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  • 1.
    Andersson, Lena
    et al.
    Department of Geriatrics, Piteå Älvdal Hospital.
    Burman, Marie
    Department of Orthopaedics, Piteå älvdal Hospital.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Experiences of caretime during hospitalization in a medical ward: older patients' perspective2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 4, p. 646-652Article in journal (Refereed)
    Abstract [en]

    he population is ageing the world over, and there is an increasing prevalence of chronic illness and complex conditions. Older people are at greater risk of having several complications than the general population, leading to more time spent in hospital and an increased risk of readmission. The most specific need of older patients is often the multiple need of care. The aim of this study was to describe older patients’ experiences of caretime during a hospitalization in a medical ward. Data were collected with semi-structured interviews with nine older patients, and analysed using qualitative thematic content analysis. The analysis resulted in two themes and five categories. The results show that caretime during hospitalization includes a lot of waiting and that patients manage the waiting in different ways. The results also point out the importance of patients developing good relationships with professionals since good relations creates feelings of security and can reduce anxiety and fear during a hospital stay. The patients pointed out the importance of being more involved in their own care and asked for more detailed information about the hospital stay. The results revealed that information makes patients’ more secure and safe during a hospitalization and makes them participate and affect their own care and treatment more.

  • 2. Axelsson, Karin
    et al.
    Norberg, Astrid
    Umeå University, Department of Nursing.
    Asplund, Kjell
    Umeå University, Department of Nursing.
    Söderberg, Ove
    Umeå University, Department of Otorhinolaryngology.
    Wenngren, Britt-Inger
    Umeå University, Department of Otorhinolaryngology.
    Training of eating after a stroke in a patient with dysphagia of pharyngeal type1988In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 2, no 1, p. 31-6Article in journal (Refereed)
  • 3.
    Bontje, Peter
    et al.
    Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University.
    Asaba, Eric
    Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University.
    Josephsson, Staffan
    Luleå University of Technology, Department of Health Sciences, Health and Rehab. Karolinska institute, Neurobiology Care Sciences and Society, Division of Occupational Therapy, Karolinska institutet, Sektionen för arbetsterapi.
    Balancing struggles with desired results in everyday activities: strategies for elderly persons with physical disabilities2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 1, p. 154-163Article in journal (Refereed)
    Abstract [en]

    The number of elderly persons with disabilities needing support with everyday activities increasing in Japan and around the world. Yet, engagement in everyday activities can support the quality of their daily life. Despite research focusing on reported meanings of people's actions, there is still limited knowledge on how engagement in everyday activity is enacted along with the meanings of persons’ actions. The aim of the present study was to identify meanings of persons’ actions within everyday activities of elderly Japanese with physical disabilities. Five elderly persons with physical disabilities living in the community participated in this study. Data were gathered by 10 participant observations of everyday activities supplemented with 13 unstructured interviews. Narrative analysis was used to identify meanings of persons’ actions. The analysis identified an overall plot termed ‘balancing struggles with desired results’. This plot illustrated that participants’ and other involved individuals balanced problematic situations with finding situations that accommodated their needs. Meanings of these actions were further identified as three complementary strategies. Two of three strategies aimed to mitigate given problems, one by ‘acting on a plan to achieve one's goals’, the other by ‘taking a step in a preferred direction by capitalising on emerging opportunities’. The third strategy focused on avoiding undesirable experiences by ‘modifying problematic situations’. In conclusion, these findings call for care and rehabilitation providers’ sensitivity to shifting foci of what matters in daily life's situations as well as aligning with persons’ skills, resources and perspectives. Accordingly, the judicious and flexible use of these complementary strategies can enhance elderly persons’ quality of daily living through everyday activities.

  • 4. Brännström, Benny
    et al.
    Gustafson, Yngve
    Umeå University, Department of Geriatric and Long-Term Care Medicine.
    Norberg, Astrid
    University of Umeå, Department of Advanced Nursing.
    Winblad, Bengt
    Karolinska institute, Department of Geriatric Medicine.
    ADL performance and dependency on nursing care in patients with hip fractures and acute confusion in a task allocation care system1991In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 5, no 1, p. 3-11Article in journal (Refereed)
    Abstract [en]

    In a prospective study 35 patients operated on for cervical hip-fractures were followed with respect to Acute Confusional State (ACS), problems of basic nursing care and dependency on care-givers. Fifteen patients became acutely confused after the fracture. They turned out to be more dependent on help from others than the non-confused patients were even before the fracture. They rapidly reached a significantly higher level of dependence than the non-confused patients and remained on that level throughout the study month. Six months after the fracture the post-operatively confused patients were still highly dependent on care-givers, significantly more than they were before the fracture. Only three of them were not hospitalised. All the non-confused patients lived in their own homes six months after the fracture and had regained the same level of independence as before it. These findings will be discussed in relation to the organisation of the nursing care. Task allocation nursing care was applied in the wards. A model for the development of dependency in acutely confused hip-fracture patients will be presented and suggestions for how to reduce nurse/patient dependency induced by nursing care will be made

  • 5. Brännström, Benny
    et al.
    Gustafson, Yngve
    Umeå University, Department of Geriatric Medicine.
    Norberg, Astrid
    University of Umeå, Department of Advanced Nursing.
    Winblad, Bengt
    Umeå University, Department of Geriatric Medicine.
    Problems of basic nursing care in acutely confused and non-confused hip-fracture patients.1989In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 3, no 1, p. 27-34Article in journal (Refereed)
    Abstract [en]

