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Melander, C., Sävenstedt, S., Olsson, M. & Välivaara, B.-M. (2018). Assessing BPSD with the support of the NPI-NH: a discourse analysis of clinical reasoning. International psychogeriatrics, 30(4), 581-589
Open this publication in new window or tab >>Assessing BPSD with the support of the NPI-NH: a discourse analysis of clinical reasoning
2018 (English)In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 30, no 4, p. 581-589Article in journal (Refereed) Published
Abstract [en]

The ability of nursing staff to assess and evaluate behavioral and psychological symptoms of dementia (BPSD) to determine when intervention is needed is essential. In order to assist with the assessment process, the current use of the Neuropsychiatric Inventory Nursing Home version (NPI-NH) is internationally accepted. Even though the NPI-NH is thoroughly validated and has several advantages, there are also various challenges when implementing this system in practice. Thus, the aim of this study was to explore clinical reasoning employed by assistant nurses when utilizing the NPI-NH as a tool to assess frequency and severity of BPSD in individuals with advanced dementia.

Twenty structured assessment sessions in which assistant nurses used the NPI-NH were audio recorded and analyzed with a discourse analysis focusing on the activities in the communication.

Four categories were identified to convey assistant nurses' clinical reasoning when assessing and evaluating BPSD using the NPI-NH: considering deteriorations in ability and awareness, incorporating individual and contextual factors, overcoming variations in behaviors and ambiguous formulations in the instrument, and sense-making interactions with colleagues.

The NPI-NH served as a supportive frame and structure for the clinical reasoning performed during the assessment. The clinical reasoning employed by assistant nurses became a way to reach a consensual and broader understanding of the individual with dementia, with the support of NPI-NH as an important framework.

Place, publisher, year, edition, pages
Cambridge University Press, 2018
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-65964 (URN)10.1017/S1041610217002009 (DOI)000431404300014 ()28965503 (PubMedID)
Note

Validerad;2018;Nivå 2;2018-05-17 (andbra)

Available from: 2017-10-04 Created: 2017-10-04 Last updated: 2018-09-12Bibliographically approved
Melander, C., Sävenstedt, S., Välivaara, B.-M. & Olsson, M. (2018). Human capabilities in advanced dementia: Nussbaum's approach. International Journal of Older People Nursing, 13(2), Article ID 12178.
Open this publication in new window or tab >>Human capabilities in advanced dementia: Nussbaum's approach
2018 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, article id 12178Article in journal (Refereed) Published
Abstract [en]

Aims and objectives

To explore how Martha Nussbaum's approach to human capabilities can apply to dignity in the lives of people with advanced dementia living in nursing homes.

Background

Challenges experienced when supporting people with advanced dementia who express problematic behaviours include understanding their needs and ensuring a dignified life for them.

Design and methods

Data were gathered using an ethnographic approach based on participatory observation. Nussbaum's capability approach was then used as a framework for the analysis. Four women diagnosed with advanced dementia who also expressed problematic behaviours were recruited from a nursing home in Northern Sweden. The data collection was performed during 2015.

Findings

Individuals with advanced dementia had difficulties in participating in the planning of their lives and achieving the human capability of practical reasoning. They were also at risk of being placed outside the social group, thus hindering them from attaining the human capability of affiliation. A dignified life for individuals with advanced dementia requires nursing staff to be present and to provide adapted support to ensure that the individual can actually pursue human capabilities.

Conclusion

Creating opportunities for the human capabilities of practical reasoning and affiliation is essential as they permeate all other human capabilities. For these individuals, it was crucial not only to create opportunities for human capabilities but also to attend to their expressions and needs and to guide and steer them towards a dignified life.

