.
    Graff, Caroline
    Karolinska Institute.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Ethical aspects of undergoing a predictive genetic testing for Huntington’s disease2013In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 20, no 2, p. 189-199Article in journal (Refereed)
    Abstract [en]

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

  • 103.
    Lilja Andersson, Petra
    et al.
    Lund University.
    Petersén, Åsa
    Lund University.
    Graff, Caroline
    Karolinska Institutet, Stockholm.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Ethical aspects of a predictive test for Huntington’s Disease: a long term perspective2016In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 23, no 5, p. 565-575Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

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

  • 104.
    Lundqvist, Pia
    et al.
    Lund University.
    Kleberg, Agneta
    Karolinska University Hospital.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Larsson, Björn A.
    Karolinska University Hospital.
    Hellström-Westas, Lena
    Uppsala University.
    Norman, Elisabeth
    Skåne University Hospital, Lund.
    Development and psychometric properties of the Swedish ALPS-Neo pain and stress assessment scale for newborn infants2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 8, p. 833-839Article in journal (Refereed)
    Abstract [en]

    AIM: To validate and evaluate the psychometric properties of the ALPS-Neo, a new pain assessment scale created for the continuous evaluation of pain and stress in preterm and sick term infants.

    METHODS: A unidimensional scale for continuous pain, Astrid Lindgren Children's Hospital Pain Scale (ALPS 1), was developed further to assess continuous pain and stress in infants treated in the neonatal intensive care unit (NICU). The pain scale includes observations of five behaviours. A manual was created, clarifying the scoring criteria. An internal and an external panel assessed face validity. Psychometric properties were evaluated in three different steps. Inter-rater reliability was estimated from video-based assessments (n = 625) using weighted kappa statistics (test I). Inter-rater reliability was further evaluated in test II (n = 125) and test III (n = 96) by real-time assessments using the intraclass correlation coefficient (ICC) and Cronbach's alpha.

    RESULTS: The final inter-rater reliability (test III) was assessed as good with ICC 0.91 for the total score and 0.62-0.81 for the five items. Cronbach's alpha showed 0.95 for the total score.

    CONCLUSION: ALPS-Neo is a new assessment tool for optimising the management of pain and stress in newborn infants in the NICU. It has proved easy to implement and user-friendly, permitting fast, reliable observations with high inter-rater reliability.

  • 105.
    Martinsson, Ingrid
    et al.
    Blekinge Institute of Technology.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Janlöv, Ann-Christin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Growing old in a foreign context: older immigrants experience of the everyday life in nursing home2013In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 33, no 3, p. 34-38Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the study was to illuminate older immigrants’ experiences of moving to a residential care facility.

     

    Background: Increased immigration will lead to a future increase in the number of older immigrants in residential care. In order to adjust nursing care to their needs it is important to acquire knowledge of their situation.

     

    Methods: Semi-structured interviews with seven immigrants living in residential care in Sweden were analysed using a qualitative manifest content analysis.

     

    Findings: Older immigrants’ experience of everyday life in residential care facilities was: Trying to adjust to relocation to residential care, Feeling alienated by communication difficulties, and Trying to stay connected by keeping ties to the origin and past, with internal variation seen as subcategories.

     

    Conclusion: Older immigrants, who move into residential care are vulnerable and experience a major transition as they move from a familiar social and cultural environment into a place mainly designed for older Swedes. There is a great risk that they will become alienated and highly dependent on their relatives if not nursing care interventions with specific focus on their needs are developed.

  • 106.
    Orban, Kristina
    et al.
    Lunds universitet.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II.
    Erlandsson, Lena-Karin
    Lunds universitet.
    Challenges for change: results from an occupation-based intervention targeting parents to children with obesity2012Conference paper (Refereed)
    Abstract [en]

    Background: A family intervention has been developed targeting parents with children having obesity. The parents attended the programme during one year. The assumption was that a change in parents’ daily occupations to include more regular meals, physical activity and a variation among obligations and rest would lead to a healthier lifestyle and a normalization of their children’s BMI.

    Aim: The study aim was to investigate whether parents attending the intervention, gradually changed their time use and experiences in occupations together with their children regarding; preparing and having meals, in physically active and inactive occupations.

    Method: The research context was a randomized trial involving families with preschool children having obesity. Forty parents (n=40) were included. Time-geographical diaries were collected from all parents (T1-T 6) together with The Occupational Value Assessment with predefined items (Oval-pd). Analysis was performed by a repeated measures design.

    Results will be reported and discussed at the conference.

  • 107.
    Orban, Kristina
    et al.
    Lunds universitet.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II.
    Erlandsson, Lena-Karin
    Lunds universitet.
    Factors associated with parents’ time use change in daily occupations and children’s subsequent decrease in BMI: generating knowledge for further development of occupation focused intervention2013Conference paper (Refereed)
  • 108.
    Orban, Kristina
    et al.
    Department of Health Sciences, Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Lund University.
    Using a time-geographical diary method in order to facilitate reflections on changes in patterns of daily occupations2012In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 3, p. 249-259Article in journal (Refereed)
    Abstract [en]

    Objective and methods: Time-use methodologies have been proposed to be established research techniques when exploring aspects of daily occupations. In this study, two graphs illustrating the time arrangement of occupations as they appear in a continuous sequence were used in order to encourage individuals to reflect on their everyday life. The aim was to investigate the usefulness of a time-geographical diary method (using illustrative graphs) in combination with stimulated-recall interviews, to facilitate reflections on how patterns of daily occupations change over time and the causes that lie behind these changes. The study had a qualitative design. The participants were two working, married mothers, i.e. individuals considered to have highly complex patterns of daily occupations. The data analysis was performed by using thematic content analysis. Results: The results showed that the stimulated-recall interviews, based on the graphs, facilitated new insights that came to light concerning the scope of the participants' daily life. The method enabled the participants to reflect on their patterns of daily occupations and become aware of changes relevant to explain the causes for engaging in occupations the way they did. Conclusions: The method thus seems useful in research and practice for occupational therapists working with individuals with a need to change lifestyle.