    Thirty-five patients operated on for femoral neck fracture were studied. Fifteen (42.9%) became acutely confused after surgery. Problems in the 14 components of basic nursing care (Henderson 1964), were identified by means of interviews with the patients and their caregivers. The quantitative analysis of the results showed that significantly more of the acutely confused patients had problems in nine out of 14 components of basic nursing care as compared with the non-confused patients. The qualitative analysis showed that the problems of the non-confused patients were mostly caused by the fracture and by hospitalisation. The same problems were also present among the acutely confused patients who, in addition, had problems which arose from the acute confusional state

  • 6.
    Gabrielsson, Sebastian
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Ejneborn-Looi, Git-Marie
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Zingmark, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Knowledge of the patient as decision-making power: staff members’ perceptions of interprofessional collaboration in challenging situations in psychiatric inpatient care2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, p. 784-792Article in journal (Refereed)
    Abstract [en]

    Challenging situations in psychiatric inpatient settings call for interprofessional collaboration, but the roles and responsibilities held by members of different professions is unclear. The aim of this study was to describe staff members' perceptions of interprofessional collaboration in the context of challenging situations in psychiatric inpatient care. Prior to the study taking place, ethical approval was granted. Focus group interviews were conducted with 26 physicians, ward managers, psychiatric nurses, and nursing assistants. These interviews were then transcribed and analysed using qualitative content analysis. Results described participants' perceptions of shared responsibilities, profession-specific responsibilities and professional approaches. In this, recognising knowledge of the patient as decision-making power was understood to be a recurring theme. This is a delimited qualitative study that reflects the specific working conditions of the participants at the time the study was conducted. The findings suggest that nursing assistants are the most influential professionals due to their closeness to and first-hand knowledge of patients. The results also point to the possibility of other professionals gaining influence by getting closer to patients and utilising their professional knowledge, thus contributing to a more person-centred care.

  • 7.
    Gabrielsson, Sebastian
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Zingmark, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Person-centred care: Clarifying the concept in the context of inpatient psychiatry2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 3, p. 555-562Article in journal (Refereed)
    Abstract [en]

    This paper reports an analysis of the concept of person-centred care in the context of inpatient psychiatry. It has been suggested that person-centred care in inpatient psychiatry might differ from person-centred care in other contexts, indicating a need to clarify the concept in this specific context. Scholarly papers from health-related disciplines were identified following a systematic search of the electronic databases CINAHL, PUBMED and PsycINFO, covering records indexed up until March 2014. An evolutionary approach to concept analysis was applied, integrating principles for data extraction and analysis in integrative reviews. The concept of person-centred care was defined as cultural, relational and recovery-oriented. It aspires to improve care and calls for a transformation of inpatient psychiatry. The concept is closely related to the concepts of recovery and interpersonal nursing. The result is described in terms of attributes, antecedents, consequences and related concepts. It is concluded that the further development of the concept needs to consider the contexts of the concept at both conceptual and praxis levels. Further research should explore the nature of and relationships between context, culture, care practice and outcomes in inpatient psychiatry from a perspective of person-centred care. The results of this analysis can provide a framework for such research

  • 8.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gille, Kent-Åke
    Piteå älvdals sjukhus, Sjukgymnastiken.
    Grahn, Birgitta
    Kronoberg occupational rehabilitation service, Växjö.
    Functional activities and psychosocial factors in the rehabilitation of patients with low back pain2000In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, no 2, p. 75-81Article in journal (Refereed)
    Abstract [en]

    A four-week rehabilitation programme for back patients, focusing on functional activities and psychosocial factors in the demands of work and daily living, was evaluated. The programme is a combination of training of functional activities and increased psychological knowledge, body awareness and coping. A total of 40 patients with lumbago or lumbago ischias participated in the program and were compared with a matched control group. The results showed that the patients had significantly more ergonomic and psychosocial problems in their working environment than did the controls. A significant reduction in ratings of low back pain was noted in patients compared with controls after rehabilitation. Increased functional ability and physical fitness were shown in the patient group after rehabilitation. Significantly more patients than controls returned to work after the rehabilitation.

  • 9.
    Gustafsson, Silje
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Vikman, Irene
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Psychometric evaluation of a Swedish self-efficacy scale and recovery locus of control scale in the context of minor illness2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 765-772Article in journal (Refereed)
    Abstract [en]

    Reliable and valid instruments are essential when examining the role of self-efficacy and locus of control in the self-care context. The aim of this study was to test the validity and reliability of the Self-Efficacy Scale in Self-Care (SESSC) and the Swedish version of the Recovery Locus of Control scale (RLoC) in the context of minor illness. A descriptive correlational design was used to assess the psychometric characteristics of the scales. The study population was 317 randomly selected Swedish inhabitants aged 18–80. The results from this study showed that the RLoC has limitations in reliability and validity and should not be applied in the context of self-care of minor illness. The SESSC proved to be a reliable and valid instrument in assessing self-efficacy in self-care for minor illness.

