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  • 1. Alverbratt, Catrin
    et al.
    Berlin, Johan
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Nursing, Health and Culture, University West, Trollhättan.
    Kauffeldt, Anders
    Carlström, Eric
    A New Working Method in Psychiatric Care: The Impact of Implementation2017Inngår i: International Journal of Public Administration, ISSN 0190-0692, E-ISSN 1532-4265, Vol. 40, nr 3, s. 295-304Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.

  • 2.
    Antonsson, Helena
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Isaksson, U
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lundström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Effects and experiences of a web-based training program for professional carers working with people with learning disabilities and challenging behaviourManuskript (preprint) (Annet vitenskapelig)
  • 3.
    Antonsson, Helena
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. University West, Department of Health Sciences, Trollhättan, Sweden.
    Isaksson, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. University West, Department of Health Sciences, Trollhättan, Sweden.
    Lundström, Mats O.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design2016Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, nr 10, s. 734-743Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The interaction between people with intellectual disabilities and professional carers is often influenced by communicative difficulties contributing challenging behaviours. The aims of this study were to evaluate to a web-based training program aimed at improving carers' abilities to interact with people with learning disabilities who exhibit challenging behaviours and to explore carers' experiences of participating in such a program. A single-subject experimental design and mixed methods were used to integrate qualitative and quantitative data. Triangulation of questionnaires, interviews with carers, and assessments of one woman's behaviour was performed. The participants were professional carers aged 20 to 55 years. The web-based training program increased carers' abilities to handle challenging behaviours and decreased challenging behaviours in daily care. The program improved the opportunities to offer training to carers who work in community-based accommodations with limited time to receive training.

  • 4.
    Antonsson, Helena
    et al.
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Lundström, Mats
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Caregivers' reflections on their interactions with adult people with learning disabilities.2008Inngår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1365-2850, Vol. 15, nr 6, s. 484-91Artikkel i tidsskrift (Fagfellevurdert)
  • 5.
    Antonsson, Helena
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lundström, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Skilled interaction among professional carers in special accommodations for adult people with learning disabilities2013Inngår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, nr 7, s. 576-583Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    ACCESSIBLE SUMMARY: • Communicative difficulties affect interactions between people with learning disabilities and their carers. • Interactions between carers and residents in special accommodations for people with learning disabilities were recorded on video and skilled interactions were illuminated. • Results of the study show that skilled interaction between the carers and the people with learning disabilities is based upon being confirming, sharing daily life experience, giving time and space, and using congruent and distinct language.

    ABSTRACT: Communicative difficulties affect interactions between people with learning disabilities and their carers. Despite such difficulties, however, some carers seem to interact successfully with people who have limited ability to communicate verbally and exhibit challenging behaviour. This study aims to illuminate skilled interaction among carers working in special accommodations for people with learning disabilities. Interactions between 16 caregivers and 11 residents with learning disabilities were recorded on video. Verbal and non-verbal interaction skills among the carers were identified. Four caring situations with people with learning disabilities were chosen to illuminate skilled interaction. The transcribed text was subjected to qualitative content analysis and core stories were created. The results show that skilled interaction between the carers and the people with learning disabilities is based upon being confirming, sharing daily life experience, giving time and space, and using congruent and distinct language. In this paper we present examples that offer concrete suggestions of how to promote successful interaction and create meaning in the shared day-to-day life in special accommodations for people with learning disabilities.

  • 6.
    Berglund, Sara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindgren, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Patients' Experiences After Attempted Suicide: A Literature Review2016Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, nr 10, s. 715-726Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    The aim of this study has been to synthesize research on suicidal patients' experiences of the suicide process. A literature search was performed in CINAHL, PubMed, and PsycINFO, and the analysis of the 15 articles covered was based on meta-synthesis. Patients experience a wide variety of feelings regarding their situation during the suicide process, and these exist on two levels: they relate to the different aspects of care that the patients receive and the patients' need to communicate with others and regain hope. The patients in this study described the struggle to maintain hope when life became too difficult and their suffering despite a sense of security, and they sought to achieve emotional balance. A good understanding of how suicidal individuals live with and manage suicidal ideation, while maintaining hope is important for planning effective nursing care. Further research from the patient perspective is needed to further develop psychiatric care for people at risk of suicide.

  • 7. Carlbo, Adam
    et al.
    Claesson, Hanna Persic
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Nurses' experiences in using physical activity as complementary treatment in patients with schizophrenia2018Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, nr 7, s. 600-607Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Schizophrenia is a common disease with a high risk of comorbidity in both psychiatric and somatic diseases. Physical activity is proven effective in reducing symptoms of schizophrenia and increasing overall health. Still it is not used systematically in the care of persons with schizophrenia.

    Aim: The aim of this study is to describe nurses' experience, including personal motivation, in using physical activity as complementary treatment in patients with schizophrenia.

