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  • 2351.
    Ödling, Evelina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Engström, Lovisa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Erfarenheter av stigmatisering i hälso- och sjukvården bland personer som drabbats av HIV.: -en litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Title: Experiences of stigma in health care among people affected by HIV- A literature review Background: HIV (Human Immunodeficiency Virus) has been associated with stigmatization for a long time because of ignorance and uncertainty still exists regarding the transmission routes and infectivity. Aim: The aim for the study was to highlight experiences of stigma in health care among people affected by HIV. Method: A literature study was conducted with ten qualitative articles from eight different countries. The articles were examined, analyzed and compiled. Results: The result generated two categories and five subcategories. The categories are: To be treated with a lack of care actions and experiences of integrity violation. The sub-categories are: excessive security measures, ignorant attitudes, lack of secrecy, offensive body language and abusive verbal communication.                                                                   Conclusion: Lack of knowledge about HIV can be seen internationally seen as a contributing factor to the patients still experiencing varying stigmatized treatment by health professionals. To counteract the stigma requires research that can generate knowledge on how health professionals can provide better treatment and that this information is disseminated to the medical staff. Keywords: HIV, stigmatization, patient-experience, discrimination.

  • 2352.
    Ödling, Gunvor
    Umeå University, Faculty of Medicine, Department of Nursing.
    Professional caregivers’ experiences of caring for women with breast cancer on a surgical ward2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of the thesis was to describe caregivers’ experiences of caring for women with breast cancer on a surgical ward. The study was based on interviews with narrative parts and tape-recorded clinical supervision sessions. The interviews and clinical supervision sessions were transcribed verbatim, and analysed by content analysis.

    Nurses (n=10) described life for women with breast cancer as either having freedom or not having freedom, with both physical and existential suffering. Dying occurred either naturally in patients’ own home or unnaturally in hospital. The nurses felt that it is possible to alleviate suffering during dying through providing adequate pain relief but also, through listening, providing information and changing the caring atmosphere (I).

    Breast cancer as an illness was described from a dark point of view by caregivers (n=37). The descriptions focused on loss of breasts and control, progression of the illness and annihilation. The illness seemed, in the caregivers’ mind, to often end with a painful death. Caregivers who had the opportunity to follow the total care process described a lighter viewpoint (II).

    According to nurses (=31) the most important needs among women, their relatives and nurses themselves were the needs to talk and receive information. There was a discrepancy between what was described as important needs and the descriptions of how these needs were provided for. Nurses, whose own needs for support were sometimes unsatisfactorily met (III), seemed almost to be unaware of the needs among women and their relatives.

    In the clinical supervision sessions caregivers reflected on difficult care situations related to women’s, relatives’, and most often caregivers’ feelings (n=38). The care situations were described as evoking feelings of discomfort, powerlessness and reduced self-esteem. These feelings were described by caregivers as arising in connection with caring for especially women with advanced breast cancer in a changing organisation (IV).

    Caregivers’ descriptions of caring for women with breast cancer show a lot of negative experiences of powerlessness and frustration. They met women and their relatives who suffered in various ways and had considerable need for support. Caregivers often found themselves unable to meet these needs due to organisational obstacles e.g. lack of time and lack of knowledge about other caregivers’ responsibility in the care.