  • 10. Harrefors, Christina
    et al.
    Sävenstedt, Stefan
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Elderly people's perceptions of how they want to be cared for: an interview study with healthy elderly couples in Northern Sweden2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 2, p. 353-360Article in journal (Refereed)
    Abstract [en]

    Many countries encounter a demographic change where the number of elderly people will increase. As a result, the number of very old people needing care, services and medical assistance will increase. Care in the private home is often described as providing the best alternative for many elderly people. The aim of this study was to describe elderly people's perceptions of how they wanted to be cared for, from a perspective of becoming in need of assistance with personal care, in the future. Twelve couples of healthy elderly people living in a couple hood participated in an interview study. They were all 70 years and older and received no kind of professional care or social support. Open individual semi-structured interviews were conducted with the support of written vignettes. The vignettes were formed as scenarios that described three levels of caring needs where the elderly people would become ill. A qualitative content analysis was used to analyse the interviews. The findings were interpreted in one main theme: maintaining the self and being cared for with dignity to the end. The theme was built from three categories: at home as long as possible, professional care at nursing home when advanced care is needed and fear of being abandoned. The categories reflect the perception that when minimum help was needed, care and support by the partner and nursing staff were preferred. As the scenarios changed to being totally dependent on care, they preferred care in a nursing home. There was a pervading concern of the risk of not being seen as an individual person and becoming a nobody with no meaningful relations. Thus, there must be a singular goal to support old people, in all stages of their lives, through the recognition and affirmation of self, and providing care with dignity to the end.

  • 11.
    Holmdahl, Solveig
    et al.
    Norrbotten County Council, Luleå.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Imoni, RoseMarie
    Norrbotten County Council, Luleå.
    Parenteral nutrition in home-based palliative care: Swedish district nurses experiences2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 1, p. 89-96Article in journal (Refereed)
    Abstract [en]

    AimThe aim of this study was to describe the experiences of district nurses in caring for patients with home-parenteral nutrition (HPN) in palliative care.MethodA qualitative approach was adopted using thematic content analysis of semi-structured interviews. Twelve district nurses working with primary health care in Sweden participated in the study that was conducted during 2011.FindingsThe analysis resulted in one overarching theme: The agony of terminating hope and three categories: all focus is on the infusion, alone without support, confidence in the relationship. HPN seemed to have a symbolic meaning when patients and family members connected the infusion with hope and life. District nurses expressed that they felt alone with the responsibility for the HPN due to the lack of a structured plan. Difficult discussions around termination of the infusion seemed to be connected to a feeling of agony of terminating hope among the district nurses. All district nurses expressed a need for support in their work, and factors like experience and the development of a good relationship with the patient and the family, could decrease the agony.ConclusionThe draw up of a plan when starting HPN, could be a support for the district nurse and make the aim, follow-up and future termination clearer. The establishment of a plan could make the work easier and reduce the feeling of agony of terminating hope among the district nurses.

  • 12.
    Isaksson, Rose Marie
    et al.
    Southern Lapland Research Department, Vilhelmina.
    Brulin, Christine
    Umeå University, Department of Nursing.
    Eliasson, Mats
    Department of Medicine, Sunderby Hospital.
    Näslund, Ulf
    Umeå University, Department of Public Health and Clinical Medicine.
    Zingmark, Karin
    Southern Lapland Research Department, Vilhelmina, County Council of Norrbotten, Department of Research and Development.
    Prehospital experiences of older men with a first myocardial infarction: A qualitative analysis within the Northern Sweden MONICA Study2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 4, p. 787-797Article in journal (Refereed)
    Abstract [en]

    Aim: To explore older men's prehospital experiences of their first myocardial infarction (MI). Background: The delay between the onset of symptoms to the initiation of medical care is a major determinant of prognosis in MI. The majority of people experiencing MI are men. But few studies have been conducted solely on men's experiences before seeking medical care for MI. The objective of this study was to explore older men's experiences of symptoms and their reasoning during the prehospital phase of their first MI. Method: Data collection was carried out through individual interviews with 20 men representing the age range 65-80 (mean 71)years. The participants were interviewed 3days after admission for a confirmed first MI. The interviews were designed to prompt the men to describe their symptoms and their reasoning up to the decision to seek care. A qualitative content analysis was used to analyse the interviews. Findings: The prehospital phase in older men was found to be a complex and extended journey. The symptoms were perceived from diffuse ill-being to a cluster of alarming symptoms. The participants dealt with conceptions about MI symptoms. They were unsure about the cause of their symptoms, which did not correspond to their expectations about an MI, and whether they should seek medical care. They had difficulty making the final decision to seek care and strived to maintain a normal life. They initially tried to understand, reduce or treat the symptoms by themselves. The decision to seek medical care preceded a movement from uncertainty to conviction. Conclusions: Understanding older men's prehospital experiences of MI is essential to reduce their patient decision times. This requires knowledge about the complexity and dynamic evolvement of symptoms, beliefs and strategies to maintain an ordinary life. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  • 13.
    Johansson, Karin C
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sandman, Per-Olof
    Umeå University, Department of Nursing.
    Karlsson, Stig
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Picking behaviour in cognitively impaired residents in geriatric settings: prevalence of the behaviour and characteristics of the residents2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, no 1, p. 12-8Article in journal (Refereed)
    Abstract [en]

    This paper presents the findings of a point prevalence study performed at all geriatric settings within a county in Northern Sweden. The aims of the study were twofold: to investigate the prevalence of picking behaviour in cognitively impaired residents in various kinds of geriatric care settings and describe the characteristics of the residents, and to investigate how the residents who exhibit picking behaviour are experienced by their care providers. The study comprises 1928 cognitively impaired residents. The prevalence of picking behaviour was found to be 17%. Multivariate analyses showed that behavioural and psychiatric symptoms such as 'often stands at the outer door and wants to go out', 'wanders alone or with other patients back and forth', 'aggressive threats to patients and staff' and being 'manic' and 'fearful' were associated with picking behaviour. Other factors associated with picking behaviour were 'taking part in daily tasks', 'can walk without assistance' and imposing a high psychological workload. Furthermore, residents who exhibited picking behaviour were experienced by care providers as more uncertain and unhappier than residents who did not behave in this way.

