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  • 1.
    Andersson, Ida-Maria
    et al.
    University of Skövde.
    Nilsson, Sandra
    University of Skövde.
    Adolfsson, Annsofie
    University of Skövde, School of Life Sciences.
    How women who have experienced one or more miscarriages manage their feelings and emotions when they become pregnant again: a qualitative interview study2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 2, p. 262-270Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to investigate how women who have experienced one or more miscarriages manage their feelings when they become pregnant again.

    Method:  Individual qualitative interviews were conducted with 16 women who were pregnant again after experiencing one or more miscarriages. The interviews were analysed using qualitative content analysis with an inductive approach.

    Results: The analysis of the material ended up in five categories: distancing herself from her pregnancy, focusing on her pregnancy symptoms, searching for confirming information, asking for ultrasound examination and asking for professional and social support. Because of their past experience with miscarriage, it could be painful to have another pregnancy terminate in disappointment. Therefore, the women manage their feelings by distancing themselves from their pregnancies. Simultaneously, they are managing their emotions by seeking affirmation that their current pregnancy is normal.

    Conclusion: Generally speaking, women manage their emotions by themselves. They feel isolated with their worries and concerns, and they are in need of the support provided from their intimate circle of friends and family as well as from the staff of the maternity health care ward. Unfortunately, the women do not feel that they get the support they need from the staff, instead they have to rely on their friends, family and partners to help them manage their emotions.

  • 2.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Gunnarsson, Magnus
    Department of Linguistics, Göteborg University, Göteborg, Sweden.
    Allwood, Jens
    Department of Linguistics, Göteborg University, Göteborg, Sweden.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University, Göteborg, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University, Göteborg, Sweden.
    Descriptions of pain in elderly patients following orthopaedic surgery2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 2, p. 110-118Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to investigate what words elderly patients, who had undergone hip surgery, used to describe their experience of pain in spoken language and to compare these words with those used in the Short-Form McGill Pain Questionnaire (SF-MPQ) and Pain-O-Meter (POM). The study was carried out at two orthopaedic and two geriatric clinical departments at a large university hospital in Sweden. Altogether, 60 patients (mean age =77) who had undergone orthopaedic surgery took part in the study. A face-to-face interview was conducted with each patient on the second day after the operation. This was divided into two parts, one tape-recorded and semi-structured in character and one structured interview. The results show that a majority of the elderly patients who participated in this study verbally stated pain and spontaneously used a majority of the words found in the SF-MPQ and in the POM. The patients also used a number of additional words not found in the SF-MPQ or the POM. Among those patients who did not use any of the words in the SF-MPQ and the POM, the use of the three additional words 'stel' (stiff), 'hemsk' (awful) and 'räd(d)(sla)' (afraid/fear) were especially marked. The patients also combined the words with a negation to describe what pain was not. To achieve a more balanced and nuanced description of the patient's pain and to make it easier for the patients to talk about their pain, there is a need for access to a set of predefined words that describe pain from a more multidimensional perspective than just intensity. If the elderly patient is allowed, and finds it necessary, to use his/her own words to describe what pain is but also to describe what pain is not, by combining the words with a negation, then the risk of the patient being forced to choose words that do not fully correspond to their pain can be reduced. If so, pain scales such as the SF-MPQ and the POM can create a communicative bridge between the elderly patient and health care professionals in the pain evaluation process.

  • 3.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Quantification of the pain terms hurt, ache and pain among nursing students2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 2, p. 163-168Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine the quantitative meaning nursing students ascribe to the pain terms hurt (ont), ache (värk) and pain (smärta). In total, 549 nursing students filled in a questionnaire including questions about age, gender, and health care work experience. The students were also requested to rate response using a Visual Analogue Scale (VAS) rating for different statements about hurt, ache and pain. The results show that there were significant differences (p < 0.001) between rated intensity of the statements of hurt, ache and pain. There were, however, large variations in the students’ ratings of the pain terms; hurt ranged from 3 to 97 mm, ache from 7 to 97 mm and pain from 27 to 100 mm. There were no significant differences between male and female students regarding their ratings of hurt and ache when they were used to describe the worst self-experienced pain. Female students rated their experience of pain significantly higher (p < 0.001) on the VAS compared with male students. There was no significant correlation between previous experience of health care work and rated intensity of hurt, ache and pain. In conclusion, this study shows that there exist significant differences between the pain terms hurt, ache and pain according to a rating on a VAS. However, the results also demonstrate that there are large individual variations in how the students quantify the fictitious patient statements of hurt, ache and pain.

