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  • 1.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden.
    Seiger Cronfalk, Berit
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden, Stord Haugesund University College, Norway.
    Henrikssen, Eva
    Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden, FOUnu, Stockholm County Council, Stockholm, Sweden.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Nursing, Umeå University, Umeå, Sweden.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden, Stockholms Sjukhem foundation, Research, Development and Education Unit, Stockholm, Sweden.
    Sandberg, Jonas
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Nursing, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care2014In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 8, 71-78 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate first-line nursing home managers’ views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care.

    Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviewswere conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes.

    The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested.

  • 2.
    Håkansson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Seiger Cronfalk, Berit
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Henriksen, Eva
    Karolinska institutet.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Sandberg, Jonas
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    First-line managers’ views on leadership and palliative care in Swedish nursing homes2014In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 8, 71-78 p.Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate first-line nursing home managers' views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested.

  • 3. Riddebäck, Christina
    et al.
    Seiger Cronfalk, Berit
    Ersta Sköndal University College, Department of palliative care research.
    Palliativ vård: en mänsklig rättighet2009In: Äldre i centrum, ISSN 1653-3585, no 4Article in journal (Other (popular science, discussion, etc.))
  • 4.
    Rustad, Else Cathrine
    et al.
    Norge.
    Furnes, Bodil
    Norge.
    Cronfalk, Berit Seiger
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Stord Haugesund University College, Stord, Norway, Karolinska institutet.
    Dysvik, Elin
    Norge.
    Older patients' experiences during care transition.2016In: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 10Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A fragmented health care system leads to an increased demand for continuity of care across health care levels. Research indicates age-related differences during care transition, with the oldest patients having experiences and needs that differ from those of other patients. To meet the older patients' needs and preferences during care transition, professionals must understand their experiences.

    OBJECTIVE: The purpose of the study was to explore how patients ≥80 years of age experienced the care transition from hospital to municipal health care services.

    METHODS: The study has a descriptive, explorative design, using semistructured interviews. Fourteen patients aged ≥80 participated in the study. Qualitative content analysis was used to describe the individuals' experiences during care transition.

    RESULTS: Two complementary themes emerged during the analysis: "Participation depends on being invited to plan the care transition" and "Managing continuity of care represents a complex and challenging process".

    DISCUSSION: Lack of participation, insufficient information, and vague responsibilities among staff during care transition seemed to limit the continuity of care. The patients are the vulnerable part of the care transition process, although they possess important resources, which illustrate the importance of making their voice heard. Older patients are therefore likely to benefit from more intensive support. A tailored, patient-centered follow-up of each patient is suggested to ensure that patient preferences and continuity of care to adhere to the new situation.

  • 5.
    Seiger Cronfalk, Berit
    Ersta Sköndal University College, Department of palliative care research. Karolinska institutet.
    Being in safe hands: the experiences of soft tissue massage as a complement in palliative care. Intervention studies concerning patients, relatives and nursing staff2008Doctoral thesis, comprehensive summary (Other academic)
  • 6.
    Seiger Cronfalk, Berit
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Betydelsen av mjuk massage2013In: Palliativ vård: begrepp & perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt, Cecilia Håkanson, Lund: Studentlitteratur AB, 2013, 443-451 p.Chapter in book (Other academic)
  • 7.
    Seiger Cronfalk, Berit
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Massage och beröring i palliativ omvårdnad2012In: Palliativ medicin och vård / [ed] Peter Strang, Barbro Beck-Friis, Stockholm: Liber, 2012, 4 rev., 300-305 p.Chapter in book (Refereed)
  • 8.
    Seiger Cronfalk, Berit
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Karolinska institutet.
    Massage och beröring: inspiration för äldreomsorgen2017 (ed. Första upplagan)Book (Other academic)
    Abstract [sv]

    Forskning visar att massage och snäll mänsklig beröring har positiva effekter på välbefinnandet hos äldre och svårt sjuka. Beröring har ibland livsavgörande betydelse för hur människor upplever olika situationer. Både den som tar emot och den som ger beröring påverkas positivt.

    Det här är en inspirerande bok som ger tankar, reflektioner och kunskaper om hur du kan använda beröring och massage i omvårdnaden av äldre personer. Den innehåller flera fallbeskrivningar och besvarar vanliga frågor.

    • Vad är det som händer när en person får massage?

    • Spelar det någon roll vem det är som ger massage?

    • Kan vem som helst ge massage?

    Boken Massage och beröring vänder sig främst till personal inom äldreomsorgen, men är även lämplig för andra yrkesutövare samt anhöriga.

  • 9.
    Seiger Cronfalk, Berit
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Fjell, Astrid
    Norge.
    Carstens, Nina
    Norge.
    Rosseland, Lars Malvin Kvinge
    Norge .
    Rongve, Arvid
    Norge.
    Rönnevik, Dag-Helge
    Norge.
    Seiger, Åke
    Karolinska institutet.
    Skaug, Knut
    Norge.
    Ugland Vae, Karen Johanne
    Karolinska institutet.
    Hauge Wennersberg, Marianne
    Norge.
    Boström, Anne-Marie
    Norge.
    Health team for the elderly: a feasibility study for preventive home visits.2017In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, 1-11 p.Article in journal (Refereed)
    Abstract [en]

    The aim was to describe the development, utilization and feasibility of a model of preventive home visits, in an urban and a rural municipality in Norway.

