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  • 351.
    Dorell, Åsa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bäckström, Britt
    Ericsson, Marie
    Johansson, Maria
    Östlund, Ulrika
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Experiences With Family Health Conversations at Residential Homes for Older People2016In: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 25, no 5, p. 560-582Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to highlight family members' experiences of participating in Family Health Conversation (FamHC), based on families in which a family member was living in a residential home for older people. A total of 10 families and 22 family members participated in evaluating family interviews 1 month after participating in FamHC. The interviews were analyzed by qualitative content analysis. The main finding was being a part of FamHC increased family members' insights, understanding, and communication within the family. Getting confirmation from nurses was essential to cope with the new life situation, which also meant that they felt comfortable to partly hand over the responsibility for the older person who moved to the residential home. By being open and expressing their feelings, a bad conscience could be relieved. These findings showed that FamHC could be helpful for family members in adapting to this novel situation.

  • 352.
    Dorell, Åsa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Östlund, Ulrika
    Centre for Research & Development, Uppsala University/ Region Gävleborg, Gävle.
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Family Health Conversations have positive outcomes on families: A mixed method studyArticle in journal (Refereed)
    Abstract [en]

    Background: A Family Systems Nursing intervention, “Family Health Conversations” (FamHC) was conducted in order to strengthen the health of families having relatives at residential home for older people. Having a family member living in a residential home affects the entire family and can be hard to handle. Family members require encouraging and open communication support from nurse during and after relocation to a residential home.

    Objectives: The aims of this study were to evaluate the responses to and effects of the Family Health Conversations in families with a member living at a residential home for older people and to integrate the empirical results with a theoretical assumption upon which the intervention was based.

    Methods: A mixed method research design was used. The Swedish Health-Related Quality of Life Survey and the Family Hardiness Index were administered before and 6 months after the intervention. Qualitative data was collected by semi-structured interviews with each family 6 months post-intervention. The sample included families of residents, a total of 10 families comprising 22 family members.

    Result: Main finding was that FamHCs helped family members process their feelings about having a member living at a residential home and made it easier for them to deal with their own situations. FamHCs helped to ease their consciences, improve their emotional well-being, and change their beliefs about their own insufficiency and guilt. Seeing problems from a different perspective facilitated the families’ thinking in a new way.

    Conclusion: These findings showed that FamHC can be an important type of intervention to improve family functioning and enhance the emotional well-being.

  • 353.
    Dorell, Åsa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Becoming visible: Experiences from families participating in Family Health Conversations at residential homes for older people2016In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 37, no 4, p. 260-265Article in journal (Refereed)
    Abstract [en]

    Having a sick family member living at a residential home for older people can be difficult for families, who as a result often suffer from feelings of forsakenness and powerlessness. In response, the purpose of this study was to illuminate family members' experiences with participating in Family Health Conversations at residential homes for older persons 6 months after concluding the conversation series. Twenty-two family members who participated in the conversations later took part in group interviews, the texts of which were analyzed according to qualitative content analysis. Findings showed that participating in Family Health Conversations mediated consolation, since within such a liberating communicative interaction, family members for the first time felt visible as persons with individual significance. Family members reported a positive experience involving both being open to each other and speaking and listening to each other in a new, structured way. As a result, families were able to discover their family members' problems and suffering, as well as to identify their family's resources and strengths.

  • 354.
    Dorell, Åsa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Östlund, Ulrika
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses' perspective of conducting family conversation2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 30867Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Nurses are in a prime position to manage to support families that have a family member living in a residential home for older people. Nurses' attitudes about meeting patients' family members vary. Studies describe that some nurses consider family members as a burden. But some nurses consider family members a resource and think it is important to establish good relationships with them.

    AIM: The aim of this study was to describe how registered nurses (RNs) experienced to participate in and conduct the intervention Family Health Conversations (FamHCs) with families in residential homes for older people.

    METHODS: The intervention FamHC was accomplished at three residential homes for older people. FamHC is a family systems nursing (FSN) intervention developed to support families facing the ill health of someone in the family. One RN from each residential home conducted the conversations. The RNs wrote diary notes directly after each conversation. The RNs were also interviewed 1 month after they had each conducted four FamHCs. The diary notes and the interviews were analysed separately by qualitative content analysis, and the findings were then summarized in one theme and further discussed together.

    FINDINGS: The main findings were that the RNs experience the conversations as a valuable professional tool involving the whole family. The RNs grasped that silence can be a valuable tool and had learned to attentively listen to what the families were saying without interrupting, allowing them and the families to reflect upon what the family members said.

    CONCLUSION: The findings show that the FamHC can be helpful for RNs in their work, helping them to perceive and understand the needs and desires of the families.

  • 355.
    Dunhäll, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Fossland, Ulrika
    Umeå University, Faculty of Medicine, Department of Nursing.
    En resa där toppas och dalar bör undvikas: En litteraturstudie om ungdomars upplevelse av att leva med sjukdomen typ 1-diabetes.2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In Sweden, around 7000-8000 children and adolescents live with type 1- diabetes. Youth is a period of constant turmoil, confusion and alienation. To have an illness at that age can be perceived as a life readjustment since the disease makes great demands on the capacity to self-management. Purpose: The purpose of this study was to elucidate adolescent’s experience of living with type 1-diabetes. Method: Study search was performed in the databases CINAHL, PubMed, Scopus and ub.umu's search engine together with manual search. The literature study compiled of eight qualitative empirical studies. The studies were analyzed with ‘analysis of content’ based on Friberg analysis. The young people in the trials were between 12-18 years. Results: Adolescent’s experience of living with type 1 diabetes is individual and diverse. The experiences can switch between manageability and hopelessness, feeling normal and different and also experience of the possibilities and limitations. Adolescent’s varied also between a sense of confidence in their own abilities over their treatment, and frustration, guilt, anxiety and uncertainty about the lack of own capacity. Conclusion: Adolescents' experiences demonstrate the need for person-centered care and a greater knowledge of their situation in life. The authors believe that there is further need for the nurse's insight that approach may impact on adolescence´s quality of life. The literature study may contribute to increased understanding of the need for further research into young people's experience of living with type 1- diabetes and how the nurse's attitude can have effects on young people's quality of life.

    Keywords: Adolescenc*. Life experience. Type 1-diabetes. Nursing care.

  • 356.
    Duzgun, Ramazan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mohammad, Sonia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Unga och vuxna kvinnors upplevelser av att leva med Anorexia Nervosa.- En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Eating disorders has become more common and an increase occurs among all ethnic’s groups. Anorexia nervosa is recognized by the fact that the persons has a false image of themselves and a fear of getting fat.Aim: The aim of this study was to illustrate young and adult women’s experiences of living with anorexia nervosa.Method: A literature review based on eight qualitative studies where the result has been quality audited, analyzed and compiled. The databases which have been used to find different studies are CINAHL, PsycINFO and PubMed.Result: The main results of the study shows that the anorexia nervosa causes lots of pain and suffering for women's and that there is an ambivalence to recover from the disorder. The limitations of living with anorexia nervosa, often came with a price of isolation, shame and feelings of guilt.Conclusion: Anorexia nervosa provides control, stability and was a way for the women to cope with negative emotions.

  • 357.
    Dyborn, Julia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mella, Josefine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Åtgärder för att minska stråldoser till patient vid interventionell radiologi: - En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Measures aiming to reduce the radiation doses to patients undergoing interventional radiology – A literature review

     

    Background: It's important during radiological procedures that the advantages outweighs the risks. Patients should only be exposed by radiation that can be motivated. The responsability to optimize the radition dose lays with the radiographer and methods to reduce the dose should therefore be researched.

