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Rasmussen, Birgit H
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Publications (10 of 33) Show all publications
Nilsson, A., Rasmussen, B. H. & Edvardsson, D. (2016). A threat to our integrity: meanings of providing nursing care for older patients with cognitive impairment in acute care settings. Scandinavian Journal of Caring Sciences, 30(1), 48-56
Open this publication in new window or tab >>A threat to our integrity: meanings of providing nursing care for older patients with cognitive impairment in acute care settings
2016 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 1, p. 48-56Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Older people with cognitive impairment represent a large group of patients in acute care settings. Research show that these acute care environments can be unsafe and even unfriendly for frail older patients. Research and clinical experience show that being a nurse in acute/specialised medical facilities means to work in a high-speed, technologically complex and demanding environment. When caring for older patients with cognitive impairment, nurses' workload and responsibilities have been shown to increase. This is largely dependent on how easily it is to connect with and help patients understand what to do, and what is best for them.

AIM: This study aimed to illuminate meanings of caring for older patients with cognitive impairment in acute care settings as experienced by nursing staff.

METHOD: A purposeful sample of thirteen nurses experienced in caring for older people with cognitive impairment in acute care settings participated in the study. Narrative interviews were conducted during autumn 2012 and interpreted using a phenomenological hermeneutic method.

FINDINGS: Caring for older, acutely ill cognitively impaired patients was found to be very complex. The meanings of caring for these older patients seemed to change depending on the nurses' perceptions of the patients and the gap between what they could do (real) and wanted to do (ideal) in providing care for them. The greater this gap was felt to be and the more care was perceived as meaningless, the more serious was the threat to nurses' personal-professional integrity which could be at risk, compromised or harmed.

CONCLUSION: The comprehensive understanding indicates that being a nurse and having to care for older patients in acute care settings means providing nursing care in an environment that does not support possibilities to protect and develop nurses' personal-professional integrity.

Place, publisher, year, edition, pages
John Wiley & Sons, 2016
Keywords
acute care, cognitive impairment, integrity, meaning, nursing, older people, personal–professional, phenomenological hermeneutical
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-103676 (URN)10.1111/scs.12220 (DOI)000371477400005 ()25919338 (PubMedID)
Note

Article first published online 2015

Available from: 2015-05-27 Created: 2015-05-27 Last updated: 2018-06-07Bibliographically approved
Hajdarevic, S., Rasmussen, B. H. & Fransson, P. (2016). You Need to Know More to Understand My Scoring on the Survey: Free-Text Comments as Part of a PROM-Survey of Men with Prostate Cancer. Open Journal of Nursing, 6(5), 365-375
Open this publication in new window or tab >>You Need to Know More to Understand My Scoring on the Survey: Free-Text Comments as Part of a PROM-Survey of Men with Prostate Cancer
2016 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, no 5, p. 365-375Article in journal (Refereed) Published
Abstract [en]

Prostate cancer and its treatment have long-term implications for men's lives. We aimed to describe the content, extent, and frequency of written comments to the open-ended question, "Further comments?" in the patient-reported outcome measures questionnaire. During the study period, 897 men participated; 372 wrote 747 free-text comments in the questionnaire. These comments were analysed using qualitative content analysis and were grouped into four categories: 1) prostate cancer's influence on health; 2) clarifications of answers to the survey; 3) descriptions of well-being despite the cancer; and 4) experiences of care and the need for contact with health care. The distribution of the comments shifted over time. The open-ended question not only allowed the participants to explain their other responses and describe important aspects of their lives during and after treatment, something not normally covered by a questionnaire, but it also indicated their experiences of health care services along the patients' PC-trajectory. This further raises the issue of including an open-ended item in a forced-choice survey into the ethical realm to ensure that proper care is taken of participants’ answers and thoughts.