  • 2353.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Danielson, E
    Christensen, SB
    Norberg, A
    Living with breast cancer: care givers’ perceptions in a surgical ward1998In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 21, no 3, p. 187-195Article in journal (Refereed)
  • 2354.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Danielson, E
    Jansson, L
    Caregivers’ descriptions of patients with advanced breast cancer in connection with supervision sessions in a surgical ward2001In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 24, no 1, p. 28-34Article in journal (Refereed)
  • 2355.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, A
    Life, suffering and dying as narrated by nurses in a surgical wardArticle in journal (Refereed)
  • 2356.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, A
    Danielson, E
    Care of women with breast cancer on a surgical ward: nurses’ opinions of needs for support for women, relatives and themselves2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 39, no 1, p. 77-86Article in journal (Refereed)
  • 2357.
    Ölund, Erika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Olofsson, Lina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Andlighet inom palliativ vård2013Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inom hälso- och sjukvården finns ett ökat intresse för andlig vård, vilket har resulterat i mer forskning kring ämnet andlighet. Det finns dock lite forskning som visar hur sjuksköterskan definierar och ger andlig vård. Andlighet är något som bör integreras inom den palliativa vården enligt de internationella och nationella riktlinjer som finns för sjuksköterskans arbete. Syftet med denna litteraturstudie var att beskriva hur sjuksköterskor såg på andlighet och hur de tillgodosåg andlig vård. I studien analyserades och sammanställdes nio artiklar om hur sjuksköterskorna såg på andlighet och gav andlig vård. Artiklarna söktes fram i databaser Pubmed, CINAHL, Scopus och Medline. Även manuell sökning genomfördes. Analysen resulterade i att tre huvudteman framkom: (1) sjuksköterskans syn på begreppet andlighet, (2) befrämjande för andlig vård och (3) hinder för att tillgodose andliga behov, subteman presenterades under huvudtema 2 och 3. Vid vårdandet av döende patienter är det viktigt att sjuksköterskan tillgodoser fysiska, sociala, emotionella och andliga behov. Förmedla livsmening, hopp, tröst, att beröra och följa med patienten på resan mot döden är viktigt när sjuksköterskan ger andlig vård. Tidsbrist, stress, hög arbetsbelastning och bristande kunskap kring andlig vård är faktorer som leder till brister inom den andliga vården av döende patienter

  • 2358.
    Öresland, Stina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses go visiting: ethics and gender in home-based nursing care2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis is to explore how nursing is constructed in home-based nursing care from the viewpoint of patients and nurses who are receiving or giving care. Since nursing both constructs and is in turn constructed by the context in which it serves, language plays a central part in those constructions and in this thesis. The thesis has been guided by social constructionism, meaning that the positions the patients and the nurses inhabits have been considered as social phenomenon constructed in discursive processes.

    There are two ideas that guided this thesis. One idea was that home-based nursing care promotes the association of caring abilities in relation to nursing, women and the private sphere. Another idea was that the place where the care was carried out has ethical implications.

    Data was collected from interviews with 10 home-based nurses (study I) working in community in the western part of Sweden and 10 patients cared for in their home by these nurses (study II). Nurses and patients were interviewed about their experiences of giving respectively receiving home-based nursing care. The interviews were transcribed verbatim and analyzed with a discourse analytic method in study I and II. The findings in study I show that the nurses described their subject positions as "guests" and "professionals" and that they have to make a choice between these positions, as it is impossible to perform both positions at the same time. Dependent on the situation, both an ethics of care and an ethics of justice were applied by the nurses, that is, to perform according to the subject positions of "guest" or "professional."

    In study II, the patients describe their own subject position as "safeguard" and the nurses‟ positions as "substitutes". These subject positions provided the opportunities, and the obstacles, for the patients‟ possibilities to receive care in their home which included which kind of strategies, habits and activities the patients described and what tasks and how they considered or expected the nurses to perform. These findings are discussed within a theoretical framework, i.e. a gendered dichotomy of the private spheres versus the public spheres. Inherent in this framework is a discussion of the findings related to the habits that are essential in the nurses‟ and the patients‟ constructions of subject positions.

    In study III, metaphors used by home-based nurses‟ were explored as a means to discover values and norms held by nurses working in home-based nursing care. Ten interviews with nurses working in home-based nursing care (the same interviews as in study I) were analyzed and interpreted with a metaphor analytic method. In the analysis metaphoric linguistic expressions (MLE) were explored and patterns of MLEs formed two entailments. After exploring MLEs and entailments on an explicit surface level the analysis went to a broader underlying dimension of conceptual metaphors identifying the overall metaphor: "Home-based nursing care is an endless journey". The metaphor "Home-based nursing care is an endless journey" exposed home-based nursing care in constant motion, thereby requiring nurses to adjust to circumstances. This adjustment required ethical maturity based on experience, knowledge, and creativity. The study III focuses on the importance of further developing reflections over experiences related to everyday ethical issues.