     

    Aim: To describe measures aiming to reduce the radiation doses to patients undergoing an examination within interventional radiology.

     

    Method: The aim was met through a literature review with ten quantitative studies. The search for literature was done in two databases.

     

    Results: The results were organized in two domains; measures that could be done before examination and measures that could be done during examination. Five categories were formulated; upgrade of software and hardware, upgrade of control panel, use of techniques with predetermined programs, use of Dynamic Trace Digital Angiography (DTDA) and spot flouroscopy and use of low-dose parameters.

     

    Conclusion: The results showed that an upgrade of equipment and use of different techniques may reduce the radiation dose. Through this literature review and more research within this area the radiographer may be helped with optimizing the dose.

                                                         

  • 358.
    Edelbro, Mia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Helander, Johanna
    Umeå University, Faculty of Medicine, Department of Nursing.
    "Män kan ju inte amma...": - en fokusgruppsstudie om blivande förstagångsföräldrars diskurser kring amning och jämställt föräldraskap2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt

    ”Män kan ju inte amma...”- en fokusgruppsstudie om blivande förstagångsföräldrars diskurser kring amning och jämställt föräldraskap

    Mia Edelbro och Johanna Helander

    Syfte: Att undersöka blivande förstagångsföräldrars diskurser runt amning och jämställt föräldraskap samt hur de diskuterar barnmorskors roll kring amning och jämställt föräldraskap.

    Design: Kvalitativ fokusgruppsdiskussion som analyserats med diskursanalys med inspiration av diskursteoretiskt perspektiv.

    Studiekontext: En stad i norra Sverige.

    Deltagare: 17 blivande förstagångsföräldrar, 11 deltagare rekryterades med hjälp av barnmorskor via föräldrautbildning och sex deltagare genom nyckelpersoner. Deltagarna har fördelats på fyra mixade fokusgrupper. Deltagarna utgjordes av åtta män och nio kvinnor i åldrarna 24-33 år. Alla deltagare hade genomgått gymnasial utbildning eller högre.

    Resultat: Ur analysen framkom tre diskurser: Amning och matning av spädbarn, Att göra jämställdhet i praktiken samt Barnmorskors påverkan på blivande föräldrar. Amning och matning av spädbarnet diskuterades som en specifik uppgift. Amning identifierades som norm och beskrevs som svårt. Att amma offentligt lyftes som problematiskt hos andra. Då män inte kan amma ansågs amning inte vara jämställt. Att ge männen möjligheten att vara med och mata barnet beskrevs som viktigt för barnets anknytning. Jämställt föräldraskap var en utmaning som pendlade mellan att dela lika eller att lösa efter behov, ofta handlade jämställt föräldraskap om att män måste involveras i uppgifter kring barnet, hemmet och att ta ut föräldraledighet då det sågs som norm att kvinnor är i hemmet den första tiden. Barnmorskor beskrevs kunna påverka blivande föräldrar och verka för jämställdhet, framförallt genom att involvera männen. Detta genom stöttning inför föräldraskapet och genom att informera om amning. Barnmorskor ansågs förespråka endast amning och bidra till amningsnormen. Det diskuterades att barnmorskor behöver inkludera alternativ till amning i deras information.

    Slutsats: Amning uppfattas som svårt och kan problematiseras i relation till det jämställda föräldraskapet. För att öka jämställdheten i föräldraskapet behöver männen involveras och där har barnmorskor en roll. Amningens fördelar är inte central i diskursen om amning och barnmorskor behöver lyfta fördelarna ytterligare i mötet med blivande föräldrar.

    Kliniska implikationer: Mer resurser behövs för att barnmorskor ska kunna ges möjlighet att utveckla sitt stöd till blivande föräldrar. Förstagångsföräldrar kan behöva mer kunskap om amningens fördelar för kvinnor och barn samt hjälp att nyansera uppfattningen om att amning är svårt.

    Nyckelord: Jämställdhet, Amning, Barnmorskor, Diskursanalys, Fokusgrupp, Förstagångsföräldrar

    Abstrakt och referenslista är anpassade enligt tidskriften Midwiferys författarguide.

  • 359.
    Edholm, Angelique
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nyberg, Peter
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vårdpersonalens följsamhet till riktlinjer för handhygien: En litteraturstudie2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Vårdrelaterade infektioner är vanligt förekommande över hela världen.Det innebär en hög kostnad, ökat lidande och medför fler vårddygn för patienten.God handhygien är den viktigaste påverkbara faktorn för att minska vårdrelateradeinfektioner. Det är sjuksköterskans ansvar att säkerställa rutiner för en godhandhygien.

    Syfte: Syftet är att beskriva vårdpersonalens följsamhet till riktlinjer för handhygien.

    Metod: En litteraturstudie där datainsamlingen valdes att göra från 10 olikakvantitativa studier. Genom analysen gjordes en sammanställning av de resultat somsvarade på vårt syfte och frågeställningar.

    Resultat: Resultatet redovisas i tre stapeldiagram med tillhörande text. Förstarubriken är följsamhet till riktlinjer för handhygien medel %. De två andradiagrammen är följsamhet till riktlinjer för handhygien före och efter patientkontaktsamt sjuksköterskor och läkares följsamhet till riktlinjer för handhygien. Huvudfynden i litteraturstudien visade att följsamhet till handhygien varierar i allastudier och att det är statistiskt säkerställt att fler vårdpersonal utför handhygienefter patientkontakt än före samt att fler sjuksköterskor än läkare följde riktlinjer förhandhygien.

    Konklusion: Det finns brister i följsamhet till handhygien. Kunskapen omsmittspridning och handhygien mellan olika arbetsmoment i den patientnära vårdenär otillräcklig. Ytterligare forskning behövs och alla länder måste sträva efter sammamål.

  • 360.
    Edholm, Miriam
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Westin, Lisett
    Umeå University, Faculty of Medicine, Department of Nursing.
    Anhörigas upplevelser när en familjemedlem flyttar till ett särskilt boende för äldre: Relatives’ experiences when a family member move to a residential home for older people2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Omorganisation inom vården ställer högre krav på anhöriga då fler vårdas i hemmet. Därför behövs mer kunskap om anhörigas situation för att stärka familjehälsan. Syfte: Syftet med studien var att belysa hur anhöriga upplever sin situation i flyttprocessen före, under och efter flytten av en vårdbehövande familjemedlem till ett särskilt boende för äldre, vilket framkom vid hälsostödjande familjesamtal.

    Metod: Åtta familjer deltog i en samtalsserie av tre samtal. Samtalen analyserades med kvalitativ innehållsanalys.

    Resultat: Huvudresultatet visade på att före flytten upplevdes livssituationen som ohållbar med ett krävande ansvar. Under flytten upplevdes både känslor av frid och frustration. Efter flytten upplevdes sorg, varierat förtroende för boendet, att de anhöriga ville behålla relationen med den vårdbehövande och en förändrad familjesituation.

    Slutsats: Anhörigas upplevelser var varierande under flyttprocessen. Distriktsköterskan bör vara synlig och finnas som stöd.

