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  • 151.
    Ballovarre, Eva
    Kristianstad University, School of Health and Society.
    Samtalet mellan distriktssköterskan och patienten med nyligen upptäckt essentiell hypertoni: En kvalitativ intervjustudie2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Hypertension related to lifestyle factors is an increasing problem in Sweden and according to current guidelines should changes in lifestyle associated with these factors be highly prioritized in the treatment of hypertension. District nurse's work with patients with the diagnosis of hypertension includes checking blood pressure and giving advice in lifestyle changes that can reduce the blood pressure. The purpose of this study was to describe the conversation with the patient with newly discovered essential hypertension as it was experienced by the district nurse. The study has a qualitative approach and was conducted with qualitative, semi-structured interviews with seven district nurses. The analysis of the collected data material was done with a content analysis including both the manifest and latent content and resulted in three main categories; alternate between different functions, create confidence in the relationship with the patient and adapt the conversation to the patients needs. The results showed that the district nurses in the conversation with the patient with hypertension were striving to create a trusting relationship and in this relationship provide lifestyle-related healthcare to the patient. In the conversation the district nurse alternated between various functions such as acting as a catalyst and express messages. She tried to ensure the patient's needs. Sometimes dilemmas arose when the district nurse had to prioritise between topics which were important for lifestyle changes, but could be considered as offensive to the patient. Thereby she prevented negative effects that could impact on the relationship. The conclusion of the result was that the conversation and thus the care of patients with hypertension differed depending on which district nurse the patient came to.

  • 152.
    Bashota, Dren
    et al.
    Kristianstad University, School of Health and Society.
    Isenheim, Sascha
    Kristianstad University, School of Health and Society.
    Hur är det att vara patient på en akutmottagning?: en litteraturstudie baserad på patienters upplevelse2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Människor besöker akutmottagningen vid försämrat hälsotillstånd. Patienterna omhändertas genom triagering beroende på patienten tillstånd. På en akutmottagning arbetar olika vårdprofessioner med varandra i team. Ett möte utspelar sig då patienten kommer i kontakt med vårdpersonalen. Patienten kan känna sig i en utsatt position då kontakt etableras med sjukvården. Patienterna uttrycker sina upplevelser i mötet och beskriver sin vistelse relaterat till bemötandet. Syfte: Syftet var att belysa personers upplevelser av att vara patient på akutmottagningen inom den somatiska vården. Metod: Studien är en kvalitativ innehållsanalys bestående av 10 vetenskapliga artiklar. Vi använde oss utav Fribergs (2012) analysmetod. Resultat: Kommunikationens betydelse, väntetiden, att bli sedd, förtroendet för vårdpersonal och patientens delaktighet var faktorer som påverkade patientens upplevelser. Dessa kunde ge positiva eller negativa upplevelser för patienten. Kategorierna är oberoende av varandra och kan vara tillfredsställande även om någon av kategorierna brister. Slutsats: Studier visar att relevanta arbetsmodeller kan implementeras för att påverka patienternas återkommande besök genom förbättrat bemötande och kommunikation.

  • 153.
    Basic, Edita
    Kristianstad University, School of Health and Society.
    Språk som hinder: kommunikationssvårigheter mellan vårdpersonal och patienter som är immigranter med annat modersmål2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: When health care staff interact with immigrant patients who have a different native tongue language skills are sometimes not sufficient. Aim: The aim is to describe the employees’ experiences when communicating with patients with a foreign native tongue. Method: A literature review was carried out based on ten scientific articles. These articles were reviewed with a review model used by the Red Cross Collage. Result: Based on the given context the results were compiled into three categories: Language barrier as an obstacle for health care, here attention is drawn to the fact that a ”language barrier”, which occurs between employees and immigrant patients, is an obstacle in health care. Language barrier as a stress factor, emphasizes that the language barrier can create stress for the staff. Language barrier which requires temporary interpreters: a need and an obstacle, temporary interpreters are presented here, namely bilingual employees or patients’ relatives. This is perceived as a necessity and an obstacle when communicating. Conclusion: The Swedish National Board of Health and Welfare emphasizes that the healthcare staff shall give all patients good health and social care no matter the native language. The strategies to combat language barriers should be specific for different professionals. The need to use trained interpreters, in order to assure a satisfactory communication between personnel and patients, is important.  To fight the language barriers actions from researchers, decision-makers and healthcare staff are required.

  • 154.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    An intervention applying a palliative care approach in residential care: influences on nurse assistants' work situation2013Conference paper (Other academic)
    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.

  • 155.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Att fokusera på "varandet" i en värld av görande: stöd till personalen i ett palliativt förhållningssätt vid vård- och omsorgsboende för äldre2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to study nurse assistants’ experience of palliative care and to investigate how an intervention with a focus on a palliative care approach in residential care facilities influenced the nurse assistants and their work situation. The thesis is based on two qualitative and two quantitative studies, focusing on nurse assistants working at residential care facilities for older people. The qualitative studies were based on focus-group interviews before the intervention (I) and individual interviews after the intervention (IV). The quantitative studies (II, III) were based on a questionnaire, including several measurements, that was answered pre-, and post- intervention. The intervention consisted of study circles with nurse assistants, and workshops together with their leaders, focusing on improvement work. 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. The results show that the nurse assistants experienced that it was difficult to focus on “being”, i.e. on relationship aspects in their work, since the main discourse in residential care focused on “doing”, i.e. on task oriented aspects. Palliative care was described as something that was only applied during a short and defined phase, namely the very last days of the residents’ life. The results also show that nurse assistants experienced difficulties facing emotional and existential issues with regards to both the residents and their relatives (I). The results of study I were, in turn, used as a basis for the development of the intervention. The evaluation of the intervention showed that the nurse assistants, 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 (III). The nurse assistants also stated that they experienced less criticism from their superiors as well as from the residents after the intervention (II). However, the evaluation also showed that the nurse assistants had a more negative view of the leadership (II), were more critical to the medical and the nursing care (III), and that their job satisfaction had decreased (II) 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 (IV), standing in the way of the implementation of changes. The results indicate that the nurse assistants, through discussions and reflections over praxis in their ordinary work group, developed an increased awareness about, and focus on “being”, i.e. on relationship aspects. However, it would seem that essential prerequisites, such as support from the leaders and sufficient resources for working in line with a palliative care approach, were not provided. When implementing a palliative care approach in residential care facilities, more focus on support to the leaders is needed in order to maintain sustainable changes.

