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Norberg, Astrid
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Publications (10 of 136) Show all publications
Hedman, R., Norberg, A. & Hellström, I. (2019). Agency and communion in people with Alzheimer’s disease, as described by themselves and their spousal carers. Dementia, 8(4)
Open this publication in new window or tab >>Agency and communion in people with Alzheimer’s disease, as described by themselves and their spousal carers
2019 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 8, no 4Article in journal (Refereed) Published
Abstract [en]

Agency (individuality) and communion (togetherness) are vital to a positive sense of self. People with Alzheimer’s disease are at risk of experiencing diminished agency and decreased communion. Their family members’, especially their partner’s, view on their agency and communion is also likely to influence their sense of agency, communion, and self. In the present study, individual interviews with 10 people with Alzheimer’s disease and their spousal carers were qualitatively analysed to describe how in each couple the two spouses viewed the agency and communion of the person with Alzheimer’s disease from an individual perspective. The findings show that the carers generally described the agency of the person with Alzheimer’s disease as slightly weaker compared with the persons with Alzheimer’s disease themselves. The carers also appeared to have poor knowledge of what supported and threatened the sense of communion of the person with Alzheimer’s disease.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
agency, Alzheimer’s disease, communion, self, spousal relationships
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-135499 (URN)10.1177/1471301217706268 (DOI)000469352700008 ()28440706 (PubMedID)
Available from: 2017-05-30 Created: 2017-05-30 Last updated: 2019-06-17Bibliographically approved
Holmberg, B., Hellström, I., Norberg, A. & Österlind, J. (2019). Assenting to exposedness: meanings of receiving assisted bodily care in a nursing home as narrated by older persons. Scandinavian Journal of Caring Sciences
Open this publication in new window or tab >>Assenting to exposedness: meanings of receiving assisted bodily care in a nursing home as narrated by older persons
2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed) Epub ahead of print
Abstract [en]

Most older persons moving to a nursing home need to receive assisted bodily care, which means being in a position of vulnerability. However, few studies have explicitly focused on the meanings of receiving assisted bodily care from the older persons' perspective. This study aimed to elucidate meanings of receiving assisted bodily care, as narrated by older persons living in a nursing home. Twelve men and women, aged 80 or older, living in a Swedish nursing home, participated in the study. Data were generated by narrative interviews and analysed with a phenomenological-hermeneutical method. The regional ethics committee approved the study. In the analysis, one main theme emerged: 'Assenting to exposedness'. This theme comprised five themes, 'To have hope in hopelessness', 'To relinquish one's body into others' hands', 'To be between power and powerlessness', 'To oscillate between one's own responsibility and demands', 'To be in an ongoing interaction', and ten subthemes. In conclusion, receiving assisted bodily care means to be exposed, but not passively. Rather, it means to be self-determinant for as long as possible, to perceive the body as lived. When the body must be relinquished to others, it might be objectified, leading to care-suffering. To avoid this, the older persons use a certain competence, acquired through life, to decide when to take action or when to assent. However, this is but one of the several possible interpretations, which may be considered a limitation.

Keywords
assent, assisted bodily care, exposedness, hermeneutics, lifeworld, lived body, nursing home, older persons, phenomenology, self-determination
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-164680 (URN)10.1111/scs.12683 (DOI)30888087 (PubMedID)
Available from: 2019-10-28 Created: 2019-10-28 Last updated: 2019-11-04
Norberg, A. (2019). Sense of self among persons with advanced dementia. In: Thomas Wisniewski (Ed.), Alzheimer's Disease: (pp. 205-221). Codon Publications
Open this publication in new window or tab >>Sense of self among persons with advanced dementia
2019 (English)In: Alzheimer's Disease / [ed] Thomas Wisniewski, Codon Publications , 2019, p. 205-221Chapter in book (Refereed)
Abstract [en]

Abstract: As humans, we have a sense of self, and at best, we are proud of ourabilities and feel respected by other persons. Persons with dementia have beenregarded losing their self. Quantitative research has shown that this is true, whilequalitative research has shown that parts of self are severely affected while otherparts remain even among persons with advanced dementia. These persons sometimeskeep feeling "still the same" as before getting dementia. Their memory deficitshelp as does support from other persons. The theory of three aspects of self bythe psychologists Rom Harré and Steven Sabat are presented, that is, the feelingthat we are, who we are, and who we are together with other persons. Based onempirical research, suggestions will be given about how by promoting experiencesof at-homeness, dignity, and being oneself related to others we can helppersons with advanced dementia experience themselves as valuable persons