  • 14.
    Karlsson, Stig
    et al.
    Umeå University, Department of Geriatric Medicine.
    Nyberg, Lars
    Sandman, Per-Olof
    Umeå University, Department of Nursing.
    The use of physical restraints in elder care in relation to fall risk1997In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 11, no 4, p. 238-42Article in journal (Refereed)
    Abstract [en]

    Physical restraints are a frequently used but disputed method to prevent falls. The aim of the present study was to investigate how the use of restraints in institutional elder care relates to previous falls and to the estimated fall risk of the individual patient. A total of 1142 patients, mean age 82 years, were included in the study. A questionnaire, the Multi-Dimensional Dementia Assessment Scale (MDDAS), was used to measure motor function, vision, hearing, ADL performance, behavioral symptoms, psychiatric symptoms, cognitive impairment and use of medication. Questions concerning the use of physical restraints and known previous falls were added to the instrument. Based on data from the questionnaire (MDDAS), a score on the Downton Fall Risk Index was calculated for each patient. All in all, 248 (22%) of the patients had been subject to restraints and for 155 of them (14%) such measures had been taken to prevent falls. Only weak connections were found between the restraining of patients to prevent falls and the prevalence of known previous falls during hospital stay (phi = 0.05), and estimated fall risk (phi = 0.07). The results indicate that the use of physical restraints is poorly connected with the estimated fall risk. Therefore, this study may point to a possible overuse of these measures

  • 15.
    Larsson, Ingalill L.
    et al.
    Lund University, Institution of Health Science, Division of Physiotherapy.
    Jönsson, Carita
    Lund University, Institution of Health Science, Division of Physiotherapy.
    Olsson, Ann C.
    Lund University, Institution of Health Science, Division of Physiotherapy.
    Gard, Gunvor
    Johansson, Karin
    Lund University, Institution of Health Science, Division of Physiotherapy.
    Women's experience of physical activity following breast cancer treatment2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, p. 422-429Article in journal (Refereed)
    Abstract [en]

    Physical activity is of great benefit to women treated for breast cancer and can even be vital. The aim of this qualitative study was to describe how women treated for breast cancer experience physical activity after surgery. Twelve women, strategically selected according to hospital, age and length of time since surgery, took part in a semi-structured interview. A qualitative method with a phenomenographic approach was used. The result indicates that the incentive to remain or return to a normal physical condition is an important motive for physical activity after breast cancer surgery. The experience of physical activity was, from the women's perspective, expressed in (i) compliance to instructions and need for support, (ii) struggle to get back to normal and fear of negative side-effects, (iii) a wish to stay normal and not allow limitations and (iv) getting control of the situation with new strategies. In conclusion, instructions and motivation are important in starting up and/or continuing physical activity after breast cancer treatment. While in considering the vital benefits of physical activity for breast cancer patients healthcare professionals, and in particular physiotherapists, must be aware of the need for information and the patients' motive for exercise and physical activity to be able to guide and encourage them individually. The professionals must also understand the need for empowerment for these women to take control over their lives and to allow the limitations that eventually occur.

  • 16. Lilja, Margareta
    et al.
    Borell, Lena
    Department of Clinical Neuroscience and Family Medicine, Section of Geriatric Medicine, Stockholm University College of Health Sciences.
    Elderly people's daily activities and need for mobility support1997In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 11, no 2, p. 73-80Article in journal (Refereed)
    Abstract [en]

    The aim of the present study is to describe elderly people's performance of some daily activities in relation to their need for mobility support in their living environment. Two groups of individuals, over the age of 65 and living in an old urban area with access to elevators in their housing, were compared, as regards mobility, shopping, hobbies and social contacts. The first group (n = 284) comprised persons who needed assistance from another person in using the elevator. The subjects in the second group (n = 325) were able to manage the elevator independently. The subjects in the first group experienced more problems in carrying out the activities than those in the second group. Weekly shopping was the only action in which the findings demonstrated no main differences between the groups. Throughout all the activities of daily living (ADL), and in both groups, there were persons who were rated as having the capacity to perform the activities, but did not do so and did not want to do so. The elderly, especially in the first group, wanted to engage in more activities than they were judged to have the capacity for and/or the environmental support to do. The implications of the result for the assessment of the homes of the elderly in relation to their environment are discussed.

