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  • 1.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    How can we as researchers enhance the quality of our studies?2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7Article in journal (Refereed)
  • 2.
    Fagerberg, Ingegerd
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Engström, Gabriella
    Care of the old - a matter of ethics, organization and relationships2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7Article in journal (Refereed)
  • 3. Friberg, F
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Searching for knowledge and understanding while living with impending death - a phenomenological case study2007In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 4, 217-26 p.Article in journal (Refereed)
  • 4.
    Häggström, Marie
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Kristiansen, Lisbeth
    Mittuniversitetet.
    Struggle with a gap between intensive care units and general wards2009In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 3, 181-192 p.Article in journal (Refereed)
    Abstract [en]

    Nursing critically ill patients includes planning and performing safe discharges from Intensive Care Units (ICU) to the general wards. The aim of this study was to obtain a deeper understanding of the main concern in the ICU transitional process-the care before, during, and after the transfer of ICU patients. Interviews were conducted with 35 Swedish nurses and analysed according to grounded theory. The main concern was the nurses' "struggling with a gap." The "gap" was caused by differences in the altered level of care and contributed to difficulties for nurses encountering an overlap during the transitional care. The categories: Sheltering, seeking organizational intertwining and striving for control are related to the core category and were used to generate a theory. The nurses sought improved collaboration, and employed patient-centred routines. They wanted access to necessary tools; they relayed or questioned their own competence and sought assurance of the patients' ability to be transferred. If the nurses felt a loss of control, lack of intertwining and lack of collaboration, they sheltered their patients and themselves. Intertwining was more difficult to perform, but actually even more important to do. With knowledge about ICU transitional care, collaboration, routines, and with an organization that provides an educational environment, the process could be improved.

  • 5.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlén, Joakim
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Göteborgs universitet.
    Illness narratives of people who are homeless.2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, no 1, 32924Article in journal (Refereed)
    Abstract [en]

    Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and "freedom" in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony). The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  • 6.
    James, Inger
    et al.
    Örebro universitet.
    Andershed, Birgitta
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Gustavsson, Bengt
    Örebro universitet.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Emotional knowing in nursing practice: In the encounter between life and death2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, 53-67 p.Article in journal (Refereed)
  • 7.
    Kneck, Åsa
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Eriksson, Lars E
    Karolinska Institutet.
    Lundman, Berit
    Umeå universitet.
    Living with diabetes: Development of learning patterns over a 3-year period2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, 24375Article in journal (Refereed)
    Abstract [en]

    Background: Learning involves acquiring new knowledge and skills, and changing our ways of thinking, acting, and feeling. Learning in relation to living with diabetes is a lifelong process where there is limited knowledge of how it is experienced and established over time. It was considered important to explore how learning was developed over time for persons living with diabetes.

    Aim: The aim of the study was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period.

    Materials and methods: A longitudinal qualitative descriptive design was used. Thirteen participants, with both type I and type II diabetes, were interviewed at three different occasions during a 3-year period. Qualitative content analysis was used in different steps in order to distinguish patterns.

    Findings: Five main patterns of learning were identified. Two of the patterns (I and II) were characterized by gradually becoming comfortable living with diabetes, whereas for one pattern (IV) living with diabetes became gradually more difficult. For pattern V living with diabetes was making only a limited impact on life, whereas for Pattern III there was a constant management of obstacles related to illness. The different patterns in the present study showed common and different ways of learning and using different learning strategies at different timespans.

    Conclusion: The present study showed that duration of illness is not of importance for how far a person has come in his own learning process. A person-centered care is needed to meet the different and changing needs of persons living with diabetes in relation to learning to live with a lifelong illness.

  • 8.
    Kristiansen, Lisbeth
    et al.
    Mittuniversitetet & Karolinska institutet.
    Hellzén, Ove
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Swedish assistant nurses´experiences of job satisfaction when caring for persons suffering from dementia and behavioural disturbances: An interview study2006In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 1, no 4, 245-256 p.Article in journal (Refereed)
    Abstract [en]

    Job satisfaction is complex and is an important component in facilitating high quality nursing care. Behavioural and psychological symptoms of dementia (BPSD) can be clustered into one of five syndromes: psychosis, aggression, psychomotor agitation, depression and apathy, and comprise signs and symptoms of disturbed perception, thought content, mood or behaviour that frequently occur in patients with dementia. BPSD can cause tremendous distress both for the patients and for their caregivers and they have been seen as the most stressful aspect of care giving. Two registered nurses, 16 assistant nurses and two nursing assistants in Sweden talked about their job satisfaction when caring for residents suffering from dementia and BPSD. Thematic content analysis was conducted. The nurses' narrations indicate exposure, insufficiency, not being valued and doubt, as well as respect and importance and devotion towards the residents. One core theme was formulated: "Job satisfaction as a process moving between breaking down and occasionally building up the working person". A positive relationship with colleagues was the primary reason for nurses continuing to work at the group dwellings. The organization and resident behaviours were seen as very negative. Some nurses described insecurity in terms of how long they could continue to take rudeness, being spat at, being scratched or physically hit by residents, without "hitting back". In order to increase the well-being of the nurses, the pressure on them needs to be relieved. The development of leadership, education, supervision and reflection might be one possible way of reducing the prevalence of BPSD-related violence, enhancing job satisfaction and handling moral stress.