Place, publisher, year, edition, pages
Codon Publications, 2019
Keywords
advanced dementia, anosognosia, confirmation, dignity, self
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-165628 (URN)10.15586/alzheimersdisease.2019 (DOI)978-0-646-80968-7 (ISBN)
Available from: 2019-12-02 Created: 2019-12-02 Last updated: 2019-12-05Bibliographically approved
Lundman, B., Hammarström, A., Ahlgren, C. & Norberg, A. (2019). Use of the model of Inner Strength for analysing reflective interviews in a group of healthy middle-aged adults. Safety, 7
Open this publication in new window or tab >>Use of the model of Inner Strength for analysing reflective interviews in a group of healthy middle-aged adults
2019 (English)In: Safety, ISSN 0036-3375, E-ISSN 2050-3121, Vol. 7Article in journal (Refereed) Published
Abstract [en]

Objective: Inner Strength has been described as a human resource that promotes well-being linked to health. The aim of this study was to explore how Inner Strength and its four dimensions are manifested in interviews in a group of middle-aged healthy women and men.

Methods: Retrospective reflective interviews with middle-aged healthy women (n = 5) and men (n = 4) selected from a population study were content analysed deductively.

Results: The following themes and their constituents were found in the respective dimensions of the Model of Inner Strength. Firmness: having a drive to act, being purposeful, having trust in one’s competence, and having a positive view of life. Connectedness: being in community, receiving and giving support, and, receiving and giving care. Creativity: changing unsatisfactory life situations, seeing new opportunities, and realizing dreams. Stretchability: balancing between options, and extending oneself.

Conclusions: Expressions that were interpreted as belonging to Inner Strength could be referred the different dimensions of Inner Strength. The Model of Inner Strength is suitable for analysing Inner Strength among middle-aged men and women. The findings indicate that Inner Strength can be identified in human beings’ narratives if asked for.

Place, publisher, year, edition, pages
SAGE Open, 2019
Keywords
Nursing, mental health, psychiatry, Inner Strength, content analysis, deductive
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-161455 (URN)10.1177/2050312119856812 (DOI)000471113000001 ()31217970 (PubMedID)
Funder
Swedish Research Council Formas, 259-2012-37
Available from: 2019-07-10 Created: 2019-07-10 Last updated: 2019-09-05Bibliographically approved
Mazaheri, M., Ericson-Lidman, E., Joakim, Ö. & Norberg, A. (2018). Meanings of troubled conscience and how to deal with it: expressions of Persian-speaking enrolled nurses in Sweden.. Scandinavian Journal of Caring Sciences, 32(1), 380-388
Open this publication in new window or tab >>Meanings of troubled conscience and how to deal with it: expressions of Persian-speaking enrolled nurses in Sweden.
2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 380-388Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: A feature of the healthcare system in Sweden, particularly in the care of older people, is its cultural diversity in terms of having considerable numbers of both caregivers and care recipients with an immigrant background. Considering the influence of culture in ethical decision-making processes, the idea of conscience and the adverse effects of a troubled conscience, it is important to study the concepts of conscience and troubled conscience in culturally diverse populations. There is no published study regarding troubled conscience among immigrant populations that includes enrolled nurses.

AIM: To illuminate the meanings of troubled conscience and how to deal with it among enrolled nurses with Iranian backgrounds working in Swedish residential care for Persian-speaking people with dementia who have emigrated from Iran.

METHOD: The study was conducted with a phenomenological hermeneutic design. Ten enrolled nurses with an Iranian background, with at least one year's experience of taking care of older people with dementia, were interviewed. The study was reviewed by the Regional Ethical Review Board for ethical vetting of research involving humans. Appropriate measures were taken to ensure confidentiality and voluntary participation.

RESULTS: The meanings of having a troubled conscience for the participants comprise not being a good person, including being an uncaring person, not acting according to one's values and living in a state of unease. Dealing with a troubled conscience involves trying to compensate for the harm one has caused and trying to prevent similar situations by being a responsible caregiver.

CONCLUSIONS: The enrolled nurses understood themselves as caring people and not only caregivers. They knew that they should hear their conscience and respond to it by trying to be a caring person and acting according to their values. The findings should be interpreted in the given specific context.

