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  • 1.
    Axelsson, Karin
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Harrefors, Christina
    Sävenstedt, Stefan
    Wälivaara, Britt-Marie
    E-Health in care of older persons in the future2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no Suppl. 1, p. 54-Article in journal (Other academic)
    Abstract [en]

    Introduction: To achieve quality care in the person's home implies that the way we perform the care has to be developed. In this development new technology services, including mobile distance-spanning technology and information- and communication technology, has to be used. The aim of this presentation is to explore some issues important to consider before implementation of e-health services in care of older persons at home. Method: The presentation is based on studies where healthy older persons (n=23), older persons who had experience of being cared for with mobile distance-spanning technology (n=9) and general practitioners (n=17) were interviewed about their perceptions, views and experiences concerning the use of technology in care at home and quality care. The interviews were analysed by qualitative content analysis. Results: In the results from the different studies there were some common results. One was the importance of human meetings; another was that the person in need of care and the health professional need to know each other if virtual meetings should be possible. Other issues brought up in the different studies were trust, quality care, the need of combining home care services with visits at health care centres and hospitals, different technical equipment are only useful in specific circumstances, and mobile distance-spanning technology should not be looked at separately but as one part of a complex chain of health care services where all parts of the chain are needed. Conclusion: E-health including mobile distance-spanning technology and information- and communication technology is on its way to be accepted and used in home care for older persons. It is important that nurses as professionals actively take part in the development, designing and testing of the technical devices.

  • 2.
    Eilertsen, Grethe
    et al.
    Høgskolen i Buskerud, Buskerud and Vestfold University College, Kongsberg.
    Ormstad, Heidi
    Buskerud and Vestfold University College, Kongsberg.
    Kirkevold, Marit
    Universitetet i Oslo.
    Mengshoel, Anne Marit
    University of Oslo.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Olsson, Malin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Similarities and differences in the experience of fatigue among people living with fibromyalgia, multiple sclerosis, ankylosing spondylitis and stroke2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 13-14, p. 2023-2034Article in journal (Refereed)
    Abstract [en]

    Aims and objectivesTo elucidate the experience of fatigue across several long-term illnesses, focusing on the similarities and differences.BackgroundFatigue is common to many long-term illnesses, but it has been studied mainly within the context of a single illness; qualitative studies comparing the experience and its impact on daily life across different long-term illnesses are lacking.DesignQualitative design.MethodsA secondary analysis was conducted of five original interview studies involving 95 persons with ankylosing spondylitis, fibromyalgia, multiple sclerosis or stroke.ResultsSimilarities and differences concerning experiences of fatigue were found across the studied long-term illnesses. All patients expressed the perception of having an unfamiliar body. Fatigue was also commonly expressed as unpredictable, uncontrollable and invisible to others. Differences were related to a constant versus a varying condition, a sudden and an uncontrollable sleepiness, a mutual reinforcement with pain and increased stress sensitivity. A lack of energy and a need for sleep and rest were common experiences, as was the impact on social relationships. There were also similarities regarding how the patients managed their daily life. The search for practical solutions and attitude adjustment differed with the fatigue characteristics. All patients felt a lack of understanding and disbelief from others.Conclusion and relevance to clinical practiceFatigue is commonly expressed by patients with long-term illnesses. Variations in experience are related to the type of diagnosis. The disparity between experiences influences how patients managed and adjusted to the conditions of everyday life. The illness-specific characteristics of fatigue warrant increased clinical awareness and may allow professionals to offer adequate information and establish effective methods of managing the condition. The feeling of invisibility and difficulty describing the experience of fatigue in particular highlights this need.

  • 3.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Forsberg, Angelica
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Peripheral intravenous catheter difficulty: A clinical survey of registered nurse and critical care nurse performance2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 3-4, p. 686-694, article id 15960276Article in journal (Refereed)
    Abstract [en]

    Objectives To describe the characteristics, problems and interventions associated with performing peripheral intravenous catheterisation in difficult situations when registered nurses need support from critical care nurses. Background Only a few studies have focused on peripheral intravenous catheterisation problems or interventions to promote success. There is limited research on the education, knowledge, confidence and skills of registered nurses associated with successful peripheral intravenous catheterisations. Design A descriptive cross‐sectional survey design was used. Results A total of 101 questionnaires were completed by critical care nurses (n = 32) and 92 by registered nurses (n = 83); the total number of participants was 115. The same critical care nurses and registered nurses could participate several times on different occasions. Statistical analyses were performed using descriptive statistics. The patterns differed in part between the registered nurses who needed support and the critical care nurses who provided the support. Both registered nurses and critical care nurses used ultrasound to a very low extent (2.2% vs. 1.0%). The registered nurses indicated to a significantly higher extent (p = 0.02) that the veins were invisible and that they had performed the optional interventions. The success rate for critical care nurses was considerably high (86.1%). The most common place for successful insertion was the wrist. Critical care nurses performed fewer interventions, and they informed the patients and assessed that the veins were fragile to a higher extent. Conclusions Superior nursing skills are required in order to adapt and assess specific situations related to peripheral intravenous catheterisation difficulties and to choose the adequate interventions. Young and newly graduated registered nurses should be offered individualised training during the post‐educational period on how to assess problems and perform peripheral intravenous catheterisations in specific difficult situations. Relevance to Clinical Practice Simulation is suggested for practical training in order to increase patient safety related to the performance of technical skills such as peripheral intravenous catheterisation.