  • 109.
    Orban, Kristina
    et al.
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Thorngren-Jerneck, Kristina
    Lund University.
    Önnerfält, Jenny
    Lund University.
    Erlandsson, Lena-Karin
    Lund University.
    Changes in parents’ time use and its relationship to child obesity2014In: Physical & Occupational Therapy in Pediatrics, ISSN 0194-2638, E-ISSN 1541-3144, Vol. 34, no 1, p. 44-61Article in journal (Refereed)
    Abstract [en]

    Objective:The aim was to explore any change in parents' time use together with theirchildren, changes in their perceived occupational value, and its relationshipto children's body mass index (BMI) over the course of a one-yearoccupation-focused family intervention. Method: The study sample consisted ofparticipants in one arm of a randomized controlled trial, involving mothers andfathers (n = 30) of 17 children aged 4–6 years who were considered obese. Datawere collected by time-geographical diaries during the intervention and bymeasuring the parents’ occupational value and the children's BMI before andafter the intervention. Results: At the end of the intervention, an increasewas shown in the amount of time parents spent together with their childrenduring weekdays (p = .042) and the parents perceived occupational value (p =.013). Children's BMI z-score changed with −0.11 units. Conclusion:Collaboration with parents may be useful in interventions aiming atfacilitating a normal weight development among children.

  • 110.
    Orban, Kristina
    et al.
    Lund University.
    Erlandsson, Lena-Karin
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Önnerfält, Jenny
    Lund University.
    Thorngren-Jerneck, Kristina
    Lund University.
    Effect of an occupation-focused family intervention on change in parents’ time use and children’s body mass index2014In: American Journal of Occupational Therapy, ISSN ISSN 0272-9490, EISSN 1538-7488, Vol. 68, no 6, p. e217-e226Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE. This study explored factors related to changes in the time parents spent with their children with obesity and associated decreases in children’s body mass index (BMI) z-scores after an occupation-focused intervention.

    METHOD. Parents participated in a 1-yr occupation-focused intervention to promote healthy family lifestyles. Data on 40 parents of 22 children with obesity ages 4–6 yr were collected before and after intervention and analyzed using linear and multiple regression methods.

    RESULTS. Parents increased time spent with their children by an average of 91 min/day. Parents’ finances, perceived satisfaction in daily occupations, low BMI, and mastery at inclusion were associated with increased time spent with their children. Mothers’ subjective health and high mastery and fathers’ perceived occupational value and education explained 67% of the variance in children’s BMI z-scores.

    CONCLUSION. The results indicate important factors to consider in developing interventions that facilitate occupational engagement and health among children with obesity and their families.

  • 111.
    Orrung Wallin, Anneli
    et al.
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health.
    Jakobsson, Ulf
    Lund University.
    Psychometric properties concerning four instruments measuring job satisfaction, strain, and stress of conscience in a residential care context2013In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 57, no 2, p. 162-171Article in journal (Refereed)
    Abstract [en]

    There are many instruments assessing the wellbeing of staff, but far from all have been psychometrically investigated. When evaluating supportive interventions directed toward nurse assistants in residential care, valid and reliable instruments are needed in order to detect possible changes. The aim of the study was to investigate validity in terms of data quality, construct validity, convergent and divergent validity and reliability in terms of the internal consistency and stability of the Job Satisfaction Questionnaire, the Psychosocial Aspects of Job Satisfaction, the Strain in Dementia Care Scale (SDCS), and the Stress of Conscience Questionnaire (SCQ) in a residential care context. The psychometric properties of the instruments were investigated in terms of data quality, construct validity, convergent and divergent validity and reliability, including test-retest reliability, in a residential care context with a sample consisting of nurse assistants (n=114). The four instruments responded with different psychometric-related problems such as internal missing data, floor and ceiling effects, problems with construct validity and low test-retest reliability, especially when assessed on the item level. These problems were however reduced or disappeared completely when assessed for total and factor scores. From a psychometric perspective, the SDCS seemed to stand out as the best instrument. However, it should be modified in order to reduce floor effects on item level and thereby gain sensitivity. The Job Satisfaction Questionnaire seemed to have problems both with the construct validity and test-retest reliability. The final choice of instrument must, however, be made dependent on what one intends to measure.

  • 112. Orrung Wallin, Anneli
    et al.
    Edfors, Ellinor
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II.
    Job satisfaction among nurse assistants working in residential care for older people2014Conference paper (Refereed)
  • 113.
    Orrung Wallin, Anneli
    et al.
    Department of Health Sciences, Lund University.
    Jakobsson, Ulf
    Department of Clinical Sciences in Malmö, Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Job satisfaction and associated variables among nurse assistants working in residential care2012In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 24, no 12, p. 1904-1918Article in journal (Refereed)
    Abstract [en]

    Background:While the work situation for nurse assistants in residential care is strenuous, they themselves often state that they are satisfied with their job. More knowledge is clearly needed of the interrelationship of variables associated with job satisfaction. This study aims to investigate job satisfaction and explore associated variables among nurse assistants working in residential care.