Keywords
Prostate Cancer, Questionnaire, Open-Ended Question, Information, Feedback, Quality of Life, Nursing
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-121988 (URN)10.4236/ojn.2016.65038 (DOI)
Available from: 2016-06-13 Created: 2016-06-13 Last updated: 2019-06-27Bibliographically approved
Näppä, U., Rasmussen, B. H., Axelsson, B. & Lindqvist, O. (2014). Challenging situations when administering palliative chemotherapy: a nursing perspective. European Journal of Oncology Nursing, 18(6), 591-597
Open this publication in new window or tab >>Challenging situations when administering palliative chemotherapy: a nursing perspective
2014 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 6, p. 591-597Article in journal (Other academic) Published
Abstract [en]

Palliative chemotherapy treatments (PCT) are becoming more common for patients with incurable cancer; a basic challenge is to optimize tumour response while minimizing side-effects and harm. As registered nurses most often administer PCT, they are most likely to be confronted with difficult situations during PCT administration. This study explores challenging situations experienced by nurses when administering PCT to patients with incurable cancer.

Methods: Registered nurses experienced in administering PCT were asked in interviews to recall PCT situations they found challenging. Inspired by the narrative tradition, stories were elicited and analysed using a structural and thematic narrative analysis.

Results: A total of twenty-eight stories were narrated by seventeen nurses. Twenty of these were dilemmas that could be sorted into three storylines containing one to three dilemmatic situations each. The six dilemmatic situations broadly related to three interwoven areas: the uncertainty of the outcome when giving potent drugs to vulnerable patients; the difficulty of resisting giving PCT to patients who want it; and insufficient communication between nurses and physician.

Conclusion: Nurses who administer PCT are engaged in a complex task that can give rise to a number of dilemmatic situations. The findings may be interpreted as meaning that at least some situations might be preventable if the knowledge and insight of all team members – nurses, physicians, patients, and relatives – are jointly communicated and taken into account when deciding whether or not to give PCT. Forming palliative care teams early in the PCT trajectory, could be beneficial for staff and patients.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
communication barriers, dilemma, narrative, registered nurse, palliative chemotherapy, patient care team
National Category
Nursing Cancer and Oncology
Research subject
Oncology
Identifiers
urn:nbn:se:umu:diva-87307 (URN)10.1016/j.ejon.2014.06.008 (DOI)000346222800008 ()
Note

Included in theses in manuscript form with the title: "Dilemmas administering palliative chemotherapy : a nursing perspective"

Available from: 2014-03-28 Created: 2014-03-28 Last updated: 2018-06-08Bibliographically approved
Hajdarevic, S., Rasmussen, B. & Hörnsten, A. (2014). You never know when your last day will come and your trip will be over - Existential expressions from a melanoma diagnosis.. European Journal of Oncology Nursing, 18(4), 355-361
Open this publication in new window or tab >>You never know when your last day will come and your trip will be over - Existential expressions from a melanoma diagnosis.
2014 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 4, p. 355-361Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of this study was to further explore expressions of existential experiences by patients diagnosed with malignant melanoma (MM).

METHOD: Semi-structured interviews were performed consecutively after diagnosis among 30 patients with MM. The methodological approach was inspired by Gadamer's hermeneutic philosophy.

RESULTS: The analysis of expressions of existential experiences after having been diagnosed with malignant melanoma revealed that it is an existential process that people go through, beginning with feelings of suddenly becoming groundless at the time of the diagnosis, including being empty and in a vacuum, being in chaos and uncertainty and being confronted with one's own death. Next theme searching for solid ground included striving to understand what lies ahead, striving to find a balance in life - fighting, hoping, going on living and striving to prioritize family. The last theme creating islands of solid ground when living with cancer included understanding what is meaningful in life, living in the moment - seizing the day and keeping watch on the body.

CONCLUSION: On being diagnosed with malignant melanoma, people go through a process where many questions emerge, including an existential turmoil, which health professionals should be aware of to provide these patients with sufficient support.