  • 4.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Close relatives in intensive care from the perspective of critical care nurses2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 9, p. 1651-1659Article in journal (Refereed)
    Abstract [en]

    The aim was to describe critical care nurses' experiences of close relatives within intensive care. Background. There is a lack of research describing critical care nurses' experiences of the significance of close relatives in intensive care. Knowledge in this area will support critical care nurses to develop good nursing care for the critically ill person and their close relatives. Design and method. The design of the study was qualitative. Data collection was carried out through focus group discussions with 24 critical care nurses in four focus groups during spring 2004. The data were subjected to qualitative thematic content analysis. Results. The focus groups discussions showed that the presence of close relatives was taken for granted by critical care nurses and it was frustrating if the critically ill person did not have any. Information from close relatives made it possible for critical care nurses to create individual care for the critically ill person. They supported close relatives by giving them information, being near and trying to establish good relations with them. Close relatives were important. Critical care nurses lacked forums for reflection and discussion about the care given. Relevance to clinical practice. This study indicates that close relatives are a prerequisite for critical care nurses to give good nursing care to meet the needs of the critically ill person. A communication based on mutual understanding is necessary if critical care nurses are to be able to support close relatives. Dealing constantly with situations that were ethically difficult without any chance to reflect was an obstacle for critical care nurses to improve their work with close relatives

  • 5.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Critical care nurses experiences of follow-up visits to an ICU2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 19-20, p. 2925-2932Article in journal (Refereed)
    Abstract [en]

    Aim.  The aim of this study was to describe critical care nurses' experiences of follow-up visits for formerly critically ill people discharged from an intensive care unit and their close relatives.Background.  The critical illness experience affects the ill person and their close relatives not only during the stay in an intensive care unit, but also for a long time afterwards. Follow-up visits were introduced to offer people the opportunity to talk about their experiences. This activity has not been studied earlier from the perspective of critical care nurses.Design.  The design of this study was qualitative.Method.  Eight critical care nurses narrated their experiences of follow-up visits by formerly critically ill people and their close relatives to an intensive care unit. Data were collected during 2007-2008. Qualitative thematic content analysis was applied to the interview texts.Results.  The findings show that to feel they were doing a good job it was vital for the critical care nurses to be well prepared for the follow-up visits. It was difficult, in a positive way, to recognise formerly critically ill people when they returned looking healthy. The critical care nurses were disappointed that their former patients remembered so few real events. The follow-up visits gave the critical care nurses a new picture of how the critically illness experience influenced the former patient's everyday life during and after their stay in the intensive care unit and how it affected the lives of their close relatives.Conclusions.  Through sharing the experiences of formerly critically ill peoples' and their close relatives' critical care nurses receive valuable feedback about their work.Relevance to clinical practice.  Receiving feedback about one's work from follow-up visits gives critical care nurses the possibility for to evaluate given care. Follow-up visits to intensive care units can provide them with valuable knowledge that might lead to improved nursing care.

  • 6.
    Forsberg, Angelica
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    People's experiences of suffering a lower limb fracture and undergoing surgery2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 1-2, p. 191-200Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe people's experiences of suffering a lower limb fracture and undergoing surgery, from the time of injury through to the care given at the hospital and recovery following discharge.BACKGROUND: There is a lack of research on people's experiences of suffering a lower limb fracture and undergoing surgery - from injury to recovery.DESIGN: A qualitative approach was used.METHODS: Interviews with nine participants were subjected to thematic content analysis.RESULTS: One theme was expressed: from realising the seriousness of the injury to regaining autonomy. Participants described feelings of frustration and helplessness when realising the seriousness of their injury. The wait prior to surgery was a strain and painful experience, and participants needed orientation for the future. They expressed feelings of vulnerability about being in the hands of staff during surgery. After surgery, in the postanaesthesia unit, participants expressed a need to have control and to feel safe in their new situation. To mobilise and regain their autonomy was a struggle, and participants stated that their recovery was extended.CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: Participants found themselves in a new and unexpected situation and experienced pain, vulnerability and a striving for control during the process, that is, 'from realising the seriousness of the injury to regaining autonomy'. How this is managed depends on how the patient's needs are met by nurses. The nursing care received while suffering a lower limb fracture and undergoing surgery should be situation specific as well as individual specific. The safe performance of technical interventions and the nurse's comprehensive explanations of medical terms may help the patient to feel secure during the process.