    In study IV, the findings from study I were the starting point for a philosophical exploration of the concept "guest" and its relation to other adjacent concepts such as hosts and hospitality. The question to be answered was as follows: In what ways can home-based nurses‟ description of being "guests" in patients‟ home be understood? The exploration was based on Derrida‟s philosophy of unconditional and conditional hospitality, Levinas‟ philosophy of "face" and "the Other" and Arendt‟s philosophy of "go visiting". The findings indicated that the concept "guest" was not appropriate for the nurses to use when describing their position in home-based nursing care, since the concept was problematic for the content and the complexity of home-based nursing care. The findings also showed that exposing concepts as binaries is fruitful since they show relationship between concepts. Just illuminating the concept "guest" did not reveal the power relationship between the "guest" and the "host" and their relationship to hospitality.

    The distinction between diverse ethical perspectives could be seen as problematic or as an opportunity. According to this study, the nurses used a plurality of different ethical ideas, such as an ethics of care, an ethics of justice, an ethics of virtue and an "everyday ethics." A possible interpretation could be that this was a sign of a difficulty to maintain distinction between ethical theories in clinical practice. 

    Ethical issues in the private sphere are less commonly explored compared to ethical issues in the public sphere, for example in hospital care. As showed in this thesis, the distinction between the private and the public spheres was problematic. It does not describe two spatially separate spheres, but rather it describes functionally dependent activities, interests and relations, such as diverse areas of ethical ideas and "feminine" and "masculine" positions.

    Home-based nursing care is a complex area and discourse analysis of the relation between home-based nursing care, subject positions, ethics and gender is more or less lacking. Exploring home-based nursing care outgoing from discourse analytic perspectives and methods is rewarding for nurses‟ practice, education and research as it opens up new perspectives of home-based nursing care.

  • 2359. Öresland, Stina
    et al.
    Lutzen, Kim
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rasmussen, Birgit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Maatta, Sylvia
    Nurses as 'guests' - a study of a concept in light of Jacques Derrida's philosophy of hospitality2013In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 14, no 2, p. 117-126Article in journal (Refereed)
    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.

  • 2360.
    Öresland, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lützén, Kim
    Institutionen för Neurobiologi, Vårdvetenskap och Samhälle (NVS), Sektionen för Omvårdnad, Huddinge, Karolinska Institutet.
    Määttä, Sylvia
    Institutionen för vårdvetenskap och hälsa, Göteborgs universitet.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rasmussen, Birgit H
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses go visitingManuscript (preprint) (Other academic)
  • 2361.
    Öresland, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Määttä, Sylvia
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jörgensen, Marianne Winther
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Lützén, Kim
    Nurses as guests or professionals in home health care2008In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 15, no 3, p. 371-383Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and interpret the diverse subject of positions, or roles, that nurses construct when caring for patients in their own home. Ten interviews were analysed and interpreted using discourse analysis. The findings show that these nurses working in home care constructed two positions: ;guest' and ;professional'. They had to make a choice between these positions because it was impossible to be both at the same time. An ethics of care and an ethics of justice were present in these positions, both of which create diverse ethical appeals, that is, implicit demands to perform according to a guest or to a professional norm.

  • 2362.
    Öresland, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Määttä, Sylvia
    Institutionen för vårdvetenskap och hälsa, Göteborgs universitet.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lützén, Kim
    Institutionen för Neurobiologi, Vårdvetenskap och Samhälle (NVS), Sektionen för Omvårdnad, Huddinge, Karolinska Institutet.
    Home-based nursing: an endless journey2011In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 18, no 3, p. 408-417Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore metaphors for discovering values and norms held by nurses in home-based nursing care. Ten interviews were analysed and interpreted in accordance with a metaphor analytical method. In the analysis, metaphoric linguistic expressions and two entailments emerged, grounded in the conceptual metaphor ‘home-based nursing care is an endless journey’, which were created in a cross-domain mapping between the two conceptual domains of home-based nursing care and travel. The metaphor exposed home-based nursing care as being in constant motion, thereby requiring nurses to adjust to circumstances that demand ethical maturity. The study focuses on the importance of developing further theories supporting nurses’ expressions of their experiences of everyday ethical issues.