    Methods: A total of 225 respondents completed a questionnaire measuring general job satisfaction, satisfaction with nursing-care provision and measures concerning person-centered care, work climate, leadership, and health complaints. Job satisfaction was the outcome measure and comparisons were made among those reporting low, moderate, and high levels of job satisfaction; multiple regression analyses were used to explore associated variables.

    Results: The caring climate and personalized care provision were associated with general job satisfaction. High levels of satisfaction with nursing-care provision were also associated with the general work climate, organizational and environmental support, and leadership. Low job satisfaction was mainly associated with health complaints.

    Conclusions: Nurse assistants working in a positive work climate, caring climate, with a positive attitude to their leaders, who receive organizational and environmental support, provide person-centered care and experience a higher degree of job satisfaction. It seems essential, however, to include both general and context-specific measures when investigating job satisfaction in this field as they reveal different aspects of the nurse assistant's work situation.

  • 114.
    Orrung Wallin, Anneli
    et al.
    Kristianstad University, School of Health and Society. Lund University.
    Jakobsson, Ulf
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Job strain and stress of conscience among nurse assistants working in residential care2015In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 23, no 3, p. 368-379Article in journal (Refereed)
    Abstract [en]

    Aim The aim was to investigate job strain and stress of conscience among nurse assistants working in residential care and to explore associations with personal and work-related aspects and health complaints. Background It is important to investigate job strain and stress of conscience, both for the well-being of the nurse assistants themselves and for the impact on the quality of care they provide. Method Questionnaires measuring job strain, stress of conscience, personal and work-related aspects and health complaints were completed by NAs (n = 225). Comparisons of high and low levels of job strain and stress of conscience and multiple linear regression analyses were performed. Result Organisational and environmental support and low education levels were associated with low levels of job strain and stress of conscience. Personalised care provision and leadership were related to stress of conscience and the caring climate was related to job strain. Conclusion There is a need for support from the managers and a supportive organisation for reducing nurse assistants work-related stress, which in turn can create a positive caring climate where the nurse assistants are able to provide high quality care. Implications for nursing management The managers' role is essential when designing supportive measures and implementing a value-system that can facilitate personalised care provision.

  • 115.
    Orrung Wallin, Anneli
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II.
    Jakobsson, Ulf
    Lunds universitet.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II.
    Leadership and person-centeredness – important factors of job strain and stress of conscience among nurse assistants’ working in residential care2013Conference paper (Refereed)
    Abstract [en]

    Introduction : It is important to investigate the job strain and stress of

    conscience (SC) of NAs not only for the sake of nurse assistants

    (NAs), but also due to the impact on the quality of care they provide.

    Thus, the aim of this study was to investigate job strain, SC and

    associated variables among NAs working in residential care. Method :

    NAs (n=225) completed questionnaires, including job strain, SC and

    potentially associated variables. The variables were compared

    concerning high and low job strain and SC and were explored with

    multiple linear regression analyses. Results : Organisational and

    environmental support, personalised care provision and, a positive

    caring climate were associated with low job strain and SC as well as

    NAs receiving a supportive leadership. In addition, having compulsory

    schooling in comparison with upper secondary schooling was

    associated with low job strain and SC. Factors related to health

    complaints and work-related information were associated with high

    job strain and SC. Conclusion : Exploring and adopting a broader

    perspective of factors which are connected to strenuous aspects of

    NAs’ work situation in residential care are important for the provision

    and management of nursing-care. In order to ensure the wellbeing of

    NAs and in turn the quality of care, both the NAs and their leaders

    need to be addressed simultaneously. Person-centeredness concerns

    the actual care-provision and the care climate which need to be

    implemented into the care system/care philosophy. This highlights the

    importance of the leaders’ role as crucial when implementing or

    sustaining person-centred care in residential care for older people.

  • 116.
    Persson, Lena
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Kvist, Ulf
    Centralsjukhuset i Kristianstad.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Jakobsson, Liselotte
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Framväxt av en forskningsplattform2013In: Aktionsforskning i vård och omsorg: tillämpning och teori / [ed] Liselotte Jakobsson, Malmö: Gleerups Utbildning AB , 2013, p. 173-180Chapter in book (Other (popular science, discussion, etc.))
  • 117.
    Petersson, Pia
    et al.
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Westergren, Albert
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Haak, Maria
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health.
    Developing a model that support preventive home visit for seniors – a collaborative development and research project2019Conference paper (Refereed)
  • 118.
    Rahm, Henrik
    et al.
    Lunds universitet.
    Andersson, Magdalena
    Malmö Högskola.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    The collective voice: legitimation strategies in focus group discussion with nurses in municipal palliative care for older people in Sweden2014In: Communication & Medicine: An Interdisciplinary Journal of Healthcare, Ethics and Society, ISSN 1612-1783, E-ISSN 1613-3625, Vol. 11, no 2, p. 167-177Article in journal (Refereed)
    Abstract [en]

    This paper explores focus group discussions of registered nurses in municipal palliative care for older people, using data collected by researchers with an interest in health sciences. The linguistically based discourse analyis builds on a combination of Bakhtinian notions of dialogicity, the Other and addressivity, the use of quotations, and also van Leeuwen’s framework for legitimation in discourse. The aim is to investigate strategies of addressing and legitimizing palliative care. Three types of narrative are discerned: the cautionary tale, fictionalization of professional experiences and the enactment of a fictive dialogue. The other professions involved (physicians, assistant nurses) are positioned as the Other as a means of legitimizing the perspectives of the registered nurses. As the patients and their next of kin are the objects of professional activities, the notion of the Third (connecting to the Other) is proposed. The objectification is a manifestation of commitment with routinized and professional distance to the patients.