  • 7.
    Forsberg, Angelica
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Vikman, Irene
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Wälivaara, Britt-Marie
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Patients' perceptions of their postoperative recovery for one month2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 13-14, p. 1825-1836Article in journal (Refereed)
    Abstract [en]

    Aims and objectivesTo explore orthopaedic and general surgery patients' perceptions of their postoperative recovery for one month.BackgroundIn general, nursing research in the postoperative context has been directed towards a single symptom or area, which is valuable. However, there is a lack of studies of orthopaedic and general surgery patients' perceptions of postoperative recovery from a short-term perspective.DesignA quantitative approach with a longitudinal design was used.MethodsA total of 180 patients participated in the study. Data were collected using a standardised questionnaire, the Postoperative Recovery Profile, for self-assessment of recovery. Descriptive statistics reported as proportions were used for the categorical variables. Analytic statistics were used to identify statistically significant differences. Mean values and t-tests were used for quantity variables, and Mann–Whitney U-tests and Chi-squared tests were used for nonparametric variables.ResultsOverall, the orthopaedic patients were substantially less recovered than the general surgery patients. Two-thirds of the orthopaedic patients and half of the general surgery patients perceived severe or moderate pain in the acute recovery phase. Within the general surgery group, there were significant differences in the recovery between the Gastric Bypass patients and colon/ileum surgery patients. The gastric bypass patients were overall more recovered than the other groups of patients. The Gastric Bypass patients reported that they had improved after one month compared to their own status prior to surgery.Conclusions and relevance to clinical practiceNursing support for orthopaedic patients must be improved, especially after they are discharged from the hospital. To structure and monitor individual recovery, a top-five priority profile of the most important problems should be used during follow-up calls after the patient is discharged from the hospital. Postoperative pain continues to represent a clinical problem that requires attention. Heterogeneity in the perceptions of recovery within the general surgery group was indicated, which may depend on the surgical procedure as well as the patients' expectations and comparisons with their lives before surgery. Rather than return to their preoperative levels, certain patients tend to continue towards a new or different life postoperatively.

  • 8.
    Forslund, Ann-Sofie
    et al.
    The Northern Sweden MONICA Myocardial Registry, Department of Research, Norrbotten County Council.
    Lundblad, Dan
    Department of Medicine, Sunderby Hospital.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sudden cardiac death among people with diabetes: preventive measures documented in their medical records2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 23/24, p. 3401-3409Article in journal (Refereed)
    Abstract [en]

    Aims: The purpose of this study was to examine how prevention of complications for people with diabetes mellitus had been conducted, as described in their medical records, focusing particularly on sudden cardiac death. A further aim was to compare the documentation with guidelines for diabetes care. Background: Diabetes mellitus is associated with an increased risk of cardiovascular disease, death and sudden cardiac death. About half of those affected by sudden cardiac death are assumed to have had one or more risk factors for cardiovascular disease that could have been treated effectively resulting in a reduced risk of sudden death. Design: Survey. Method: Fifty-six people diagnosed with diabetes mellitus, who had died of a sudden cardiac arrest between the years 2003-2005, from the Northern Sweden MONICA myocardial registry were included. These people's medical records were examined with regard to documentation of the care given during the year prior to the person's sudden cardiac death. Results: The qualitative content analysis resulted in four categories: individualised goals for diabetes care; prevention of complications; self-care; and factors which may affect ability to adhere to treatment. The quantitative analysis showed that few people with diabetes mellitus achieved goals for metabolic control, compared with those set in guidelines for diabetes mellitus care.Conclusion. To prevent complications for people with diabetes mellitus, it is a challenge for nurses and physicians to involve people with diabetes mellitus in their own care to improve the prognosis. Relevance to clinical practice: Examination of medical records of people with diabetes mellitus showed that documentation could be more informative and systematic. It is important to achieve better adherence to treatment and to increase people's understanding of their illness

  • 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.
    Martinsson, Jesper
    Luleå University of Technology, Department of Engineering Sciences and Mathematics, Mathematical Science.
    Välivaara, Britt-Marie
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Need for reassurance in self-care of minor illnesses2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1183-1191Article in journal (Refereed)
    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.

  • 10.
    Gustafsson, Silje
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Vikman, Irene
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Martinsson, Jesper
    Luleå University of Technology, Department of Engineering Sciences and Mathematics, Mathematical Science.
    Perceptions of needs related to the practice of self-care for minor illness2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 21-22, p. 3255-3265Article in journal (Refereed)
    Abstract [en]