  • 17.
    Lindberg, Birgitta
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Axelsson, Karin
    Öhrling, Kerstin
    Adjusting to being a father to an infant born prematurely: experiences from Swedish fathers2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 1, p. 79-85Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the experiences of being a father to a prematurely born infant. Eight fathers of prematurely born children were interviewed using a narrative approach, and a thematic content analysis was used to analyse the interviews. The fathers described that the preterm birth gave them the chance to get to know their infant as they had to spend time at the intensive care unit. They also felt better educated by professionals who helped them take care of their infant. Their feelings and attachment for their infant increased over time and the fathers felt that they had a stronger bond with their child compared with friends who had babies born at term. As time passed, they became more confident as a father. In spite of the strain, the experience made them change as a person and they expressed having different values. The relationship with their partner was strengthened as they handled this situation together as a couple. However, the fathers felt fortunate despite everything and described having managed a prematurely born infant rather well. Although there are similarities between being a father to a child born at term and to one born preterm, it is significant to gain further knowledge about the specific experiences of fathers of prematurely born infants. The results of this study have implications for nurses working with families who have children born prematurely

  • 18. Nilsson, Carina
    et al.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Swedish district nurses' experiences on the use of information and communication technology for supporting people with serious chronic illness living at home: a case study2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 259-265Article in journal (Refereed)
    Abstract [en]

    The aim of this case study was to describe two District Nurses' (DN) experiences of using information and communication technology (ICT) to communicate with chronically ill people in their homes. An electronic messaging program via computers and mobile phones with an Internet connection was used, enabling DNs and the ill people to exchange messages to and from anywhere. The program comprised different virtual rooms, and communication was via text messages. The DNs in this study used the program two to four times each week from November 2003 to March 2004. Semi-structured interviews were performed before, during and after the implementation of the new technology and were analysed using thematic content analysis. The results showed that the DNs felt that the technology increased accessibility to nursing care through a more direct communication with the ill person meaning that a more trusting relationship could be created. The DNs also experienced that the use of ICT saved working time. This study indicates that the use of ICT for communication allowed the DN to better support a chronically ill person at home leading to improved home nursing care. This method of communication cannot replace physical presence, but can be seen as a complement to nursing care at home.

  • 19.
    Nilsson, Imogene
    et al.
    Umeå University, Department of Nursing, Community Health and Rehabilition.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Gustafson, Yngve
    Umeå University, Department of Community Health and Rehabilitation.
    Lundman, Berit
    Umeå University, Department of Nursing.
    Norberg, Astrid
    Umeå University, Department of Nursing.
    Well-being, sense of coherence, and burnout in stroke victims and spouses during the first few months after stroke2001In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 3, p. 203-214Article in journal (Refereed)
    Abstract [en]

    Ten stroke victims, who had recently suffered their first manifest stroke with lasting neurological symptoms, participated, together with their spouses, in a study aimed at elucidating the well-being, sense of coherence (SOC), and burnout during the first few months after discharge. The stroke victims had no substantial speech disturbances, and showed no evidence of significant cognitive impairment, signifying they were mildly to moderately impaired by their stroke. All subjects were investigated at 1 and 3 months after homecoming. The methods used in this study were open-ended interviews with all research participants, performed at two different appointments, and three self-reporting questionnaires: the well-being measure (WM), the SOC scale, and the burnout measure (BM). The instruments suit each other well, broaden the picture of living with stroke and give an attuned comprehensive understanding. The most striking finding was the substantial differences in the results, both regarding the stroke victims and their spouses, clearly indicating the limited value current generalizations have. The results also pointed to considerable distress both in stroke victims and spouses, although individuals with a weak SOC clearly displayed more difficulties in coping with the situation and risk of burnout, than did those with a strong SOC.

  • 20.
    Nord-Ljungquist, Helena
    et al.
    Department of Health and Caring Science, Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University,Växjö, Sweden,.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Fridlund, Bengt
    Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.
    Elmqvist, Carina
    Centre of Interprofessional Collaboration within Emergency care (CICE), Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article, review/survey (Refereed)
    Abstract [en]

    Background

    In a rural environment where distances and access to ambulance resources in people’s immediate area are limited, other responders like firefighters dispatched to perform a first aid before ambulance arrives in areas where a longer response time exists; an assignment called ‘While Waiting for the Ambulance’ (WWFA). Knowledge is limited about the experience from a caller’s perspective when a person has a life‐threatening condition needing emergency help and both firefighters in a WWFA assignment and ambulance staff are involved.

    Aim

    The aim of the study is to describe the emergency situation involving a WWFA assignment in a rural environment from the caller's perspective.

    Method

    A descriptive design using qualitative methodology with a reflective lifeworld research (RLR) approach was used for this study, including in‐depth interviews with eight callers.

    Results

    An emergency situation involving WWFA assignment in a rural environment mean a sense of being lone and lonely with a vulnerability in while waiting to hand over responsibility for the affected person. Ambivalence in several dimensions arises with simultaneous and conflicting emotions. A tension between powerlessness and power of action where the throw between doubt and hope are abrupt with a simultaneous pendulum between being in a chaos and in a calm.

    Conclusion

    A double ambivalence emerges between, on one hand feeling alone in the situation and having full control, on the other hand, with trust handing over the responsibility, thereby losing control. Contact with the emergency medical dispatcher becomes a saving lifeline to hold onto, and access to emergency help in the immediate area of WWFA is valuable and important. Trust and confidence are experienced when callers are met with empathy, regardless of personal acquaintance with arriving responders.

  • 21.
    Olofsson, Birgitta
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Lundström, Maria
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Borssén, Bengt
    Umeå University Hospital, Department of Orthopaedics.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Delirium is associated with poor rehabilitation outcome in elderly patients treated for femoral neck fractures2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 2, p. 119-27Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe risk factors for delirium and the impact of delirium on the rehabilitation outcome for patients operated for femoral neck fractures. Sixty-one patients, aged 70 years or older, consecutively admitted to the Department of Orthopaedic Surgery at Umea University Hospital, Sweden for femoral neck fractures were assessed and interviewed during hospitalization and at follow up 4 months after surgery. Delirium occurred in 38 (62%) patients and those who developed delirium were more often demented and/or depressed. Patients with delirium were longer hospitalized and they were more dependent in their activity of daily living (ADL) on discharge and after 4 months. They had poorer psychological well-being and more medical complications than the nondelirious. A large proportion of the patients who developed delirium did not regain their previous walking ability and could not return to their prefracture living accommodation. Delirium after hip fracture surgery is very common especially among patients with dementia or depression. This study shows that delirium has a serious impact on the rehabilitation outcome from both short- and long-term perspectives. Because delirium can be prevented and treated, it is important to improve the care of elderly patients with hip fractures.