  • 9.
    Lööf, Helena
    et al.
    Sophiahemmet Högskola.
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Henriksson, Elisabeth
    Karolinska institutet.
    Lindblad, Staffan
    Karolinska institutet.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Body awareness in persons diagnosed with rheumatoid arthritis2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, 24670Article in journal (Refereed)
    Abstract [en]

    Living with rheumatoid arthritis (RA) poses physiological and psychological demands on a person. RA is a autoimmune disease that can cause pain, disability, and suffering. The ability to notice bodily inner sensations and stimuli (body awareness, BA) is described in the literature in ways that could have either a positive or a negative impact on a person's health. The concept of BA is complex and a thorough understanding is needed about what BA means from the patient's perspective. This study was therefore conducted to acquire greater insight into this phenomenon. The study is grounded in a phenomenological life-world perspective. Eighteen narrative interviews were conducted in patients (age range 23–78 years) with RA. The interviews were analyzed using the Empirical Phenomenological Psychological method. General characteristics were found running through all 18 interviews, indicating that the disease resulted in a higher degree of negatively toned BA. BA was either a reactive process of searching or controlling after disease-related symptoms or a reactive process triggered by emotions. BA was an active process of taking an inventory of abilities. All participants had the ability to shift focus from BA to the outside world. Four typologies were identified: “A reactive process on symptoms,” “A reactive process on emotional triggers,” “An active process of taking an inventory of abilities,” and “A shifting from BA to the outside world.” In conclusion, because BA can be both positively and negatively toned, health care professionals must have a good understanding of when BA is positive and when it is negative in relation to the patient. RA had caused a higher degree of negatively toned BA. Thus, the ability to shift attention from BA to activity in the outside world could sometimes be beneficial for the patient's general health.

  • 10. Martinsson, Gunilla
    et al.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Lindholm, Christina
    Wiklund Gustin, Lena
    Struggling for existence – life situation experiences of older persons with mental disorders2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, Vol. 7Article in journal (Refereed)
  • 11. Martinsson, Gunilla
    et al.
    Wiklund-Gustin, Lena
    Lindholm, Christina
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Being altruistically egoistic - Nursing aides' experiences of caring for older persons with mental disorders2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 7530Article in journal (Refereed)
    Abstract [en]

    Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the futureinternational increase in the older population, mental disorders will increase as well, thus entailing new challenges for theircaregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. Withlittle previous research, an increased workload and facing new strenuous situations, it is important to make use of theknowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminatingthe meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home helpservice. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneuticalresearch method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in thenursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic andegoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balancebetween their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancingfunctions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increasedknowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursingaides to improve the quality of the care given.

  • 12.
    Storli, Sissel L.
    et al.
    University of Tromsø, Norway.
    Lindseth, Anders
    University of Tromsø, Norway & Bodø Regional University, Norway.
    Asplund, Kenneth
    University of Tromsø, Norway & Mittuniversitetet.
    Being somwhere else - delusion or relevant experience: A phenomenological investigation into the meaning of lived experience from being in intensive care2007In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 3, 144-159 p.Article in journal (Refereed)
    Abstract [en]

    Patients' experiences of having been “elsewhere” during intensive care than in the intensive care unit (ICU) has traditionally been placed in a context with described pathological circumstances, such as brain dysfunction, and labeled with terms such as “unreal” and “delusional”. The aim of the study was to look more closely into this type of experience by turning to its meaning as reflected on by patients themselves. Through a phenomenological investigation based on follow-up and interviews with three patients, we found that the “delusions” were in fact filled with meaning. They mattered to the patients and were not to be dismissed as unreal because they were so inherently real in the lived body. The experiences were grounded in the patient's lifeworld and could be interpreted as expressions of basic aspects related to being human in the world. The phenomenological term “lived mood” emerged as one such aspect to which intensive care patients appear to surrender more readily than man does in daily existence. The notion of “being somewhere else” as meaningful and relevant experience challenges the explanatory model whereby such experiences are placed in a context with brain dysfunction.