  • 156.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health.
    Increasing nurse assistants' focus on residents' situation and needs by applying a palliative care approach in residential care facilities2014Conference paper (Refereed)
  • 157.
    Beck, Ingela
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Palliativ vård2017In: Omvårdnad & äldre / [ed] Kerstin Blomqvist, Anna-Karin Edberg, Marie Ernsth Bravell, Helle Wijk, Lund: Studentlitteratur, 2017, p. 509-526Chapter in book (Other academic)
  • 158.
    Beck, Ingela
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Stödet till personalen vid vård- och omsorgsboende är avgörande för deras möjlighet att möta äldre personers situation och behov2013In: Tidningen Ä, en tidning för Riksföreningen Sjuksköterskan inom Äldrevård, no 4, p. 16-19Article in journal (Other academic)
  • 159.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Teori och modeller som stöd för personcentrerade möten2017In: Omvårdnad & Äldre / [ed] Kerstin Blomqvist, Anna-Karin Edberg, Marie Ernsth Bravell, Helle Wijk, Lund: Studentlitteratur, 2017, p. 49-60Chapter in book (Other academic)
  • 160.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health. Vårdalinstiutet.
    Jakobsson, Ulf
    Lunds universitet.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health. Vårdalinstitutet.
    An intervention applying a palliative care approach in residential care-effects on care provision and caring climate2013Conference paper (Refereed)
    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.

  • 161.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health.
    Jakobsson, Ulf
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Applying a palliative care approach in residential care: effects on nurse assistants' experiences of care provision and caring climate2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, p. 830-841Article in journal (Refereed)
    Abstract [en]

    Background

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

    Methods

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

    Results

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

    Conclusion

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

  • 162.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health.
    Jakobsson, Ulf
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Applying a palliative care approach in residential care: effects on nurse assistants' work situation2015In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 3, p. 543-553Article in journal (Refereed)
    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.

  • 163.
    Beck, Ingela
    et al.
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Pålsson, Christina
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Bengtsson-Tops, Anita
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Upholding an ideal image of palliative work in the face of obstacles2018In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 24, no 12, p. 611-617Article in journal (Refereed)
    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.

  • 164.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Runeson, Ingrid
    Blomqvist, Kerstin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    To find inner peace: soft massage as an established and integrated part of palliative care2009In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 15, no 11, p. 541-545Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to demonstrate how people with incurable cancer experienced soft massage in a palliative care setting in which massage was used as an established and integrated part of the nursing care. To reach a deep understanding of the experiences of receiving soft massage a qualitative method with a phenomenological approach was chosen. The study was based on interviews with eight patients in an advanced home care setting who had all received soft massage as part of their daily care. Soft massage was experienced by the informants as a way to find inner peace. During the massage the patients felt dignified, while memories from past massage sessions were about becoming free. These experiences of dignity and freedom brought hopes for the future. The conclusion is that soft massage ought to be offered in the ordinary palliative care. More research is needed to understand what is needed to integrate and establish methods such as soft massage in the palliative care.

  • 165. Beck, Ingela
    et al.
    Tastesen, Karin
    Beröringsmassage i den dagliga omvårdnaden2006 (ed. 2)Book (Other academic)
  • 166.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Lunds universitet & Vårdalinstitutet .
    Törnquist, A
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society.
    Nurse assistants’ experience of an intervention focused on a palliative care approach to frail older people in residential care2011Conference paper (Other academic)
  • 167.
    Beck, Ingela
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Lunds universitet & Vårdalinstitutet .
    Törnquist, A
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society.
    Nurses’ experience of palliative care in nursing homes2010Conference paper (Other academic)
  • 168.
    Beck, Ingela
    et al.
    Lund University.
    Törnquist, Agneta
    Lund University.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Nurse assistants’ experience of an intervention focused on a palliative care approach for older people in residential care2012In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, no 2, p. 140-150Article in journal (Refereed)
    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.

  • 169.
    Becovic, Jasminka
    et al.
    Kristianstad University, Faculty of Health Science.
    Fager, Johanna
    Kristianstad University, Faculty of Health Science.
    Sjuksköterskors upplevelse av att möta patienter med ett aktivt självskadebeteende: En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Självskadebeteende är ett ökande samhällsproblem och idag räknas det till ett folkhälsoproblem. Detta beteende är ett sätt för personen att göra om den psykiska smärta till en fysisk smärta då det kan vara lättare att hantera, vilket kan ge en ångest lindrade effekt.  Personer som har ett självskadebeteende upplever ibland att i mötet med sjuksköterskor i somatisk akutsjukvård inte är bra. Patientgruppen självskadebeteende är en komplex och komplicerad grupp; dessa personer kan upplevas som provocerande samt att sjuksköterskor kan ha svårt att förstå dem. Syfte: Syftet var att belysa sjuksköterskors upplevelse av att möta personer med ett aktiv självskadebeteende inom den somatiska akutsjukvården. Metod: Kvalitativ litteraturstudie. Studien har en induktiv design och omfattas av åtta artiklar. Sökorden utformades efter syftet. Sökningarna gjordes i tre olika databaser. Resultat: Två kategorier med fem underkategorier kom fram: ” Sjuksköterskors upplevelse av hur bristande kunskap och erfarenheter kunde påverka mötet med personer som har ett självskadebeteende” och ” Sjuksköterskors upplevelse av en ökad förståelse för patienter med självskadebeteende”. Diskussion: Sjuksköterskors upplevelse av bristande adekvat kunskap och kompetens har lyfts fram i denna litteraturstudie. Det har också visats att sjuksköterskors inställning och tillit till den egna förmågan att möta patienter med självskador kunde förbättras genom ökad kunskap.