Keywords
Persian-speaking, Sweden, dementia, enrolled nurse, immigrant, residential care, troubled conscience
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-138752 (URN)10.1111/scs.12472 (DOI)000426524200039 ()28799165 (PubMedID)
Available from: 2017-08-29 Created: 2017-08-29 Last updated: 2018-06-09Bibliographically approved
Hedman, R., Hellström, I., Ternestedt, B.-M., Hansebo, G. & Norberg, A. (2018). Sense of self in Alzheimer's research participants. Clinical Nursing Research, 27(2), 191-212
Open this publication in new window or tab >>Sense of self in Alzheimer's research participants
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2018 (English)In: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 27, no 2, p. 191-212Article in journal (Refereed) Published
Abstract [en]

The sense of self is vulnerable in people with Alzheimer’s disease (AD), and might be positively and negatively influenced by research participation. The purpose of this study was to describe how people with AD express their experience of being a research participant with respect to their sense of self. Interviews and support group conversations involving 13 people with mild and moderate AD were analyzed using qualitative content analysis. Three themes were constructed: contributing to an important cause, gaining from participating, and experiencing risks and drawbacks. Participants described contributing to research as being in line with their lifelong values and lifestyles. They expressed contentment and pride about being research participants, emphasized their positive relationships with the researchers, and described participation as a meaningful activity. When research procedures threatened their sense of self, they were able to reason about risks and decline participation.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Alzheimer’s disease, research participation, self, support group
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-127088 (URN)10.1177/1054773816672671 (DOI)000423586200005 ()29374986 (PubMedID)
Available from: 2016-10-28 Created: 2016-10-28 Last updated: 2018-06-09Bibliographically approved
Seiger-Cronfalk, B., Norberg, A. & Ternestedt, B.-M. (2018). They are still the same: family members’ stories about their relatives with dementia disorders as residents in a nursing home. Scandinavian Journal of Caring Sciences, 32(1), 168-176
Open this publication in new window or tab >>They are still the same: family members’ stories about their relatives with dementia disorders as residents in a nursing home
2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 168-176Article in journal (Refereed) Published
Abstract [en]

In order to better understand the context of suffering from dementia disorders, greater efforts should be made to understand and identify what persons with such disorders experience when living in a nursing home. The aim of this qualitative study was to gain further understanding of how persons with dementia disorders experienced and coped with their changed life situation after being relocated to a nursing home as described by their family members’ perceptions. Qualitative data were collected from ten interviews with family members and evaluated using content analysis. The main findings suggest that residents with dementia disorders largely maintained their personality intact throughout the trajectory of illness as they were able to keep their habits and interests. The local environment of the nursing home and the residents’ relationships to staff were important in order to feel accepted. Four categories were discerned during the analysis: living in limbo; coming to peace; keeping old habits and relationships; and thoughts about impending death. It is reasonable to believe that old habits and interests may be preserved as the embodiment of such habits are deeply rooted and connected to a person′s identity even when going through various changes and transitions in life. Therefore, to be accepted as the person you are requires care and services to specific needs, i.e. person-centeredness. Lack of understanding from staff may therefore have an adverse effect on a person's self-respect and identity. For that reason, staff needs to reflect on their attitudes and relationships as well as extending their knowledge about how to address sensitive topics such as the residents′ impending death. To achieve this support from managers is pivotal. Future research should focus on support to nursing staff to further knowledge and understanding about the individual changes resident go through near the end of life.

Keywords
dementia care, nursing home, family care givers, relocation, transition
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-135494 (URN)10.1111/scs.12442 (DOI)000426524200016 ()28464382 (PubMedID)
Available from: 2017-05-30 Created: 2017-05-30 Last updated: 2018-06-09Bibliographically approved
Seiger-Cronfalk, B., Ternestedt, B.-M. & Norberg, A. (2017). Being a close family member of a person with dementia living in a nursing home. Journal of Clinical Nursing, 26(21-22), 3519-3528
Open this publication in new window or tab >>Being a close family member of a person with dementia living in a nursing home
2017 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 21-22, p. 3519-3528Article in journal (Refereed) Published
Abstract [en]

Aim and objective

To illuminate how family members of persons with dementia describe their own experiences, before and after placing their relative in a nursing home.

Background

In the Western world and with a growing population of older people, the number of persons with dementia increases. Family members often become carers in their own homes creating stressful and exhausting situation that eventually leads to relocating the person to a nursing home. This may lead to troubled conscience among family members.

Method and design

This is a qualitative study with descriptive design based on interviews with ten family members to residents with dementia at one small nursing home ward. Data were analysed using content analysis.

Results

Five categories were derived from data: relocating a person with dementia – a responsibility; visiting the resident – a relief or a burden; the participants taking part in and monitoring the residents’ care needs; participants meeting their own needs; and thoughts about the future and resident's death. The result shows both positive and negative aspects of being a family member to persons with dementia. Family members described feeling relief as well as having a troubled conscience when placing a relative in a nursing home. They held themselves responsible for monitoring and evaluating the quality of the care. Family members expressed fearing a slow death for the person with dementia as well as for their own sake. Most felt well treated by the staff.