  • 4.
    Berglund Kristiansson, Elisabeth
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Källman, Ulrika
    Research Department, Region Västra Götaland, South Älvsborg Hospital, Borås, Sweden.
    Healthcare staff's views on the patients' prerequisites to be co-creator in preventing healthcare-associated infections2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Background Every year, patients are affected by suffering and death caused by adverse events in connection with health care and the most common adverse events are healthcare-associated infections (HAI). The Swedish Patient Act from 2015 strengthens the patient's position in health care; however, there is lack of knowledge of how healthcare staff experience the possibilities to make the patient involved in the preventive work of HAI. Aim To describe healthcare professionals' views on the patient's prerequisites to be co-creator in preventing HAI in connection with hospital care. Method This study had a qualitative descriptive design with semi-structured individual interviews. Qualitative inductive content analysis was used to analyse the transcribed interview data. The study setting was a hospital in Sweden in 2015. Interviews were carried out among six healthcare professionals. Results In the analysis, 5 themes and 14 categories were identified in three different domains: Organisation, Healthcare staff and Patient. The result indicates an obstacle in each domain for the patient to become co-creator in preventing HAI. In Organisation domain, a lack of organizational structure such as elaborated working methods to involve the patient was pointed out. In the domain Healthcare staff, it showed that the professionals allocate the responsibility of preventing HAI to the patient but only if they had to or if they trusted the patient. In the Patient domain, the result states that the patient was perceived as passive; they did not take own initiatives to get involved. Conclusion The patient has an important role in successful HAI prevention work and should be considered as an obvious co-creator. Nevertheless, this study shows that neither organisation nor healthcare staff are sufficiently prepared for this. The organisation must make an anchored, structured and systematic work centred on the patient's needs and give more support both to healthcare professionals and patients.

  • 5.
    Fagerström, Lisbeth
    University of Skövde, School of Life Sciences.
    Positive life orientation - an inner health resource among older people2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 2, p. 349-356Article in journal (Refereed)
    Abstract [en]

    As pertains to life orientation, the study's conceptual framework demonstrates the importance of close relationships, meaning in life, and the strength of individuals to look forward and make plans for future. The aim of this study is to discover, in relation to background factors such as language, living situation, and culture, how people aged 65 and 75 experience life orientation. The study is a population-based cross-sectional survey with its material taken from 3,370 questionnaires which included the six-question Life Orientation scale. The SPSS static program, version 14.0, was used for all calcuations and the Chi-squared test was applied to determine if any significant differences between the groups existed. As seen in this study, most respondents aged 65 (85%) and 75 (73.2%) experienced a high degree of positive life orientation, clearly expressing a zest for life (93.5%), overall satisfaction with their lives (88.4%), and feelings of being needed (83.7%). Lower scores were given for never/seldom being depressed/sad (55.3%) and never/seldom feeling lonely (71.8%). Approximately every second respondent (51.9%) had plans for the future. A clear decreasing trend was seen in all questions for respondents aged 75 in comparison to those aged 65: only ``are you satisfied with life?'' showed no significant differences. Language/culture seems to clearly affect experiences of life orientation and well-being. Additionally, older people living alone reported significantly more negative response to all dimensions of life orientation. Positive life orientation is an important inner health resource for older. Accordingly, health promotion for older people should focus on facilitating the maintenance of important and close relationships and should include supporting older people's need to be needed.