Implications for Practice

The normative structure of the capability approach described by Nussbaum can ensure that nursing staffs move beyond fulfilling patients’ basic needs to consider other capabilities vital for a dignified life.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-66049 (URN)10.1111/opn.12178 (DOI)000434118100002 ()28990351 (PubMedID)2-s2.0-85047906757 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-06-04 (svasva)

Available from: 2017-10-11 Created: 2017-10-11 Last updated: 2018-09-12Bibliographically approved
Gustafsson, S., Sävenstedt, S., Martinsson, J. & Välivaara, B.-M. (2018). Need for reassurance in self-care of minor illnesses. Journal of Clinical Nursing, 27(5-6), 1183-1191
Open this publication in new window or tab >>Need for reassurance in self-care of minor illnesses
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1183-1191Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

This study describes people's need for reassurance in self-care of minor illnesses.

BACKGROUND:

Self-care and active surveillance are advocated as important strategies to manage minor illnesses. Reassurance influences patient satisfaction and confidence in the practicing of self-care.

DESIGN:

This study is a descriptive and interpretive qualitative study.

METHODS:

Twelve persons with experience in self-care and receiving self-care advice were recruited, and data were collected using semi-structured interviews between September and December 2014. Data were analyzed using qualitative content analyses.

RESULTS:

Having previous experience and the ability to actively manage symptoms using self-care interventions was described as reassuring. Participants became stressed and concerned when the symptoms persisted and interventions lacked the desired effect, which often resulted in a decision to consult. Participants wanted to feel that the nurse was an actual person, who was sympathetic, present and understanding, when they received self-care advice. The nurse's assessment and reasoning of the symptoms facilitated care-seekers' assessments of risk, and clear and concrete advice on how to manage the symptoms exerted a calming effect. Patients needed to trust that the nurse understood their situation to embrace the advice, and being invited to return created a feeling that the nurse had listened and taken them seriously.

CONCLUSION:

Reassurance has the potential to allay doubts and fears to build confidence, which influences self-care and consultation behavior. Personal presence in the encounter, receiving an assessment and an explanation of the symptoms and precise advice are reassuring. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Nursing Probability Theory and Statistics
Research subject
Nursing; Matemathical Statistics
Identifiers
urn:nbn:se:ltu:diva-66572 (URN)10.1111/jocn.14157 (DOI)000428419400078 ()29119676 (PubMedID)
Note

Validerad;2018;Nivå 2;2018-04-10 (andbra)

Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2018-04-27Bibliographically approved
Kikhia, B., Stavropoulos, T. G., Meditskos, G., Kompatsiaris, I., Hallberg, J., Sävenstedt, S. & Melander, C. (2018). Utilizing ambient and wearable sensors to monitor sleep and stress for people with BPSD in nursing homes (ed.). Journal of Ambient Intelligence and Humanized Computing, 9(2), 261-273
Open this publication in new window or tab >>Utilizing ambient and wearable sensors to monitor sleep and stress for people with BPSD in nursing homes
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2018 (English)In: Journal of Ambient Intelligence and Humanized Computing, ISSN 1868-5137, E-ISSN 1868-5145, Vol. 9, no 2, p. 261-273Article in journal (Refereed) Published
Abstract [en]

Clinical assessment of behavioral and psychological symptoms of dementia (BPSD) in nursing homes is often based on staff member’s observations and the use of the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) instrument. This requires continuous observation of the person with BPSD, and a lot of effort and manual input from the nursing home staff. This article presents the DemaWare@NH monitoring framework system, which complements traditional methods in measuring patterns of behavior, namely sleep and stress, for people with BPSD in nursing homes. The framework relies on ambient and wearable sensors for observing the users and analytics to assess their conditions. In our proof-of-concept scenario, four residents from two nursing homes were equipped with sleep and skin sensors, whose data is retrieved, processed and analyzed by the framework, detecting and highlighting behavioral problems, and providing relevant, accurate information to clinicians on sleep and stress patterns. The results indicate that structured information from sensors can ease and improve the understanding of behavioral patterns, and, as a consequence, the efficiency of care interventions, yielding a positive impact on the quality of the clinical assessment process for people with BPSD in nursing homes.