  • 170.
    Beda, Boniface
    Kristianstad University, School of Health and Society.
    Sjuksköterskans preventionsåtgärder i omvårdnad av personer med självmordsrisk: en litteraturstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Suicide is a problem of existence and each suicide act is a call for help. It is just over 1 million people committing suicide in the whole world every year, which means that ten times more are trying to take their lives. Approximately 1 500 people are dying of suicide in Sweden every year. Some of them have been in contact with the health care system during the last month in their life because of a suicide problem. Purpose: The aim of this essay is to describe the nurses´ prevention strategies for people at a risk of suicide. Method: A literature review based on 11 articles on qualitative and quantitative articles. Results: The analysis of the material showed four crucial categories to be important to handle the risk of suicide: to expand knowledge on prevention, ability to identify risk factors, a therapeutic approach and a preventive social support system. Discussion: The findings discussed show the nurse has to employ all the categories to give a favourable support for people at a risk of suicide. The four categories are interdependent to improve the caring for people at a risk of suicide. The deficit of prevention in any category could degrade the patient´s opportunities to handle its situation. Conclusion: This article could contribute to give information to nurses´ prevention strategies to prevent and handle suicide acts to improve the quality of life for people at a risk of suicide.

  • 171.
    Beeckman, Dimitri
    et al.
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University and Research Staff, Nursing Department, University College Arteveldehoge-school.
    Schoonhoven, Lisette
    Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre.
    Fletcher, Jacqui
    School of Nursing and Midwifery, University of Hertfordshire, Hatfield.
    Furtado, Kátia
    Community Nursing Specialist Centro de Saúde de Arronches, Portalegre.
    Gunningberg, Lena
    Nursing Research and Development Surgery Division, Uppsala University Hospital.
    Heyman, Hilde
    Nursing Home Sint Bartholomeus, Antwerp.
    Lindholm, Christina
    Kristianstad University College, Department of Health Sciences.
    Paquay, Louis
    Wit-Gele Kruis van Vlaanderen, Brussels.
    Verdú, José
    Department of Community Nursing, Preventive Medicine, Public Health and History of Science, School of Nursing, University of Alicante.
    Defloor, Tom
    Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University.
    EPUAP classification system for pressure ulcers: european reliability study2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 6, p. 682-691Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study of the inter-observer reliability of the European Pressure Ulcer Advisory Panel pressure ulcer classification system and of the differential diagnosis between moisture lesions and pressure ulcers. Background. Pressure ulcer classification is a valuable tool to provide a common description of ulcer severity for the purposes of clinical practice, audit and research. Despite everyday use of the European Pressure Ulcer Advisory Panel system, its reliability has been evaluated in only a limited number of studies. Methods. A survey was carried out between September 2005 and February 2006 with a convenience sample of 1452 nurses from five European countries. Respondents classified 20 validated photographs as normal skin, blanchable erythema, pressure ulcers (four grades), moisture lesion or combined lesion. The nurses were familiar with the use of the European Pressure Ulcer Advisory Panel classification scale. Results. Pressure ulcers were often classified erroneously (kappa = 0.33) and only a minority of nurses reached a substantial level of agreement. Grade 3 lesions were regularly classified as grade 2. Non-blanchable erythema was frequently assessed incorrectly as blanchable erythema. Furthermore, the differential diagnosis between moisture lesions and pressure ulcers appeared to be complicated. Conclusion. Inter-observer reliability of the European Pressure Ulcer Advisory Panel classification system was low. Evaluation thus needs to focus on both the clarity and complexity of the system. Definitions and unambiguous descriptions of pressure ulcer grades and the distinction between moisture lesions will probably enhance clarity. To simplify the current classification system, a reduction in the number of grades is suggested.

  • 172.
    Behm, Lina
    University of Gothenburg/ Sahlgrenska Academy.
    It´s never too late: health-promotion and disease-prevention for very old person2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to evaluate the effects of health-promoting and disease-preventive interventions on health and frailty in very old community-dwelling persons, and to explore the participants’ experiences in relation to these interventions. Studies I and II were evaluations of the three-armed randomised, single-blind and controlled trial Elderly Persons in the Risk Zone, which consisted  of the two health-promoting and disease-preventive interventions preventive home visits (PHV) and multi-professional senior group meetings (senior meetings). A total of 459 persons aged 80 years or older and still living at home were included in the study. Participants were independent in ADL and without overt cognitive impairment. They were assessed at baseline and followed up at one and two years after intervention. An intention-to-treat analysis was performed using the outcome variables; morbidity, symptoms, self-rated health, satisfaction with health (study I), frailty measured as tiredness in daily activities and frailty measured with eight frailty indicators (study II). In study III, seventeen participants in the intervention preventive home visits were interviewed in their own homes. The interviews were analysed using a phenomenographic method. In study IV focus group methodology was used to interview a total of 20 participants who had participated in the intervention senior meetings. The interviews were analysed according to the focus group method described by Kreuger.  The results of studies I and II showed that both interventions postponed morbidity and delayed deterioration in satisfaction with physical and psychological health for up to two years compared to the control group. Both interventions also showed favourable effects in postponing the progression of frailty measured as tiredness in daily activities for up to one year. The intervention senior meetings had an advantage over preventive home visits since it prevented a decline in general self-rated health for up to one year. However, neither of the interventions was effective in postponing the progression of symptoms or frailty as measured with the sum of frailty indicators. The participants that were defined as frail according to frailty indicators (>3 indicators) increased in all three study arms during the two-year study period. The interviews with the participants involved in the intervention preventive home visits (study III) revealed four categories which explained how they experienced the visit and its consequences for health: the PHV made them visible and proved their human value, it brought a feeling of security and gave the participants an incentive to action. A few of the participants experienced that the PHV was of no value. The focus group interviews with the participants who had received the senior meetings (study IV) revealed that the participants lived in the present. However, the supportive environment together with learning a preventive approach contributed to the participants’ experiencing the senior meetings as a key to action.  In conclusion, the studies in this thesis show that it is possible to postpone a decline in health outcomes measured as morbidity, self-rated health, satisfaction with health and frailty measured as tiredness in daily activities in older persons at risk of frailty. Both interventions might have functioned as a trigger to motivate the participants to engage in a health-promoting behaviour. The contributing factors were the holistic information, the fact that participants were strengthened in their role as older persons, that someone cared about their health, and the fact that the interventions focused on personal needs. The senior meetings were the most beneficial intervention, which may be due to the group setting where the participants could learn from each other, gain role models and share their problems. Altogether this could have increased participants’ understanding and ability to use their own resources and may have motivated them to take measures and engage in health-promoting activities