  • 22.
    Riekkola, Jenni
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Rutberg, Stina
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lilja, Margareta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Isaksson, Gunilla
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Healthcare professionals’ perspective on how to promote older couples’ participation in everyday life when using respite care2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 2, p. 427-435Article in journal (Refereed)
    Abstract [en]

    Aims

    The aim is to describe healthcare professionals’ perspectives on how they understand and promote older couples’ participation in everyday life when using residential respite care.

    Design and Methods

    Eighteen healthcare professionals with varying degrees of competence and from one residential respite care facility participated in four focus group interviews. Data were analysed through qualitative latent content analysis.

    Findings

    The findings revealed a broad, multifaceted view of participation and ways in which participation in everyday life is promoted by these professionals. Trustworthy relationships between professionals, spousal caregivers and clients were implicated. Promoting participation also necessitated that clients have access to meaningful activities. In addition, participation entailed an environment that supported various needs.

    Conclusion

    Promoting participation for older couples that are using respite care involves multifaceted perspectives that consider social–relational aspects including both the client and their spouse. Furthermore, attention is needed to the meaning a change of context between home and the respite care facility has on relationships, environments and activities in everyday life. Such an approach could benefit the couples’ shared everyday life situation and in a wider perspective, also influence their health and well‐being when ageing in place together.

  • 23.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Disabled children's perceptions of technical aids, assistance and peers in play situations2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 1, p. 27-33Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to gain a deeper understanding of how children with disabilities perceive their technical aids in play situations. Transcribed interviews with eight children with disabilities were analysed according to the constant comparative method of grounded theory described by Glaser & Strauss. Three categories were found in the data, forming a model describing the child's relations in play situations (core category): to technical aids, to assistance and to the play environment. Two of the categories included relations to adults. The children's opportunities to play required that a parent or an assistant be present. Access to the playground also required the assistance of adults. The third category, relation to technical aids, is an individual one, as the technical aids were perceived differently by all the children. The technical aids were also seen as an extension of the child. The implications for parents and service providers are discussed

  • 24.
    Skär, Lisa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Prellwitz, Maria
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Participation in play activities: a single-case study focusing on a child with obesity experiences2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 2, p. 211-219Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to describe how a child with obesity perceived participation in play activities. A single-case study design was chosen to optimize the understanding of the complexities of the research question. A 9-year-old boy diagnosed with obesity was studied. This is a typical case and is studied mainly to provide understanding to the issue. The data were collected from interviews with the boy, his mother and his teacher. Data were also collected through observations and a self-report assessment instrument called Kid Play Profile. The results showed that the boy was ridiculed by his peers and that at times he felt excluded from them, which prevented him from participating in play activities. The boy's experience came from different perceived problems such as lack of friends to play with, his inability to know how to perform in different play activities, and lack of proper support and encouragement from adults. Supporting children to overcome social skills deficits could prevent them from being teased and may have a positive effect on health. To optimize children's participation in play activities, it is important for adults to give them proper support and encouragement. The results were discussed with regard to earlier research, and topics for further research are suggested.

  • 25.
    Skär, Lisa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Complaints with encounters in healthcare: Men’s experiences2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 2, p. 279-286Article in journal (Refereed)
    Abstract [en]

    Complaints with encounters in healthcare - men's experiences Good encounters within healthcare are important for the manner in which ill people facilitate their health and their perception of quality of care. Research about quality of care are important, but point out that dissatisfaction with healthcare may in the future be even more common regarding the demands for a more effective healthcare. The aim of this study was therefore to describe experiences of dissatisfaction with encounters in healthcare among men who personally filed a complaint to the Patients' Advisory Committee in the county council. Qualitative data were collected in semi-structured interviews with a purposive sample of nine men who have filed a complaint to the Patients' Advisory Committee. The analysis resulted in two categories: being met with a disrespectful manner and not receiving a personal apology. The results in the first category describe that the men were treated with disrespect and suspicions by healthcare professionals. This was related to lack of communication which made the men sensitive to negative attitudes on the part of professionals. The results in the second category show that the men expected amends to be made in form of a personal apology about the dissatisfaction. The men were given no opportunities to influence the encounters and the professionals were unconscious of their behaviour in form of bad treatment. In conclusion, the results indicate the importance of meeting patients and their relatives with respect and dignity, listening to their experiences and proceeding with the treatment without insulting anyone as a person. © 2011 The Authors. Scandinavian Journal of Caring Sciences

  • 26.
    Stridsman, Caroline
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Lindberg, Anne
    OLIN studies, Sunderby Hospital.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Fatigue in chronic obstructive pulmonary disease: a qualitative study of peoples experiences2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 1, p. 130-138Article in journal (Refereed)
    Abstract [en]