Place, publisher, year, edition, pages
Springer, 2018
National Category
Media and Communication Technology Nursing
Research subject
Pervasive Mobile Computing; Nursing
Identifiers
urn:nbn:se:ltu:diva-9225 (URN)10.1007/s12652-015-0331-6 (DOI)000429249200005 ()7c97293a-e058-4224-b5bb-882faec2867e (Local ID)7c97293a-e058-4224-b5bb-882faec2867e (Archive number)7c97293a-e058-4224-b5bb-882faec2867e (OAI)
Note

Validerad;2018;Nivå 2;2018-04-04 (rokbeg)

Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-04-26Bibliographically approved
Karlsson, E., Zingmark, K., Axelsson, K. & Sävenstedt, S. (2017). Aspects of Self and Identity in Narrations About Recent Events: Communication With Individuals With Alzheimer's Disease Enabled by a Digital Photograph Diary. Journal of Gerontological Nursing, 43(6), 25-31
Open this publication in new window or tab >>Aspects of Self and Identity in Narrations About Recent Events: Communication With Individuals With Alzheimer's Disease Enabled by a Digital Photograph Diary
2017 (English)In: Journal of Gerontological Nursing, ISSN 0098-9134, E-ISSN 1938-243X, Vol. 43, no 6, p. 25-31Article in journal (Refereed) Published
Abstract [en]

The ability to narrate autobiographical memories is important for maintaining the identity of individuals with Alzheimer's disease (AD). The current study explored how the sense of self is manifested in narrations about recent events, enabled via a digital photograph diary. Use of a digital photograph diary was tested with seven individuals with AD and their household members. Narrative analysis was used to analyze audiorecordings of the pairs' communication about recent events shown in the photographs. The results show how individuals with AD understand events illustrated in recent photographs in relation to their sense of self and associated skills and abilities that are facets of their selfhood. This type of digital photograph diary has the potential to support individuals with AD to maintain their sense of self and participation in everyday life, and strengthen their relationships with household members; it could be an important tool in person-centered care.

Place, publisher, year, edition, pages
SLACK, 2017
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-64200 (URN)10.3928/00989134-20170126-02 (DOI)000404264400004 ()2-s2.0-85021768839 (Scopus ID)
Note

Validerad;2017;Nivå 2;2017-08-14 (andbra)

Available from: 2017-06-19 Created: 2017-06-19 Last updated: 2018-07-10Bibliographically approved
Ejneborn-Looi, G.-M., Sävenstedt, S. & Engström, Å. (2016). Easy but not simple: Nursing students’ descriptions of the process of care in a psychiatric context (ed.). Issues in Mental Health Nursing, 37(1), 34-42
Open this publication in new window or tab >>Easy but not simple: Nursing students’ descriptions of the process of care in a psychiatric context
2016 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 1, p. 34-42Article in journal (Refereed) Published
Abstract [en]

The nurse-patient interaction is the cornerstone of psychiatric care, yet the concept “mental health nursing” is difficult to describe. This article aims to address this problem through the experiences of nursing students. Online journals from 14 nursing students were analyzed using qualitative content analysis, resulting in three categories: Trusting the Trusting Relationship, Voicing the Unspoken Needs, and Balancing the Dynamics of Doing and Being. This study demonstrates that providing nursing care based on trusting relationships is not a demanding task, but it takes place in a complex environment that has a tendency to make easy things complicated.