  • 6.
    Fagerström, Lisbeth
    et al.
    University of Skövde, School of Life Sciences. Department of Health Sciences, Buskerud University College, Drammen, Norway.
    Wikblad, Annika
    Svenska University of Applied Sciences, Vaasa, Finland.
    Nilsson, Jenny
    Svenska University of Applied Sciences, Vaasa, Finland.
    An integrative research review of preventive home visits among older people: is an individual health resource perspective a vision or a reality?2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 3, p. 558-568Article in journal (Refereed)
    Abstract [en]

    This study has two aims: (i) to explore and evaluate the health-promoting effect of preventive home visit (PHV) by analysing the activities conducted during the PHV and the reported results, and (ii) to critically analyse if PHV is characterized by an individualized health resource perspective. The material was compiled through a systematic literature search in the databases Ebsco, CINAHL, Medline, Science Direct and CSA from the period 1984 to 2004. The result of the systematic database search was a total number of 49 scientific research articles, of which 18 are included in this study. The analysing method was a four-step integrating research review. The review describes the following content concerning (i) activities during home visits: screening, observation and evaluation, guidance, support, referral to care and other services, follow-up and individual aim; (ii) positive effects: reduced mortality, improved ability to function, improved life quality, improved subjective health, fewer admittances for care, older people's experiences of home visits and increased knowledge on health and (iii) unclear/negative effects: admittance to care, no effect on mortality, unaffected ability to function, unaffected general health and uninfluenced life quality. PHVs had been implemented based on an individual perspective in a total of 13 studies out of 18. The focus on sickness was surprisingly clear, and in 10 studies out of 18 a health resource perspective was lacking. The effects of PHVs have been questioned. Despite this, current research results imply that this method has a positive affect on older people's health and well-being. This form of care must still be developed to include extensive screenings and interventions, as well as a health resource perspective where the starting point during every home visit is the older person's individual needs and wishes.

  • 7.
    Gärden, Bodil
    et al.
    University of Skövde, School of Life Sciences.
    Samarina, Arina
    Karolinska University Hospital, Sweden.
    Stavchanskaya, Irina
    Tuberculosis Dispensary Nr 8, St. Petersburg, Russia.
    Alsterlund, Rolf
    Central Hospital, Kristianstad, Sweden.
    Övregaard, Amanda
    Uddevalla Hospital, Sweden.
    Taganova, Olga
    Tuberculosis Dispensary Nr 8, St. Petersburg, Russia.
    Shpakovskaya, Ludmilla
    City Tuberculosis Dispensary, St. Petersburg, Russia.
    Zjemkov, Vladimir
    City Tuberculosis Dispensary, St. Petersburg, Russia.
    Ridell, Malin
    The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Larsson, Lars-Olof
    Karolinska University Hospital, Sweden.
    Food incentives improve adherence to tuberculosis drug treatment among homeless patients in Russia2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 1, p. 117-122Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to evaluate the impact of food incentives on adherence to tuberculosis (TB) drug treatment among homeless patients with TB. Food packages were thus given as a part of directly observed therapy to 142 homeless patients with TB at a dispensary in Saint Petersburg, Russian Federation. In addition, a social worker provided the patients with information and legal assistance, for example help with internal passports. Among the 142 patients, 66 were included in the study at the dispensary during their entire treatment period, while 76 patients were included in the study during shorter periods mainly because of transfer to inpatient care. In the first group, 59% of the patients continued the TB drug treatment without interruption in contrast to 31% in a control group. In the second group, that is those studied during shorter periods, 95% continued the TB drug treatment without interruption while attached to the dispensary. Food was introduced in the TB programme of the City of St. Petersburg as a consequence of this study. In conclusion, it can be stated that the food incentive had a strong positive impact on the adherence to TB drug treatment among these socially marginalized patients. The social support contributed in all probability also to the positive results.

  • 8.
    Hrybanova, Yana
    et al.
    Högskolan Väst.
    Ekström, Anette
    Högskolan Väst.
    Thorstensson, Stina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    First-time fathers’ experiences of professional support from child health nurses2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Nowadays, in Sweden, fathers are expected to be active in their father role and to share caring responsibilities for their children equally with mothers. This active role of a father in a family can be challenging, especially for the first-time fathers. Child health nurses’ support is an important factor for fathers to become confident caregivers. The Father Perceived Professional Support scale (FaPPS scale) can be used in nursing practice for better understanding father’s needs of professional support.