  • 173.
    Behm, Lina
    et al.
    Lund University.
    Björkman, Eva
    Lund University.
    Ahlström, Gerd
    Lund University.
    Mental health and reactions to caregiving among next of kin of older people (65+) with multi-morbidity discharged home after hospitalization2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 4, p. 1458-1467Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 174.
    Behm, Lina
    et al.
    Universities of Gothenburg and Lund.
    Eklund, Kajsa
    Universities of Gothenburg and Lund.
    Wilhelmson, Katarina
    University of Gothenburg.
    Zidén, Lena
    University of Gothenburg.
    Gustafsson, Susanne
    University of Gothenburg.
    Falk, Kristin
    University of Gothenburg.
    Dahlin-Ivanoff, Synneve
    University of Gothenburg.
    Health promotion can postpone frailty: results from the RCT elderly persons in the risk zone2016In: Public Health Nursing, ISSN 0737-1209, E-ISSN 1525-1446, Vol. 33, no 4, p. 303-15Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Very old persons (80+) are often described as "frail", implying that they are particularly vulnerable to adverse health outcomes. Elderly Persons in the Risk Zone was designed to determine whether a preventive home visit or multiprofessional senior group meetings could postpone deterioration in frailty if the intervention is carried out when the person is not so frail.

    DESIGN AND SAMPLE: The study was a RCT with follow-ups at 1 and 2 years. A total of 459 persons (80+), still living at home, were included. Participants were independent in activities of daily life and cognitively intact.

    MEASURES: Frailty was measured in two complementary ways, with the sum of eight frailty indicators and with the Mob-T Scale measuring tiredness in daily activities.

    RESULTS: Both interventions showed favorable effects in postponing the progression of frailty measured as tiredness in daily activities for up to 1 year. However, neither of the two interventions was effective in postponing frailty measured with the sum of frailty indicators.

    CONCLUSIONS: The results in this study show the potential of health promotion to older persons. The multiprofessional approach, including a broad spectrum of information and knowledge, might have been an important factor contributing to a more positive view of aging.

  • 175.
    Behm, Lina
    et al.
    University of Gothenburg.
    Ivanoff, Synneve Dahlin
    Zidén, Lena
    Preventive home visits and health: experiences among very old people.2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As more people reach older age, there is a growing interest in improving old person's health, activity, independence and social participation, thereby adding quality to the extended years. Preventive home visits (PHV) programs for old people have received much attention in recent decades. A large body of research shows mixed effects, and argues that a home visit is a complex social process influenced by numerous factors. To evaluate the impact of PHV, as well as making decisions on whether, how, and to whom the service should be provided, requires a deeper understanding of PHV than we have now. Consequently, the aim of the study was to describe the variations in older people's (80+) experiences of a single preventive home visit and its consequences for health.

    METHODS: Seventeen participants between 80 and 92 years of age who had all received a structured PHV were interviewed in their own homes. The interviews were analyzed using the phenomenographic method, looking at the variations in the participants' experiences.

    RESULTS: The interviews revealed four categories: "The PHV made me visible and proved my human value"; "The PHV brought a feeling of security"; "The PHV gave an incentive to action"; and "The PHV was not for me".

    CONCLUSIONS: The experiences of a PHV were twofold. On one hand, the positive experiences indicate that one structured PHV was able to empower the participants and strengthen their self-esteem, making them feel in control over their situation and more aware of the importance of keeping several steps ahead. Together this could motivate them to take measures and engage in health-promoting activities. On the other hand, the PHV was experienced as being of no value by a few. These findings may partly explain the positive results from PHV interventions and emphasize that one challenge for health care professionals is to motivate older people who are healthy and independent to engage in health-promoting and disease-preventive activities.