    Method: Interviews in three focus groups with 12 participating nurses were conducted. Qualitative content analysis was used to analyze data.

    Results: Physical activity was commonly used. Although several nurses signaled positive patient response, i.e. less anxiety and better quality of sleep, the overall consensus was an uncertainty regarding the benefits. It was perceived as non-evidence based form of intervention.

    Conclusion: The uncertainty of the benefits of physical activity is evident in nursing staff and poses a resistance to implement systematic physical activity as a complementary treatment in schizophrenia. A new awareness of evidence based nursing is suggested to promote a wider and more receptive attitude to reduce patient vulnerability in persons with schizophrenia.

  • 8.
    Egberg Thyme, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Sundin, Eva C.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Wiberg, Britt
    Division of Psychology, Nottingham Trent University, Nottinham, United Kingdom.
    Öster, Inger
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindh, Jack
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Individual brief art therapy can be helpful for women with breast cancer: A randomized controlled clinical study2009Inngår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 7, nr 1, s. 87-95Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Recent research shows that almost every second woman with breast cancer is depressed or has anxiety; the risk for younger women is even higher. Moreover, research shows that women are at risk for developing depression, also a threat for women with breast cancer. The aim of this randomized controlled clinical trial was to study the outcome of five sessions of art therapy given at a 5-week period of postoperative radiotherapy.

    Methods: The participants were between 37 and 69 years old; six participants in each group were below 50 years of age. Half of the participants (n = 20) received art therapy and the other half (n = 21) were assigned to a control group. At the first measurement, at least 17% (n = 7) of the participants medicated with antidepressants. Data were collected before and after art therapy and at a 4-month follow-up using self-rating scales that measure self-image (the Structural Analysis of Social Behaviour) and psychiatric symptoms (the Symptom Check List–90).

    Results: At follow-up, significant lower ratings of depression, anxiety, and somatic symptoms and less general symptoms were reported for the art therapy group compared to the control group. The regression analysis showed that art therapy relates to lower ratings of depression, anxiety, and general symptoms; chemotherapeutic treatment predicts lower depressive symptoms; in contrast to axilliary surgery and hormonal treatment as well as being a parent predicts higher ratings of anxiety and general symptoms.

    Significance of results: The conclusion suggests that art therapy has a long-term effect on the crisis following the breast cancer and its consequences.

  • 9. Erlingsson, Christen
    et al.
    Carlson, Sharon L
    Åström, Sture
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Saveman, Britt-Inger
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Dilemmas in Witnessing Elder Abuse in Caregiving Situations: A Family Member Perspective2009Inngår i: Southern Online Journal of Nursing Research, Vol. 9, nr 1Artikkel i tidsskrift (Fagfellevurdert)
  • 10.
    Erlingsson, Christen
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Carlson, Sharon
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    The secret shame of witnessing elder abuse in the familyManuskript (preprint) (Annet vitenskapelig)
  • 11. Høye, Sevald
    et al.
    Kvigne, Kari
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Severinsson, Elisabeth
    Öster, Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Encounters between multicultural family members and the nurses in the context of intensive care2015Inngår i: Clinical Nursing Studies, ISSN 2324-7940 (Print); 2324-7959 (Online), Vol. 3, nr 1, s. 89-99Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The increase in people on the move creates populations that are culturally diverse. People meet various challenges regarding the migration process, social life, jobs and health issues. When a person suffers from acute and critical illness, he/she may be in need of intensive care. The aim of this study was to explore the comprehension of culture, caring and gender among first and second generation immigrant women as relatives on their encounters with intensive care nurses in Norwegian hospitals. A design based upon discursive psychology to explore subject positions, interpretative repertoires and ideological dilemmas focused immigrant female relatives’ experiences with a cultural and gender perspective. Immigrants who were relatives to critically ill people were interviewed. The results of the discourse analysis revealed the following themes: being the caring person as woman, being intertwined between the Western hospital culture and the original family culture and belonging to a minority in a Western majority culture. Conclusion: The women in the families with a critically ill family member mainly act as the caring person. There are dilemmas in how much every family transfer the responsibility for their loved one to the nurses. Anxious attitudes regarding caring activities are rarely linked to their cultural background.

  • 12.
    Isaksson, Ulf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Karlsson, Stig
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Physically violent behaviour in dementia care: characteristics of residents and management of violent situations2011Inngår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 15, nr 5, s. 573-579Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Physically violent behaviour (PVB) is common among residents with dementia and often complicates nursing care. This study aims to explore types of caring situations, resident characteristics related to PVB and professional caregivers' management of PVB.

    Methods: The study included 40 group homes for 309 residents with dementia. Data was gathered by means of structured interviews, the Multi-Dimensional Dementia Assessment Scale and the Geriatric Rating Scale.