  • 119.
    Sjöberg, Marina
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Existentiell ensamhet -en utmaning i vården av sköra äldre presoner: äldre personers upplevelser2016Conference paper (Other academic)
  • 120.
    Sjöberg, Marina
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Rasmussen, Birgit H
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Being disconnected from life - meanings of existential loneliness as narrated by frail older people2017Conference paper (Other academic)
  • 121.
    Sjöberg, Marina
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Rasmussen, Birgit H
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Being disconnected from life: meanings of existential loneliness as narrated by frail older people2018In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 22, no 10, p. 1357-1364Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study illuminated the meanings of existential loneliness (EL) as narrated by frail older people.

    METHOD: Data were collected through individual narrative interviews with 23 people 76-101 years old receiving long-term care and services. A phenomenological hermeneutical analysis was performed, including a naïve reading and two structural analyses as a basis for a comprehensive understanding of EL.

    RESULT: Four themes were identified related to meanings of EL: (1) being trapped in a frail and deteriorating body; (2) being met with indifference; (3) having nobody to share life with; and (4) lacking purpose and meaning. These intertwined themes were synthesized into a comprehensive understanding of EL as 'being disconnected from life'.

    CONCLUSION: Illness and physical limitation affects access to the world. When being met with indifference and being unable to share one's thoughts and experiences of life with others, a sense of worthlessness is reinforced, triggering an experience of meaninglessness and EL, i.e. disconnection from life. It is urgent to develop support strategies that can be used by health care professionals to address older people in vulnerable situations, thereby facilitating connectedness.

  • 122.
    Sjöberg, Marina
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Rasmussen, Birgit H
    Malmö universitet.
    Beck, Ingela
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Being acknowledged by others and bracketing negative thoughts and feelings: frail older people's narrations of how existential loneliness is eased.2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 14, no 1Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

  • 123.
    Sjöblom, Ingela
    et al.
    Lunds universitet.
    Nordström, Berit
    Lunds universitet.
    Edberg, Anna-Karin
    Lunds universitet.
    A qualitative study of women's experiences of home birth in Sweden.2006In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 22, no 4, p. 348-355Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: to illuminate the experiences of women who have given birth at home.

    METHODS: a descriptive design with a qualitative approach based on interviews with 12 women. The text was analysed using a phenomenological-hermeneutic method.

    FINDINGS: giving birth at home meant preserved authority and autonomy whereby the women themselves ruled the situation. The women's experiences of giving birth at home can be divided into three themes, with internal variations viewed as sub-themes. The main themes were as follows: 'having faith in one's own competence'; 'choosing support on one's own terms'; and 'being at home'. The experience embraced an earthly dimension, represented by reliance on inherent natural forces, and an existential, spiritual dimension, represented by faith in life itself, expressed in terms of the sacredness of giving birth, a heavenly experience, and wisdom about life itself.

    CONCLUSION: the experience of giving birth at home seems to differ from findings of studies focusing on the experience of giving birth in hospital. A reasonable goal for maternity care in hospital could, however, be that all women should have the opportunity to give birth on their own terms in a supportive and calm environment, surrounded by people who can assist if needed.

  • 124.
    Sjödahl Hammarlund, Catharina
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Lund University.
    Westergren, Albert
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Åström, Ingrid
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Hagell, Peter
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    The Impact of Living with Parkinson’s Disease: Balancing within a Web of Needs and Demands2018In: Parkinson's Disease, ISSN 2090-8083, E-ISSN 2042-0080, Vol. 2018, article id 4598651Article in journal (Refereed)
    Abstract [en]

    This study explores the impact of living with Parkinson’s disease (PD). Nineteen persons (11 women) aged 55–84 diagnosed with PD 3–27 years ago participated. Data were collected through semistructured interviews, which were recorded, transcribed verbatim, and analysed by qualitative content analysis. Four categories represented the impact of living with PD: “Changed prerequisites for managing day-to-day demands,” “Loss of identity and dignity,” “Compromised social participation,” and “The use of practical and psychological strategies.” There was a shift from an internal to an external locus of control in managing, control, competence, relatedness, and autonomy. According to self-determination theory, a shift towards extrinsically motivated behaviours may occur when these basic needs are thwarted, leading to compensatory strategies or needs substitutes with negative consequences on health and well-being. We suggest a needs-based approach as an important starting point to better understand the consequences of living with PD and to explore the means for people with PD to acquire an improved quality of life on their own terms. In conclusion, our findings suggest for a shift in focus, from a biomedical to a needs-based approach to understand the impact of living with PD and facilitate more person-centred care and person-centred outcome measurement.