  • 2363.
    Öresland, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Määttä, Sylvia
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lützén, Kim
    Patients as 'safeguard' and nurses as 'substitute' in home health care2009In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 16, no 2, p. 219-230Article in journal (Refereed)
    Abstract [en]

    One aim of this study was to explore the role, or subject position, patients take in the care they receive from nurses in their own home. Another was to examine the subject position that patients say the nurses take when giving care to them in their own home. Ten interviews were analysed and interpreted according to a discourse analytical method. The findings show that patients constructed their subject position as 'safeguard', and the nurses' subject position as 'substitute' for themselves. These subject positions provided the opportunities, and the obstacles, for the patients' possibilities to receive care in their home. The subject positions described have ethical repercussions and illuminate that the patients put great demands on tailored care.

  • 2364.
    Öster, Inger
    Umeå University, Faculty of Medicine, Omvårdnad.
    Bildterapi vid bröstcancer: Kvinnors berättelser i ord och bild2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aims of this thesis are to describe women’s experiences of breast cancer from a gender perspective, describe women’s experiences of an art therapy intervention and the effects of an art therapy intervention on self-rated coping resources and quality of life. The thesis presents results from a study with 42 women with primary breast cancer without distance metastasis who participated in a randomized intervention study with art therapy carried out between 2001 and 2004. All women were recruited as they were referred to the Department of Oncology at Umeå University Hospital in northern Sweden for postoperative radiotherapy. They were randomized to an intervention group (n = 20) with individual art therapy for 1 hour/week during postoperative radiotherapy, or to a control group (n = 22). The women were between 37–69 years old and had a range of educational and socioeconomic backgrounds. All 42 women completed questionnaires in connection with three interview occasions during six months: at baseline (start of radiotherapy), two and six months later. The questionnaires assessed coping resources, quality of life, symptoms, and self-image. In addition, all women were interviewed about their experiences, and were asked to write a weekly diary about their experiences of breast cancer during the six months of participation. All women signed a written consent form in which they were assured voluntariness and that ending their participation would not affect the care or medical treatment in any way. The study protocol was approved by the Umeå University Ethical Committee at the Medical Faculty (archive number 99-386). In this thesis, part of results from the study is reported.

    The results presented in the first study show an overall increase in coping resources as measured by the Coping Resources Inventory (CRI) among women with breast cancer after taking part in the art therapy intervention. Significant differences were seen between the study group and the control group in the total score on the second occasion and in the social domain on the second and third occasions.

    The second study reports results of the art therapy intervention, with regard to quality of life aspects as measured by the instruments WHOQOL-BREF and EORTC QLQ-BR23, at baseline (start of radiotherapy) and two and six months later. Significant increases in total health, total quality of life, physical health and psychological health were found in the art therapy group compared to the control group. A significant positive difference was also found within the intervention group, concerning future perspectives, body image and systemic therapy side effects.

    The third study builds on previous quantitative results, drawing on gender theories and, taking a discursive approach in analyzing the women’s use of interpretative repertoires in diaries and interviews. The results show 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. A connection between the control group, repertoire conflicts, and lower scores on the CRI was also found.

    The fourth study presents further knowledge about women’s trajectories, in art therapy, towards helpful management of restraining boundaries. We were inspired by discursive psychology and the analytic concept of subject position. The result shows that art therapy helped women to get access to subject positions that enabled them to protect and strengthen their boundaries and put forward their own needs.

    Taken together, the results from all four studies support art therapy as a valuable complement in oncology care and rehabilitation of women with primary breast cancer in similar contexts.

  • 2365.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hedestig, Oliver
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Johansson, Mona
    Umeå University, Faculty of Medicine, Department of Nursing.
    Klingstedt, Nina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Sharing experiences in a support group: men's talk during the radiotherapy period for prostate cancer2013In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 11, no 4, p. 331-339Article in journal (Refereed)
    Abstract [en]

    Objective: Prostate cancer, one of the most common cancers in men, is often treated with radiotherapy, which strains both physical and mental health. This study aimed to describe the experiences of men living with prostate cancer shared within conversational support groups during a course of radiotherapy. Method: Nine men participated in one of two groups that met six or seven times, led by a professional nurse. Qualitative content analysis was used to identify themes and subthemes in the recorded group conversations. Results: The analysis resulted in six themes: living with a changing body, being in the hands of others, learning to live with the disease, the importance of knowledge, everyday life support, and meeting in the support group. The men discussed a wide variety of bodily experiences and described support from healthcare professionals, relatives, friends, and the support group as crucial to their recovery. Significance of results: Meeting men in a similar situation, sharing experiences of living with the disease, and feeling allied to each other were important to the men in our study. The conversational support group provided the patient with prostate cancer a forum where sharing was made possible.