Conclusion

Family members were responsible for relocating the residents to the nursing home. This in itself was found to cause feelings of moral concerns and generating troubled conscience.

Relevance to clinical practice

Staff at nursing homes needs to exercise family-centred care to benefit the persons with dementia, their family members and the staff themselves.

Keywords
Dementia; family caregiver; family member; nursing home; troubled conscience
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-135493 (URN)10.1111/jocn.13718 (DOI)000417389400025 ()28042920 (PubMedID)
Available from: 2017-05-30 Created: 2017-05-30 Last updated: 2018-10-25Bibliographically approved
Åhlin, J., Strandberg, G., Norberg, A., Ternestedt, B.-M. & Ericson-Lidman, E. (2017). Care providers’ narrated experiences of working in private non-profit residential care for older people during downsizing and reorganisation, focusing on troubled conscience. Nordic journal of nursing research, 37(4), 177-185
Open this publication in new window or tab >>Care providers’ narrated experiences of working in private non-profit residential care for older people during downsizing and reorganisation, focusing on troubled conscience
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2017 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 37, no 4, p. 177-185Article in journal (Refereed) Published
Abstract [en]

Knowledge about care providers’ experiences of working in residential care of older people during times of downsizing and reorganisation is scarce, and it is not known whether/how their conscience is influenced by such changes. The aim was to describe care providers’ experiences of working in private residential care for older people during downsizing and reorganisation, focusing on troubled conscience. This study adopted a qualitative descriptive design based on interviews with seven care providers. A qualitative content analysis was used. The overall understanding was revealed as perceiving oneself as pinioned in between current circumstances to provide care and what one’s conscience conveyed. Care providers perceived: deteriorating working conditions as exhausting, downsizing and reorganisation as triggering one’s conscience when collaborating, troubled conscience when downsizing and reorganisation decrease the quality of care, and good management as crucial during downsizing and reorganisation. The results highlight that adequate communication strategies, well-functioning leadership and opportunities to know together and share what one’s conscience tells are aspects that need consideration.

Keywords
care providers, conscience, content analysis, downsizing, reorganisation, residential care of older people
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-129450 (URN)10.1177/2057158516678160 (DOI)
Available from: 2016-12-29 Created: 2016-12-29 Last updated: 2018-11-16Bibliographically approved
Mazaheri, M., Ericson-Lidman, E., Zargham-Boroujeni, A., Öhlén, J. & Norberg, A. (2017). Clear conscience grounded in relations: expressions of Persian-speaking nurses in Sweden. Nursing Ethics, 24(3), 349-361
Open this publication in new window or tab >>Clear conscience grounded in relations: expressions of Persian-speaking nurses in Sweden
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2017 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 24, no 3, p. 349-361Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Conscience is an important concept in ethics, having various meanings in different cultures. Because a growing number of healthcare professionals are of immigrant background, particularly within the care of older people, demanding multiple ethical positions, it is important to explore the meaning of conscience among care providers within different cultural contexts.

RESEARCH OBJECTIVE: The study aimed to illuminate the meaning of conscience by enrolled nurses with an Iranian background working in residential care for Persian-speaking people with dementia.

RESEARCH DESIGN: A phenomenological hermeneutical method guided the study.

PARTICIPANTS AND RESEARCH CONTEXT: A total of 10 enrolled nurses with Iranian background, aged 33-46 years, participated in the study. All worked full time in residential care settings for Persian-speaking people with dementia in a large city, in Sweden.

ETHICAL CONSIDERATIONS: The study was approved by the Regional Ethical Review Board for ethical vetting of research involving humans. Participants were given verbal and written study information and assured that their participation was voluntary and confidential.

FINDINGS: Three themes were constructed including perception of conscience, clear conscience grounded in relations and striving to keep a clear conscience. The conscience was perceived as an inner guide grounded in feelings, which is dynamic and subject to changes throughout life. Having a clear conscience meant being able to form a bond with others, to respect them and to get their confirmation that one does well. To have a clear conscience demanded listening to the voice of the conscience. The enrolled nurses strived to keep their conscience clear by being generous in helping others, accomplishing daily tasks well and behaving nicely in the hope of being treated the same way one day.

CONCLUSION: Cultural frameworks and the context of practice needed to be considered in interpreting the meaning of conscience and clear conscience.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
Care provider, conscience, dementia, immigrant, Persian-speaking residential care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-109970 (URN)10.1177/0969733015603442 (DOI)000401584200009 ()26385903 (PubMedID)
Available from: 2015-10-09 Created: 2015-10-09 Last updated: 2018-06-07Bibliographically approved
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