    Results: Ninety-eight of the residents (31.7%) were assessed as showing PVB during the preceding week. Three factors were independently associated with PVB: male gender, antipsychotic treatment and decline in orientation. Violent residents were more likely to have impaired speech, difficulties understanding verbal communication and prescribed analgesics and antipsychotics than were non-violent residents. PVB occurred mainly in intimate helping situations and was managed by symptom-oriented approaches, such as distraction, medication and isolation. The working team also held frequent discussions about the residents with PVB.

    Conclusion: This study shows that PVB is frequently displayed among residents in group homes for persons with dementia and the caregivers mainly manage PVB in a symptom-oriented way. To enhance the quality of care for patients with dementia, there is a need for interventions that aim to understand and manage the residents' physical violent behaviour.

  • 13.
    Isaksson, Ulf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Santamäki-Fischer, Regina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Nygren, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lundman, Berit
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Supporting the oldest old when completing a questionnaire: risking bias or gaining reliable results?2007Inngår i: Research on aging, Vol. 29, nr 6, s. 576-89Artikkel i tidsskrift (Fagfellevurdert)
  • 14.
    Isaksson, Ulf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Being flexible and tuning in: professional caregivers' reflections on management of violent behaviour in nursing homes2013Inngår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 8, nr 4, s. 290-298Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives: This qualitative, descriptive study aimed to illuminate professional caregivers' reflections on managing residents' violent behaviour in nursing homes.

    Background: Violence towards caregivers in the care of older people is a challenge attracting increasing attention in nursing research. However, studies that focus on the approaches caregivers in nursing homes resort to and how they manage everyday care situations involving threats and violent situations are relatively few.

    Methods: The study was based on 41 interviews in which the caregivers reflected on their own courses of action in violent situations. The interviews were subjected to qualitative content analysis.

    Results: This study showed that caregivers were flexible and in tune with the resident by averting and defusing threatening and violent situations. The caregivers tried to give care in line with the residents' condition, control their own spontaneous reactions and interpret the residents' reactions as communicative signs indicating how they should interact with the resident in the situation. As a last resort, when previous approaches had been unsuccessful, the caregivers took a firm stand, confronted the resident and the violent behaviour more directly, but with respect and with the residents' best interests in mind.

    Conclusions: These findings illuminate how caregivers successfully can manage threatening and violent behavior in nursing homes by being flexible and tuning in with the resident but also by taking a firm stand with the residents' best interests in mind. To be flexible and in tune with residents, it is important to know the residents' personal histories. This may mean involving stakeholders, such as family members and friends, in the care of residents with violent behaviour.

    Implications for practice: We believe that it is important to involve stakeholders in the care of threatening and violent residents in nursing homes as it is important to get information on the residents' personal history. However, there are risks when interpreting residents' behaviour in light of their personal histories as relatives experiences may be subjective and the information may give the caregivers preconceived ideas about the resident.

  • 15.
    Isaksson, Ulf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    In the eye of the beholder: How female caregivers in nursing homes perceive violence2007Inngår i: 5th European congress on violence in clinical psychiatry., 2007Konferansepaper (Fagfellevurdert)
  • 16. Johansson, Catrin
    et al.
    Åstrom, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. University West, Trollhättan.
    Kauffeldt, Anders
    Carlstrom, Eric
    Daily Life Dialogue Assessment in Psychiatric Care-Face Validity and Inter-Rater Reliability of a Tool Based on the International Classification of Functioning, Disability and Health2013Inngår i: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 27, nr 6, s. 306-311Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article describes the development of an assessment tool based on the International Classification of Functioning Disability and Health (ICF) adapted to a psychiatric nursing context where both the patient and the nurse assess the patient's ability to participate in various spheres of life. The aim was to test psychometric properties, focusing on face validity and inter-rater reliability. Three Swedish expert groups participated. Analysis of inter-rater reliability was conducted through simulated patient cases. The results of an unweighted kappa value of 0.38, a linear weighted kappa value of 0.65 and a quadratic weighted kappa value of 0.73 were considered as acceptable when using simulated patient cases. (C) 2013 Elsevier Inc. All rights reserved.

  • 17. Johansson, Catrin
    et al.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
    Kauffeldt, Anders
    Helldin, Lars
    Carlström, Eric
    Culture as a predictor of resistance to change: a study of competing values in a psychiatric nursing context2014Inngår i: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 114, nr 2-3, s. 156-162Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    It is well known that a conservative organizational culture can hinder the implementation of new organizational models. Prior to introducing something new it is important to identify the culture within the organization. This paper sets out to detect the feasibility of reform in a psychiatric clinic in a Swedish hospital prior to implementation of a new working method - a structured tool based on the International Classification of Functioning Disability and Health. A survey consisting of two instruments - an organizational values questionnaire (OVQ) and a resistance to change scale (RTC) - was distributed to registered and assistant nurses at the clinic. The association between the organizational subcultures and resistance to change was investigated with regression analysis. The results revealed that the dominating cultures in the outpatient centers and hospital wards were characterized by human relation properties such as flexibility, cohesion, belongingness, and trust. The mean resistance to change was low, but the subscale of cognitive rigidity was dominant, reflecting a tendency to avoid alternative ideas and perspectives. An instrument like the one employed in the study could be a useful tool for diagnosing the likelihood of extensive and costly interventions.