  • 2366.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Omvårdnad.
    Magnusson, E
    Thyme, K E
    Lindh, J
    Åström, Sture
    Umeå University, Faculty of Medicine, Omvårdnad.
    Erratum to "Art therapy for women with breast cancer: The therapeutic consequences of boundary strengthening" [Arts Psychother. 34 (2007) 277-288] (DOI:10.1016/j.aip.2007.04.003)2008In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 35, no 3, p. 242-Article in journal (Other (popular science, discussion, etc.))
  • 2367.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Magnusson, Eva
    Umeå University, Faculty of Social Sciences, Centre for Women's Studies.
    Egberg Thyme, Karin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Art therapy for women with breast cancer: the therapeutic concequences of boundary strenghtening2007In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 34, no 3, p. 277-288Article in journal (Refereed)
    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.

  • 2368.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Svensk, Ann-Christine
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Magnusson, Eva
    Umeå University, Faculty of Social Sciences, Centre for Women's Studies.
    Thyme Egberg, Karin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Sjõdin, Marie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Aström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Art therapy improves coping resources: a randomized, controlled study among women with breast cancer.2006In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 4, no 1, p. 57-64Article in journal (Refereed)
    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.

  • 2369.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Tavelin, Björn
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Edberg Thyme, Karin
    Magnusson, Eva
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Art therapy during radiotherapy – A five-year follow-up study with women diagnosed with breast cancer2014In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 41, no 1, p. 36-40Article in journal (Refereed)
    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.

  • 2370.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Tavelin, Björn
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Egberg Thyme, Karin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Magnusson, Eva
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Art therapy during radiotherapy: a five-year follow-up study with women diagnosed with breast cancer2014In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 41, no 1, p. 36-40Article in journal (Refereed)
    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.

  • 2371.
    Öster, Inger
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Magnusson, Eva
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Women with breast cancer and gendered limits and boundaries: Art therapy as a safe space for enacting alternative subject positions2009In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 36, no 1, p. 29-38Article in journal (Refereed)
    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.

  • 2372.
    Östlund, Ida
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundgren, Mattias
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kvinnors erfarenheter av cytostatika-inducerad alopeci: En kvalitativ litteraturstudie2019Independent thesis Basic level (university diploma), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Background: Hair loss is a common side effect of chemotherapy treatment. It has a negative impact on quality of life and causes suffering. The nurse needs a greater understanding of the suffering the woman endures in order to support her.

    Aim: To describe women’s experiences of hair loss caused by chemotherapy treatment against cancer.

    Method: A qualitative literature review containing eight empirical studies analysed with inspiration of Febe Friberg.

    Result: Women could react with acceptance, great chock or see the hair loss as a necessary evil. Need for information and support was expressed and some shortened their hair in preparation. The hair loss could give psychical pain, sense of not recognizing oneself, threaten identity, sexuality and femininity and to be identified and stigmatized as “cancer patients”. Wigs and head coverings could hide the hair loss in order to protect the children and the people around them. Support from family and friends was needed. For some, the return of hair symbolised an end to the disease.

    Conclusion: Hair loss affects women psychically and mentally. The nurse can contribute with person-centred information and support which may alleviate suffering and support the woman to accept and cope with the hair loss.

  • 2373. Östlund, Ulrika
    et al.
    Bäckström, Britt
    Lindh, Viveca
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses' fidelity to theory-based core components when implementing Family Health Conversations: a qualitative inquiry2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 3, p. 582-590Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIM: A family systems nursing intervention, Family Health Conversation, has been developed in Sweden by adapting the Calgary Family Assessment and Intervention Models and the Illness Beliefs Model. The intervention has several theoretical assumptions, and one way translate the theory into practice is to identify core components. This may produce higher levels of fidelity to the intervention. Besides information about how to implement an intervention in accordance to how it was developed, evaluating whether it was actually implemented as intended is important. Accordingly, we describe the nurses' fidelity to the identified core components of Family Health Conversation.