  • 176.
    Behm, Lina
    et al.
    Universities of Gothenburg and Lund.
    Wilhelmson, Katarina
    University of Gothenburg.
    Falk, Kristin
    University of Gothenburg.
    Eklund, Kajsa
    University of Gothenburg.
    Zidén, Lena
    University of Gothenburg.
    Dahlin-Ivanoff, Synneve
    University of Gothenburg.
    Positive health outcomes following health-promoting and disease-preventive interventions for independent very old persons: long-term results of the three-armed RCT Elderly Persons in the Risk Zone.2014In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 58, no 3, p. 376-83Article in journal (Refereed)
    Abstract [en]

    UNLABELLED: The aim of this study was to analyze the long-term effect of the two health-promoting and disease-preventive interventions, preventive home visits and senior meetings, with respect to morbidity, symptoms, self-rated health and satisfaction with health. The study was a three-armed randomized, single-blind, and controlled trial, with follow-ups at one and two years after interventions. A total of 459 persons aged 80 years or older and still living at home were included in the study. Participants were independent in ADL and without overt cognitive impairment. An intention-to-treat analysis was performed. The result shows that both interventions delayed a progression in morbidity, i.e. an increase in CIRS-G score (OR=0.44 for the PHV and OR=0.61 for senior meetings at one year and OR=0.60 for the PHV and OR=0.52 for the senior meetings at two years) and maintained satisfaction with health (OR=0.49 for PHV and OR=0.57 for senior meetings at one year and OR=0.43 for the PHV and OR=0.28 for senior meetings after two years) for up to two years. The intervention senior meetings prevented a decline in self-rated health for up to one year (OR=0.55). However, no significant differences were seen in postponing progression of symptoms in any of the interventions. This study shows that it is possible to postpone a decline in health outcomes measured as morbidity, self-rated health and satisfaction with health in very old persons at risk of frailty. Success factors might be the multi-dimensional and the multi-professional approach in both interventions.

  • 177.
    Behm, Lina
    et al.
    University of Gothenburg.
    Zidén, Lena
    University of Gothenburg.
    Dunér, Anna
    University of Gothenburg.
    Falk, Kristin
    University of Gothenburg.
    Dahlin-Ivanoff, Synneve
    University of Gothenburg.
    Multi-professional and multi-dimensional group education--a key to action in elderly persons.2013In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, no 5, p. 427-35Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study was intended to evaluate a multi-professional health-promoting and disease-preventive intervention organized as multi-professional senior group meetings, which addressed home-dwelling, independently living, cognitively intact elderly persons (80±), by exploring the participants' experiences of the intervention.

    METHOD: The focus group methodology was used to interview a total of 20 participants. The informants had participated in four multi-professional senior group meetings at which information about the ageing process and preventive strategies for enhancing health were discussed.

    RESULTS: The overall finding was that the elderly persons involved in the intervention lived in the present, but that the supportive environment together with learning a preventive approach contributed to the participants' experiencing the senior meetings as a key to action.

    CONCLUSIONS: Elderly persons who are independent may have difficulty accepting information about preventing risks to health. However, group education with a multi-professional approach may be a successful model for achieving an exchange of knowledge, which may possibly empower the participants, give them role models, the opportunity to learn from each other and a sense of sharing problems with people in similar circumstances.

  • 178.
    Bengtsson, Emelie
    et al.
    Kristianstad University, School of Health and Society.
    Larsson, Susanne
    Kristianstad University, School of Health and Society.
    Oväntad död: en litteraturstudie om närståendes och sjuksköterskors upplevelser i mötet2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Bakgrund: Att vara med om en oväntad död kan för närstående innebära en livskris och för en sjuksköterska kan mötet som uppstår i samband med detta vara svårt att hantera. Syfte: Syftet var att belysa upplevelser i mötet mellan närstående och sjuksköterska i samband med att en person oväntat har avlidit. Metod: En litteraturstudie baserad på kvalitativa artiklar har genomförts. Resultat: Resultatet innefattar närståendes upplevelser och under den kategorin ingår subkategorierna lång väntan och önskan om information samt vänlighet och trygghet och under kategorin sjuksköterskans upplevelser ingår följande subkategorier osäkerhet, rädsla och oro; behov av att få vara hos de närstående; otillräcklighet och ovisshet samt tidsbrist. Diskussion: Utebliven information skapar oro och osäkerhet hos närstående, brist på tid ökar känsla av stress hos sjuksköterskor och osäkerhet hos sjuksköterskor i mötet påverkar närståendes trygghet och tillit.

  • 179.
    Bengtsson, Madeleine
    et al.
    Kristianstad University College, School of Health and Society.
    Andersson, Jennie
    Kristianstad University College, School of Health and Society.
    Att leva med ADHD: Vuxnas upplevelser av funktionshindret i vardagslivet.2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: ADHD is a neuropsychiatric disease. It has only recently been discovered that also adults suffer from ADHD and this is an area under development. Aim: The aim is to illustrate what it is like to be an adult living with ADHD, with a focus on the functional disorder. Method: A literature study has been performed in which seven qualitative and quantitative articles were examined and analyzed. Result: The analysis showed five common denominators in the case of ADHD: loss of impulse control, difficulties socializing with others, problems organizing their everyday life, diagnosis: an advantage or a disadvantage in handling everyday life, and the effect of medication on their personality. Discussion: Persons living with ADHD use different strategies to cope with their everyday life. The strategies can have a positive or negative impact on the life of the person with the functional disorder. It was also shown that the impulsivity made them more accident-prone as car drivers. Conclusion: Healthcare staff may need more knowledge about ADHD to be able to treat and support affected persons in a respectful manner.

  • 180.
    Bengtsson, Mariette
    et al.
    Division of Gastroenterology and Hepatology, Department of Medicine, Malmö University Hospital.
    Ohlsson, Bodil
    Division of Gastroenterology and Hepatology, Department of Medicine, Malmö University Hospital.
    Ulander, Kerstin
    Kristianstad University College, Department of Health Sciences.
    Women with irritable bowel syndrome and their perception of a good quality of life2007In: Gastroenterology Nursing, ISSN 1042-895X, E-ISSN 1538-9766, Vol. 30, no 2, p. 74-82Article in journal (Refereed)
    Abstract [en]

    Irritable bowel syndrome has a negative impact on a person's quality of life, but only a few existing studies have been based on patients' own perceptions. This study therefore aimed to collect information on the view of female patients with irritable bowel syndrome regarding what constitutes a good quality of life for them and to create a healthcare model for these patients. For the study, 30 women with irritable bowel syndrome (median age, 38.5 years; range, 20-65 years) responded in writing to a single, all-inclusive question: What is your perception of a good quality of life? When the questionnaires were returned, there was time for a short dialogue, and notes of the conversations were made. Data were analyzed qualitatively according to Burnard's method of thematic content analysis. The answers also were counted and thereby quantified.