Keywords
cancer experience, existential expression, existential suffering, groundlessness, life disruption, malignant melanoma, nursing, qualitative method
National Category
Health Sciences
Identifiers
urn:nbn:se:umu:diva-90645 (URN)10.1016/j.ejon.2014.03.015 (DOI)000339533600003 ()24785793 (PubMedID)
External cooperation:
Available from: 2014-06-26 Created: 2014-06-26 Last updated: 2018-06-07Bibliographically approved
Fallbjörk, U., Rasmussen, B. H., Karlsson, S. & Salander, P. (2013). Aspects of body image after mastectomy due to breast cancer: a two-year follow up study. European Journal of Oncology Nursing, 17(3), 340-345
Open this publication in new window or tab >>Aspects of body image after mastectomy due to breast cancer: a two-year follow up study
2013 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, no 3, p. 340-345Article in journal (Refereed) Published
Abstract [en]

Purpose: This 2-year follow-up study explores aspects of body image after mastectomy due to breast cancer.

Materials and Methods: This population-based study included 76 women living in northern Sweden who, during November 2006 to October 2007, underwent mastectomy due to breast cancer. The women completed a questionnaire entitled “Life After Mastectomy (LAM)” 10 months after the mastectomy and again 2 years later. We used SPSS version 18.0 for data processing and analysis.

Results:The findings indicate that few significant changes in body image had taken place during the 2-year interval between the first and second completion of the questionnaire. An exception was a significant decrease in feelings of sexual attractiveness and comfort during sexual intimacy. At follow-up, 21% of the women had undergone breast reconstruction (BR). They were significantly younger than the women who had not had BR (53 v. 63 years). Besides being younger, no other significant differences could be found between those women who had undergone BR and those who had not. The fact that the decrease in sexual attractiveness and feelings of comfort during sexual intimacy also applied to the subgroup of women who had had BR may therefore be surprising. A better understanding of issues related to breast cancer treatment and sexual function is vital.

Conclusion: It is important for health care professionals to be aware of problems related to sexual intimacy and to be prepared not just to provide information about these, but also to reflect on expectations v. reality together with the women.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
body image, breast cancer, breast reconstruction, femininity, mastectomy
National Category
Nursing Cancer and Oncology
Research subject
caring sciences in social sciences
Identifiers
urn:nbn:se:umu:diva-58312 (URN)10.1016/j.ejon.2012.09.002 (DOI)000318466500012 ()23083641 (PubMedID)
Available from: 2012-08-29 Created: 2012-08-29 Last updated: 2018-06-08Bibliographically approved
Nilsson, A., Rasmussen, B. & Edvardsson, D. (2013). Falling behind: a substantive theory of care for older people with cognitive impairment in acute settings. Journal of Clinical Nursing, 22(11-12), 1682-1691
Open this publication in new window or tab >>Falling behind: a substantive theory of care for older people with cognitive impairment in acute settings
2013 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 11-12, p. 1682-1691Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To develop a theoretical understanding of the processes hindering person-centred care of older people with cognitive impairment in acute care settings.

BACKGROUND: Although person-centred care with its holistic focus on the biopsychosocial needs of patients is commonly considered the gold standard care for older people with cognitive impairment, the extent to which care is person-centred can increase in acute care settings generally.

DESIGN: Grounded theory inspired by Strauss and Corbin.

METHOD: The study used a grounded theory approach to generate and analyse data from a Swedish sample of acute care staff, patients and family members.

RESULTS: The substantive theory postulates that staff risks 'falling behind' in meeting the needs of older patients with cognitive impairment if working without consensus about the care of these patients, if the organisation is disease-oriented and efficiency-driven, and if the environment is busy and inflexible. This facilitated 'falling behind' in relation to meeting the multifaceted needs of older patients with cognitive impairment and contributed to patient suffering, family exclusion and staff frustration.

CONCLUSIONS: The theory highlights aspects of importance in the provision of person-centred care of older people with cognitive impairment in acute settings and suggests areas to consider in the development of caring environments in which the place, pace and space can meet the needs of the older person.

RELEVANCE TO CLINICAL PRACTICE: The proposed substantive theory can be used to critically examine current ward practices and routines, and the extent to which these support or inhibit high-quality person-centred care for older patients with known or unknown cognitive impairments.