  • 361.
    Edin, Karolina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Westerholm, Moa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Patienters erfarenheter av att vårdas för anorexia nervosa inom slutenvård: En litteraturstudie2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Anorexia nervosa is a disease where self-starvation leads to underweight. People with the disease have a disturbed body image which affects their self-esteem. Symptoms include low body weight, excessive weight loss, mental illness and absent periods. Treatment includes prevention along with acute psychiatric and somatic interventions. Anorexia nervosa can be treated in outpatient care, day care or inpatient care. Aim: The aim of this study was to describe individuals’ experiences of being treated for anorexia nervosa in inpatient care. Method: A literature review based on eight qualitative research articles. A literature search was conducted in CINAHL with Full Text and PubMed. Searches were also conducted in Medline, PsycINFO and AMED but no further hits were found. Results: The analyze identified three major themes and eight subthemes. The themes were “Loss of control and a desire for participation”, “Equal relationships and support” and “Responsibility and learning for life”. Conclusion: Anorexia nervosa is a complex disease to be treated for. Nursing staff must understand patients’ experiences of care to be able to give the best care possible. This understanding can contribute to a patient-centered care in the meeting with these patients.

  • 362.
    Edin, Kerstin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Nilsson, Bo
    Umeå University, Faculty of Arts, Department of culture and media studies. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Between desire and rape - narratives about being intimate partners and becoming pregnant in a violent relationship2013In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 6, p. 20984-Article in journal (Refereed)
    Abstract [en]

    Background: Women subjected to intimate partner violence (IPV) experience different forms of abuse. Sexual violence is often under-reported because physically abused women, in particular, might see forced sex as an obligatory part of the sexual interplay. Accordingly, abused women have less sexual autonomy and experience unplanned pregnancies more often than other women. Objective: To describe and analyse nine Swedish women's retrospective stories about IPV with a focus on power and coping strategies as intimate partners, particularly regarding experiences of sex, contraception, and becoming pregnant. Design: Nine qualitative interviews were carried out with women who had been subjected to very severe violence in their intimate relationships and during at least one pregnancy. The stories were analysed using 'Narrative method' with the emphasis on the women's lived experiences. Results: Despite the violence and many contradictory and ambivalent feelings, two of the women described having sex as desirable, reciprocal and as a respite from the rest of the relationship. The other seven women gave a negative and totally different picture, and they viewed sex either as obligatory or as a necessity to prevent or soothe aggression or referred to it as rape and as something that was physically forced upon them. The women's descriptions of their pregnancies ranged from being carefully planned and mostly wanted to completely unwelcome and including flawed contraceptive efforts with subsequent abortions. Conclusions: Women subjected to IPV have diverse and complex experiences that have effects on all parts of the relationship. Intimacy might for some turn into force and rape, but for others sex does not necessarily exclude pleasure and desire and can be a haven of rest from an otherwise violent relationship. Accordingly, women may tell stories that differ from the ones expected as 'the typical abuse story', and this complexity needs to be recognized and dealt with when women seek healthcare, especially concerning contraceptives, abortions, and pregnancies.

  • 363.
    Edin, Kerstin
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Nursing.
    Nilsson, Bo
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Arts, Department of culture and media studies.
    Men's violence: narratives of men attending anti-violence programmes in Sweden2014In: Women's Studies: International Forum, ISSN 0277-5395, E-ISSN 1879-243X, Vol. 46, p. 96-106Article in journal (Refereed)
    Abstract [en]

    The efficacy of batterer-intervention programmes for men has frequently been questioned, inviting additional research and development. Men inclined to violence have multifaceted problems but are frequently squeezed into ‘one-size-fits-all’ programmes with high ambitions for change that often show little evidence of effectiveness. Some research even indicates that any changes in men's violent behaviour might result from factors not at all linked to the programmes.

    For this study, ten interviews were carried out with men who had attended anti-violence programmes within the Swedish Probation Service. The overall aim was to analyse gendered identity constructions in the narratives of men attending the programmes — how men articulate the course of violent events and in what way they talk about themselves and the programmes.

    According to our results, men defended themselves by making excuses, explanations and victim positions. Furthermore, the men's gendered identity constructions collided with the programmes' ambitions of changing men's conceptions and behaviour.

  • 364.
    Edin, Kerstin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/ Wits Rural Public Health & Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    Nilsson, Bo
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Ivarsson, Anneli
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/ Wits Rural Public Health & Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    Kinsman, John
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Norris, Shane A
    Kahn, Kathleen
    Umeå University, Faculty of Arts, Department of culture and media studies. MRC/ Wits Rural Public Health & Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
    Perspectives on intimate relationships among young people in rural South Africa: the logic of risk2016In: Culture, Health and Sexuality, ISSN 1369-1058, E-ISSN 1464-5351, Vol. 18, no 9, p. 1010-1024Article in journal (Refereed)
    Abstract [en]

    This paper explores how young people in rural South Africa understand gender, dating, sexuality and risk-taking in adolescence. The empirical material drawn upon consists of 20 interviews with young men and women (aged 18-19) and reflects normative gender patterns characterised by compulsory heterosexuality and dating as obligatory, and representing key symbols of normality. However, different meanings of heterosexual relationships are articulated in the interviews, for example in the recurring concept of 'passing time', and these meanings show that a relationship can be something arbitrary: a way to reduce boredom and have casual sex. Such a rationale for engaging in a relationship reflects one of several other normative gender patterns, which relate to the trivialisation of dating and sexual risk-taking, and which entail making compromises and legitimising deviations from the 'ideal' life-script and the hope of a better future. However, risks do not exclusively represent something bad, dangerous or immoral, because they are also used as excuses to avoid sex, HIV acquisition and early pregnancy. In conclusion, various interrelated issues can both undermine and/or reinforce risk awareness and subsequent risk behaviour. Recognition of this tension is essential when framing policies to support young people to reduce sexual risk-taking behaviour.

  • 365.
    Edin, Marina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vallner, Kristina
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Psykosocial arbetsmiljö och förutsättningar att bedriva systematiskt arbetsmiljöarbete för första linjens chefer i primärvården2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Cheferna inom vård och omsorg i offentliga organisationer har hög arbetsbelastning och ett komplext uppdrag. Ofta finns rutiner för det systematiska arbetsmiljöarbetet, men de är bristfälliga och används inte. Syftet var att undersöka hur första linjens chefer i primärvården upplevde sin psykosociala arbetsmiljö samt deras förutsättningar att bedriva systematiskt arbetsmiljöarbete. En tvärsnittsstudie där samtliga 126 första linjens chefer från fyra landsting i primärvården deltagit, med svarsfrekvens 51%. I studien har enkät QPS Nordic 34+ använts samt 10 kompletterande frågor om systematiskt arbetsmiljöarbete. Analys delvis med referensdata och Pearsons korrelation. Cheferna hade en hög arbetsbelastning och arbetet tenderade att hopa sig. I jämförelse med referensdata 3,2 var chefernas medelvärde 4,02. De upplevde gott stöd, bra klimat och hade goda kunskaper för arbetsuppgifterna, men 32,8% av cheferna ansåg att de inte alls eller bara lite var insatt i AFS 2015:4. Avseende om arbetsbelastningen gav utrymme för att bedriva systematiskt arbetsmiljöarbete svarade fyra femtedelar av alla chefer inte alls eller i viss mån. Trots det goda stöd som cheferna upplevde är det viktigt att förebygga hög arbetsbelastning, då varaktig stress kan leda till ohälsa. Förutsättningar att bedriva systematiskt arbetsmiljöarbete begränsas också av deras arbetsbelastning och kan innebära negativa konsekvenser för medarbetarna.