    Aims and objectivesThe aim of this study was to describe people's perceptions of needs to feel confident in self-care for minor illnesses as well as their perceptions about supporting and obstructing factors in the practice of self-care.BackgroundMinor illness constitutes a large part of primary care, and patients' attendance to doctors' appointments for minor illness has been seen to increase future attendance for the same condition. Almost half of the consultations with telenurses result in the provision of self-care advice.DesignA cross-sectional survey.MethodPrimary data were collected using a questionnaire, and the study participants (n = 315) were randomly selected from the national Swedish address register.ResultsHaving knowledge and receiving health care advice and reliable information were perceived to be needs in order for participants to feel confident in self-care. Having family or friends to consult with was perceived to be a positive factor influencing confidence in self-care, especially for persons under the age of 35. Health care services were perceived to support self-care practice by offering easy access to care, giving information about self-care, and offering increased follow-up after consultations. Lack of knowledge, along with difficulties being away from work, were obstructing factors in the practice of self-care.ConclusionsYoung age was the factor influencing people's perceptions of needs and supporting factors the most. Young age and low knowledge scores about minor illnesses were the two factors that had the most influence on perceived obstructing factors.Relevance to clinical practiceNurses play a major role in the promotion of self-care and in the dissemination of self-care advice. If health care services fail to meet the needs of care-seekers with minor illnesses, patients might turn to out-of-hours clinics and emergency departments for help.

  • 11.
    Harrefors, Christina
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Axelsson, Karin
    Healthy older persons perceptions about care and the use of Assistive Technology Services (ATS)2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no Suppl. 1, p. 54-Article in journal (Other academic)
    Abstract [en]

    Introduction: Dignity is a basic concept for quality care regardless of how and where care is given. Researchers have described the use of Assistive Technology Services (ATS) in order to promote quality care and support of older persons. However, in perceptions of the use of ATS there are values imbedded that only to limited extent are studied. The aim of this study was therefore to describe healthy older persons' perception about care and the use of ATS.Methods and Materials: Qualitative research interviews were conducted with twelve healthy older couples living in their own homes. All participants were 70 years of age or older and received no professional care or social support. Open, individual, semi-structured interviews were conducted with the support of written vignettes where three levels of care needs were described. A qualitative content analysis was used to analyze the interviews. Results: Regardless of whether participants were discussing quality care in general or ATS supported care, they were convinced that the best place to receive care was the home. Values associated with the use of ATS in care were closely connected to the ability of being in control of the care situation. ATS as a tool to facilitate care was perceived as an asset as long as the couples were in control of their care situation. Hesitation in their abilities to use ATS increased if they lacked a partner and their cognitive impairment increased. Regardless of other factors, dignity is highly valued, and has greater importance when other values like autonomy and independence are reduced. Conclusion: These findings highlight older persons' values about quality care and the use of ATS in care and should be taken into consideration when planning care of older persons, and implementing new technology related to their care. It is necessary that politicians and care planners explore various options to deliver the best care, as perceived by older persons.

  • 12.
    Hertzberg, Annika
    et al.
    Karolinska institutet, Department of Neurotec.
    Ekman, Sirkka-Liisa
    Karolinska institutet, Department of Neurotec.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    'Relatives are a resource, but...': registered nurses' views and experiences of relatives of residents in nursing homes2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 3, p. 431-41Article in journal (Refereed)
    Abstract [en]

    Registered Nurses (RNs) working in nursing homes in Sweden have obligations towards the residents' relatives, besides the care of residents. Relatives' involvement and satisfaction with the care partly depend on their contacts and communication with the staff. This study aimed to explore and describe RNs' views and experiences of relatives of residents who live in nursing homes. Open interviews were conducted with 19 RNs at three nursing homes. The verbatim-transcribed interviews were subjected to qualitative content analysis. Relatives were seen as a resource (with some restrictions) and nice, although demanding. The RNs saw relatives as part of their work--a part that could be time-consuming and had low priority. Interviewees noticed a difference between young and old relatives, and between female and male relatives. A large proportion of accounts could be related to issues about communication and interpersonal relationships with relatives. Building a trusting relationship with relatives may result in them being involved in residents' care and thus giving the nurses time rather than consuming time.

  • 13.
    Hertzberg, Annika
    et al.
    Röda korsets högskola.
    Ekman, Sirkka-Liisa
    Blekinge Tekniska Högskola, sektionen för hälsa.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Staff activities and behaviour are the source of many feelings: relatives' interactions and relationships with staff in nursing homes2001In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, no 3, p. 380-388Article in journal (Refereed)
    Abstract [en]

    Family members do not give up their involvement in the life of their older relatives when they move to an institution. Relatives feel that it is they who take the initiative to establish a working relationship with the staff at the nursing home. Relatives want more spontaneous information from staff, particularly about residents' daily lives, and there is a need for relatives to have opportunities to talk with staff under relaxed conditions. Staff behaviour and activities towards residents and relatives are a source of many feelings for relatives. Relatives' understandings of the challenges faced by staff are not communicated to staff, nor are positive or negative experiences explicitly passed on to staff.