    INTERVENTION AND RESEARCH METHODS: Six nurses, working in alternating pairs, conducted Family Health Conversations with seven families in which a family member younger than 65 had suffered a stroke. The intervention contained a series of three-1-hour conversations held at 2-3 week intervals. The nurses followed a conversation structure based on 12 core components identified from theoretical assumptions. The transcripts of the 21 conversations were analysed using manifest qualitative content analysis with a deductive approach.

    RESULTS AND CONCLUSION: The 'core components' seemed to be useful even if nurses' fidelity varied among the core components. Some components were followed relatively well, but others were not. This indicates that the process for achieving fidelity to the intervention can be improved, and that it is necessary for nurses to continually learn theory and to practise family systems nursing. We suggest this can be accomplished through reflections, role play and training on the core components. Furthermore, as in this study, joint reflections on how the core components have been implemented can lead to deeper understanding and knowledge of how Family Health Conversation can be delivered as intended.

  • 2374. Östlund, Ulrika
    et al.
    Bäckström, Britt
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Viveca
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    A Family Systems Nursing Approach for Families Following a Stroke: Family Health Conversations2016In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 22, no 2, p. 148-171Article in journal (Refereed)
    Abstract [en]

    Stroke in midlife is a life altering, challenging experience for the whole family thereby necessitating a family approach to intervention. The aim of this study was to describe the experiences of 17 family members living in Sweden, including seven adult stroke patients (six males; one female) under the age of 65 who participated in a series of three nurse-led family conversations that were offered in each family's home. These Family Health Conversations (FamHC) were guided by the conceptual lens of Family System Nursing. Individual, semi-structured, evaluative interviews conducted with each participant one month after the FamHC were analyzed by qualitative content analysis. The FamHC were described by family members as a unique conversation that they had not previously experienced in health care contexts. Family members described possibilities for relational sharing and meaningful conversations as well as changes in family functioning that support the suitability of FamHC for family stroke care.

  • 2375.
    Öström, Ia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Tesfay, Arsiema
    Umeå University, Faculty of Medicine, Department of Nursing.
    Legitimerade sjuksköterskors upplevelser av att handleda sjuksköterskestudenter under verksamhetsförlagd utbildning: En litteraturstudie2019Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Background: The meaning of preceptorship may vary depending on the context. Precepting nursing students during clinical practice is considered a mandatory assignment for Registered Nurses in Sweden. However, many nurses consider themselves unprepared for the task and inadequately supported by their peers and managers.

    Aim: The purpose of this study was to explore Registered Nurses’ experiences of precepting nursing students during clinical practice.

    Method: A literature study was conducted and the results of eight qualitative studies were compiled and analyzed. The databases used for searching scientific articles were CINAHL and PubMed.

    Findings: The results were compiled into three categories: Lack of organizational conditions, Preceptorship as an individual responsibility and Preceptorship as an opportunity for development. By precepting students nursing preceptors experienced new insights in their way of working and were also able to contribute to the education of possible future colleagues. With increased support and communication between managers, faculty and the nursing preceptor it is possible the role as preceptor could be improved.

    Conclusion: A continuous lack of support for nursing preceptors may lead to the student being deprived of valuable preconditions to develop from novice to expert.

    The nursing preceptor is an invaluable bridge between theory and practice and therefore should be given adequate support to be able to accomplish the task of precepting, while providing patient-safe and evidence-based care worthy of the future.

     

    Keywords: Nurse, Experiences, Preceptorship, Nursing student, Clinical practice, Literature study.