Place, publisher, year, edition, pages
Hoboken: Wiley-Blackwell, 2013
Keywords
Acute care, cognition disorders, culture, frail older, grounded theory, patient-centred, person-centred care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-70118 (URN)10.1111/jocn.12177 (DOI)000317614300022 ()23452009 (PubMedID)
Available from: 2013-05-06 Created: 2013-05-06 Last updated: 2018-06-08Bibliographically approved
Lindqvist, O., Lundquist, G., Dickman, A., Buekki, J., Lunder, U., Hagelin, C. L., . . . Fürst, C. J. (2013). Four essential drugs needed for quality care of the dying: A Delphi-study based international expert consensus opinion. Journal of Palliative Medicine, 16(1), 38-43
Open this publication in new window or tab >>Four essential drugs needed for quality care of the dying: A Delphi-study based international expert consensus opinion
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2013 (English)In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 16, no 1, p. 38-43Article in journal (Refereed) Published
Abstract [en]

Purpose: The majority of dying patients do not have access to necessary drugs to alleviate their most common symptoms, despite evidence of drug efficacy. Our aim was to explore the degree of consensus about appropriate pharmacological treatment for common symptoms in the last days of life for patients with cancer, among physicians working in specialist palliative care. Material and methods: Within OPCARE9, a European Union seventh framework project aiming to optimize end-of-life cancer care, we conducted a Delphi survey among 135 palliative care clinicians in nine countries. Physicians were initially asked about first and second choice of drugs to alleviate anxiety, dyspnea, nausea and vomiting, pain, respiratory tract secretions (RTS), as well as terminal restlessness. Results: Based on a list of 35 drugs mentioned at least twice in the first round (n = 93), a second Delphi round was performed to determine <= 5 essential drugs for symptom alleviation in the last 48 hours of life that should be available even outside specialist palliative care. There was 80% consensus among the participants (n = 90) regarding morphine, midazolam, and haloperidol as essential drugs. For RTS, there was consensus about use of an antimuscarinic drug, with 9%-27% of the physicians each choosing one of four different drugs. Conclusion: Based on this consensus opinion and other literature, we suggest four drugs that should be made available in all settings caring for dying patients with cancer, to decrease the gap between knowledge and practice: morphine (i.e., an opioid), midazolam (a benzodiazepine), haloperidol (a neuroleptic), and an antimuscarinic.

National Category
Nursing Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-66416 (URN)10.1089/jpm.2012.0205 (DOI)000313559000009 ()
Available from: 2013-02-22 Created: 2013-02-19 Last updated: 2018-06-08Bibliographically approved
Hajdarevic, S., Lagerlund, M., Tishelman, C., Rasmussen Holritz, B. & Runesdotter, S. (2013). Kända och okända riskfaktorer för cancer bland svenskar. Onkologi i Sverige (5), 36-43
Open this publication in new window or tab >>Kända och okända riskfaktorer för cancer bland svenskar
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2013 (Swedish)In: Onkologi i Sverige, ISSN 1653-1582, no 5, p. 36-43Article in journal (Other academic) Published
Abstract [sv]

Sammanfattningsvis identifierades lägre medvetenhet om riskfaktorer för cancer främst  bland dem med lägre utbildning och bland dem i åldersgruppen 50+. Skillnader identifierades även mellan män och kvinnor. Hittills genomförda insatser med syfte att öka kunskapen om  PV verkar otillräckliga(20) och behöver framförallt riktas mot män och grupper med lägre utbildning vilket också bekräftas av andra studier.

Vissa livsstilsrelaterade riskfaktorer för cancer som alkoholkonsumtion, att äta rött- och förbehandlat kött, lågt intag av frukt och grönsaker, och låg fysisk aktivitet var mindre kända hos allmänheten. Eftersom detta är faktorer som den enskilda individen skulle kunna påverka utgör de goda kandidater för preventionskampanjer.

En sammanställning av cancerpreventionsåtgärder i Sverige och deras effekt saknas och vi  efterlyser en sådan. Informationskampanjer höjer oftast den generella kunskapen i samhället men effekten kan vara kortvarig och den självuppfattade risken att drabbas av cancer kan förbli låg.

Våra resultat kan ge en vägledning för att bättre anpassa och rikta information för att nå  lika riskgrupper och höja medvetenhet om cancer.