  • 125.
    Skogman Pavulans, Katarina
    et al.
    Department of Clinical Sciences-Lund, Division of Psychiatry, Lund University.
    Bolmsjö, Ingrid
    Department of Health and Science, Malmö University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Öjehagen, Agneta
    Department of Clinical Sciences-Lund, Division of Psychiatry, Lund University.
    Being in want of control: experiences of being on the road to, and making, a suicide attempt2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, p. 16228-Article in journal (Refereed)
    Abstract [en]

    Attempted suicide is a risk factor for future suicidal behaviour, but understanding suicidality from the perspective of people who have experienced attempted suicide is limited. The aim of the study was to explore the lived experience of being suicidal and having made a suicide attempt, in order to identify possible implications for health care professionals. Semi-structured individual interviews were held with 10 persons shortly after they attempted suicide and were analysed through qualitative content analysis. The participants’ experience of being suicidal and of having attempted suicide could be described as “Being on the road towards suicidal action”, which culminated in an experience of either chaos or turned off emotions, “Making sense of the suicide attempt”, and “Opening the door to possible life lines”. An overall theme, “Being in want of control”, captured their all-embracing lack of sense of control and was seen in relation to different aspects of oneself, overall life-situation, the immediate suicide attempt situation and in the outlook on the future. Being in want of control may be a relevant and general feature of being suicidal. People who have attempted suicide need more adequate help to break vicious circles before they reach a point of no return and enter an acute suicidal state of mind. Patients’ experience-based knowledge is highly important to listen to and use clinically as well as theoretically when constructing suicide prevention programs.

  • 126.
    Skovdahl, Kirsti
    et al.
    Örebro universitet.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Stöd för relationen: metoder för kommunikation och sinnesstimulering2011In: Att möta personer med demens / [ed] Anna-Karin Edberg, Lund: Studentlitteratur, 2011, 2, p. 323-344Chapter in book (Other academic)
  • 127.
    Sundström, Malin
    et al.
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Rämgård, Margareta
    Malmö Universitet.
    The context of care matters: older people’s existential loneliness from the perspective of healthcare professionals: a multiple case study2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 14, no 3Article in journal (Refereed)
    Abstract [en]

    AIM:

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

    BACKGROUND:

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

    DESIGN:

    A multiple case study design was used.

    METHODS:

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

    FINDINGS:

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

    CONCLUSIONS:

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

    IMPLICATIONS FOR PRACTICE:

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

  • 128.
    Sundström, Malin
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Rämgård, Margaret
    Malmö University.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Health care staff’s perception of existential loneliness among older people2017Conference paper (Other academic)
  • 129.
    Sundström, Malin
    et al.
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Rämgård, Margareta
    Malmö University.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Encountering existential loneliness among older people: perspectives of health care professionals2018In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Existential loneliness is part of being human that is little understood in health care, but, to provide good care to their older patients, professionals need to be able to meet their existential concerns. The aim of this study was to explore health care professionals' experiences of their encounters with older people they perceive to experience existential loneliness.

    METHOD: We conducted 11 focus groups with 61 health professionals working in home care, nursing home care, palliative care, primary care, hospital care, or pre-hospital care. Our deductive-inductive analytical approach used a theoretical framework based on the work of Emmy van Deurzen in the deductive phase and an interpretative approach in the inductive phase.

    RESULTS: The results show that professionals perceived existential loneliness to appear in various forms associated with barriers in their encounters, such as the older people's bodily limitations, demands and needs perceived as insatiable, personal shield of privacy, or fear and difficulty in encountering existential issues.

    CONCLUSION: Encountering existential loneliness affected the professionals and their feelings in various ways, but they generally found the experience both challenging and meaningful.

  • 130. Svensson, Carita
    et al.
    Edfors, Ellinor
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Research Platform for Collaboration for Health.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Sjuksköterskors upplevelser av faktorer som bidrar till närvaro i mötet med äldre personer2017Report (Other academic)
    Abstract [sv]

    Hur upplever sjuksköterskan mötet med den äldre personen inom kommunal vård ochomsorg? Ett sätt för sjuksköterskan att känna närvaro i mötet är genom att helhjärtatlyssna på den äldre när hen inbjuder till samtal om sina tankar eller om livshistorian.Sjuksköterskan kan genom mötet uppleva en högre mening med sitt arbete och få enmöjlighet att etablera en relation med den äldre. Att vårda äldre personer ställer högakrav på omvårdnaden där en helhetssyn med fokus på personcentrerad omvårdnadstår i centrum och kunskaper i äldre personers psykologiska och sociala åldrande kanhjälpa sjuksköterskan vara närvarande i mötet. Syftet var att beskriva sjuksköterskorsupplevelser av faktorer som bidrar till möjligheten att vara närvarande i mötet medäldre personer inom kommunal vård och omsorg. Nio intervjuer genomfördes medsjuksköterskor inom kommunal vård och omsorg. Intervjuerna analyserades med hjälpav kvalitativ innehållsanalys. Resultatet visade att sjuksköterskorna hade som sin främstaintention att prioritera mötet med vårdtagaren. Faktorer som bidrog till sjuksköterskornasmöjlighet till närvaro i mötet med äldre var relaterade till; (I) mötet i form avatt kunna bygga på en tidigare relation, att ha gemensamma beröringspunkter, att haen ömsesidig öppenhet och vilja att dela varandras glädje- och sorgeämnen (II) vårdtagareni form av att vårdtagaren har förtroende för sjuksköterskan, att vårdtagareninbjuder till samtal och vårdtagarens tillstånd (III) sjuksköterskan i form av kunskaperom vårdtagaren och betydelsen av att vara närvarande i mötet, personlig mognad ochsjälvkännedom, att vara genuint intresserad av vårdtagaren och visa respekt och attkunna hantera sina känslor, samt (IV) organisationen i form av att ha tid, att ha möjlighetatt prioritera mellan olika arbetsuppgifter, hur vårdarbetet fördelas och organiserasoch den kontext som sjuksköterskan befinner sig i. Resultatet visade att sjuksköterskornahade som intention att vara närvarande i mötet. Det var dock inte alltid så lättatt få tid till mötet på grund av tids- och/eller personalbrist, men även sjuksköterskanspersonliga mognad och erfarenhet hade betydelse för att kunna/våga vara närvarandei mötet. En positiv och stödjande arbetsledning samt ett nära samarbete med kollegersågs som viktiga resurser i det dagliga omvårdnadsarbetet.