  • 366.
    Edin-Liljegren, Anette
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Västerbottens läns landsting.
    Daerga, Laila
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Västerbottens läns landsting.
    Sahlén, Klas-Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Institutionen för omvårdnad.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Psychosocial Perspectives on Working Conditions among Men and Women in Reindeer Breeding in Sweden2017In: Journal of Northern Studies, ISSN 1654-5915, Vol. 11, no 2, p. 31-47Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this project was to describe the work organisation in the Sami communities and in reindeer-herding work and to explore the range of female duties and compare how men and women experience their psychosocial working conditions. Design: A kind of intervention study was performed by means of a questionnaire sent out to 200 individuals from seven Sami communities. Questions were asked about work organisation, communication, personal relations, solitary work, support, participation and appreciation from colleagues and women's tasks. Meetings and discussions were held about what was perceived as being important in the life of the Sami communities. Notes from 16 group discussions were written down and analysed according to themes of topics relating to how men and women in the Sami communities experience their lives. Results: Communication and relations were described as being inadequate and some respondents experienced a heavy workload. The women reported more troubled relations, less participation in decision-making and less appreciation from colleagues. Positive issues reported were the Sami identity and a strong connection to the reindeer and to nature. Conclusions: This study indicates a need for a more systematic study of the psychosocial work conditions in the Sami communities in Sweden. Measures should be taken to develop the organisation of work, e.g. through developing communication strategies and conflict management, which has been requested by several Sami communities.

  • 367.
    Edin-Liljegren, Anette
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sahlen, Klas-Göran
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Daerga, Laila
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Reindeer-herding Sami experiences of seeking care in the mainstream society2016In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 75, no 33200Article in journal (Refereed)
  • 368.
    Edlund, Anette
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Holmström, Frida
    Umeå University, Faculty of Medicine, Department of Nursing.
    M-hälsa i behandlingen av ungdomar med självskadebeteende2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: In Sweden self-harm behaviors among young people have been a difficult area to handle in psychiatric care. From the government's efforts have been made to synchronize the knowledge and experience from the local level aiming to prevent, reduce and faster identify self-harm among young people. M-Health refers to technology such as smartphones, notebooks and mobile phones provide.  These mobile devices have come to revolutionize aspects of health care perhaps mostly among young people, live their digital lives by these electronic media.

    Aim: To illuminate the use of m-Health in the treatment of mental illness and to present a draft of a mobile application that helps professionals in work with young people active in a mild to moderate self-injury.

    Method: A literature review based on an analysis of twelve scientific articles with qualitative and quantitative approach. We searched in November 2013-January 2014 Ebsco and PubMed databases. 

    Results: The literature review is presented as gains and losses in use of m-Health in the treatment of mental illness. The focus has been on what is possible to achieve with a mobile application in this area of concern. It appeared that young people show positive attitudes to using an application in monitoring of psychiatric symptoms and gained more control mental health. The professionals sees advantage in terms of more truthful symptom monitoring in real time in comparison with retrospective self-monitoring, expedited handling processes and better treatment outcomes.

    Conclusion: We interpret the results of the studies about m-Health as an opportunity for nurses to meet young people, active in a mild to moderate self-harm. An m- Health intervention based on an application for young people could make it easier for nurses to improve their communication and treatment outcomes. Care initiatives and relevant actions can then be tailored to young people's cultural values, beliefs and lifestyle.

  • 369.
    Edlund, Susanna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Chefer Portin, Julia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Skillnader i uppfattning av säkerhetskultur2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Våra värderingar, uppfattningar, beteenden samt de oskrivna regler som medarbetare styrs av är grunden till säkerhetskulturen på en arbetsplats, d.v.s. när medarbetare i en organisation har gemensamma attityder, förhållningssätt och normer gällande säkerhet och risker. Det har visats sig i tidigare studier att en god säkerhetskultur bland personalen har inverkan på patientsäkerheten. Att intensivvårdspersonal effektivt arbetar mot ett gemensamt mål har visats medföra positiva resultat vad gäller patientsäker vård och arbetstillfredsställelse. Syfte: Syftet med studien var att jämföra skillnader i uppfattningar om säkerhetskultur mellan grupper av sjuksköterskor som arbetar vid olika typer av intensivvårdsavdelningar. Metod: En pilotstudie med kvantitativ och jämförande design genomfördes vid två intensivvårdsenheter vid ett svenskt sjukhus under hösten 2015. Den översatta enkäten, The Safety Attitudes Questionnaire (SAQ)–ICU, användes där sex subskalor ”samarbetsklimat, säkerhetsklimat, arbetstrivsel, stressmedvetenhet, uppfattning om arbetsledning samt arbetsförhållanden” analyserades med hjälp av programmet Statistical Package for the Social Sciences (SPSS 23,0). Resultat: Bland de 56 deltagarna i grupperna påvisades generellt relativt hög uppfattning av säkerhetskulturen, men där en enhet skattade signifikant högre på samarbetsklimat och arbetsförhållanden. Slutsats: Det fanns tillfredsställande säkerhetsattityder vid båda enheterna, men vissa skillnader förelåg dock mellan grupperna av sjuksköterskor från de olika intensivvårdsenheterna när det handlar om samarbetsklimat och arbetsförhållanden. Dessa skillnader kan bero på olika arbetssätt mellan enheterna. 

  • 370.
    Edström, Emelie
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Simmons, Ella
    Umeå University, Faculty of Medicine, Department of Nursing.
    Avvikelserapportering: En möjlighet och skyldighet men finns förutsättningarna?: En kvalitativ intervjustudie om sjuksköterskors erfarenheter av avvikelserapportering2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

     

    Bakgrund: Tio procent av de patienter som vårdas på svenska sjukhus drabbas av en vårdskada. Avvikelserapportering är en av hörnstenarna i patientsäkerhetsarbetet som syftar till att undvika uppkomst av vårdskador. Att arbeta patientsäkert är en del av sjuksköterskans kärnkompetenser och utöver det är sjuksköterskor enligt patientsäkerhetslagen skyldiga att rapportera händelser, som har eller hade kunnat resultera i en vårdskada.

    Syfte: Syftet med studien var att beskriva sjuksköterskors erfarenheter av avvikelserapportering.

    Metod: En kvalitativ intervjustudie utfördes. Sex yrkesverksamma sjuksköterskor som arbetade på ett större sjukhus i norra regionen i Sverige intervjuades.

    Resultat: Sjuksköterskornas främsta motiv till att skriva avvikelserapporter var att belysa fel i verksamheten. Det fanns flera hinder för skriva avvikelserapporter. Dessa var hög arbetsbelastning, tidsbrist, organisatoriska problem och att det av olika skäl kan vara känsligt att skriva en avvikelserapport. Samtliga sjuksköterskor hade erfarenheter av återkoppling men ansåg att den återkoppling som brukade ges var undermålig och de ansåg även att avvikelserapporterer sällan leder till någon förändring i verksamheten.

    Konklusion: Det finns flera faktorer som försämrar sjuksköterskors förutsättningar för att skriva avvikelserapporter. Ökad kunskap inom området skulle kunna generera att fler avvikelserapporter skrivs. Det skulle i sin tur bidra till en patientsäkrare vård.