    The aim of this study was to describe first-time fathers’ experiences of the professional support received from child health nurses and to validate the instrument: ‘FaPPS scale’. A qualitative design, with inductive and deductive approaches, was used in this study.

    Twelve first-time fathers participated in the semi-structured interviews, thereafter grading the FaPPS scale items and commenting on them. The fathers experienced nurses’ support positively when nurses provided practical information and stimulated them to be involved in care of their children. In contrast, the support was experienced negatively because of nurses’ lack of commitment, availability and adaptation to the fathers’ individual needs. The fathers also felt inequality between the support received by fathers and by mothers. Although some fathers perceived it as negative, others considered it fair, believing that mothers needed more support. In addition, fathers expect nurses to actively offer support to them and supervise them in childcare. The fathers also needed meeting other parents, for example in parental groups.This study also indicates that FaPPS scale can be used both in research and clinical practice, though still needing further development.

  • 9.
    Jakobsson, Eva
    et al.
    University of Skövde, School of Life Sciences.
    Johnsson, Tommy
    Faculty of Health Caring Sciences, Sahlgrenska Academy at Göteborg University, Institute of Nursing, Gothenburg, Sweden.
    Persson, Lars-Olof
    Faculty of Health Caring Sciences, Sahlgrenska Academy at Göteborg University, Institute of Nursing, Gothenburg, Sweden.
    Gaston-Johansson, Fannie
    Faculty of Health Caring Sciences, Sahlgrenska Academy at Göteborg University, Institute of Nursing, Gothenburg, Sweden / Johns Hopkins School of Nursing, Baltimore, MD, United States.
    End-of-life in a Swedish population: demographics, social conditions and characteristics of places of death2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 1, p. 10-17Article in journal (Refereed)
    Abstract [en]

    The objectives of this study were to identify and describe the demographics and social conditions as well as characteristics of the places of death in a randomly selected sample that died in a county in Sweden during 2001. The present study reports part of the findings from a larger study undertaken during 2003 using a survey design of retrospective reviews of death certificates, medical records, and nursing records. Among several noteworthy findings are: first, an examination of these individuals’ living arrangements reveal not only a large and vulnerable group that lives alone at the end-of-life but also a group living separated from their partners near end-of-life; second, individuals differ with respect to residence prior to death, that is private homes versus residential care facilities, imparting highly different contexts of care at the end-oflife, and third, a high prevalence of institutionalized deaths

    demonstrates that places of death other than hospitals and residential care facilities are uncommon, if not rare. It is concluded that increased attention to the social circumstances of the time period surrounding individuals’ at the end-of-life is essential.

    There is need to develop more integrated models of care for dying people. Contemporary services available are not designed to meet a wide range of peoples’ needs at the endof- life. Home-based care, residential care and hospital care must be adapted to the changing patterns of dying. The services available should be organized to the benefit of the users rather than around the providers. This is the first study of its kind of a Swedish sample and while the data

    are limited to one county in Sweden its findings may contribute to a deeper understanding of demographic and social patterns at the end-of-life in general.

  • 10.
    Johansson, Anna
    et al.
    Department of Cardiology, Skövde Hospital, Skövde, Sweden / Nursing Science - Department of Medicine and Care, Faculty of Health Sciences, University of Linkoping, Linkoping.
    Windahl, Maria
    Nursing Science - Department of Medicine and Care, Faculty of Health Sciences, University of Linkoping, Linkoping.
    Svanborg, Eva
    Department of Neuroscience, Clinical Neurophysiology, University Hospital, Linköping, Sweden.
    Fredrichsen, Maria
    Department of Social and Welfare Studies, Palliative Research Unit, Vrinnevi Hospital, Norrköping, Sweden.
    Swahn, Eva
    Department of Cardiology, University Hospital Linköping, Linköping.
    Uhlin, Pia Yngman
    Nursing Science - Department of Medicine and Care, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
    Edéll-Gustafsson, Ulla
    Nursing Science - Department of Medicine and Care, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
    Perceptions of how sleep is influenced by rest, activity and health in patients with coronary heart disease: a phenomenographical study2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 4, p. 467-475Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: A framework is needed for identifying internal and external factors essential for the nursing management of psychological supportive health care and education for patients' self-care in sleep. In order to generate more knowledge from the patient's perspective, the aim of this study was to describe how patients with coronary artery disease (CAD) perceive that their sleep is influenced by rest, activity and health in outpatient care.