  • 131.
    Sävenstedt, Stefan
    et al.
    Luleå Universitet.
    Wijk, Helle
    Göteborgs Universitet.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Boström, Anne-Marie
    Karolinska Institutet.
    Wallerstedt, Birgitta
    Linnéuniversitetet.
    Öster, Caisa
    Uppsala Universitet.
    From, Ingrid
    Högskolan Dalarna.
    Häggström, Elisabeth
    Högskolan i Gävle.
    Kristensson, Jimmie
    Lunds Universitet.
    Sjögren Forss, Katarina
    Malmö Högskola.
    Ernsth Bravell, Marie
    Jönköping University.
    Sahlén, Klas Göran
    Umeå universitet.
    Karlsson, Margareta
    Högskolan Väst.
    Iritz Hedberg, Kristina
    Riksföreningen för sjuksköterskan inom äldrevård.
    Varför är sjuksköterskornas kunskap inte viktig?2017In: Dagens Samhälle, ISSN 1652-6511, no 21 marsArticle in journal (Other (popular science, discussion, etc.))
  • 132.
    Theander, Eva
    et al.
    Hässleholm Hospital.
    Edberg, Anna-Karin
    Kristianstad University, Department of Health Sciences.
    Preventive home visits to older people in Southern Sweden2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 5, p. 392-400Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It seems urgent to further develop and modify models of preventive measures in order to prolong a healthy functional and social situation for older people, as this population is increasing globally. The aim of the study was to describe a Swedish model of preventive home visits for persons aged 78 years with the focus on the effect on physical and social well-being, and the participants' and the visitors' experience of the home visits.

    METHOD: Three annual visits were performed and included 150 persons, 78 years old at the first visit. Data were collected in the form of a structured interview with the persons who received the visits and as a questionnaire for their visitors.

    RESULTS: Differences over time could be seen for the participants' physical and social activity, indicating that there was a deterioration between year one and two that was not seen in year three. The results further showed that the participants felt more secure and well informed as a result of the visits. The visitors said that they had gained a new, more positive view of older people and increased job satisfaction as a result of the visits and emphasized the impact on their own professional development.

    CONCLUSION: As no control group was used, the interpretation of effects concerning health factors has to be interpreted with caution. The visits did, however, have a positive impact on the participants and the visitors.

  • 133.
    Törnquist, Agneta
    et al.
    The Swedish Institute for Health Sciences, Lund University.
    Andersson, Magdalena
    The Swedish Institute for Health Sciences, Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    In search of legitimacy – registered nurses’ experience of providing palliative care in a municipal context2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 651-658Article in journal (Refereed)
    Abstract [en]

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

  • 134.
    Werntoft, Elisabet
    et al.
    Department of Health Sciences, Division of Nursing, Lund University.
    Edberg, Anna-Karin
    Department of Health Sciences, Division of Nursing, Lund University.
    Decision makers' experiences of prioritisation and views about how to finance healthcare costs2009In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 92, no 2-3, p. 259-267Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Prioritisation in healthcare is an issue of growing importance due to scarcity of resources. The aims of this study were firstly to describe decision makers' experience of prioritisation and their views concerning willingness to pay and how to finance healthcare costs. An additional aim was to compare the views of politicians and physicians.

    METHODS: The study was a cross-sectional study based on a questionnaire administered to 700 Swedish politicians and physicians. This was analysed using both quantitative and qualitative methods.

    RESULTS: A majority of the decision makers (55%) suggested that increasing costs should be financed through higher taxation but more physicians than politicians thought that higher patient fees, private health insurance and a reduction in social expenditure were better alternatives. Prioritisation aroused anxiety; politicians were afraid of displeasing voters while physicians were afraid of making medically incorrect decisions.

    CONCLUSIONS: This study do not answer the question about how to make prioritisation in health care but the result highlights the different ways that the decision makers view the subject and thereby elicit that publicly elected politicians and physicians perhaps not always work with the same goal ahead. There are needs for more research but also more media focus on the subject so the citizens will be aware and take part in the debate.

  • 135.
    Werntoft, Elisabet
    et al.
    Department of Health Sciences, Division of Nursing, Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Lack of support structures in prioritization decision making concerning patients and resources: interviews with Swedish physicians2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 6, p. 627-633Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints. Methods: Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis. Results: Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: Prioritisation, easier in theory than in practice, and Increasing costs threaten the Swedish welfare model. Conclusions: The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.

  • 136.
    Werntoft, Elisabet
    et al.
    Lunds universitet.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Lunds universitet.
    Swedish politicians’ view of obstacles when dealing with priority settings in health care2015In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 29, no 4, p. 532-542Article in journal (Refereed)
    Abstract [en]

    Purpose

    The purpose of this paper is to identify and describe main obstacles for politicians when dealing with healthcare priority setting.