  • 14.
    Jacobsson, Catrine
    et al.
    Umeå University, Department of Nursing.
    Axelsson, Karin
    Wenngren, Britt-Inger
    Norberg, Astrid
    Umeå University, Department of Nursing.
    Eating despite severe difficulties: assessment of poststroke eating1996In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 5, no 1, p. 23-31Article in journal (Refereed)
    Abstract [en]

    A programme for the assessment and nursing diagnoses of eating difficulties among stroke patients was tested. The patients' experiences regarding eating were expressed in interviews and dialogues. Eating was observed during both a test meal and regular meals. The assessments included the prerequisites for eating as well as oral, pharyngeal and oesophageal functions. General and specific nursing diagnoses as well as life consequences (handicap) were established, based on assessment of disabilities and impairments, and interviewing the patients and their families, respectively. The general nursing diagnoses were formulated on admission after the test meal and these were reformulated to form specific nursing diagnoses after assessments of the functions. The programme presented proved to be useful in clinical practice. It is emphasized that many assessments must be co-ordinated for each individual

  • 15.
    Jacobsson, Catrine
    et al.
    Umeå University, Department of Nursing.
    Axelsson, Karin
    Österlind, Per Olov
    Umeå University, Department of Geriatric Medicine.
    Norberg, Astrid
    Umeå University, Department of Nursing.
    How people with stroke and healthy older people experience the eating process2000In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 9, no 2, p. 255-64Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the process of eating, experiences of eating and oral functions. Participants consisted of 30 people with first stroke and localization of the damage verified by computer topography (CT), and 15 healthy older people. All were observed during test-meals, interviewed about eating, and oral functions were tested. The results demonstrated that most (21) people with stroke had some difficulties in eating and expressed feelings of fear and shame about eating and changed physical and social appearance, mainly related to difficulties in preparing and transporting food to the mouth as well as swallowing deficits.

  • 16.
    Jumisko, Eija
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lexell, Jan
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    The meaning of feeling well in people with moderate or severe traumatic brain injury2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 16, p. 2273-2281Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to elucidate the meaning of feeling well for people with moderate or severe traumatic brain injury.Background. Considerable attention has been given to research consequences, quality of life and satisfaction with life in people with traumatic brain injury. Most studies reveal negative aspects of living with traumatic brain injury. Knowledge that provides an understanding of the meaning of feeling well for people with a traumatic brain injury entails the possibility that they could receive support to feel well, despite their injury.Design. This study used a qualitative research approach, as the aim was to elucidate meaning.Methods. Data were collected through qualitative research interviews with two women and six men with moderate or severe traumatic brain injury who had lived with the injury for between 7-15 years. A phenomenological hermeneutic method was used to interpret the data.Results. The meaning of feeling well for people with moderate or severe traumatic brain injury was that the initially unfamiliar life with traumatic brain injury became familiar. This included finding strength, regaining control over everyday life, being close to someone and being good enough. People with traumatic brain injury felt well when they became reconciled with the circumstances of their life and created a new entity in that life, in which their complete health had been lost.Relevance to clinical practice. This study helps professionals to enhance their understanding and awareness of the possibilities for people with moderate or severe traumatic brain injury to feel well. The study showed that people with traumatic brain injury needed a lot of strength to achieve this. Professionals can help them to feel well by getting to know them and thus find ways to support the person's feeling of wellbeing.

  • 17.
    Kumlien, Suzanne
    et al.
    Karolinska institutet, Department of Neuroscience.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Stroke patients in nursing homes: eating, feeding, nutrition and related care2002In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 4, p. 498-509Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to explore eating, feeding and nutrition among stroke patients in nursing homes as described by their nurses and by assessments. Registered Nurses were interviewed about an individual stroke patient's state of health, care needs and nursing care received and nursing records were reviewed. Information on eating, feeding and nutrition was extracted from the interviews and nursing records. A comprehensive instrument, the Resident Assessment Instrument, was also used to assess these patients' state of health. The domains of eating, feeding and nutrition were focused on in this study. Manifest content analysis was used. The results showed that more than 80% of the stroke patients in nursing homes were assessed as having some sort of dependence in eating. According to the Registered Nurses, 22 out of 40 patients demonstrated different eating disabilities. The number of eating disabilities in individual patients ranged from 1 to 7, which emphasized the complexity of eating disabilities in stroke patients. Dysphagia was reported in almost one-fourth of the patients and 30% were described and/or assessed as having a poor food intake or poor appetite. The Registered Nurses' descriptions of the eating disabilities, nutritional problems and their care were often vague and unspecific. Only six weights were documented in the nursing records and there were no nutritional records. The findings highlight the importance of making careful observations and assessments, and of maintaining documentation about eating and nutrition early after a patient's arrival in the nursing home to enable appropriate care and promotion of health.

  • 18.
    Kumlien, Suzanne
    et al.
    Karolinska institutet, Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research.
    Axelsson, Karin
    The nursing care of stroke patients in nursing homes: Nurses' descriptions and experiences relating to cognition and mood2000In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 9, no 4, p. 489-97Article in journal (Refereed)
    Abstract [en]

    Registered nurses working in nursing homes often care for stroke patients with impaired cognition and mood disorders. Understanding the behaviour of these patients often puts great demands on nurses. This study illuminates registered nurses' descriptions and experiences of stroke patients and the nursing care given in nursing homes, with a focus on cognition and mood. Registered nurses responsible for the care of stroke patients in nursing homes were asked to describe the individual patient's state of health and the nursing care given. Patients' cognition and mood have been selected for this article. A qualitative content analysis was used to group the text into categories. Registered nurses' descriptions showed great complexity and variation in patients' disabilities, as well as uncertainty about understanding these patients and the appropriate nursing care. Registered nurses described the need for further education in stroke care, and adequate resources for patient activity training, as well as meeting patients' psychosocial and communicative needs.