    DESIGN: Qualitative interviews were performed with 33 outpatients.

    METHOD: The data were analysed using a phenomenographic method.

    FINDINGS: Three descriptive categories of the phenomenon were described: my lifestyle is reflected in my sleep behaviour; handling the practices around tiredness and sleep; and feelings of negative and positive efficacy. Feelings of tiredness, fatigue and sleepiness were different pre-sleep stages, but were also related to the patient's adaptation and recovery. Creating one's own personal time and feelings of efficacy gave an inner sense of strength which is indicated as being particularly important in managing stress and the demands of everyday life in a satisfactory manner.

    CONCLUSION: From a contextual, holistic perspective on health, it is important to identify the patient's needs, symptoms and intentional or unintentional self-care management strategies regarding sleep and lifestyle. To promote a positive health outcome it is essential to identify sleeplessness behaviour and perceived self-efficacy for self-care in sleep.

  • 11.
    Jonsén, Elisabeth
    et al.
    Umeå University.
    Fagerström, Lisbeth
    University of Skövde, School of Life Sciences. Department of Health Sciences, Buskerud University College, Drammen, Norway / Lovisenberg Deaconale University College, Oslo, Norway.
    Lundman, Berit
    Umeå University.
    Nygren, Björn
    Umeå University.
    Vähäkangas, Magdalena
    Department of Caring Science, Åbo Academy University, Vaasa, Finland.
    Strandberg, Gunilla
    Umeå University.
    Psychometric properties of the Swedish version of the Purpose in Life scale2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 1, p. 41-48Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to test the theoretical assumptions beyond the Purpose in Life (PIL) scale, and to elucidate the underlying structure of the Swedish version of the PIL. The PIL, originally created by Crumbaugh and Maholick, is a 20-item scale of the Lickert type with possible scores ranges from 20 to 140, the higher score, the stronger PIL. The analysis was based on 449 participants, 62% of whom were women, from five different samples, ranging from 19 to 103 years old. An exploratory factor analysis restricted to three factors was performed. The factors were labelled meaning in existence, freedom to create meaning in daily life, and will to find meaning in future challenges. These factors reflected the three dimensions described by Frankl. Cronbach's alpha coefficient for the total scale was 0.83 and varied between 0.54 and 0.83 in the three factors. We concluded that the Swedish version of the PIL scale seems to have construct validity and reliability. Our results give support to the fact that the PIL scale captures and confirms the theoretical assumptions of Frankl's existential theory. We consider the PIL scale to be both feasible and appropriate for use in nursing research.

  • 12.
    Karlsson, Veronika
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Bergbom, Ingegerd
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Ringdal, Mona
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Jonsson, Annikki
    School of Health Science, Borås University College, Borås, Sweden.
    After discharge home: a qualitative analysis of older ICU patients' experiences and care needs2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 4, p. 749-756Article in journal (Refereed)
  • 13.
    Larsson, Inga E.
    et al.
    Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
    Sahlsten, Monika J. M.
    University of Skövde, School of Life Sciences.
    Segesten, Kerstin
    University College of Borås, Sweden.
    Plos, Kaety A. E.
    Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Patients' perceptions of barriers for participation in nursing care2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 575-582Article in journal (Refereed)
    Abstract [en]

    Background:  In many Western countries as in Sweden, patients have legal right to participate in own care individually adjusted to each patient’s wishes and abilities. There are still few empirical studies of patients’ perceptions of barriers for participation. Accordingly, there is a need to identify what may prevent patients from playing an active role in own nursing care. Such knowledge is highly valuable for the nursing profession when it comes to implementation of individual patient participation.