  • 371.
    Edström, Margareta
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jacobsson, Catrine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Oja, Britt-Mari
    Umeå University, Faculty of Medicine, Department of Nursing.
    The use of e-meetings in distance education in nursing, Umea university, Sweden2006In: Consumer-centered computer-suppported care for healthy people, Amsterdam: IOS Press, 2006, p. 831-831Conference paper (Refereed)
  • 372.
    Edström, Pernilla
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jessica, Fjellström
    Umeå University, Faculty of Medicine, Department of Nursing.
    ”..som en berg- och dalbana.. det har gått upp och ned..”: Nyblivna barnmorskors upplevelse av att börja arbeta inom yrket.2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att belysa nyblivna barnmorskors upplevelse av att börja arbeta inom yrket. Metod: Kvalitativ metod med semistrukturerade intervjuer som analyserats med kvalitativ innehållsanalys. Deltagare/urval: Sex barnmorskor i norra regionen i Sverige intervjuades och samtliga hade arbetat mellan ett och tre år som barnmorska, inom prenatal vård, förlossningsvård och/eller antenatal vård. Resultat: Sex kategorier hittades: Att pendla mellan glädje och osäkerhet, Att känna stöd, Att uppleva för lite handledning och mentorskap, Att uppleva arbetsmiljön hämmande, Att formas med tiden och Att ha förberett sig via utbildningen, samt nio subkategorier och det övergripande temat: Att befinna sig i en bergoch dalbana. Slutsats: Det är ett stort steg att börja arbeta som barnmorska. Det nya yrket innebär ett livslångt lärande och det krävs stöd från andra samt självförtroende. Praktisk implikation: Universitet, verksamheter och berörd personal kan ta del av studien och fokus bör läggas på god utbildning, stöd, mentorskap och handledning för den nyblivna barnmorskan.

  • 373.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Nursing.
    Atmosphere in care settings: Towards a broader understanding of the phenomenon2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of the study is to understand and describe the phenomenon ‘atmosphere in care settings’ as experienced by patients, significant others and health care staff. The study consists of four papers, each of which illuminates various aspects of the phenomenon. Data consisted of observations and interviews with patients, significant others and staff (n=126) within a hospice, a geriatric, a medical and an oncology setting, and community care settings for older people. Narrative analysis, grounded theory, and phenomenological hermeneutics were used in a triangular fashion to analyse the data.

    The findings illuminate the phenomenon ‘atmosphere in care settings’ as being constituted by two interacting and interwoven dimensions: the physical environment and people’s doing and being in the environment. The physical environment is the first dimension, and five aspects were illuminated, namely the physical environment as a symbol; as containing symbols; as influencing interaction; as facilitating a shift of focus from oneself to the environment, and; as containing scents and sounds influencing experiences of at-homeness or alienation. People’s doing and being in the environment is the other dimension, and five aspects were illuminated, namely the experience (or absence of experience) of a welcoming; of seeing and being seen; of a willingness to serve; of a calm pace; and of safety. It was understood that people’s doing and being influences experiences of the physical environment and that the physical environment influences experiences of people’s doing and being. The comprehensive understanding illuminated that the phenomenon is not merely subtle qualities of the place for care, but an active part of care. Both the physical environment and peoples doing and being conveys messages of caring and uncaring. The atmosphere of a care setting can at best support experiences of at-homeness in relation to oneself, others and the surrounding world.

  • 374.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Balancing between being a person and being a patient: A qualitative study of wearing patient clothing2009In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, no 1, p. 4-11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The nursing literature is replete with articles on the function of clothing in preventing and controlling infections. However, although contemporary literature demonstrates intimate connections between clothing and identity, there is a lack of studies which illuminate the meanings associated with wearing patient clothing. OBJECTIVES: This study aimed to illuminate the meanings of wearing patient clothing as narrated by patients and nurses in Swedish care settings. DESIGN: The data collection was based on grounded theory. Interviews with patients (n=9) and staff (n=5) were drawn from a larger study and analysed with a phenomenological hermeneutical method. SETTINGS: Data was collected between 2001 and 2003 at a hospice, an in-patient geriatric unit, an acute medical unit, and an in-patient oncology unit in Sweden. RESULTS: The phenomenon of 'wearing patient clothing' was found to consist of four themes: (1) being comfortable and cared for; (2) being depersonalised; (3) being stigmatised; and (4) being devitalised. Interpreted in the light of philosophical literature on identity and symbols, the comprehensive understanding of wearing patient clothing is that it is a balancing between being a person and being a patient. Patient clothes were experienced as being comfortable and practical, but also as being stigmatising symbols of illness, confinement, and depersonalisation. CONCLUSIONS: The tension between patient clothing as being practical and comfortable and at the same time enabling feelings of being depersonalised and stigmatised suggests that nursing staff need to balance the practical benefits of these garments with the social and existential meanings they might have.

  • 375.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Beteendeförändringar vid demenssjukdom: perspektiv på värdighetsbefrämjande analyser, tolkningar och interventioner2009In: Omsorg: Nordisk tidsskrift for Palliativ Medisin, ISSN 0800-7489, Vol. 26, no 3, p. 33-37Article in journal (Refereed)
    Abstract [sv]

    Artikeln presenterar forskningsbaserade perspektiv på vad som kan konstituera värdighetsbefrämjande analyser och tolkningar av, samt interventioner mot beteendemässiga och psykologiska symptom vid demenssjukdom (BPSD). I artikeln argumenteras för att beteendeförändringar hos personer med demenssjukdom ofta manifesteras i interaktion med vårdare och/eller medboende, all tid uppstår inom ramen för en omgivande miljö, samt kan influeras av personens livshistoria. Dessa bör inkluderas i en systematisk analys av det förändrade beteendet till grund för interventioner.

  • 376.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Commentary on McCance T, Slater P & McCormack B (2009) Using the caring dimensions inventory as an indicator of person-centred nursing. Journal of Clinical Nursing 18, 409-417.2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 3-4, p. 592-593Article in journal (Other academic)
  • 377.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. La Trobe University, Melbourne, Victoria, Australia.
    Everyday activities in nursing homes: associations with person-centredness and quality of life2016In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 56, p. 195-195Article in journal (Other academic)
  • 378.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Personcentrerad omvårdnad: definition, mätskalor och hälsoeffekter2009In: Personcentrerad omvårdnad: i teori och praktik / [ed] David Edvardsson, Studentlitteratur , 2009, p. 29-37Chapter in book (Other academic)
  • 379.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Research needed for person-centred care2011In: Versorgungsforschung für demenziell erkrankte Menschen: Health Services Research for People with Dementia / [ed] Olivia Dibelius & Wolfgang Maier, Stuttgart: W. Kohlhammer GmbH, 2011, p. 62-65Chapter in book (Other academic)
  • 380.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. Australian Centre for Evidence-Based Aged Care (ACE-BAC), La Trobe University, Bundoora, Australia.
    Therapeutic environments for older adults: constituents and meanings2008In: Journal of Gerontological Nursing, ISSN 0098-9134, E-ISSN 1938-243X, Vol. 34, no 6, p. 32-40Article in journal (Refereed)
    Abstract [en]

    This article presents the findings of a study that aimed to describe what constitutes therapeutic environments and interpret what it means to be in such environments for older adults. Interview and observational data collected in Swedish health care contexts were subjected to qualitative content analysis. The findings describe therapeutic environments as being constituted by three interacting and interwoven categories: the physical environment, people's doing and being in the environment, and an organizational philosophy of care. The findings are interpreted in light of the existential philosophy of home as a concept, a place, and an existential experience, highlighting that therapeutic environments can support existential at-homeness among patients. The findings of this study can contribute to nursing practice by providing a conceptual basis for reflecting on and evaluating how the physical environment, staff's doing and being, and the organizational philosophy of care cooperate to support well-being among older adults living in long-term care facilities.

  • 381.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Är det personalen eller patienterna som har ett störande beteende?2009In: Demens & Alderspsykiatri, ISSN 0809-3520, Vol. 113, no 2, p. 15-19Article in journal (Refereed)
    Abstract [sv]

    Denna artikel syftar till att problematisera begreppet “Beteendemässiga och Psykologiska Symptom av Demenssjukdom” (Behavioral and Psychological Symptoms of Dementia -BPSD) genom att belysa hur beteendeförändringar hos personer med demenssjukdom kan uppstå i interaktion med vårdare och vårdmiljö, och då förstås som försök till meningsfull kommunikation. Problematiseringen grundar sig på aktuell empirisk forskning kring förändrat beteende, tillsammans med interaktiva, kommunikativa och miljöfokuserade teorier kring förändrat beteende hos människor med demenssjukdom.