    Design/methodology/approach

    The study had an exploratory descriptive design based on interviews with 18 politicians from two different county councils in Sweden. The interviews were analyzed using inductive qualitative content analysis.

    Findings

    The politicians highlighted the importance of, and difficulties in, communicate political missions; the politicians in this study saw the media as not always being fair watchdogs, implying that possibly important but unpopular prioritizing decisions were not made because of the risks of being badly reported and therefore not re-elected. Breaking up established structures in care practice is difficult and change takes time, partly because of existing higher level financing and rules and the system’s traditional separation of facilities and services. Although the politicians highlighted their limited power to influence and control resource allocation they could give small and “lower profile”, low-prioritized disciplines control of their own budgets and base payments on the results the disciplines accomplished.

    Originality/value

    This study highlights the difficulties that politicians experience, for example, having to take unpleasant decisions and thereby run the risk of being scrutinized by media, which in turn could influence how effectively tax money is being used.

  • 137.
    Werntoft, Elisabet
    et al.
    Lunds universitet.
    Edberg, Anna-Karin
    Lunds universitet.
    The views of physicians and politicians concerning age-related prioritisation in healthcare.2009In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 23, no 1, p. 38-52Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study is to describe the view of age-related prioritisation in health care among physicians and healthcare politicians and to compare their views regarding gender and age.

    DESIGN/METHODOLOGY/APPROACH: Swedish physicians (n=390) and politicians (n=310), mean age 52 years, answered an electronic questionnaire concerning age-related priority setting in healthcare. The questionnaire had fixed response alternatives with possibility of adding comments.

    FINDINGS: A majority of the participants thought that age should not influence prioritisation, although more physicians than politicians thought that younger patients should be prioritised. There were also significant differences concerning their views on lifestyle-related diseases and on who should make decisions concerning both vertical and horizontal prioritisation. The comments indicated that the politicians referred to ethical principles as a basis for their standpoints while the physicians often referred to the importance of biological rather than chronological age.

    RESEARCH LIMITATIONS/IMPLICATIONS: Web-based surveys as a method has its limitations as biased samples and biased returns could cause major problems, such as limited control over the drop-outs. The sample in this study was, however, judged to be representative.

    PRACTICAL IMPLICATIONS: The results indicate that supplementary guiding principles concerning prioritisation in healthcare are needed in order to facilitate decision-making concerning resource allocation on a local level.

    ORIGINALITY/VALUE: This paper adds important knowledge about decision makers' views on age-related priorities in healthcare, thus contributing to scientific base for prioritisation in healthcare and the ongoing debate in society.

  • 138. Werntoft, Elisabet
    et al.
    Edberg, Anna-Karin
    Department of Health Sciences, Division of Gerontology and Caring Sciences, Lund University.
    Rooke, Liselotte
    Hermerén, Göran
    Elmståhl, Sölve
    Hallberg, Ingalill Rahm
    Older people's views of prioritization in health care: the applicability of an interview study2005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 8B, p. 64-74Article in journal (Refereed)
    Abstract [en]

    AIM: Older people's views of prioritization in health care. The applicability of an interview study. Old age has been stated as a criterion for prioritization in health care, although older people are seldom asked for their opinions. The aim of this pilot study was to investigate the applicability of a questionnaire as a base for an interview study to explore older people's experiences and views of prioritization in health care.

    DESIGN: Descriptive, with a qualitative and quantitative approach. Fifty-four persons, 32 women and 22 men (aged 60-93 years), were asked to participate in a structured, tape-recorded interview covering their experience and views of the priorities applied in health care.

    RESULTS: The questions in the interview manual appeared to be applicable for collecting data concerning views of prioritization, but the analysis revealed that certain questions, particularly on economic matters, were missing. The procedure, a personal structured interview had advantages, for example, in capturing the respondents' reflections on the questions. The respondents emphasized the equal value of all human beings and that age is not a basis for prioritization within health care. The respondents also showed an unwillingness to precede anyone in rank.

    IMPLICATIONS: The questions used proved to be adequate but to be really complete further questions need to be added. This pilot study indicates that older people's views on priorities in health care differ from those expressed by the younger population. The study therefore needs to be replicated in a larger sample to be fully able to understand older people's views of prioritization, which will require exploring gender and age differences as well as other aspects that may explain variations.

  • 139.
    Werntoft, Elisabet
    et al.
    Lund University.
    Hallberg, Ingalill R.
    Lund University.
    Edberg, Anna-Karin
    Lund University.
    Older people's reasoning about age-related prioritization in health care2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 3, p. 399-412Article in journal (Refereed)
    Abstract [en]

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

  • 140.
    Werntoft, Elisabet
    et al.
    Lunds universitet.
    Hallberg, Ingalill R
    Lunds universitet.
    Edberg, Anna-Karin
    Lunds universitet.
    Prioritization and resource allocation in health care: the views of older people receiving continuous public care and service.2007In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 10, no 2, p. 117-128Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe the views of people, 65 years and over, receiving continuous public care and service, on prioritization and resource allocation in health care, in relation to gender, age, housing, health-related quality of life (QoL) and degree of activities of daily living (ADL) dependency.

    BACKGROUND: How older people receiving continuous public care and service view prioritization and resource allocation in health care is sparsely investigated, although this group most certainly has the experience and also often is the target in discussions concerning prioritization. It is necessary, for democracy and for the development of new models of service delivery, to find out how people receiving long-term care and service view these issues.