  • 13.
    Swall, Anna
    et al.
    Högskolan Dalarna.
    Ebbeskog, Britt
    karolinska institutet.
    Lundh Hagelin, Carina
    Karolinska institutet, Sophiahemmet högskola.
    Fagerberg, Ingegerd
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Stepping out of the shadows of Alzheimer's disease: A phenomenological hermeneutic study of older people with Alzheimer´s disease caring for a therapy dog.2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1Article in journal (Refereed)
    Abstract [en]

    Purpose: Living with Alzheimer’s disease (AD) can involve a person being unable to recall and convey information in daily life. There are several ways to provide person-centred care to older people with AD, e.g. by empowering them in a situation. The use of animal-assisted therapy (AAT) with a therapy dog in the care of people with dementia is increasing, with the presence of a therapy dog being described as improving, among other things, the well-being and socialization of the person. The aim of this study was to illuminate meanings of care for people with AD in their encounters with a therapy dog.

    Method: The study used video-recorded observations of the person with AD and the dog. Data were transcribed and analysed using a phenomenological hermeneutic method.

    Results: The main theme was “Using one’s own resources and abilities as a human being”, which meant being the person one can be and distancing oneself from the symptoms of AD during the time with the dog.

    Conclusions: The feelings evoked in the people with AD included empathy and altruism, which allowed for a sense of joy and tenderness, which may induce a sense of self-worth, of being needed, and of being meaningful.

  • 14.
    Wiklund, Susanne
    et al.
    Stockholms läns landsting, Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Örtqvist, Åke
    Karolinska institutet, Stockholms läns landsting.
    Broliden, Kristina
    Karolinska institutet.
    Tammelin, Ann
    Stockholms läns landsting, Karolinska institutet.
    Acquisition of extended spectrum β-lactamases during travel abroad: A qualitative study among Swedish travellers examining their knowledge, risk assessment, and behaviour2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, 32378- p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Travel to foreign countries involves the risk of becoming a carrier of antibiotic-resistant bacteria, especially when the destination is a country with a high prevalence of this type of bacteria.

    AIM AND METHODS: The aim of this study was to learn about the knowledge of antibiotic resistance, and the behaviour and risk-taking among travellers, who had become carriers of extended spectrum beta-lactamases (ESBL)-producing bacteria during travel to a high-prevalence country. A modified version of grounded theory was used to analyse 15 open interviews.

    RESULTS: The analysis resulted in a core category: A need for knowledge to avoid risk-taking. Before the journey, the participants did not perceive there to be any risk of becoming a carrier of antibiotic- resistant bacteria. The low level of knowledge of antibiotic-resistant bacteria and transmission routes influenced their behaviour and risk-taking during their journey, resulting in them exposing themselves to risk situations. After their trip, the majority did not believe that their personal risk behaviour could have caused them to become carriers of ESBL.

    CONCLUSION: The participants' lack of knowledge of antibiotic-resistant bacteria resulted in unconscious risk-taking during their journey, which may have resulted in becoming carriers of ESBL-producing bacteria.

  • 15.
    Öhlen, Joakim
    et al.
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Ekman, Inger
    Zingmark, Karin
    Bolmsjö, Ingrid
    Benzein, Eva
    Conceptual development of "at-homeness" despite illness and disease: a review.2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, 23677- p.Article in journal (Refereed)
    Abstract [en]

    Only one empirical study, the one by Zingmark, Norberg and Sandman published in 1995, explicitly focuses on at-homeness, the feeling of being metaphorically at-home, as a particular aspect of wellness. However, other studies reveal aspects of at-homeness, but if or how such aspects of at-homeness are related to each other is unclear. For this reason, the aim was to review Scandinavian nursing research related to at-homeness in the context of wellness-illness in severe and long-term conditions in order to take a step towards conceptual clarification of "at-homeness." The review included interpretive studies related to severe and long-term illness conducted in Sweden: 10 original articles and 5 doctoral theses. "At-homeness" was found to be a contextually related meaning of wellness despite illness and disease embedded in the continuum of being metaphorically at-home and metaphorically homeless. This was characterized by three interrelated aspects and four processes: being safe through expanding-limiting experiences of illness and time, being connected through reunifying-detaching ways of relating, and being centred through recognition-non-recognition of oneself in the experience and others giving-withdrawing a place for oneself. This conceptualization is to be regarded as a step in conceptual clarification. Further empirical investigation and theoretical development of "at-homeness" are needed. The conceptualization will be a step of plausible significance for the evaluation of interventions aimed at enhancing wellness for people with severe long-term illness, such as the frail elderly, and people with chronic illness or palliative care needs.

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