  • 19.
    Nilsson, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Nurses' views of shortcomings in patent care encounters in one hospital in Sweden2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 19-20, p. 2807-2814Article in journal (Refereed)
    Abstract [en]

    Aim and objectiveTo describe nurses' views of shortcomings in patient care encounters in one hospital in Sweden.BackgroundShortcomings in encounters in healthcare have increased during recent years. Dissatisfaction with encounters in healthcare can affect patients' experiences of dignity, health and well-being.DesignA qualitative design was used in the study.MethodsThree focus group discussions with 15 nurses were conducted. The nurses worked in five different wards. The focus group discussions were subjected to a thematic content analysis.ResultsThe results are presented in two themes. The first theme, ‘Disregard for the patient's unique nursing needs’, describes that information without consideration of the patient's needs, and nurses not being completely present in the meeting with the patient affected healthcare encounters and experiences of quality of care. In the second theme, ‘Difficulty managing obstacles’, nurses described care situations over which they could not always prevail due to lack of time and/or lack of awareness of the patient's vulnerability.ConclusionThe findings illustrate the importance of nurses and their approaches to patients. The nurse's attitude is important for the patient's experiences of participation, security, dignity, and well-being. The findings also illustrate the importance of routines in the healthcare organisation that support and facilitate positive encounters between patients, their close relatives and the healthcare staff.Relevance to clinical practiceNurses require understanding, presence and commitment in their relationships to every unique patient, and their goal should be to adopt interventions with regard to positive healthcare encounters based on each patient's experiences of good nursing care.

  • 20.
    Paulson, Margareta
    et al.
    Mid Sweden University, Östersund, Department of Nursing and Health Sciences.
    Norberg, Astrid
    Umeå University, Department of Nursing.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Living in the shadow of fibromyalgic pain: the meaning of female partners' experiences2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 2, p. 235-43Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate the meaning of being a female partner living with a man with fibromyalgic pain. Fourteen partners were interviewed about the meaning of their experiences, using a narrative approach. A phenomenological hermeneutic method, inspired by the French philosopher Ricoeur, was used to interpret the interview text. The structural analysis is presented in three major themes: struggling to give support and comfort, struggling to keep going on, and experiencing lack of understanding and support. The findings elucidate that the meaning of living with a man with fibromyalgic pain meant living a life strongly influenced by the man's illness and in the shadow of the man's pain. Taking daily life for granted was interrupted and restricted family and social life. Prominent in this study was the frustration partners felt as a result of men's reluctance to communicate. This led to feelings of being excluded from men's emotions. The responsibility day in and day out meant that women's own caring and tenderness were replaced, which brought about an almost constant sense of fatigue. Women became drained by the long duration of men's illness. This gave them a feeling of being alone, although they were a couple. Gaining comfort outside the family helped partners to reach a new insight and appreciation for life, which was viewed from a renewed perspective. This involved feelings of both togetherness and separateness in the relationship. The findings also consider the lack of support from the health care system for female partners living with men with fibromyalgic pain.

  • 21.
    Sjögren, Karin
    et al.
    Umeå University, Department of Nursing.
    Lindkvist, Marie
    Umeå universitet, Department of Statistics, Umeå School of Business and Economics, Umeå University.
    Sandman, Per-Olof
    Umeå University, Department of Nursing, Umeå universitet, Geriatriska institutionen, Umeå universitet, Institutionen för Omvårdnadsforskning.
    Zingmark, Karin
    Research Department, County Council of Norrbotten.
    Edvardsson, David
    Umeå University, Department of Nursing, Umeå university, School of Nursing and Midwifery, University of Dundee.
    To what extent is the work environment of staff related to person-centred care?: A cross-sectional study of residential aged care2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 9-10, p. 1310-1319Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To explore the relationship between staff characteristics, perceived work environment and person-centred care in residential aged care units. Background: Person-centred care is often described as the model of choice in residential aged care and in the care of persons with dementia. Few empirical studies have reported on the relationship between how staff experience different aspects of their work and person-centred care. Design: The study had a cross-sectional quantitative design. Methods: Staff in 151 residential aged care units in Sweden (n = 1169) completed surveys which included questions about staff characteristics, valid and reliable measures of person-centred care, satisfaction with work and care, job strain, stress of conscience and psychosocial unit climate. Statistical analyses of correlations, group differences and multiple linear regression analysis estimated with generalised estimating equation were conducted. Results: Higher levels of staff satisfaction, lower levels of job strain, lower levels of stress of conscience, higher levels of a supportive psychosocial unit climate and a higher proportion of staff with continuing education in dementia care were associated with higher levels of person-centred care. Job strain and a supportive psychosocial climate, explained most of the variation in person-centred care. Conclusions: This study shows that the work environment as perceived by staff is associated with the extent to which staff perceive the care as being person-centred in residential aged care. These empirical findings support the theoretical postulation that the work environment is an important aspect of person-centred care. Relevance to clinical practice: Promoting a positive and supportive psychosocial climate and a work environment where staff experience balance between demands and control in their work, to enable person-centred care practice, seems to be important implications for managers and leaders in residential aged care