    Aim and objective:  To explore barriers for patient participation in nursing care with a special focus on adult patients with experience of inpatient physical care.

    Methodological design and justification:  Data were collected through 6 focus groups with 26 Swedish informants recruited from physical inpatient care as well as discharged patients from such a setting. A content analysis with qualitative approach of the tape-recorded interview material was made.

    Ethical issues and approval:  The ethics of scientific work was adhered to. Each study participant gave informed consent after verbal and written information. The Ethics Committee of Göteborg University approved the study.

    Results:  The barriers for patient participation were identified as four categories: Facing own inability, meeting lack of empathy, meeting a paternalistic attitude and sensing structural barriers, and their 10 underlying subcategories.

    Conclusions:  Our study contributes knowledge and understanding of patients’ experiences of barriers for participation. The findings point to remaining structures and nurse attitudes that are of disadvantage for patients’ participation. The findings may increase the understanding of patient participation and may serve as an incentive in practice and nursing education to meet and eliminate these barriers, in quality assurance of care, work organization and further research.

  • 14.
    Larsson, Inga E.
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden / Department of Nursing, Health and Culture, University West, Vänersborg, Sweden / Granvägen 12, SE-468 30 Vargön, Sweden.
    Sahlsten, Monika J. M.
    Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Lindencrona, Catharina S. C.
    Department of Health and Welfare, Stockholm, Sweden.
    Plos, Kaety A. E.
    Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Patient participation in nursing care from a patient perspective: a Grounded Theory study2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 3, p. 313-320Article in journal (Refereed)
    Abstract [en]

    The study's rationale: Patients’ active participation in their own care is expected to contribute to increased motivation to improve their own condition, better treatment results and greater satisfaction with received care. Knowledge of patients’ understanding of participation is of great importance for nurses in their efforts to meet patient expectations and for quality of nursing care.

    Aim: The aim was to explore the meaning of patient participation in nursing care from a patient point of view.

    Methodological design and justification: Six tape-recorded focus group interviews with 26 Swedish informants described opinions on and experiences of patient participation. The informants consisted of patients in somatic inpatient care as well as discharged patients from such a setting. The Grounded Theory method was used and the data were analysed using constant comparative analysis.

    Ethical issues and approval: The ethics of scientific work was followed. Each study participant gave informed consent after verbal and written information. The Ethics Committee of Göteborg University approved the study.

    Findings: The patients emphasised the importance of collaboration to improve participation. The core category, Insight through consideration, was generated from four inter-related categories: (i) Obliging atmosphere; (ii) Emotional response; (iii) Concordance; and (iv) Rights and their 15 subcategories.

    Conclusions: The meaning structures of patient participation in nursing care revealed from a patient point of view, seemed to mainly consist of not only external factors presented by the institutions – by the professionals – but also internal patient factors. The patients’ view of participation should be considered to a greater degree in nursing practice and education, as should also further development of nursing care policy programmes, evaluation and quality assurance criteria. For further development, studies are needed in similar and other settings.

  • 15.
    Lilja, Gunilla
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden .
    Edhborg, Maigun
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden .
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 2, p. 245-253Article in journal (Refereed)
    Abstract [en]

    Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum Background: Although many studies have reported negative impact of maternal depressive symptoms on family relations, few studies have explored whether or not early depressive symptoms influence interfamily relationships. The aim was to describe first-time mothers feelings for their infant and partner during the first postpartum year in relation to maternal depressive symptoms. Research questions were addressed about: What is the prevalence of maternal depressive symptoms 10 days postpartum? How does maternal depressive symptoms on day 10 relate to her mood and feelings for the infant and partner at days 3 and 10, and at 6 and 12 months postpartum? Methods: A longitudinal study with first-time mothers, normal pregnancies, giving birth to healthy babies participated in the study; altogether, n = 419. Depressive symptoms were measured by Edinburgh Postnatal Depression Scale (EPDS) at 3 and 10 days. Additional questionnaires assessing the womans mood and relationship with her infant and partner were filled out at days 3 and 10, and at 6 and 12 months postpartum. Results: Twenty-two per cent of the women scored high on EPDS on day 10 postpartum. In addition, low mood seemed to remain prevalent over the babys first year, as confirmed by the mood scale at 6 and 12 months postpartum. Women with depressive symptoms showed less closeness, warmth and confidence as measured by the infant and partner relationship scales over the first year. Mothers with a high EPDS score on day 3 scored less optimal on the relationship scale to the infant at days 3 and 10, but not 6 or 12 months postpartum. Conclusions: To screen women for depressive symptoms, 10 days postpartum seems to be predictive of maternal assessment of maternalinfant relationship throughout the first year and enables early intervention.