Place, publisher, year, edition, pages
Gustavsberg: Pharma Industry Publishing AB, 2013
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-88052 (URN)
Available from: 2014-04-22 Created: 2014-04-22 Last updated: 2018-06-08Bibliographically approved
Nilsson, A., Lindkvist, M., Rasmussen, B. & Edvardsson, D. (2013). Measuring levels of person-centeredness in acute care of older people with cognitive impairment: evaluation of the POPAC scale. BMC Health Services Research, 13, 327
Open this publication in new window or tab >>Measuring levels of person-centeredness in acute care of older people with cognitive impairment: evaluation of the POPAC scale
2013 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, p. 327-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Person-centeredness is increasingly advocated in the literature as a gold-standard, best practice concept in health services for older people. This concept describes care that incorporates individual and multidimensional needs, personal biography, subjectivity and interpersonal relationships. However, acute in-patient hospital services have a long-standing biomedical tradition that may contrast with person-centred care. Since few tools exist that enable measurements of the extent to which acute in-patient hospital services are perceived as being person-centred, this study aimed to translate the English version of the Person-centred care of older people with cognitive impairment in acute care scale (POPAC) to Swedish, and evaluate its psychometric properties in a sample of acute hospital staff.

METHODS: The 15-item POPAC was translated, back-translated and culturally adjusted, and distributed to a cross-sectional sample of Swedish acute care staff (n = 293). Item performance was evaluated through assessment of item means, internal consistency by Cronbach's alpha on total and on subscale levels; temporal stability was assessed through Pearson's product correlation and intra-class correlation between test and retest scores. Confirmatory factor analysis was used to explore model fit.

RESULTS: The results indicate that the Swedish version POPAC provides a tentatively construct-valid and reliable contribution to measuring the extent to which acute in-patient hospital services have processes and procedures that can facilitate person-centred care of older patients with cognitive impairment. However, some questions remain regarding the dimensionality of POPAC.

CONCLUSIONS: POPAC provides a valuable contribution to the quest of improving acute care for older patients with cognitive impairment by enabling measures and subsequent accumulation of internationally comparable data for research and practice development purposes. POPAC can be used to highlight strengths and areas for improvements in care practice for older patients, and to illuminate aspects that risk being overlooked in busy acute hospital settings.

Keywords
Person-centred care, nursing, older people, cognitive impairment, scale, measurement, intervention
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-81054 (URN)10.1186/1472-6963-13-327 (DOI)000323384800001 ()23958295 (PubMedID)
Available from: 2013-10-01 Created: 2013-10-01 Last updated: 2018-06-08Bibliographically approved
Öresland, S., Lutzen, K., Norberg, A., Rasmussen, B. & Maatta, S. (2013). Nurses as 'guests' - a study of a concept in light of Jacques Derrida's philosophy of hospitality. Nursing Philosophy, 14(2), 117-126
Open this publication in new window or tab >>Nurses as 'guests' - a study of a concept in light of Jacques Derrida's philosophy of hospitality
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2013 (English)In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 14, no 2, p. 117-126Article in journal (Refereed) Published
Abstract [en]

As revealed in previous empirical research, nurses describe their position in home-based nursing care (HBNC) as that of guests' in the patient's home. Such a description is problematic as guests' might not be considered to belong to the realm of professionalism. As Jacques Derrida's work on hospitality has received wide publicity, sparking theoretical and philosophical discussion about host and guest, the aim of this study was to explore how the concept guests' can be understood in the light of Derrida's philosophy of hospitality. The study revealed that (a) guest must be considered a binary concept; and (b) hospitality should be regarded as an exchange of giving and receiving between a host and a guest. The present study demonstrated that it is important to reflect on the meaning of the concepts used by nurses in HBNC. Further theoretical and empirical exploration of the concept hospitality' would be fruitful, i.e. what is patients' understanding of hospitality' and hostility' related to nurses' descriptions of themselves as guests' in the patient's home.

Keywords
Derrida, guest, host, hospitality, binary concept, home-based nursing care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-68258 (URN)10.1111/j.1466-769X.2012.00557.x (DOI)000316218300006 ()
Available from: 2013-04-18 Created: 2013-04-15 Last updated: 2018-06-08Bibliographically approved

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