  • 18. Lier, Haldis Økland
    et al.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Nursing Health and Culture, University West, Trollhättan,Sweden.
    Rørtveit, Kristine
    Patients' daily life experiences five years after gastric bypass surgery: a qualitative study2016Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 3-4, s. 322-331Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM AND OBJECTIVE: The objective was to explore and describe patients' daily life experiences five years after gastric bypass surgery.

    BACKGROUND: Bariatric surgery markedly decreases body weight. Previous studies describe positive consequences, as well as physical, social and emotional challenges during the first few years after surgery. An understanding of how patients adjust to and cope with postsurgical changes in the long term is crucial to help them obtain a successful outcome after bariatric surgery.

    METHOD: A qualitative method was employed. In-depth interviews with 10 men and women were conducted five years after bariatric surgery in a Norwegian hospital.

    RESULTS: One overarching theme - a multitude of daily life changes following bariatric surgery - was developed based on three main themes: relational aspects related to weight loss, the new body and changes in self-esteem. Six sub-themes are described.

    CONCLUSION: Those who undergo gastric bypass surgery experience enormous changes in their daily lives. Their social lives, their relationship to their body and their self-esteem may be altered by the weight loss.

    RELEVANCE TO CLINICAL PRACTICE: The results of this study suggest directions for patient education, health staff education and peer education. A patient education programme focusing on changes in daily life experiences when undergoing gastric bypass surgery is suggested due to the changes experienced by the patients involved in this study.

  • 19.
    Lindgren, Britt-Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Aström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Graneheim, Ulla Hällgren
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Held to ransom: parents of self-harming adults describe their lived experience of professional care and caregivers2010Inngår i: International journal of qualitative studies on health and well-being, ISSN 1748-2631, Vol. 5, nr 3Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to discover and describe lived experiences of professional care and caregivers among parents of adults who self-harm. Narrative interviews were conducted with six parents of daughters with self-harming behaviours and analysed using a phenomenological hermeneutic approach. The meanings of the parents' narratives of their lived experiences of professional care and caregivers were interpreted as their being involved in 'limit situations' comparable to hostage dramas. Several meaningful themes contributed to this interpretation: being trapped in a situation with no escape; being in the prisoner's dock; groping in the dark; and finding glimmers of hope. Parents of daughters who were in care because of self-harming often felt obliged to pay an emotional ransom, which included feelings of being accused, being 'broken', being confused, and feeling lost. Moments of peace occurred as welcome breaks offering a short time of rest for the parents. Situations that were understood by the parents and solved in a peaceful way were experienced as a respite and inspired parents with hope for their daughters' recovery.

  • 20.
    Lindgren, Britt-Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Öster, Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    'They don't understand…you cut yourself in order to live.': Interpretative repertoires jointly constructing interactions between adult women who self-harm and professional caregivers2011Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, nr 3, s. 7254-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to illuminate interpretative repertoires that jointly construct the interaction between adult women who self-harm and professional caregivers in psychiatric inpatient care. Participant observations and informal interviews were conducted among six women who self-harm and their professional caregivers in two psychiatric inpatient wards, and analysed using the concept of interpretative repertoires from the discipline of discursive psychology. The analysis revealed four interpretative repertoires that jointly constructed the interaction. The professional caregivers used a "fostering repertoire" and a "supportive repertoire" and the women who self-harmed used a "victim repertoire" and an "expert repertoire." The women and the caregivers were positioned and positioned themselves and people around them within and among these interpretative repertoires to make sense of their experiences of the interaction. It was necessary to consider each woman's own life chances and knowledge about herself and her needs. The participants made it clear that it was essential for them to be met with respect as individuals. Professional caregivers need to work in partnership with individuals who self-harm-experts by profession collaborating with experts by experience. Caregivers need to look beyond behavioural symptoms and recognise each individual's possibilities for agency.