  • 16.
    Olsson, Ann
    et al.
    Karolinska Institute, Danderyds Hospital, BB Stockholm AB, Stockholm, Sweden / Karolinska Institute, Danderyds Hospital, BB Stockholm, S-182 88 Stockholm, Sweden.
    Lundqvist, Martina
    Nycomed AB, Lidingö, Sweden.
    Faxelid, Elisabeth
    Division of International Health, Department of Public Health Science, Karolinska Institute, Stockholm, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Women´s thoughts about sexual life after childbirth: focus group discussions with women after childbirth2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 381-387Article in journal (Refereed)
    Abstract [en]

    Background: To give birth and become a parent is a source of many emotions and expectations. Several studies show that women experience different problems after giving birth. It can bring many physical, emotional and social changes that may alter the woman’s sexual needs and impact on her relationship. The aim of this study was to elucidate how some women experienced their sexual life with their partner after giving birth. Methods: Twenty-seven women participated in six focus group discussions (FGDs). These discussions took place 3–24 months postdelivery. The midwives at their antenatal clinics selected them. A discussion guide with broad questions related to the subject was used and an observer took notes during the FGD. Results: Four themes were identified: body image after childbirth, how sexual patterns are altered following new stresses of family life, discordance of sexual desire with the partner and the necessity for reassurance. The women did not feel comfortable with the physical changes that had taken place and their body image. Childbirth meant less sleep and less free time; consequently, instead of having sex, women wanted to sleep or have time for themselves and that led to a changed sex pattern. Discordance of sexual desire with the partner was a problem but most of the women expressed confidence that their sexual desire would return shortly. Reassurance and confirmation that they were physically alright and back to normal was essential. Conclusion: New mothers are concerned with their body image and the ability to adapt to parenting. They need sensitive, professional counselling and reassurance about their body, as well as about sexual life after childbirth. This level of professional counselling is presently not widely available to new mothers, while midwives and gynaecologists

    should be the key persons to provide this service.

  • 17.
    Olsson, Ann
    et al.
    Karolinska Institutet.
    Robertson, Eva
    Karolinska Institutet.
    Björklund, Anders
    Karolinska Institutet.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Fatherhood in focus, sexual activity can wait: New fathers' experience about sexual life after childbirth2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 716-725Article in journal (Refereed)
    Abstract [en]

    Background: Becoming a parent is overwhelming for most men  and  women  and  alters  the  sexual  relationship  for many couples. Aim: To describe fathers’ experience about sexual life after childbirth within the first 6 months after childbirth. Method: A descriptive design, using content analysis with a qualitative approach, based on focus group discussions and one-to-one interviews. Participants: Eight  first-time  and  two  subsequent  fathers participated. Results: Three subthemes were identified: Struggling between stereotypes  and  personal  perceptions  of  male  sexuality  during transition to fatherhood; new frames for negotiating sex; a need to feel  safe  and  at  ease  in  the  new  family  situation. The over-arching  theme  emerged  as  ‘transition  to  fatherhood  brings sexual life to a crossroads’ and guided us to a deeper understanding  of  the  difficulties  men  experience  during  the transition  to  fatherhood.  To  get  sexual  life  working,  a number  of  issues  had  to  be  resolved,  such  as  getting involved in the care of the baby and the household and getting  in  tune  with  their  partners  in  regard  to  sexual desire. The men needed to be reassured and prepared for this new situation by health care professionals. Conclusions: New fathers in our study put the baby in focus in early parenthood and were prepared to postpone sex until  both  parties  were  ready,  although  they  needed reassurance to feel at ease with the new family situation. The fathers’ perceptions of sexual life extended to include all kinds of closeness and touching, and it deviated from the stereotype of male sexuality. This is important information for health care providers and midwives to be aware of for their encounters with men (and women) during the transition  to  fatherhood,  and  parenthood  and  can  contribute  to  caring  science  with  a  gender  perspective  on adjustment of sexual life after childbirth.