  • 2376.
    Överby, Kari
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rådman, Agneta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Utmaningar vad gäller smärtlindring hos patienter som vårdas på postoperativ avdelning - anestesisjuksköterskors upplevelser2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Research has shown that despiteacademic progress in fields of pain physiology and analgesic/anaesthetic medicine, patients are still experiencing postoperative pain. The anaesthetic nurse play a central role in the prevention, discovery and treatment of postoperative pain. Motive: To the authors knownledge there is no Swedish study that examines anaesthetic nurses´experience of care and treatment for patients with pain in hospital recovery units. Research in this area could contribute to improvements in the care of postoperative patients. Aim: To document anaesthetic nurses´experiences and challenges in caring for patients´postoperative pain in hopspital recovery units. Methods: A qualitative semi-structured interview methodology was adopted in this study. Interviews were conducted in autumn 2018. Interview subjects were 10 anaesthetic nurses´who work both in recovery and operation units. A qualitative analysis was then applied to the data collected. Result: 3 categories and 11 sub-categories were identified. These 3 categories were: prediction and proactivity, attentiveness and perception and administration of medicine and teamwork. The categories reveal som of the challenges the anaesthetic nurse face in the prevention, discovery and treatment of postoperative pain. Discussion: There are several challenges that anaesthetic nusres´are well aware of and which effect their capacity to treat pain. These challenges are dependent on the specific needs of patients, patients prerequisites as well as organisational structure. As such, staff responsible for patient care should be attentive to patients´specific needs as well as plan perioperative treatment/care in consultation with the patient. This would achieve the best patient outcomes as well as giving the perioperative staff the ability to predict and prevent postoperative pain trough treatment. Conclusion: This study shows that anaesthetic nurses´do their upmost to reduce postoperative pain. Nurses were aware of challenges. These may be avoided by adopting a more individualised care approach. Keywords: Anaesthetic nurse, postoperative pain, pain relief, experiences, nursing.

  • 2377.
    Överhem, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Westin, Harriet
    Umeå University, Faculty of Medicine, Department of Nursing.
    Skolsköterskors erfarenheter av hälsofrämjande arbete med överviktiga barn2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt

    Introduktion: Övervikt och fetma är ett snabbt växande problem som kryper allt längre ner i

    åldrarna, och kan innebära många hälsorisker, såväl fysiska som psykiska. Barn med övervikt

    och fetma löper stor risk att förbli överviktiga även i vuxen ålder. Skolhälsovården spelar en

    betydande roll i arbetet mot övervikt. Syfte: Att beskriva skolsköterskors erfarenheter av

    hälsofrämjande arbete med överviktiga barn. Metod: Individuella semistrukturerade

    intervjuer med åtta skolsköterskor genomfördes. Materialet analyserades med hjälp av

    kvalitativ innehållsanalys. Resultat: Analyserna resulterade i fyra kategorier och tolv

    underkategorier. Rådgivning, stöd och att göra barn och familjer delaktiga tillhör kärnan i

    skolsköterskans hälsofrämjande arbete med överviktiga barn. Föräldrarna kunde upplevas

    vara både ett hinder och en tillgång i arbetet. Slutsats: Skolsköterskan behöver vara en god

    samtalspartner, och erbjuda stöd till både elever och föräldrar för att arbetet mot övervikt ska

    bli framgångsrikt. Tydliga riktlinjer förenklar skolsköterskans arbete, och underlättar

    samarbetet med andra yrkeskategorier.

    Nyckelord: barn, övervikt, skolsköterskor, erfarenheter, hälsofrämjande arbete, intervju,

    kvalitativ innehållsanalys

  • 2378.
    Övling, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kvarnström, Carina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Barn som anhörig: distriktssköterskors hantering inom primärvården i Västerbotten2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Barn till föräldrar med svår psykisk eller somatisk sjukdom, med missbruk eller som avlidit, har ökad risk för framtida psykisk ohälsa. Hälso- och sjukvårdslagen samt Patientsäkerhetslagen fick ett tillägg 2010/2011 med syfte att uppmärksamma och stärka gruppen barn som anhöriga. Tilläget i lagen har tagit lång tid att implementera i sjukvården.

    Syfte: Syftet med denna studie är att beskriva i vilken omfattning distriktssköterskor inom primärvården i Västerbotten identifierar barn till förälder/annan närstående med missbruk, psykisk ohälsa, allvarlig fysisk sjukdom eller när förälder/annan närstående avlider och om dessa barn följs upp med information, råd och stöd.

    Metod: En omarbetad version av en enkät som använts i en uppsats på Masterprogrammet i hälsovetenskap vid Karlstad universitet användes. Enkäten skickades först ut som webbenkät men på grund av låg svarsfrekvens distribuerades en pappersenkät under distrikssköterskedagarna i Umeå. Studien vände sig till 190 distriktssköterskor på hälsocentraler i Västerbotten, varav 79 deltog. SPSS 23 användes för analysering av materialet.