  • 21.
    Lundström, Mats
    et al.
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Graneheim, Ulla
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Eisemann, Martin
    Richter, Jörg
    Åström, Sture
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Personality impact on experiences of strain among caregivers exposed to violence in care of people with learning disabilities.2007Inngår i: Journal of Policy and Practice in Intellectual Disabilities, ISSN 1741-1122, E-ISSN 1741-1130, Vol. 4, nr 1, s. 30-39Artikkel i tidsskrift (Fagfellevurdert)
  • 22.
    Lundström, Mats
    et al.
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Graneheim, Ulla H
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Eisemann, Martin
    Richter, Jörg
    Åström, Sture
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Influence of work climate for experiences of strain2005Inngår i: Learning Disability Practice, ISSN 1465-8712, Vol. 8, nr 10, s. 32-38Artikkel i tidsskrift (Fagfellevurdert)
  • 23.
    Lundström, Mats
    et al.
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Saveman, Britt-Inger
    Eisemann, Martin
    Åström, Sture
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Prevalence of violence and its relation to caregivers' demographics and emotional reactions: an explorative study of caregivers working in group homes for persons with learning disabilities.2007Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, nr 1, s. 84-90Artikkel i tidsskrift (Fagfellevurdert)
  • 24.
    Lundström, Mats
    et al.
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Caregivers' experiences of exposure to violence in services for people with learning disabilities.2007Inngår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, Vol. 14, nr 4, s. 338-45Artikkel i tidsskrift (Fagfellevurdert)
  • 25.
    Norberg, Monika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Magnusson, Eva
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Thyme, Karin Egberg
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Institutionen för Omvårdnad, kultur och hälsa, Universitet West, Trollhättan.
    Lindh, Jack
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Öster, Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi.
    Breast Cancer Survivorship: Intersecting Gendered Discourses in a 5-Year Follow-Up Study2015Inngår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 36, nr 5, s. 617-633Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this article we present a follow-up study of women's interview narratives about life five to seven years after a breast cancer operation. The women had taken part in a study during the six-month post-operation period. Art therapy contributed to well-being, including strengthening personal boundaries. In the new study, interview analysis informed by critical discursive psychology indicated three problematic discourses that the women still struggled with several years after the operation: the female survivor, the "good woman", individual responsibility. We concluded that many women with a history of breast cancer need support several years after their medical treatment is finished.

  • 26.
    Richter, Jörg
    et al.
    Regional Centre of Child and Adolescent Mental Health, Oslo, Norway.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Isaksson, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Personality characteristics of staff in elderly care-a cross-cultural comparison2012Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 33, nr 2, s. 96-100Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Communication and interaction between carers and residents in elderly and dementia care can be challenging and demanding. The carer's personality, one factor shaping this interaction, seems to have been neglected in the literature. This article looks at cross-cultural comparisons of staff in elderly and dementia care with individuals from the general population matched by age and gender. Compared to individuals in the general population, elderly and dementia care staff are usually slower tempered, more stoic and reflective, tolerant to monotony, and more systematic. They also have more optimistic attitudes in situations that might worry most people, and more confidence in social situations and in the face of danger and uncertainty.

  • 27.
    Rørtveit, Kristine
    et al.
    Stavanger District Psychiatric Centre, Stavanger University Hospital, Stavanger Norway.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Severinsson, Elisabeth
    Centre for Women, Families and Children's Health, Vestfold University College, Tönsberg, Norway.
    Experiences of guilt as a mother in the context of eating difficulties2009Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 30, nr 10, s. 603-610Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to explore motherhood in the context of eating difficulties. The research question was: What are mothers' daily life experiences when suffering from ED? An explorative design was used. In-depth interviews (n = 8) focused on experiences of motherhood and eating difficulties. Data were interpreted by hermeneutic analysis. The main theme, "experiencing guilt as a mother in the context of eating difficulties," comprised two themes: (1) having a guilty conscience in relation to being a good enough mother and (2) being preoccupied about not involving the children in the eating difficulties. The study illuminates the importance of identifying mothers with eating difficulties and offering them treatment and support.

  • 28.
    Rørtveit, Kristine
    et al.
    Department of Health Studies, University of Stavanger, Norway.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Severinsson, Elisabeth
    Department of Research and Human Resources, Stavanger University Hospital, Stavanger, Norway.
    The feeling of being trapped in and ashamed of one's own body: A qualitative study of women who suffer from eating difficulties2009Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 18, nr 2, s. 91-99Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to explore women's bodily experiences of suffering from eating difficulties (ED). The research question was: How do women who suffer from ED experience the bodily aspects related to their condition? Women suffering from ED experience problems in both the physical and emotional areas. Few qualitative studies have specifically addressed sufferers' bodily experiences related to ED. An explorative design was used. The data were collected by means of focus group interviews on the subject of ED-related problems, guilt and shame, and being a mother. The interpretation of the qualitative data was inspired by hermeneutic content analysis. The main theme, 'Powerful feelings of being trapped in and ashamed of one's own body', comprised two themes: 'The feeling of being trapped by overwhelming physical sensations' and 'The feeling of being ashamed of one's own body'. Bodily experiences were reported as strong. One clinical implication for nurses is to acknowledge this fact and make it possible for these women to articulate their difficulties, especially those connected to the feelings of being trapped and ashamed. Support groups focusing on these themes could be one way of assisting women and easing some of the negative feelings associated with ED.