    The women's perception of a good quality of life could be divided into five categories: (a) physical and mental health, (b) social well-being, (c) welfare, (d) strength and energy, and (e) self-fulfillment. According to the results, a healthcare model for patients with irritable bowel syndrome should include four main areas: (a) treatment of the patient's symptoms, (b) confirmation of the patient, (c) confirmation of the diagnosis, and (d) instruction for the patient. The healthcare model should be focused on the primary care level and should include a longitudinal plan of healthcare that also describes the secondary care level.

  • 181.
    Bengtsson, Mariette
    et al.
    Department of Nursing, Faculty of Health and Society, Malmö University.
    Ulander, Kerstin
    Kristianstad University, School of Health and Society.
    Bergh Börgdal, Elisabet
    Division of Gastroenterology and Hepatology, Department of Medicine, Malmö University Hospital.
    Ohlsson, Bodil
    Division of Gastroenterology and Hepatology, Department of Medicine, Malmö University Hospital.
    A holistic approach for planning care of patients with irritable bowel syndrome2010In: Gastroenterology Nursing, ISSN 1042-895X, E-ISSN 1538-9766, Vol. 33, no 2, p. 98-108Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to determine whether a registered nurse can collect information and plan a holistic and individual strategy for the treatment of patients with irritable bowel syndrome (IBS) and whether this approach can reduce these patients' health aspects. The referrals of 50 Swedish-speaking female patients aged between 18 and 65 years with the preliminary diagnosis of IBS were collected and scrutinized by a gastroenterologist at a university hospital. Of these, 41 patients agreed to participate but 2 did not show up. The 39 patients were randomized into one of two groups: (1) the intervention group (n = 19) where the subjects were interviewed on the basis of the theory of culture care by a nurse before visiting a gastroenterologist and (2) the control group (n = 20) where the subjects first met a gastroenterologist. After the medical examination, 19 subjects were found to have diseases other than IBS. The interview gave a holistic view of the subjects' problems, which could be of use when planning further care. Because subjects sometimes did not receive an accurate diagnosis by their primary care physician, however, the clinic nurse could not give these subjects IBS-specific information because the subjects' diagnosis had not been established. The initial medical assessments based on the primary care doctors' care of many subjects with IBS symptoms were a noted weak point.

  • 182.
    Bengtsson Tops, Anita
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health.
    Behov av vård och stöd2014In: Att leva med psykisk funktionsnedsättning: livsssituation och effektiva vård- och stödinsatser / [ed] David Brunt & Lars Hansson, Lund: Studentlitteratur AB, 2014, 2, p. 153-170Chapter in book (Other academic)
  • 183. Bengtsson Tops, Anita
    Caregivers’ everyday work with persons with learning disability in a Swedish nursing home: an ethnographic study2009Conference paper (Other academic)
  • 184.
    Bengtsson Tops, Anita
    Växjö universitet.
    Ett ögonblick av queer i vården2009In: Lambda Nordica: Tidskrift om homosexualitet, ISSN 1100-2573, no 1, p. 43-62Article in journal (Refereed)
    Abstract [en]

    A queer moment in care. Although the perspective of caring sciences propose to cover the suffering of patients as well as humanistic aspects of caring relationships its theoretical frame lacks assumptions connected gender and sexuality. From a starting point of a concrete caring situation within the context of psychiatric care this autobiographic study makes shortcomings within the theoretical frame of caring sciences obvious. The shortcomings are related to issues of instability of gender, gender performances and heteronormativity as for granted taken assumptions. The situation concerns an encounter between me as a nurse and a patient who experienced himself as both a man and a woman. By means of queer theories, aspects of what happened in the situation are interpreted. Queer theoretical concepts such as the binary heterosexual matrix, gender instability, performativity, and subversive performativity are penetrated in relation to the caring situation. It is suggested that in order to develop and complement the theoretical frame of caring sciences the perspective of queer should be used.

  • 185.
    Bengtsson Tops, Anita
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health.
    Hot och våld mot personer med psykisk funktionsnedsättning2014In: Att leva med psykisk funktionsnedsättning: livsssituation och effektiva vård- och stödinsatser / [ed] David Brunt & Lars Hansson, Lund: Studentlitteratur AB, 2014, 2, p. 207-216Chapter in book (Other academic)
  • 186.
    Bengtsson Tops, Anita
    Växjö universitet.
    I väntan ...: Rapport om vardagslivet på privata vårdhem utifrån de boendes perspektiv2005Report (Other academic)
  • 187.
    Bengtsson Tops, Anita
    Växjö universitet.
    Social network in patients with severe mental illness2005Conference paper (Other academic)
  • 188.
    Bengtsson Tops, Anita
    Växjö universitet.
    Staff's experiences and understanding of support to abused women with mental illness2008Conference paper (Other academic)
    Abstract [en]

    Objective: Several studies have reported that care and support staff has a tendency to ignore recognising violence against women with mental illness, which lead to increased feelings of stigma in these women. Today there is a lack of in-depth knowledge about factors that may influence care providers attitudes in encounters with these women. The aim of this qualitative study was to describe how staff experience and understand their everyday work with abused women with mental illness.

    Methods: 13 professionals who in their working practice encountered women with mental illness and experience of abuse were interviewed by means of unstructured thematic interviews. Data were analysed by using latent content analysis in order to identify categories a nd themes.