  • 22.
    Sävenstedt, Stefan
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Karlsson, Eva
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Assessing needs among people with mild dementia in user-driven development of assistive technology2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no Suppl. 1, p. 90-Article in journal (Other academic)
    Abstract [en]

    Introduction: A major challenge in involving people with dementia is to determine what methodology can be used in order to optimally understand, measure, and interpret their needs and wants. The aim of this presentation was to reflect on experiences of assessing needs and wants among people with mild dementia in two user-driven development projects of assistive technology services, the Memory-Lane and COGKNOW projects. Methods and Materials: The user-driven design process in the ongoing MemoryLane project and the finished COGKNOW project followed a sequence of three steps. The first step was to acquire concrete user needs as a base for development, the second step was the development process of prototypes, and the final step the testing and evaluation of final prototypes. In both projects dyads of people with dementia and their informal carers were involved in the assessments. The assessment of concrete needs and wants was based on rigorously developed research questions. In the analysis the different type of data were first analyzed separately for both perspectives, and thereafter integrated to a comprehensive understanding. Results: General abstract questions seemed more difficult to answer for persons with dementia than more detailed and concrete questions. Despite these problems, their answers on general open questions provided valuable additional information to the structured questions. Carers could provide more elaborative information. However, there were more similarities than differences between the answers of the people with dementia and their carers, and few contradictive answers were given. Conclusions: Persons with dementia provide special challenges in user-driven development processes of assistive technology services due to their cognitive impairments. The use of a combination of data collections methods, combining open and structured questions in interviewing persons with dementia and their carers with observations by researchers can provide a comprehensive understanding that addresses some of these challenges.

  • 23.
    Söderberg, Siv
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lundman, Berit
    Umeå University, Department of Nursing.
    Norberg, Astrid
    Umeå University, Department of Nursing.
    The meaning of fatigue and tiredness as narrated by women with fibromyalgia and healthy women2002In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 2, p. 247-55Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate the meaning of fatigue and tiredness as narrated by women with fibromyalgia (FM) and healthy women. Twenty-five women with FM were interviewed with a narrative approach about the meaning of the lived experience of fatigue and tiredness. A reference group of 25 healthy women was interviewed about the same topic. 2. A phenomenological-hermeneutic method inspired by the French philosopher Ricoeur was used to interpret the interview text. 3. The meaning of fatigue and tiredness was related differently by women with FM and healthy women. The findings are presented in four major themes for women with FM -- the body as a burden, an absent presence, an interfering obstacle and being in hope of alleviation -- and in one major theme for healthy women: needing recovery. 4. Women with FM narrated fatigue as making it obvious that I have a body, instead of I am my body; the lived body becomes urgently present, as an 'it'. Healthy women narrated tiredness as a natural phenomenon when they need recovery and time to rest. 5. The findings are interpreted in the light of the phenomenological work on the lived body by Leder, Toombs and Merleau-Ponty.

  • 24.
    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.
    The importance of human meetings in health care at home with mobile distance-spanning technology2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no Suppl. 1, p. 91-Article in journal (Other academic)
    Abstract [en]

    Introduction: New solutions could be a challenge for both the persons in need of health care at home and the health care professions when the person's individual needs in health care at home have to be met. The mobile distances-spanning technology (MDST) could come into use to support the health care at home. Before implementing the MDST the voices of persons in need of health care at home need to be heard about the use of MDST. Methods and Materials: The aim was to describe views and experiences about the use of MDST in health care at home from the perspectives of persons in need of health care at home. The persons were living in ordinary homes and all had experiences of MDST when district nurses were caring for them at home. Persons in need of health care at home (n=9) participated in individual qualitative research interviews for data collection. Qualitative content analysis was used for data analysis. Results: Participants put health care at home in the first place and the MDST was put in the second place. The importance of human meetings was put forwards. The results indicate in different ways opportunities, possibilities and risks with using MDSTs. When the MDST was used, it was important to have established a relationship and trust to the district nurses and the general practitioners, and to know them and to be known by them. The participants expressed that the health care professionals need to see the person behind the technology. Conclusion: Human meetings can never be excluded in health care at home even when a virtual meeting for some issues is relevant. The MDST can never capture or replace the human meetings but human meetings and virtual meetings can be used as complement to each other.