  • 18.
    Sahlsten, Monika J. M.
    et al.
    University of Skövde, School of Life Sciences.
    Larsson, Inga E.
    Univ West, Dept Nursing Hlth & Culture, Trollhattan, Sweden .
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Plos, Kaety A. E.
    Gothenburg Univ, Sahlgrenska Acad, Inst Hlth & Care Sci, Gothenburg, Sweden.
    Nurse strategies for optimising patient participation in nursing care2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 3, p. 490-497Article in journal (Refereed)
    Abstract [en]

    The study's rationale: Patient participation is an essential factor in nursing care and medical treatment and a legal right in many countries. Despite this, patients have experienced insufficient participation, inattention and neglect regarding their problems and may respond with dependence, passivity or taciturnity. Accordingly, nurses strategies for optimising patient participation in nursing care is an important question for the nursing profession. Aim and objective: The aim was to explore Registered Nurses' strategies to stimulate and optimise patient participation in nursing care. The objective was to identify ward nurses' supporting practices. Methodological design and justification: A qualitative research approach was applied. Three focus groups with experienced Registered Nurses providing inpatient somatic care (n = 16) were carried out. These nurses were recruited from three hospitals in West Sweden. The data were analysed using content analysis technique. Ethical issues and approval: The ethics of scientific work was adhered to. According to national Swedish legislation, no formal permit from an ethics committee was required. The participants gave informed consent after verbal and written information. Results: Nurse strategies for optimising patient participation in nursing care were identified as three categories: 'Building close co-operation', 'Getting to know the person' and 'Reinforcing self-care capacity' and their 10 subcategories. Conclusions: The strategies point to a process of emancipation of the patient's potential by finding his/her own inherent knowledge, values, motivation and goals and linking these to actions. Nurses need to strive for guiding the patient towards attaining meaningful experiences, discoveries, learning and development. The strategies are important and useful to balance the asymmetry in the nurse-patient relationship in daily nursing practice and also in quality assurance to evaluate and improve patient participation and in education. However, further verification of the findings is recommended by means of replication or other studies in different clinical settings.

  • 19.
    Tofthagen, Randi
    et al.
    Lovisenberg Diaconal University College, Oslo.
    Fagerström, Lisbeth
    University of Skövde, School of Life Sciences.
    Clarifying self-harm through evolutionary concept analysis2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 3, p. 610-619Article in journal (Refereed)
    Abstract [en]

    Clarification of the concept self-harm is needed in order to enable research and theory development and facilitate the development and evaluation of medical interventions and nursing care for individuals who self-harm. This study presents such a conceptual analysis. Articles from 1997 to 2007 were sought from the Medline, PubMed, Cinahl, and PsychINFO search engines by entering the search words ‘self-harm’, ‘self-harming’, and ‘psychiatric care’. 25 medicine and 23 nursing science articles were chosen for inclusion and analysed. Rodgers’ evolutionary concept analysis process was used to delineate and clarify the concept’s context, surrogate terms, antecedents, attributes, and consequences, as well as to determine implications for further research. Attributes of self-harm may include repetitive injury of mouth or exterior body, that is to say the infliction of physical pain to alleviate mental pain, and time spent self-harming. Antecedents may be gender, mental pain, substance abuse and relational problems. Consequences often include the need for medication and help with altering coping behaviour. Some self-harm patients met with negative attitudes from nurses. Individualized care and treatment is recommended. Accordingly, inter-professional collaboration and postgraduate education is needed in order to provide better care and treatment for self-harm patients. Furthermore, better understanding is needed to help enable health care personnel understand why individuals self-harm. The conceptual analysis presented in this study may be helpful as regards theory development within this still rather unexplored field.

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