  • 29.
    Rørtveit, Kristine
    et al.
    Faculty of Social Sciences, University of Stavanger.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Severinsson, Elisabeth
    Centre for Women's, Family and Child Health, Faculty of Health Sciences, Vestfold University College, Tønsberg, Norway.
    The meaning of guilt and shame: a qualitative study of mothers who suffer from eating difficulties2010Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 19, nr 4, s. 231-239Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to illuminate and interpret guilt and shame expressed by mothers with eating difficulties (ED). The research question was: What is the meaning of guilt and shame experienced by mothers with ED? Experiences of guilt and shame in mothers with ED may be strong, yet concealed, and should be addressed when promoting women's mental health. The study design was explorative, and in-depth interviews were conducted with eight mothers suffering from ED. The data were analysed by means of qualitative content analysis and interpreted according to a hermeneutic approach. The main theme 'Struggling in silence with guilt and shame as a mother living with ED and trying to keep it secret' was interpreted on two levels: emotional, 'Feeling worried about failure and wanting to be successful', and cognitive, 'Having condemning thoughts about one's own sense of responsibility'. In addition, each theme contained two subthemes. Feelings and awareness of guilt and shame are strong; they vary between individuals and are intensified in mothers who suffer from ED. It is important for mental health nurses to help mothers with ED articulate such feelings in order to promote health.

  • 30.
    Sandvide, Åsa
    et al.
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Norberg, Astrid
    Umeå universitet, Medicinsk fakultet, Omvårdnad.
    Saveman, Britt-Inger
    Violence in institutional care for elderly people from the perspective of involved care providers.2004Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 18, nr 4, s. 351-357Artikkel i tidsskrift (Fagfellevurdert)
  • 31.
    Sandvide, Åsa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    How Care Providers' Construct and Frame Problems Related to Violence in Institutional Care for Older People2010Inngår i: Communication & Medicine, ISSN 1612-1783, Vol. 7, nr 2, s. 155-164Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to describe how care providers discursively constructed and framed problems related to the occurrence of violence in their interactions with older persons in institutional care. The study followed a social constructionist approach where violence was considered a social phenomenon constructed in discursive processes. It was based on the assumption that the way in which a problem is articulated is closely connected to beliefs, which in turn create and maintain a space for the support of certain actions and solutions that are possible and relevant in the given context. The analyzed text comprised narrative interviews with 46 care providers who had been involved in violence that occurred in social interactions with older persons. The analysis was inspired by discourse theory. The interactions were presented as a difficult and unavoidable problem related to the illness, caring for the body, competence and profession as well as the social order. The descriptions of the violence and related problems are manifestations of discourses. The prevailing discourses in the text were the medical and physical. The presentations of problems can be used to challenge dominant ways of thinking as well as the beliefs and common understandings about the subject.

  • 32.
    Svensk, Ann-Christine
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Öster, Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Egberg Thyme, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Magnusson, Eva
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Umeå universitet, Samhällsvetenskapliga fakulteten, Kvinnovetenskapligt forum.
    Sjödin, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Eisemann, Martin
    Department of Psychology, University of Tromsøe, Tromsøe, Norway.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindh, Jack
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Art therapy improves experienced quality of life among women undergoing treatment for breast cancer: A randomized controlled study2009Inngår i: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 18, nr 1, s. 69-77Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Women with breast cancer are naturally exposed to strain related to diagnosis and treatment, and this influences their experienced quality of life (QoL). The present paper reports the effect, with regard to QoL aspects, of an art therapy intervention among 41 women undergoing radiotherapy treatment for breast cancer. The women were randomized to an intervention group with individual art therapy sessions for 1 h/week (n = 20), or to a control group (n = 21). The WHOQOL-BREF and EORTC Quality of Life Questionnaire-BR23, were used for QoL assessment, and administrated on three measurement occasions, before the start of radiotherapy and 2 and 6 months later. The results indicate an overall improvement in QoL aspects among women in the intervention group. A significant increase in total health, total QoL, physical health and psychological health was observed in the art therapy group. A significant positive difference within the art therapy group was also seen, concerning future perspectives, body image and systemic therapy side effects. The present study provides strong support for the use of art therapy to improve QoL for women undergoing radiotherapy treatment for breast cancer.

  • 33.
    Wilhelmsson, Anna-Britta
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Pedagogiska institutionen.
    Hällgren Graneheim, Ulla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Berge, Britt-Marie
    Umeå universitet, Samhällsvetenskapliga fakulteten, Pedagogiska institutionen.
    Johansson, Sigurd
    Umeå universitet, Samhällsvetenskapliga fakulteten, Pedagogiska institutionen.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Everyday life experiences among relatives of persons with mental disabilities2010Inngår i: Procedia - Social and Behavioral Sciences, ISSN 1877-0428, E-ISSN 1877-0428, Vol. 2, nr 2, s. 4896-4900Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Mental disability is one of the most significant health problems facing Europe today. For example Statistics reveal that between 20 and 40 percent of the Swedish population suffer from some forms of mental disease, ranging from grave psychoses to less serious anxiety and fear. This study has aimed to illuminate the experiences of relativeś in terms of contacts with persons with mental disabilities. Eighteen tape-recorded interviews were conducted with close relatives of persons suffering from mental disabilities within the health care district of Umeå, Sweden. The results indicate that the daily lives guilt about not providing enough support for their relatives. In addition to feeling physically exhausted and worn out they felt as though they carried a large responsibility and lacked support and back-up in their daily life.