National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-12229 (URN)10.3109/01612840.2015.1085607 (DOI)000369505500006 ()26818931 (PubMedID)2-s2.0-85000366213 (Scopus ID)b54a47df-4f82-4131-8e71-65fc0baf0f1b (Local ID)b54a47df-4f82-4131-8e71-65fc0baf0f1b (Archive number)b54a47df-4f82-4131-8e71-65fc0baf0f1b (OAI)
Note

Validerad; 2016; Nivå 2; 20150819 (andbra)

Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-07-10Bibliographically approved
Gustafsson, S., Martinsson, J., Välivaara, B.-M., Vikman, I. & Sävenstedt, S. (2016). Influence of self-care advice on patient satisfaction and healthcare utilization (ed.). Journal of Advanced Nursing, 72(8), 1789-1799
Open this publication in new window or tab >>Influence of self-care advice on patient satisfaction and healthcare utilization
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2016 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 8, p. 1789-1799Article in journal (Refereed) Published
Abstract [en]

AimThe aim of this study is to explore the influence of nurse-led self-care advice on healthcare utilization and patients' satisfaction with telephone nursing.BackgroundMany consultations in high-cost settings are for conditions that are manageable through self-care and callers with greater satisfaction with the nurse interaction are nearly four times more likely to engage in self-care.DesignCross-sectional study.MethodsQuestionnaires were sent out to 500 randomly selected callers to the Swedish Healthcare Direct in Northern Sweden during March 2014. Callers were asked about their satisfaction with the consultation, their intended actions prior to consultation, the recommendation given by the nurse and the action undertaken after the call.ResultsYoung callers and persons recommended watchful waiting or recurrence if no improvements were significantly less satisfied with their care. When calling on their own behalf, both men and women rated the severity of their symptoms equally and were advised to self-care to the same extent. Self-care advice had a constricting influence on self-reported healthcare utilization, with 66·1% of cases resulting in a lower level of care than first intended. Feeling reassured after the call was the aspect of nursing care that influenced satisfaction the most.ConclusionReceiving self-care advice rather than referral to a general practitioner influences patient satisfaction negatively. Feeling reassured after consultation is strongly related to satisfaction, which in turn has been found to increase the likelihood of engaging in self-care behaviour.

National Category
Nursing Probability Theory and Statistics Physiotherapy
Research subject
Nursing; Matemathical Statistics; Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-7453 (URN)10.1111/jan.12950 (DOI)000379932000007 ()27001441 (PubMedID)2-s2.0-85028243147 (Scopus ID)5d53ffb8-d712-4795-bf3f-07728a299db7 (Local ID)5d53ffb8-d712-4795-bf3f-07728a299db7 (Archive number)5d53ffb8-d712-4795-bf3f-07728a299db7 (OAI)
Note

Validerad; 2016; Nivå 2; 20160323 (andbra)

Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-07-10Bibliographically approved
Gabrielsson, S., Sävenstedt, S. & Olsson, M. (2016). Taking personal responsibility: Nurses’ and assistant nurses’ experiences of good nursing practice in psychiatric inpatient care (ed.). International Journal of Mental Health Nursing, 25(5), 434-443
Open this publication in new window or tab >>Taking personal responsibility: Nurses’ and assistant nurses’ experiences of good nursing practice in psychiatric inpatient care
2016 (English)In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 25, no 5, p. 434-443Article in journal (Refereed) Published
Abstract [en]

Therapeutic nurse–patient relationships are considered essential for good nursing practice in psychiatric inpatient care. Previous research suggests that inpatient care fails to fulfil patients' expectations in this regard, and that nurses might experience the reality of inpatient care as an obstruction. The aim of the present study was to explore nurses' and assistant nurses' experiences of good nursing practice in the specific context of psychiatric inpatient care. Qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and assistant nurses in order to explore their experiences with nursing practice related to psychiatric inpatient care. Interviews were transcribed and analysed using an interpretive descriptive approach. Findings describe good nursing practice as a matter of nurses and assistant nurses taking personal responsibility for their actions and for the individual patient as a person. Difficulties in providing dignified nursing care and taking personal responsibility cause them to experience feelings of distress and frustration. Shared values and nursing leadership supports being moral and treating patients with respect, having enough time supports being present and connecting with patients, and working as a part of a competent team with critical daily discussions and diversity supports being confident and building trust. The findings suggest that taking personal responsibility is integral to good nursing practice. If unable to improve poor circumstances, nurses might be forced to promote their own survival by refuting or redefining their responsibility. Nurses need to prioritize being with patients and gain support in shaping their own nursing practice. Nursing leadership should provide moral direction and defend humanistic values.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-15243 (URN)10.1111/inm.12230 (DOI)000384528800006 ()27378375 (PubMedID)2-s2.0-84988433370 (Scopus ID)ebdc8edc-4468-44db-85ab-815773e9228e (Local ID)ebdc8edc-4468-44db-85ab-815773e9228e (Archive number)ebdc8edc-4468-44db-85ab-815773e9228e (OAI)
Note