    Results: Participating staff found it hard to understand abuse against women with mental illness. They lack knowledge about how to handle and interpret this phenomenon and developed personal frames of interpretations and strategies for handling the women’s needs. They experienced their everyday work with these women as painful and ambiguous and made them act pragmatic mainly in a practical way that sometimes included assertive attitudes.

    Conclusion: Staff working with abused women with mental illness is in a vulnerable position due to lack of understanding and knowledge about the phenomenon. In such position it is at risk to adopt stigmatised attitudes against the women and thereby challenge the professionals’ occupational safety.

  • 189.
    Bengtsson Tops, Anita
    Växjö universitet.
    The prevalence of abuse in Swedish female users of psychiatric care2005Conference paper (Other academic)
  • 190. Bengtsson Tops, Anita
    Vi är många: övergrepp mot kvinnor som använder psykiatrin : en omfångsstudie2004Report (Other academic)
  • 191.
    Bengtsson Tops, Anita
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Våld mot kvinnor med psykisk funktionsnedsättning på grund av psykossjukdom2013In: Våld mot kvinnor med funktionsnedsättning, Uppsala: Nationellt centrum för kvinnofrid (NCK), Uppsala universitet , 2013, p. 75-89Chapter in book (Other academic)
  • 192.
    Bengtsson Tops, Anita
    Växjö universitet.
    Övergrepp mot kvinnor och psykisk ohälsa: Utvärdering av innovativ fortbildningsinsats för poliser, socionomer och sjuksköte2007Report (Other academic)
  • 193. Bengtsson Tops, Anita
    et al.
    Brunt, David
    Rask, Mikael
    The structure of Antonovsky's sense of coherence in patients with schizophrenia and its relationship to psychopathology2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 3, p. 280-287Article in journal (Refereed)
    Abstract [en]

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

  • 194.
    Bengtsson Tops, Anita
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Ericsson, Ulf
    Kristianstad University, School of Health and Society, Avdelningen för Samhällsvetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Ehliasson, Kent
    Kristianstad University, School of Health and Society.
    Living in supportive housing for people with serious mental illness: a paradoxical everyday life2014In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 23, no 5, p. 409-418Article in journal (Refereed)
    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.

  • 195.
    Bengtsson Tops, Anita
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Hansson, Lars
    Landlords experiences of tenants sufferingfrom severe mental illness2013In: Recovery-Oriented Mental Health Services: Therapeutic, Organisational and Economic challenges, 2013, p. 194-Conference paper (Other academic)
    Abstract [en]

    Background/Objectives

    Persons suffering from severe mental illness (SMI) live – and prefer to live – independently, in either private or public apartment blocks without on-site services. Living in own apartments increase feelings of safety and well-being and function as a robust social status marker. Landlords are important actors in gaining stability and sustainability and it has been found that landlords have a plethora of preconceptions, attitudes, emotions as well as well as ethical dilemmas in offering apartments to this group of persons. Today there is a lack systematic knowledge about the role landlords have come play in providing sustainable housing for these persons. The main aim of this qualitative study was to describe landlords’ experiences of having tenant suffering from SMI

    Methods

    Sixteen landlords in various parts of Sweden participated in open in-depth interviews three years after the government proclaimed a vision zero regarding homelessness among individuals with SMI. Data was subjected to thematic latent content analysis.

    Results

    Landlords experienced being confronted with difficult circumstances such as mismanagement of apartments, sensitivity and provocative behaviors in relation to both tenants with SMI and neighbors. In acute situations landlords tried to collaborate with the community based psychiatric service system but were neglected. As a result and without the knowledge of how to best help they started to provide support to tenants with SMI involving going beyond professional boarders.

    Discussion/Conclusion

    The findings give reasons to conclude that community-based psychiatric services need to be more pro-active in their collaboration with landlords. Also education interventions with a focus on how to best help tenants with SMI need to be developed and implemented.

  • 196. Bengtsson Tops, Anita
    et al.
    Hansson, Lars
    Sandlund, Mikael
    Bjarnason, Olafur
    Korkeila, Jyrki
    Merinder, Lars
    Nilsson, Liselotte
    Sørgaard, Knut Wollo
    Vinding, Hanne R.
    Middelboe, Thomas
    Subjective versus interviewer assessment of global quality of life among persons with schizophrenia living in the community: a Nordic multicentre study2005In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 14, no 1, p. 221-229Article in journal (Refereed)
    Abstract [en]

    Background: Few studies have investigated differences between subjective and externally assessed quality of life in individuals with a severe mental illness. In a sample of 387 patients with schizophrenia living in the community the present study investigated the association between subjective and interviewer-rated quality of life, clinical and sociodemographic factors related to the two assessments, and if discrepancies in the assessments were related to any clinical or social features of the patients.

    Method: The study was a Nordic multicentre study with a cross-sectional design. Instruments used were the Lancashire Quality of Life Profile, the Brief Psychiatric Rating Scale, the Interview Schedule for Social Interaction, Camberwell Assessment of Needs and General Assessment of Functioning.

    Results: The correlation between subjective and interviewer-rated quality of life was moderate (ICC=0.33). More severe affective symptoms, fewer emotional relations and a lower monthly income were related to poorer subjectively rated quality of life but in a stepwise multiple regression analysis accounted for only 14.1 of the variance. Poorer interviewer-rated quality of life was mainly related to a more severe psychopathology but also to a lower monthly income, fewer emotional relations and not being employed. Together these factors accounted for 45.5 of the variance. A greater discrepancy between the subjective and the interviewer rating was found in patients with less affective symptoms, unemployment, and a better social network.