  • 34.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Department of Geriatric Medicine, Karolinska Institute, Huddinge Hospital, Huddinge, Sweden.
    Attitudes, empathy and burnout among staff in geriatric and psychogeriatric care1990Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    This study concerned assessments of attitudes towards demented patients among students and nursing staff as well as attitudes towards active euthanasia, wish to transfer to other jobs, ability of empathy and experience of burnout among nursing staff. The study aimed also to relate experience of burnout to attitudes towards demented patients, ability of empathy and experience of work with demented patients. The study was performed by use of questionnaires, scales measuring attitudes towards demented patients, experience of burnout and ability of empathy. Tape-recorded interviews were also included aiming to explore the staffs experience at work.

    The results showed that a majority of the students and staff held positive attitudes towards demented patients. A small proportion intended to work solely with demented patients. Staff working in psychogeriatric care and somatic long-term care held more positive attitudes than staff working in acute medical care. Proportions of staff with positive attitudes varied depending on age, duration of employment, education and place of work. A larger proportion of staff in geriatric care than in acute care reported a wish to transfer to another job. LPN’s in nursing homes to the largest proportion stated this wish to transfer.

    A majority of both students and staff expressed negative attitudes towards active euthanasia to severely demented patients in the finale stage of life. However, most favourable attitudes towards active euthanasia were found among students with shorter health care education and among nurse's aides and LPN’s.

    The staffs empathy was judged as moderately high and there were no differences found in relation to sex, staff category or place of work.

    Experience of burnout /tedium varied with the place of work and category of staff. Largest proportions at risk to develop burnout were found among those working in somatic long-term care and psychogeriatric care. RN’s showed lower burnout scores than nurse's aides and LPN’s.

    Experience of burnout was correlated to attitudes towards demented patients, indicating that the lower burnout score the staff have the more positive are the attitudes. Burnout was also related to the staffs ability of empathy i.e. the lower degree of burnout the higher is the empathie ability. Regression analysis showed that "Experience of feed-back at work” and "Time spent at present place of work" were the most important factors for the staffs experience of burnout.

  • 35.
    Åström, Sture
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Karlsson, Stig
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Sandvide, Asa
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Bucht, Gösta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Eisemann, Martin
    Norberg, Astrid
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Saveman, Britt-Inger
    Staff's experience of and the management of violent incidents in elderly care.2004Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 18, nr 4, s. 410-6Artikkel i tidsskrift (Fagfellevurdert)
  • 36.
    Öster, Inger
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Magnusson, Eva
    Umeå universitet, Samhällsvetenskapliga fakulteten, Kvinnovetenskapligt forum.
    Egberg Thyme, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Lindh, Jack
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Art therapy for women with breast cancer: the therapeutic concequences of boundary strenghtening2007Inngår i: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 34, nr 3, s. 277-288Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Between 2001 and 2004, 42 women with breast cancer (20 women in the study group and 22 women in the control group) participated in an intervention study involving art therapy. This article elaborates on previous quantitative results, taking a discursive approach and drawing on gender theories in analyzing the women's use of interpretative repertoires in interviews and diaries and their answers on single items of the Coping Resources Inventory (CRI). The aim was to inquire into whether and, if so, how and with what consequences women with breast cancer who participated in art therapy improved their access to beneficial cultural interpretative repertoires, compared to a control group. The results showed a connection between participation in art therapy, talking about protecting one's own boundaries, and scoring higher on the CRI compared to the control group. There was also a connection between the control group, repertoire conflicts, and lower scores on the CRI. Our interpretation is that art therapy became a tool the women could use to distinguish cultural understandings about boundaries and, through image making and reflections, to give higher legitimacy to their own interpretations and experience.