    BackgroundFatigue is reported to be one of the most common symptoms among people with chronic obstructive pulmonary disease COPD. However, there is hardly any qualitative research describing how fatigue affects people living with this illness.AimTo describe people's experience of fatigue in daily life when living with moderate to very severe COPD.MethodsA purposive sample of 20 people with COPD stages II–IV was recruited from the Obstructive Lung Disease in Northern Sweden COPD study. Data were collected through semi-structured interviews with participants regarding their experience of fatigue. The interviews were subjected to qualitative content analysis.ResultsOne theme was identified: Reconcile with the dimensions of fatigue, and four categories were identified: To understand the reasons of fatigue, To preserve fatigue unexpressed, When fatigue takes control and How to manage fatigue. Fatigue seems to be an always-present feeling, involving the whole body, raising feelings of hopelessness and controlling one's life. It seems to be accepted as a natural consequence of COPD and may therefore remain unexpressed. Further, when experienced with dyspnoea, fatigue becomes even heavier and more difficult to manage. To gain control of fatigue, people plan daily life and continue with physical activities.ConclusionFatigue affects the daily lives of people with COPD. Perceived with dyspnoea, fatigue was described as overwhelming. Most importantly, fatigue seems to be unexpressed to healthcare professionals and relatives.

  • 27.
    Sundin, Karin
    et al.
    Umeå University, Department of Nursing.
    Axelsson, Karin
    Jansson, Lilian
    Umeå University, Department of Nursing.
    Norberg, Astrid
    Umeå University, Department of Nursing.
    Suffering from care as expressed in the narratives of former patients in somatic wards2000In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, no 1, p. 16-22Article in journal (Refereed)
    Abstract [en]

    To illuminate patients' experiences of suffering from care, ten former patients in somatic wards narrated a desirable care episode (n = 39) and an undesirable care episode (n = 51). The interviews were analysed using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. Four themes were found: having a good rest, suffering through, searching for autonomy and being cared for by attentive and committed staff. The findings were interpreted in light of Eriksson's description of suffering, which describes three kinds of suffering: 'suffering of life', 'suffering of illness' and 'suffering of caring'. Although not mentioned explicitly, it was evident that cases of suffering from care were indicated in the patients' narratives. The themes were related to the patients' states of health, their experience of the care situation and their descriptions of themselves, and could be understood as related to the acts of the 'drama of suffering' described by Eriksson. The study highlights the need for the patient to find a co-actor in the drama of suffering in order to prevent suffering from care, i.e. prevent hindrance to the patient in her/his struggle against the 'suffering of illness' and the 'suffering of life'. The patients must be seen as the directors of their own dramas of suffering.

  • 28. Sävenstedt, Stefan
    et al.
    Zingmark, Karin
    County Council of Norrbotten, Department of Research and Development.
    Hydén, Lars-Christer
    Linköping University, Department of Communication Studies.
    Brulin, Christine
    Umeå University, Department of Nursing.
    Establishing joint attention in remote talks with the elderly about health: a study of nurses' conversation with elderly persons in teleconsultations2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 317-24Article in journal (Refereed)
    Abstract [en]

    This study is a contribution to the sparsely studied field of nurses' teleconsultations with frail elderly people. The aim was to describe how talk and interaction are accomplished and by what means problems are handled that emerge from the fact that the communication is conducted via videoconferencing techniques. Recordings were made of 22 sessions of teleconsultation between nurses and elderly nursing home residents aided by enrolled nurses. The data were analysed with a qualitative method inspired by conversation and discourse analysis. The findings indicate that in order to create a joint attention the participants often had to verbally confirm and reconfirm that contact had been established. The triad of participants played a special part in maintaining the joint attention through compensating for the contextual aspect of the medium's limitations and the demented elderly person's communication problems. 'Talks about the communication' and passages of social talk took place when the nurse or the staff member wanted to re-establish and maintain joint attention. The joint attention seemed connected to a special sort of eye contact and gaze and to the type of camera projection that was used. One conclusion was that to create joint attention in nurses' teleconsultations with frail elderly people, the limitations in transferring communication cues and the limitations of what the camera can reveal of the general context could, to some extent, be made up for by verbal communication within the triad of participants. Another conclusion was that these limitations in the context of interaction in some situations also seemed to be an advantage for the demented elderly and contributed to increased attention

  • 29.
    Söderberg, Siv
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Norberg, Astrid
    Umeå University, Department of Nursing.
    Metaphorical pain language among fibromyalgia patients1995In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 9, no 1, p. 55-9Article in journal (Refereed)
    Abstract [en]

    55-9 AB - Fourteen women with fibromyalgia described their pain experiences using words indicating a model of pain that presented pain as an aggressive physical deformation and a torture-like experience. Metaphorical expressions were used which was seen as a means for enabling the patients to disclose tacit knowledge. The pain experience was narrated as being steady and without any distinct bodily location. Only causes explaining the present aggravation of the pain and treatment leading to a temporary relief were related.