  • 382.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Australia.
    Backman, Annica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bergland, Ådel
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kirkevold, Marit
    Lindkvist, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lood, Qarin
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Australia.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Sweden; Department of Health Sciences, Luleå University of Technology, Sweden.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sköldunger, Anders
    Umeå University, Faculty of Medicine, Department of Nursing.
    Wimo, Anders
    Winblad, Bengt
    The Umeå Ageing and health research programme (U-age): exploring person-centred care and health promoting living conditions for an ageing population2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 3, p. 168-174Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to describe the Umeå ageing and health research programme that explores person-centred care and health-promoting living conditions for an ageing population in Sweden, and to place this research programme in a national and international context of available research evidence and trends in aged care policy and practice. Contemporary trends in aged care policy includes facilitating ageing in place and providing person-centred care across home and aged care settings, despite limited evidence on how person-centred care can be operationalised in home care services and sheltered housing accommodation for older people. The Umeå ageing and health research programme consists of four research projects employing controlled, cross-sectional and longitudinal designs across ageing in place, sheltered housing, and nursing homes. The research programme is expected to provide translational knowledge on the structure, content and outcomes of person-centred care and health-promoting living conditions in home care, sheltered housing models, and nursing homes for older people and people with dementia.

  • 383.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Australian Centre for Evidence-Based Aged Care (ACEBAC), La Trobe University, Melbourne, Victoria, Australia.
    Benny, Katz
    Nay, Rhonda
    Innovations in aged care: the aged care pain chart: an innovative approach to assessing, managing and documenting pain in older people2008In: Australasian Journal on Ageing, ISSN 1440-6381, E-ISSN 1741-6612, Vol. 27, no 2, p. 93-96Article in journal (Refereed)
    Abstract [en]

    This article presents the development and initial testing of a comprehensive pain chart for the assessment, management and documentation of pain in older people in subacute and residential aged care. The pain chart was developed from existing assessment scales and pain indicators, and is targeting needs of older people in residential care and geriatric hospital settings with high prevalence of cognitive impairments. The chart is based on self-report of pain but allows for observation of pain-related behaviours for those unable to report pain. The chart consists of one evaluative and one documentation dimension, and was evaluated by a group of clinicians in geriatric hospital care (n = 15) and residential aged care (n = 6). The chart was found to be content valid, informative and easy to use, facilitating clinical assessments and monitoring, and assisting visual readings of patients' temporal pain trends.

  • 384.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Fetherstonhaugh, Deirdre
    McAuliffe, Linda
    Nay, Rhonda
    Chenco, Carol
    Job satisfaction amongst aged care staff: exploring the influence of person-centered care provision2011In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 23, no 8, p. 1205-1212Article in journal (Refereed)
    Abstract [en]

    Background: There are challenges in attracting and sustaining a competent and stable workforce in aged care, and key issues of concern such as low staff job satisfaction and feelings of not being able to provide high quality care have been described. This study aimed to explore the association between person-centered care provision and job satisfaction in aged care staff. Methods: Residential aged care staff (n = 297) in Australia completed the measure of job satisfaction and the person-centered care assessment tool. Univariate analyses examined relationships between variables, and multiple linear regression analysis explored the extent to whichperceived person-centredness could predict job satisfaction of staff. Results: Perceived person-centred care provision was significantly associated with job satisfaction, and person-centred care provision could explain nearly half of the variation in job satisfaction. The regression model with the three person-centered care subscales as predictor variables accounted for 40% of the variance in job satisfaction. Personalizing care had the largest independent influence on job satisfaction, followed by amount of organizational support and degree of environmental accessibility. Personalizing care and amount of organizational support had a statistically significant unique influence. Conclusions: As person-centered care positively correlated with staff job satisfaction, supporting staff in providing person-centered care can enhance job satisfaction and might facilitate attracting and retaining staff in residential aged care. The findings reiterate a need to shift focus from merely completing care tasks and following organizational routines to providing high quality person-centered care that promotes the good life of residents in aged care.

  • 385.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Fetherstonhaugh, Deirdre
    Australian Centre for Evidence-Based Aged Care (ACEBAC), La Trobe University.
    Nay, Rhonda
    Australian Centre for Evidence-Based Aged Care (ACEBAC), La Trobe University.
    Promoting a continuation of self and normality: person-centred care as described by people with dementia, their family members and aged care staff2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 17-18, p. 2611-2618Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: This article aims to describe the content of person-centred care as described by people with dementia, family members and staff in residential aged care.

    BACKGROUND: Person-centred care is increasingly being regarded as synonymous with best quality aged care; however, studies exploring stakeholders' experiences of person-centred care are few.

    DESIGN: A qualitative explorative design was employed using conversational research interviews and content analysis.

    METHOD: Research interviews were conducted in 2007 and 2008 with staff working in aged care (n = 37), people with early onset dementia (n = 11), and family members of patients with dementia (n = 19) and were analysed using content analysis.

    RESULTS: The findings indicated that the core category of person-centred care was promoting a continuation of self and normality. Five content categories emerged as contributing to promoting a continuation of self and normality: knowing the person; welcoming family; providing meaningful activities; being in a personalised environment; and experiencing flexibility and continuity.

    CONCLUSIONS: This study describes person-centred care as it is understood by people with dementia, their family members and staff in residential aged care, and as such it contributes with inside perspectives to current understandings of person-centred care, perspectives that have been largely lacking. Relevance to clinical practice.  The findings of this study are clinically relevant and ready to be operationalised and applied in clinical aged care. The categories can be used as a topic guide for discussions in aged care organisations on the quality of current care and as elements indicating how to increase the person-centredness of care provided.

  • 386.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Fetherstonhaugh, Deirdre
    Nay, Rhonda
    The Tool for Understanding Residents' Needs as Individual Persons (TURNIP): construction and initial testing2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 19-20, p. 2890-2896Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To construct and evaluate an intervention tool for increasing the person-centredness of care in residential aged care services.

    Background: Providing care that is person-centred and evidence-based is increasingly being regarded as synonymous with best quality aged care. However, consensus about how person-centred care should be defined, operationalised and implemented has not yet been reached.

    Design: Literature reviews, expert consultation (= 22) and stakeholder interviews (= 67) were undertaken to develop the Tool for Understanding Residents’ Needs as Individual Persons (TURNIP).

    Methods: Statistical estimates of validity and reliability were employed to evaluate the tool in an Australian convenience sample of aged care staff (= 220).

    Results: The 39 item TURNIP conceptualised person-centred care into five dimensions: (1) the care environment, (2) staff members’ attitudes towards dementia, (3) staff members’ knowledge about dementia, (4) the care organisation and (5) the content of care provided. Psychometric testing indicated satisfactory validity and reliability, as shown for example in a total Cronbach’s alpha of 0·89.

    Conclusions: The TURNIP adds to current literature on person-centred care by presenting a rigorously developed intervention tool based on an explicit conceptual structure that can inform the design, employment and communication of clinical interventions aiming to promote person-centred care.

    Relevance to clinical practice: The TURNIP contains clinically relevant items that are ready to be applied in clinical aged care. The tool can be used as a base for clinical interventions applying discussions in aged care organisations about the quality of current care and how to increase person-centredness of the care provided.