  • 37.
    Öster, Inger
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Svensk, Ann-Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Magnusson, Eva
    Umeå universitet, Samhällsvetenskapliga fakulteten, Kvinnovetenskapligt forum.
    Thyme Egberg, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Sjõdin, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Aström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindh, Jack
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Art therapy improves coping resources: a randomized, controlled study among women with breast cancer.2006Inngår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 4, nr 1, s. 57-64Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Women with breast cancer suffer from considerable stress related to the diagnosis, surgery, and medical treatment. It is important to develop strategies to strengthen coping resources among these women. Research in art therapy has shown outcomes such as an increase in self-esteem and cohesion, significant improvement in global health, and a decrease in anxiety and depression. The aim of the present article was to describe the effects of an art therapy intervention program on coping resources in women with primary breast cancer. METHOD: In this article, we report some of the results from a study including 41 women, aged 37-69 years old, with nonmetastatic primary breast cancer, referred to the Department of Oncology at Umeå University Hospital in Sweden for postoperative radiotherapy. The women represented various socioeconomic backgrounds. They were randomized to a study group (n = 20) with individual art therapy for 1 h/week during postoperative radiotherapy or to a control group (n = 21). The article focuses on changes in coping resources, as measured by the Coping Resources Inventory (CRI) before and 2 and 6 months after the start of radiotherapy. The study protocol was approved by the Umeå University Ethical Committee at the Medical Faculty (archive number 99-386). RESULTS: There was an overall increase in coping resources among women with breast cancer after taking part in the art therapy intervention. Significant differences were seen between the study and control groups in the social domain on the second and third occasions. Significant differences were also observed in the total score on the second occasion. SIGNIFICANCE OF RESULTS: This study shows that individual art therapy provided by a trained art therapist in a clinical setting can give beneficial support to women with primary breast cancer undergoing radiotherapy, as it can improve their coping resources.

  • 38.
    Öster, Inger
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi.
    Tavelin, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Edberg Thyme, Karin
    Magnusson, Eva
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Isaksson, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindh, Jack
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Art therapy during radiotherapy – A five-year follow-up study with women diagnosed with breast cancer2014Inngår i: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 41, nr 1, s. 36-40Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Follow-up studies on art therapy are lacking. In a randomised art therapy intervention study from 2001 to 2004 with women with breast cancer, results showed that patients benefitted from participating in art therapy for up to four months after the intervention. The aim of this study was to describe the coping resources and quality of life amongst women treated for breast cancer five to seven years after participating in individual art therapy during radiotherapy as compared to a control group. In 2009, thirty-seven women, 18 from the intervention group and 19 from the control group, answered questionnaires about their coping resources and quality of life. The results showed no significant difference between the groups regarding their coping resources or quality of life, except for an unexpected significantly lower score in the domain 'Social relations' in the study group as compared to baseline, at the time of the follow up. However, our study from 2001 to 2004 supports various positive effects of art therapy within six months of participation as compared to a control group. Consequently, attending art therapy during the treatment period for breast cancer can be of great importance to support health, coping and quality of life in a short-term perspective.

  • 39.
    Öster, Inger
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Tavelin, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Egberg Thyme, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Magnusson, Eva
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Isaksson, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindh, Jack
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Art therapy during radiotherapy: a five-year follow-up study with women diagnosed with breast cancer2014Inngår i: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 41, nr 1, s. 36-40Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Follow-up studies on art therapy are lacking. In a randomised art therapy intervention study from 2001-2004 with women with breast cancer, results showed that patients benefitted from participating in art therapy for up to at least four months after the intervention. The aim of this study was to describe the coping resources and quality of life amongst women treated for breast cancer five - seven years after participating in individual art therapy during radiotherapy as compared to a control group. In 2009, thirty-seven women, 18 from the intervention group and 19 from the control group, answered questionnaires about their coping resources and quality of life. The results showed no significant difference between the groups regarding their coping resources or quality of life, except for an unexpected significantly lower score in the domain ‘Social relations’ in the study group as compared to baseline, at the time of the follow up. However, our study from 2001–2004 supports various positive effects of art therapy within six months of participation as compared to a control group. Consequently, attending art therapy during the treatment period for breast cancer can be of great importance to support health, coping and quality of life in a short-term perspective.

  • 40.
    Öster, Inger
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Åström, Sture
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lindh, Jack
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Magnusson, Eva
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Women with breast cancer and gendered limits and boundaries: Art therapy as a safe space for enacting alternative subject positions2009Inngår i: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 36, nr 1, s. 29-38Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article takes its starting point from certain results from our randomized study on art therapy with women with breast cancer. Previous results from this study showed significant benefits on coping, quality of life, and symptoms for women who participated in an art therapy intervention. Analyses of interviews and diaries showed that especially women from the intervention group had distanced themselves from traditionally gendered understandings about cultural limits and boundaries. The aim of this study was to gain further knowledge about how women with breast cancer who participated in the art therapy intervention gave meaning to the gendered limits and boundaries in their daily lives, and to trace their trajectories, in therapy, towards helpful management of restraining boundaries. When analyzing the women's verbal reflections on the therapy sessions, we discerned five subject positions, defining them as follows: being someone who reacts to violation attempts; actively connecting body and self; actively locating oneself and moving forward; being in a position to see important connections throughout life; and being able to acknowledge and harbour conflicting emotions. The results of the study suggest that art therapy served as a tool that helped the women to get access to subject positions that enabled them to protect and strengthen their boundaries. This involved challenging dominating discourses and reacting against perceived boundary violations. Art therapy offered a personal, physical, and pictorial “safe space” with opportunities to deal with complex existential experiences and issues, and also make important connections throughout life. Looking back and summarizing important experiences acted as a way to prepare oneself for the future and moving forward.

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