  • 25.
    Wälivaara, Britt-Marie
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Andersson, Staffan
    Axelsson, Karin
    The mobile distance-spanning technology in health care at home2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no Suppl. 1, p. 92-Article in journal (Other academic)
    Abstract [en]

    Introduction: Health care at home could be a challenge for both the persons in need of health care at home and the health care professions when the person's individual needs in health care at home have to be met. There is a need for different technical solutions in order to create opportunities for persons in need of health care to stay in their own homes and get health care. The mobile distances-spanning technology (MDST) could come into use to support the health care at home for the future. Methods and Materials: The aim of this presentation is to describe the usefulness of MDST in health care at home. During a project MDST have been tested as an addition in health care at home. The district nurses used 11 different mobile equipments in home care. During the home visits they filled out a form (n=154) about which equipment they used when caring for persons in home care. Results: The district nurses did totally 184 home visits and in 154 cases they used the equipments during the test period. The most frequently used equipment was the mobile computer with access to the patient record (73%) and the access to the patient record was reported as useful at home. The district nurses noted importance to use the bladder scanner even if it was not used so often (11%). The digital camera was used (8%) and was reported as complicated but useful when documenting the healing process of wounds. When the electronic stethoscope was used (7%) some reported a disturbing sound that hampered the assessment. Conclusion: There are several equipments that could be useful and it is important to test and identify the equipments that are most suitable for use in home care.

  • 26.
    Zotterman, Anna Nygren
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Skär, Lisa
    Blekinge Institute of Technology, Department of Health, Karlskrona.
    Olsson, Malin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Söderberg, Siv
    Mid Sweden University, Östersund, Department of Nursing and Health Sciences.
    Being in Togetherness: Meanings of encounters within primary healthcare setting for patients living with long-term illness2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 19-20, p. 2854-2862Article in journal (Refereed)
    Abstract [en]

    Aims and objectivesThe aim of this study was to elucidate meanings of encounters for patients with long-term illness within the primary healthcare setting.BackgroundGood encounters can be crucial for patients in terms of how they view their quality of care. Therefore, it is important to understand meanings of interactions between patients and healthcare personnel.DesignA phenomenological hermeneutic method was used to analyse the interviews.MethodsNarrative interviews with ten patients with long-term illness were performed, with a focus on their encounters with healthcare personnel within the primary healthcare setting. A phenomenological hermeneutical approach was used to interpret the interview texts.ResultsThe results demonstrated that patients felt well when they were seen as an important person and felt welcomed by healthcare personnel. Information and follow-ups regarding the need for care were essential. Continuity with the healthcare personnel was one way to establish a relationship, which contributed to patients' feelings of being seen and understood. Good encounters were important for patients' feelings of health and well-being. Being met with mistrust, ignorance and nonchalance had negative effects on patients' perceived health and well-being and led to feelings of lower confidence regarding the care received.ConclusionsPatients described a great need to be confirmed and met with respect by healthcare personnel, which contributed to their sense of togetherness. Having a sense of togetherness strengthened patient well-being.Relevance to clinical practiceBy listening and responding to patients' needs and engaging in meetings with patients in a respectful manner, healthcare personnel can empower patients' feelings of health and well-being. Healthcare personnel need to be aware of the significance of these actions because they can make patients experience feelings of togetherness, even if patients meet with different care personnel at each visit.

  • 27. Öhman, Marja
    et al.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    District nursing - sharing an understanding by being present: Experiences of encounters with people with serious chronic illness and their close relatives in their homes2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 7, p. 858-66Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In the homecare setting, district nurses assume a heavy responsibility and are involved in a variety of care activities. They view themselves as having a central role in care at home that centres on the development of a relationship with those who are ill and their families. AIM: The aim of this study was to elucidate the meaning of district nurses experiences of encounters with people with serious chronic illness and their close relatives in their homes. A purposive sample of 10 district nurses (female) was interviewed using a narrative approach. METHOD: To achieve the aim, a phenomenological hermeneutic interpretation inspired by the philosophy of Ricoeur was used to interpret the interview text. RESULTS: This study proposes that district nurses' experiences of encounters with people with serious chronic illness and their close relatives in their homes can be understood as district nurses being welcomed into the ill people's privacy, to share their intimacy and their understanding of being ill. This close relationship enables them to alleviate and to console the suffering and loneliness caused by illness. This is expressed in the three themes: being in a close relationship, sharing an understanding and weaving a web of protection. CONCLUSION: It seems that by being entirely present, in a close relationship, district nurses share the experiences of illness and through interpretation of the whole persons' expressions; they share an understanding of this illness experience. In this close relationship, at the home of the ill people and their close relatives, district nurses are available to alleviate people's suffering and loneliness caused by illness. RELEVANCE TO CLINICAL PRACTICE: This study reveals the need to be entirely present in encounters between the district nurses and people with serious chronic illness and their close relatives. This relation makes it possible to establish a shared understanding of the illness experience. Being aware of the importance of this shared understanding within a relationship, will increase the health care personnel's possibility to alleviate and console those suffering of illness. This proposed interpretation could be useful for reflection of care interventions, in education and supervision of district nurses.

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