  • 30.
    Söderberg, Siv
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Olsson, Malin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    A hidden kind of suffering: female patient’s complaints to Patient’s Advisory Committee2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 1, p. 144-150Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe female patients' experiences of dissatisfaction with healthcare. People who have been treated with dignity during healthcare encounters are more prone to report better adherence to treatment and higher satisfaction with their care. Good quality care is commonly described as individualized and related to individual needs. This study has a qualitative approach, as the aim was to describe female patients' experiences of dissatisfaction with healthcare from a first person perspective. A purposive sample of fourteen women was interviewed about their experiences of dissatisfaction with healthcare. The interviews were subjected to a qualitative content analysis. The findings show that the women were treated with indifference when they were being withheld information, felt distrusted, and when they were treated badly they did not receive an apology. The findings also show that the women experienced that they did not feel safe when they had no one liable to turn to within the healthcare when the encounter did not correspond to the women's needs and expectations. The women's experiences of being withheld explanations can be seen as a violation of their dignity and a hidden suffering from care. In conclusion, the study shows the importance of receiving a personal explanation after filing a complaint about healthcare and recommends that clinics that receive a complaint from a patient should contact that patient and provide an individualized explanation

  • 31.
    Westerlund, Anna
    et al.
    Umeå universitet, Umeå university, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University.
    Garvare, Rickard
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Business Administration and Industrial Engineering.
    Nyström, Monica Elisabeth
    Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Karolinska Institutet, Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet.
    Eurenius, Eva
    Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå universitet.
    Lindkvist, Marie
    Umeå universitet, Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University.
    Ivarsson, Anneli
    Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University.
    Managing the initiation and early implementation of health promotion interventions: A study of a parental support programme in primary care2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 1, p. 128-138Article in journal (Refereed)
    Abstract [en]

    BackgroundMental health problems are increasing among children and adolescents worldwide, and parental support programmes have been suggested as one preventive intervention. However, the actual impact and low rates of adoption and sustainability of prevention programmes have proven to be a concern, and thus, further studies on their implementation are needed.AimThis study focused on the initial implementation of the International Child Development Programme (ICDP) in primary care. The aim was to investigate the involved actors’ views on factors likely to affect implementation and the strategies used to manage them.DesignA case study design with a mixed-methods approach combining quantitative and qualitative data from questionnaires and interviews was used.MethodsEighty-two professionals at different positions in the involved organisations participated. Directed content analysis was used for analyses, focusing on perceived levels of importance and the manifestation of implementation factors.FindingsInterviews and questionnaires provided descriptions of factors influencing the initial ICDP implementation. Uncertainty on how to manage important factors and vague change strategies was reported. Discrepancies in the perceived levels of importance versus manifestation were found regarding several factors, including hands-on support, time and resources, communication and information, a comprehensive plan of action, follow-ups, and external and internal collaborations. Manifested factors were a need for change, motivation and the ICDP's compatibility with existing norms, values and practices.ConclusionsImplementing a parental support programme in a complex setting will benefit from being preceded by a thorough examination of the intervention and the target context and the development of clear implementation strategies based on the results of that examination. This study provides insights into how and by whom knowledge on implementation is applied during the launch of a health promotion programme, and these insights might help increase the rate of adoption and the use of such programmes and thereby increase their effectiveness.

  • 32.
    Wälivaara, Britt-Marie
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Andersson, Staffan
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    General practitioners' reasoning about using mobile distance-spanning technology in home care and in nursing home care2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 1, p. 117-125Article in journal (Refereed)
    Abstract [en]

    The trend for health care and nursing care turns from hospital to health care and nursing care at home. Studies have shown that health care professionals have no access to patient records in home and nursing home settings. Technological development creates opportunities for a host of mobile technology solutions. The aim of this study was to describe the reasoning among general practitioners (GPs) about the use of mobile distance-spanning technology (MDST) in care at home and in nursing homes. Seventeen GPs were divided in five groups for a group interview. The interviews were tape-recorded and transcribed verbatim. The qualitative content analysis resulted in four areas about the MDST, MDST has an impact on GPs' work, the nurses' profession, and the patient and the family, with nine adherent categories. The findings were interpreted and formulated in the theme: MDST should be used with caution. The results show quite a few expressions about the MDST as useful and valuable in health care at home and in nursing home settings; however, in every category, there were text that we interpreted as caution when using the MDST. The MDST cannot be used in all situations and cannot replace human meetings in health care and nursing care at home and in nursing homes. The MDST should primarily be a tool for the profession, and understanding the professions' reasoning about technology use in health care at home and in nursing home settings must be the base for implementing MDST.

  • 33.
    Zotterman, Anna Nygren
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Olsson, Malin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    District nurses' views on quality of primary healthcare encounters2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 3, p. 418-425Article in journal (Refereed)
    Abstract [en]

    Good encounters are fundamental for good and professional nursing care, and can be described as treating patients with respect and protecting their integrity and autonomy. This study describes district nurses' views on quality of healthcare encounters in primary healthcare. A purposive sample of 27 district nurses participated in five focus group interviews. The focus groups interviews were digitally recorded and transcribed verbatim. The interview texts were analysed using a thematic content analysis. The analysis resulted in four themes, including being aware of the importance and difficulties during encounters, being the patient's advocate, being attentive to the unique person and being informed when a meeting turned out poorly. The results show that district nurses believed that encounters formed the basis of their work and it was vital for them to be aware of any difficulties. District nurses found that acting in a professional manner during encounters is the most significant factor, but this type of interaction was sometimes difficult because of stress and lack of time. The district nurses considered themselves to be the patients' advocate in the healthcare system; in addition, the acts of seeing, listening, believing and treating the patient seriously were important for providing good quality care. If a poor encounter occurred between the district nurse and the patient, the district nurses found that it was necessary to arrange a meeting to properly communicate what problems arose during the interaction. The district nurses highlighted that providing an apology and explanation could improve future encounters and establish a better nurse–patient relationship. In conclusion, this study shows the importance of confirming and respecting patients' dignity as the fundamental basis for a good quality encounter in primary healthcare

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