  • 387.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Fetherstonhaugh, Deirdre
    Nay, Rhonda
    Gibson, Stephen
    Development and initial testing of the Person-centered Care Assessment Tool (P-CAT).2010In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 22, no 1, p. 101-108Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Person-centered care is increasingly regarded as being synonymous with best quality care. However, the concept and its precise meaning is a subject of debate and reliable and valid measurement tools are lacking. METHOD: This article describes the development and initial testing of a new self-report assessment scale, the Person-centered Care Assessment Tool (P-CAT), which measures the extent to which long-term aged care staff rate their settings to be person-centered. A preliminary 39-item tool generated from research literature, expert consultations and research interviews with aged care staff (n = 37), people with early onset dementia (n = 11), and family members (n = 19) was distributed to a sample of Australian aged care staff (n = 220) and subjected to item analysis and reduction. RESULTS: Psychometric evaluation of the final 13-item tool was conducted using statistical estimates of validity and reliability. The results showed that the P-CAT was shown to be valid and homogeneous by factor, item and content analyses. Cronbach's alpha was satisfactory for the total scale (0.84), and the three subscales had values of 0.81, 0.77, and 0.31 respectively. Test-retest reliability were evaluated (n = 26) and all analyses indicated satisfactory estimates. CONCLUSION: This study provides preliminary evidence in support of the psychometric properties of the P-CAT when used in an Australian sample of long-term aged care staff. The tool contributes to the literature by making it possible to study person-centered care in relation to health outcomes, organizational models, characteristics and levels of staffing, degrees of care needs among residents, and impact of interventions.

  • 388.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Innes, Anthea
    Department of Applied Social Science, Dementia Services Development Centre, University of Stirling, UK .
    Measuring person-centered care: a critical comparative review of published tools2010In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 50, no 6, p. 834-846Article in journal (Refereed)
    Abstract [en]

    Purpose of the study: To present a critical comparative review of published tools measuring the person-centeredness of care for older people and people with dementia.

    DESIGN AND METHODS: Included tools were identified by searches of PubMed, Cinahl, the Bradford Dementia Group database, and authors' files. The terms "Person-centered," "Patient-centered" and "individualized" (US and UK spelling), were paired with "Alzheimer's disease," "older people," and "dementia" in various combinations. The tools were compared in terms of conceptual influences, perspectives studied and intended use, applicability, psychometric properties, and credibility.

    RESULTS: Twelve tools eligible for review were identified. Eight tools were developed for evaluating long-term aged care, three for hospital-based care, and one for home care. One tool, Dementia Care Mapping, was dementia specific. A common limitation of the tools reviewed is that they are yet to be used and validated beyond the development period; thus, their validity, reliability, and applicability needs further exploration. Also, the perspective of people with dementia remains absent.

    IMPLICATIONS: The review demonstrates the availability of a multitude of tools for measurement of person-centered care in different settings and from different perspectives, even if further testing of the tools is needed. The conceptual underpinnings of the tools are rarely explicit, which makes it difficult to ascertain the conceptual comparability of the tools.

  • 389.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Juthberg, Christina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björk, L. S.
    Umeå University.
    Backman, A. C.
    Umeå University.
    Staffing, skill mix, quality of care and resident outcomes in swedish residential aged care2014In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 54, no Suppl 2, p. 152-152Article in journal (Other academic)
  • 390.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Koch, Susan
    Nay, Rhonda
    Psychometric evaluation of the english language person-centered climate questionnaire--patient version2009In: Western Journal of Nursing Research, ISSN 0193-9459, E-ISSN 1552-8456, Vol. 31, no 2, p. 235-244Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate psychometric properties of a questionnaire measuring to what extent the climate of health care settings are perceived as being person-centered. The English Person-Centered Climate Questionnaire-Patient version (PCQ-P) was distributed to a sample of hospital patients (n = 108) and data were subjected to psychometric evaluation using statistical estimates of validity and reliability. Content and construct validity of the PCQ-P was satisfactory in literature reviews and factor and item analysis. Cronbach's alpha was satisfactory for the total scale (0.90) and also for sub-scales: safety = 0.96 and hospitality = 0.89. The intraclass correlation coefficient indicating test-retest reliability was 0.70 with a 95% confidence interval ranging between 0.63 and 0.77. Even though the sample should be considered, the results indicate that the PCQ is a valid and reliable contribution for assessing to what extent the climate of health care settings are perceived to be person-centered by patients.

  • 391.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Koch, Susan
    Nay, Rhonda
    Psychometric evaluation of the English language person-centred climate questionnaire: staff version2010In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 18, no 1, p. 54-60Article in journal (Refereed)
    Abstract [en]

    The 14-item questionnaire showed high reliability as Cronbach's alpha was satisfactory for the total scale (0.89), and for the four subscales: 0.87, 0.79, 0.82 and 0.69. Test-retest reliability were evaluated in a subsample of 40 staff and resulted in P-values >0.05 between mean scores of the PCQ-S at test and retest, r-values between 0.6 and 0.9, and a two-way mixed effects model, single measures intra-class correlations of 0.75 with a confidence interval of 0.58-0.86. Validity of the scale needs further evaluation.

    CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: The English PCQ-S makes possible studies of associations between person-centredness and different organizational systems, environments, staff characteristics and health and managerial styles. However, scale validity needs further evaluation.

  • 392.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Austin Health Clinical School of Nursing, La Trobe University, Australia.
    Mahoney, Anne-Marie
    Hardy, Juanita
    McGillion, Tony
    McLean, Anne
    Pearce, Frances
    Salamone, Kathryn
    Watt, Elizabeth
    Psychometric performance of the English language six-item Caring Behaviours Inventory in an acute care context2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 17-18, p. 2538-2544Article in journal (Refereed)
    Abstract [en]

    Aims and objectivesThis study aimed to evaluate the psychometric performance of the six-item Caring Behaviours Inventory in a sample of Australian acute hospital inpatients. BackgroundCaring is significant for nursing, and exploring the prevalence of staff-caring behaviours is imperative for high-quality acute care. There is a need for psychometrically sound scales that measures caring in acute care, without imposing extensive respondent burden. DesignA cross-sectional survey design was used to distribute the six-item Caring Behaviours Inventory to an Australian sample of hospital inpatients (n=210) in December 2012. MethodPsychometric evaluation included item performance, construct validity and internal consistency reliability. ResultsThe six-item Caring Behaviours Inventory had satisfactory psychometric performance as evidenced by normally distributed scores, a uni-dimensional structure explaining 65% of variance in data, a total Cronbach's of 089 and corrected item-total correlations between 051-082. ConclusionThe six-item Caring Behaviours Inventory had satisfactory estimates of validity and reliability when tested in an Australian sample of acute hospital inpatients. The tool contributes to the literature by being a brief and nonburdensome alternative with seemingly strong psychometric properties to be used in future measures of caring in nursing. Relevance to clinical practiceThe six-item Caring Behaviours Inventory provides a psychometrically tested fundament for reflective clinical discussions on how nurse behaviours facilitate or impede patient experiences of caring. This can benefit quality development in clinical practice as being in tune with patient experiences and expectations is fundamental to high quality services and patient satisfaction.

  • 393.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nay, Rhonda
    Acute care and older people: challenges and ways forward2009In: Australian journal of advanced nursing, ISSN 0813-0531, Vol. 27, no 2, p. 63-69Article in journal (Refereed)
    Abstract [en]

     

    Objective: This article aims to (a) suggest ways in which acute hospital environments might be modified to better meet the needs of the older person and (b) question whether options other than acute care should be canvassed for older people.

    Setting: Acute hospital settings.