    Resultat: Resultatet visar att vetskap om riktlinjer samt utbildning inom området bidrar till att barn som anhöriga identifieras i högre grad. Kunskap om journalföring samt vetskap om riktlinjer är låg och det är få distriktssköterskor som har fått utbildning inom ämnet barn som anhörig. 

    Slutsats: Utbildning, kunskap om riktlinjer och journalföring är de viktigaste faktorerna för att öka medvetenheten om barn som anhöriga.  

     

    Nyckelord: Barn som anhöriga; psykiskt sjuk förälder; somatiskt sjuk förälder; förälder med missbruk; familjefokuserad omvårdnad.

  • 2379.
    Övre, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bogebrant, Marie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Barnsjuksköterskors erfarenheter av att använda icke farmakologiska metoder i syfte att minska  oro och smärta hos barn: En intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: To describe the pediatric nurses´ experience of using non – pharmacological methods to lessen children’s anxiety and perceived pain during medical procedures.

    Background: Insufficient alleviation of anxiety and pain in children will have negative consequences later in life. Perceived pain that remain in memory may lead to a negative experience in later contact with healthcare. Non - pharmacological methods has proven to play an important role in lessen anxiety and pain in children during medical procedures.

    Design: Qualitative study with inductive approach

    Method: Interviews were conducted with 10 pediatric nurses at two children wards at hospitals in southern Norrland. The interviews were semi-structured and analyzed with qualitative content analysis.

    Result: Three categories appeared in the result; treatment of the child, where the pediatric nurse describes the importance of meeting every single child at his level, flexible ways of working where distraction and time are important components that reduce anxiety and pain of the child and also experienced procedural difficulties where parents, negative experiences or inability to distract complicates the pediatric nurse’s ability to sustain patient safety and creates anxiety for the child. The pediatric nurses worked efficiently with non - pharmacological methods in order to give the children a good experience while creating good conditions for sustaining patient safety. Distraction was combined with preparation and the pediatric nurses advocated good communication with children and their parents. The pediatric nurses stated that difficulties with distraction mean that it is not always possible to use properly and can become a negative experience for the child and the pediatric nurse.

    Conclusion: The result emphasizes the importance of being responsive and working with a child perspective and looking at each child's specific needs. Pediatric nurses experience of using non – pharmacological methods shows benefits for both the child, parent and the pediatric nurse.

  • 2380.
    Üzüm, Damla
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ljungkvist, Emma
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att vårda patienter med omsorg inte med rädsla: En litteraturstudie om sjuksköterskors upplevelser av att vårda patienter med HIV/AIDS2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: På 80-talet upptäcktes förvärvat immunbristsyndrom (AIDS) och humant immunbristvirus (HIV) för första gången. 35 miljoner människor lever med HIV idag varav 19 miljoner är omedvetna om att de bär på smittan. Därför är det tänkbart att som sjuksköterska någon gång under sina yrkesverksamma år kommer att komma i kontakt med sjukdomen. Syfte: Syftet med litteraturstudien var att belysa sjuksköterskors upplevelser av att vårda patienter med HIV/AIDS. Metod: En litteraturstudie har använts där material har metodiskt sökts, kritiskt granskats och sammanställts. Åtta kvalitativa artiklar har inkluderats i studien. Resultat: Analysen resulterade i två huvudkategorier ”Faktorer som bidrar till god vård för patienter med HIV/AIDS” och ”Upplevda hinder i omvårdnaden av patienter med HIV/AIDS” samt sex subkategorier. Slutsats: En bidragande orsak till att rädsla uppstår hos sjuksköterskor i omvårdnaden av patienter med HIV och AIDS är att de saknar tillräcklig med kunskap och erfarenhet. Sjuksköterskorna som själva valt att arbeta på AIDS avdelningar kände empati för sina patienter. En del sjuksköterskor upplever att de blir diskriminerade av samhället på grund av att de vårdar patienter med HIV/AIDS. I vissa länder förekommer det brist på arbetsmaterial vilket leder till en ökad rädsla för att bli smittad. Kontinuerlig utbildning är viktigt för att behålla och utveckla kunskapen och kunna erbjuda god omvårdnad på lika villkor. 

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