    DESIGN: 146 persons, 34 men (23%) and 112 women (77%), aged 66-100 years were interviewed face to face, following a structured questionnaire.

    RESULTS: The respondents thought that the patients' well-being, way of living and family situation should affect prioritization, not age per se. Resourcing of several health-care services were considered to be below what is required by a majority of the respondents. The respondents wanted doctors to decide on prioritization at an individual level and wanted higher taxes to finance increasing health-care costs. Although the respondents wanted publicly financed health care, a relatively high number were willing to pay for treatment.

    CONCLUSIONS: Knowledge of how older people receiving care and services, view prioritization and resource allocation has not previously been available. It seems that their views are in line with the Swedish Parliamentary Priority Commission which suggested that no account should be taken of age when allocating resources within the health-care system. Respondents' age, gender, housing, health-related QoL and degree of dependency in ADL had limited influence on their views of resource allocation.

  • 141.
    Werntoft, Elisabet
    et al.
    Department of Health Sciences, Lund University.
    Rahm Hallberg, Ingalill
    Department of Health Sciences, Lund University.
    Elmståhl, Sölve
    Department of Health Sciences, Lund University.
    Edberg, Anna-Karin
    Department of Health Sciences, Lund University.
    Older people's views of prioritization in health care2005In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 17, no 5, p. 402-411Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: The aim of this study was to investigate and compare older people's views of prioritization in health care with specific regard to age, gender and HRQoL.

    METHODS: The sample was collected from a prospective longitudinal cohort study, the GAS project (Good Ageing in Skane) that is in progress in Sweden. For this study, 902 persons, 424 men and 478 women, aged between 60 and 93 years, were invited consecutively over a period of 17 months to participate in an additional structured interview based on an interview manual. Socio-demographic and HRQoL data were collected from the GAS project. For the analysis, the sample was divided into age groups: young-old, old-old, and oldest-old.

    RESULTS: Older people in general did not want age as a criterion for prioritization in health care. When pain was added as a criterion, age became even less important than when it was the sole criterion. The oldest-old, to a higher degree than the other age groups, prioritized younger patients, as did men, while women, more than men, preferred "old age" as an indicator for prioritization. The respondents' views on prioritization were also more associated with age and gender than HRQoL.

    CONCLUSIONS: Older people's views of priorities seem to differ from previous population-based studies, in that age per se as a criterion for selection between patients was not favored; health and wellbeing were more important. Differences were, however, found within the group of older people, as regards both age and gender.

  • 142.
    Werntoft, Elisabet
    et al.
    Lunds universitet.
    Rahm Hallberg, Ingalill
    Lunds universitet.
    Elmståhl, Sölve
    Lunds Universitet.
    Edberg, Anna-Karin
    Lunds universitet.
    Older people's views on how to finance increasing health-care costs2006In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 26, no 3, p. 497-514Article in journal (Refereed)
    Abstract [en]

    The aims of this paper are to investigate both older people's views about ways in which to finance health-care costs and their willingness to pay for treatment themselves, along with variations in these views by age and gender. The data are from the Good Ageing in Skåne (GAS) prospective longitudinal cohort study in Sweden, which involved medical examinations and a survey of living arrangements and socio-economic conditions. For the analysis reported in this paper, 930 GAS respondents aged 60–93 years were invited to participate in an additional structured interview, and 902 (97%) accepted. The sample was divided into the ‘young-old’ (aged 60–72 years), ‘old-old’ (78–84 years) and ‘oldest-old’ (87–93 years). It was found that the participants recommended increasing health-care funding by higher taxes and that they were willing to pay themselves for specific treatments, e.g. cosmetic surgery and medication to combat impotence and obesity. Many were also willing to pay privately for cataract surgery, to shorten the wait, although the respondent's financial circumstances associated with this willingness. Significantly more men than women, and of the ‘young-old’ than of the other two age groups, would pay for cataract surgery. The views of people aged 85 or more years differed from those of the young-old, e.g. significantly fewer believed that older people's health care received too little resource. Views about how to finance health care thus differed among the age groups and between men and women.

  • 143.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Blomqvist, Kerstin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Petersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Sätt måltidsupplevelsen i centrum2012In: Kristianstadsbladet, ISSN 1103-9523, no 16/6, p. B4-Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Måltidsupplevelsen påverkas av så mycket; ljuset i lokalen, ljud, dukning, servering, bemötande, maten, smakerna, doften och sällskapet. Men hur kan den kunskapen omsättas på sjukhus och äldreboenden? Det skriver Albert Westergren, professor i omvårdnad, Kerstin Blomqvist, biträdande professor i klinisk omvårdnad, Anna-Karin Edberg, professor i omvårdnad, och Pia Petersson, ansvarig för sjuksköterskeprogrammet, samtliga på Högskolan Kristianstad.

  • 144.
    Wijesiri, H S Maliga S K
    et al.
    Sri Lanka.
    Samarasinghe, Kerstin
    Kristianstad University, Faculty of Health Science.
    Edberg, Anna-Karin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Loneliness among older people living in care homes in Sri Lanka2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 145.
    Ågren Bolmsjö, Ingrid
    et al.
    Vårdalsinstitutet.
    Edberg, Anna-Karin
    Vårdalsinstitutet.
    Sandman, Lars
    Högskolan i Borås.
    Everyday ethical problems in dementia care: a teleological model.2006In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 4, p. 340-359Article in journal (Refereed)
    Abstract [en]

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

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