    Subjects: Older people and people with cognitive impairment

    Primary argument: Older people are large consumers of acute hospital care, and acute hospitals are known to pose significant risks for this vulnerable population. Such risks include delirium, falls, restraints, drug side effects, and general de-conditioning entailing loss of function and independence. Eight dimensions of person-centred care are presented to promote assessing and meeting the needs of older people in acute care. Alternatives to acute hospital admission are also suggested, such as developing ‘older people centres’ to which older people could be admitted for triage in older-friendly environments staffed by geriatric experts, places in which their multidimensional care needs could be better met.

    Conclusions: As an alternative to acute hospital admission, ‘older people centres’ could be developed to which older people could be admitted for triage in older-friendly environments staffed by experts in care of older people. In the mean time, why not provide a balanced approach that provides some environmental adjustments for older people, core knowledge and skills for all staff, and access to gerontic expertise in the acute hospital care of older people.

  • 394.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nilsson, Anita
    Umeå University, Faculty of Medicine, Department of Nursing.
    Fetherstonhaugh, Deirdre
    Nay, Rhonda
    Crowe, Shane
    The person-centred care of older people with cognitive impairmentin acute care scale (POPAC)2013In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 21, no 1, p. 79-86Article in journal (Refereed)
    Abstract [en]

    Aim: To construct and evaluate psychometric properties of the person-centred care of older people with cognitive impairment in acute care settings (POPAC) scale.

    Background: Older people with cognitive impairment are admitted frequently to acute care, with needs not always met through standard practice. Best practice models have been suggested, but few assessment scales exist.

    Methods: Psychometric evaluation using statistical estimates of validity and reliability based on an Australian sample of acute care nursing staff (n = 212).

    Results: The final 15-item questionnaire consists of three subscales, using cognitive assessments and care interventions, using evidence and cognitive expertise and individualizing care. Estimates of validity and reliability were highly satisfactory.

    Conclusion: The POPAC scale makes a valuable contribution by providing valid and reliable measures of the extent to which acute nursing staff report using best practice care processes to identify and consider cognitive impairment and to employ nursing interventions to meet the needs associated with old age and cognitive impairment.

    Implications for nursing management: The POPAC scale is short, easy to administer and not time consuming to complete, but still provides clinically relevant information. It can be used as a conceptual fundament in developing best practice nursing care in the acute clinical setting, as well as for nursing research.

  • 395.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nordvall, Karin
    Lost in the present but confident of the past: experiences of being in a psycho-geriatric unit as narrated by persons with dementia2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 4, p. 491-498Article in journal (Refereed)
    Abstract [en]

    AIM: To illuminate meanings of being in a psycho-geriatric unit. Background. There are known risks associated with moving persons with dementia from home to an institution, but little is known about how they experience being in psycho-geriatric units.

    METHOD: Using open-ended research interviews, six persons with mild to severe dementia were asked to narrate about their experiences in the hospital. The interviews were interpreted using a phenomenological hermeneutical method of analysis.

    RESULTS: The comprehensive understanding of being in a psycho-geriatric unit points towards an understanding of being lost in the present but confident of the past. The analysis showed that the participants appeared lost as they could not narrate where they were and why, but that they became confident when narrating about their previous life. The analysis also showed that being in the hospital meant sharing living space with strangers, invasions of private space and establishing new acquaintances. Being in the unit could also mean boredom and devaluation for participants. The interviews were interpreted in the light of narrative theory of identity: persons with dementia narrating about previous life experiences as to make claims of how to be interpreted by others; as persons instead of merely as 'demented' patients.

    CONCLUSIONS: Experiences of care narrated by persons with dementia present meaningful and useful information that can provide feedback to inform care practice.

    RELEVANCE TO CLINICAL PRACTICE: Experiences of care from persons with dementia provide meaningful information about care and the doing and being of staff. Creating time for conversations with these persons may facilitate well-being.

  • 396.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. La Trobe University/Austin Health Clinical School of Nursing, La Trobe University, Melbourne, Australia.
    Petersson, Lisa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sandman, Per-Olof
    Division of Nursing, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
    Everyday activities for people with dementia in residential aged care: associations with person-centredness and quality of life.2014In: International journal of older people nursing, ISSN 1748-3743, Vol. 9, p. 269-276Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Providing everyday activities is central to high quality residential aged care, but further research is needed on the association between activity participation, person-centred care and quality of life. AIMS AND OBJECTIVES: To explore the point-prevalence of participation in everyday activities for residents with dementia within a national sample of Swedish residential aged care units and to explore if residents participating in everyday activities lived in more person-centred units and/or had higher quality of life as compared to residents not participating in everyday activities. DESIGN AND METHODS: A cross-sectional design was used to collect valid and reliable questionnaire data on activity participation, unit person-centredness and quality of life in a sample of residents in residential aged care (n = 1266). RESULTS: Only 18% of residents participated in everyday activities such as making coffee, setting or clearing the table, cleaning or watering plants, 62% participated in outdoor walks, 27% participated in parlour games, and 14% and 13% participated in excursions and church visits, respectively. Those residents who had participated in everyday activities lived in more person-centred units, had significantly higher quality of life and higher cognitive scores as compared to those residents who had not participated in everyday activities. CONCLUSIONS: Even though the prevalence of resident participation in everyday activities was low, resident participation was significantly associated with unit person-centredness and resident quality of life. It seems that everyday activities that are routine and commonplace to residential aged care can be potent nursing interventions for promoting resident quality of life. IMPLICATIONS FOR PRACTICE: The study indicates that residents can benefit from participation in everyday activities that are commonly occurring in aged care practice. It seems that such everyday tasks and procedures can provide fruitful ways to make person-centred care happen in clinical practice, and ways to increasingly involve residents with cognitive impairment need to be further developed.

  • 397.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rasmussen, Birgit
    Umeå University, Faculty of Medicine, Department of Nursing.
    The quest for conceptual consistency: Commentary on Rytterström et al. (2009).2010In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 47, no 2, p. 261-262Article in journal (Other academic)
  • 398.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Nursing.
    Rasmussen, Birgit
    Riessman, Catherine
    Ward atmospheres of horror and healing: a comparative analysis of narrative2003In: Health, ISSN 1363-4593, E-ISSN 1461-7196, Vol. 7, no 4, p. 377-396Article in journal (Refereed)
    Abstract [en]

    Aspects of a social setting profoundly influence personal experience in the setting. The purpose of our study was to further understand the phenomenon of ward atmosphere through a detailed case study. One narrator describes and contrasts two ward experiences, one where she lost her mother through death, and the other where she became a mother through birthing. Using classic storytelling forms, she develops a long narrative juxtaposing the two settings: one healing, the other horrifying. Close examination of narrative structure and aesthetics of the illness narrative shows how the narrator forges a discourse about the moral life - how healing should occur. Experiences in the two settings continue to have significance in her subjectivity. The research suggests aspects of ward atmosphere that warrant further investigation.

  • 399.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Omvårdnad.
    Rasmussen, Birgit
    Umeå University, Faculty of Medicine, Omvårdnad.
    Riessman, CK
    Ward atmospheres of horror and healing: A comparative analysis of narrative2006In: Narrative Methods vol. 2 Narrative Applications, Sage, London , 2006Chapter in book (Other (popular science, discussion, etc.))
  • 400.
    Edvardsson, David
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, P.
    Borell, L.
    Improving staff wellbeing by implementing national guidelines for person-centred care of people with dementia: The Stureby intervention study2014In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 54, no Suppl 2, p. 129-129Article in journal (Other academic)
567891011 351 - 400 of 2016
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