Validerad; 2016; Nivå 2; 2016-10-07 (kribac)

Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-07-10Bibliographically approved
Hopper, L., Karakostas, A., König, A., Sävenstedt, S. & Kompatsiaris, I. (2016). The personal and societal impact of the den´mentia ambient care (Dem@care) multi-sensor remot-monitoring demential care system. Paper presented at The Alzheimer's Association International Conference®, 2016 (AAIC®, Toronto, Canada, 24-28 July 2016. Alzheimer's & Dementia, 12(7 Suppl.), P149
Open this publication in new window or tab >>The personal and societal impact of the den´mentia ambient care (Dem@care) multi-sensor remot-monitoring demential care system
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2016 (English)In: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 12, no 7 Suppl., p. P149-Article in journal, Meeting abstract (Refereed) Published
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-59818 (URN)10.1016/j.jalz.2016.06.242 (DOI)
Conference
The Alzheimer's Association International Conference®, 2016 (AAIC®, Toronto, Canada, 24-28 July 2016
Available from: 2016-10-19 Created: 2016-10-19 Last updated: 2017-11-24Bibliographically approved
Kikhia, B., Stavropoulos, T. G., Andreadis, S., Karvonen, N., Kompatsiaris, I., Sävenstedt, S., . . . Melander, C. (2016). Utilizing a Wristband Sensor to Measure the Stress Level for People with Dementia. Sensors, 16(12), Article ID 1989.
Open this publication in new window or tab >>Utilizing a Wristband Sensor to Measure the Stress Level for People with Dementia
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2016 (English)In: Sensors, ISSN 1424-8220, E-ISSN 1424-8220, Vol. 16, no 12, article id 1989Article in journal (Refereed) Published
Abstract [en]

Stress is a common problem that affects most people with dementia and their caregivers. Stress symptoms for people with dementia are often measured by answering a checklist of questions by the clinical staff who work closely with the person with the dementia. This process requires a lot of effort with continuous observation of the person with dementia over the long term. This article investigates the effectiveness of using a straightforward method, based on a single wristband sensor to classify events of "Stressed" and "Not stressed" for people with dementia. The presented system calculates the stress level as an integer value from zero to five, providing clinical information of behavioral patterns to the clinical staff. Thirty staff members participated in this experiment, together with six residents suffering from dementia, from two nursing homes. The residents were equipped with the wristband sensor during the day, and the staff were writing observation notes during the experiment to serve as ground truth. Experimental evaluation showed relationships between staff observations and sensor analysis, while stress level thresholds adjusted to each individual can serve different scenarios.

National Category
Nursing Media and Communication Technology
Research subject
Nursing; Mobile and Pervasive Computing
Identifiers
urn:nbn:se:ltu:diva-60730 (URN)10.3390/s16121989 (DOI)000391303000009 ()27886155 (PubMedID)2-s2.0-84997328010 (Scopus ID)
Note

Validerad; 2016; Nivå 2; 2016-11-28 (andbra)

Available from: 2016-11-28 Created: 2016-11-28 Last updated: 2018-10-15Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7830-8791

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