    Conclusion: Only a moderate correlation between subjective and interviewer-assessed global quality of life was found, implying that the sources of assessment differed, as was also shown in subsequent regression models. It is concluded that both perspectives on the patient's quality of life may be valuable for treatment planning, especially in cases where differences in quality of life assessment related to the patient's psychopathology may be expected.

  • 197.
    Bengtsson Tops, Anita
    et al.
    Växjö universitet.
    Markström, U
    Lewin, B
    The prevalence of abuse in Swedish female psychiatric users, the perpetrators and places where abuse occurred2005In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 59, no 6, p. 504-510Article in journal (Refereed)
    Abstract [en]

    The aims of the study were to investigate self-reported physical, sexual, emotional and economical abuse in Swedish female users of psychiatric services, who the perpetrators were and in which places abuse occurred. An anonymous self-administrated questionnaire was answered in the waiting room of the services. The drop-out rate was 21% and n=1382 women completed the questionnaire. Fifty-three per cent of the women had been abused during childhood, 63% during adulthood and 31% during past year. Seventy-four per cent of those exposed during childhood were also exposed later in life. Women subjected to abuse reported longer contact with psychiatric care. Regardless of life period, the majority reported multiple and frequent abuse. Emotional abuse was most frequent reported in both childhood and adulthood followed by physical and sexual abuse. The reported perpetrators were mainly male persons to whom the woman had an intimate relationship. Mostly the abuse occurred in the women's own home. However, other women, strangers, acquaintances and relatives were also stated as perpetrator and abusive acts also took place in other homes, outdoors or down town. The high prevalence of abuse and its multiplicity point to the necessity for the care and support system to prioritize abuse against women with psychiatric illness.

  • 198.
    Bengtsson Tops, Anita
    et al.
    Växjö universitet.
    Saveman, B. -I
    Tops, D.
    Staff experience and understanding of working with abused women suffering from mental illness2009In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 17, no 5, p. 459-465Article in journal (Refereed)
    Abstract [en]

    The phenomenon of abused women with mental illness is often unrecognised by staff working within welfare services. This may be explained by staff members' attitudes, insecurity or lack of awareness. Today, there are shortcomings in the knowledge of staff members' experiences and interpretations of abuse against women suffering from mental illness. The aim of this qualitative study was to describe how staff members experience and understand their work with abused women suffering from mental illness. Thematic interviews were conducted with 13 staff members from various welfare services. Data were subject to content analysis. The findings showed that working with abused women was experienced as ambiguous and painful and made the staff act pragmatically. Feelings of ambiguity were mainly related to the lack of theoretical frameworks for interpreting why women with mental illness are exposed to abuse. Painful experiences involved intertwined feelings of distress, frustration, worthlessness, ambivalence and powerlessness. These were all feelings that emerged in the direct encounters with the abused women. In response to the abused women's comprehensive needs, staff members acted pragmatically, implying networking without any sanction from the leaders of the organisation, compliance with routines and taking action in here-and-now situations. By acting pragmatically, staff members could achieve concrete results through their interventions. It is concluded that staff members, working with abused women with mental illness, are in a vulnerable situation and in need of formally accepted and implemented support and legitimacy as well as theoretical knowledge regarding causes and consequences of abuse in this particular group of women.

  • 199.
    Bengtsson Tops, Anita
    et al.
    Växjö universitet.
    Svensson, B
    Lunds universitet.
    Mental health users' experiences of being interviewed by another user in a research project: a qualitative study2010In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 19, no 3, p. 237-242Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although user involvement in research is an area of high priority there is a lack of knowledge about how users of the mental health system perceive participation in studies carried out by other users.

    AIM: The aim of the study was to describe how users experience participation in research interviews performed by other users.

    METHOD: A varied sample of 17 mental health users with experience of being interviewed in a research project by another user was thematically interviewed in this qualitative study. Data was subject to content analysis.

    RESULTS: Being interviewed by another user was a special experience including both negative and positive aspects, and took place in an atmosphere of comradeship. However, being interviewed by another user could generate feelings of insecurity. This finding indicates requirements from the informants how to perform user-involved research in the future.

    CONCLUSIONS: In planning for user-involved research education, it is necessary to consider training and issues related to secure ethical principals concerning the informants.

  • 200.
    Bengtsson Tops, Anita
    et al.
    Växjö universitet.
    Tops, Dolf
    Lunds universitet.
    Self-reported consequences and needs for support associated with abuse in female users of psychiatric care2007In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 16, no 1, p. 35-43Article in journal (Refereed)
    Abstract [en]

    The aims of the study were to investigate the prevalence of adult abuse in female users of psychiatric care, the relationship between abuse and self-esteem and self-reported consequences of abuse, and women's self-reported needs of support. A total of 1382 women participated in the study. A self-administrated anonymous questionnaire with both closed-ended and open-ended questions was used. Quantitative data were analysed by mainly descriptive statistics and qualitative data were analysed by content analysis. Forty-six per cent (n = 638) of the women had been exposed to emotional, sexual, and/or physical abuse in adulthood. Twenty-eight per cent (n = 385) reported experiences of moderate physical abuse, 27% (n = 373) reported threats of injury, and 20% (n = 277) reported threats of being killed. Further, 19% (n = 261) reported experience of sexual violence, and 12% (n = 164) had experiences of serious physical violence. Women who had been abused rated lower self-esteem than those who were not abused. Self-reported consequences of abuse included intrapersonal problems such as poor self-esteem, fears, anxiety, and worries but also problems in social relations especially with regard to close relationships and reliance to others. To a lesser extent, disease-specific manifestations were reported. The needs of support included interventions directed to the experiences of abuse by professionals trained in the area, family interventions, self-help groups, medical care, legal support, or practical help to find new housing situations. It is concluded that female users of psychiatric care services constitute a vulnerable group with regard to abuse. To meet the women's needs, the care system has to adopt a perspective that includes personal, social, and societal factors.

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