    BACKGROUND: Older people >65 years will rise significantly in coming years. Increased age is associated with risk of disability, illness and need for public health services. Preventive home visits is assumed to help older people to maintain their functional level longer, delaying disease and thus delaying the need for health care.

    METHOD: Descriptive explorative design describing the development, utilization and feasibility of preventive home visits in two different settings. All 77-year-old persons living at home in an urban municipality and all 75 years and older in a rural municipality were invited to participate. A questionnaire including a substantial number of tests concerning; fall, nutrition, polypharmacy and cognitive impairment was used by Health Team Nurses as base for a risk assessment. Pilot studies were conducted to validate the questionnaire including an inter-rater reliability study of the risk assessment tool. A multiprofessional team, Health Team for the Elderly met each week to evaluate risk assessments and make recommendations to be sent to each respective general practitioner. Data were analysed using descriptive and inferential statistics. In total, 167 persons (109 from the urban municipality and 58 from the rural municipality) participated, corresponding to 60% of the approached individuals. The mean time for the visits was 108 minutes (SD 20). Missing data were identified for; Do you feel safe in your municipality (17.5%) and Are you looking forward to ageing (11.4%). In total, 36 persons (21.7%) were identified with increased risk for developing illness. We suggest that a structured model of preventive home visits and collaboration between highly specialized health care professionals are important factors for reliable health promoting risk assessments of elderly home dwellers.

  • 10.
    Seiger Cronfalk, Berit
    et al.
    Ersta Sköndal University College, Department of palliative care research. Karolinska institutet.
    Friedrichsen, Maria
    Milberg, Anna
    Strang, Peter
    A one-day education in soft tissue massage: experiences and opinions as evaluated by nursing staff in palliative care.2008In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 6, no 2, 141-148 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Increasing awareness of well-being aspects of physical touch has spurred the appreciation for soft tissue massage (STM) as part of palliative care. Educational programs are available but with no specific focus on utilization for this kind of care. The aim was to study the feasibility of a 1-day course in STM in clarifying nursing staff's experiences and opinions, but also to shed light on their motivation and ability to employ STM in the care of dying cancer patients. METHOD: In all, 135 nursing staff participated. The course consisted of theory and hands-on training (hand-foot-, back massage). Focus-groups with 30/135 randomly chosen participants were conducted 4 weeks after the intervention. This study engaged a qualitative approach using content analysis. RESULTS: The overall opinion of the 1-day course was positive. The majority experienced the contents of the course to be adequate and sufficient for clinical care. They emphasized the pedagogical expertise as valuable for the learning process. The majority of nurses shared the opinion that their extended knowledge clarified their attitudes on STM as a complement in palliative care. Still, a few found it to be too basic and/or intimate. Three categories emerged during the analysis: experiences of and attitudes toward the education, experiences of implementing the skills in every-day care situations, and attitudes to the physical body in nursing care. SIGNIFICANCE OF RESULTS: The approach to learning and the pedagogical skills of the teacher proved to be of importance for how new knowledge was perceived among nurses. The findings may encourage hospital organizations to introduce short courses in STM as an alternative to more extensive education.

  • 11.
    Seiger Cronfalk, Berit
    et al.
    Ersta Sköndal University College, Department of palliative care research. Karolinska institutet.
    Strang, Peter
    Karolinska institutet.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Inner power, physical strength and existential well-being in daily life: relatives' experiences of receiving soft tissue massage in palliative home care.2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 15, 2225-2233 p.Article in journal (Refereed)
    Abstract [en]

    AIM AND OBJECTIVES: This article explores relatives' experiences of receiving soft tissue massage as a support supplement while caring for a dying family member at home. BACKGROUND: In palliative home care, relatives play an important role as carers to seriously ill and dying family members. To improve their quality of life, different support strategies are of importance. Complementary methods, such as soft tissue massage have become an appreciated supplement for these patients. However, only few studies focus on relatives experiences of receiving soft tissue massage as a supplemental support. DESIGN: Qualitative design METHOD: Nineteen relatives received soft tissue massage (hand or foot) nine times (25 minutes) in their homes. Open-ended semi-structured tape-recorded interviews were conducted once per relative after the nine times of massage, using qualitative content analysis. RESULTS: Soft tissue massage gave the relatives' feelings of 'being cared for', 'body vitality' and 'peace of mind'. For a while, they put worries of daily life aside as they just experienced 'being'. During massage, it became apparent that body and mind is constituted of an indestructible completeness. The overarching theme was 'inner power, physical strength and existential well-being in their daily lives'. CONCLUSION: All relatives experienced soft tissue massage positively, although they were under considerable stress. Soft tissue massage could be an option to comfort and support relatives in palliative home care. RELEVANCE TO CLINICAL PRACTICE: In palliative nursing care, soft tissue massage could present a worthy supplement in supporting caring relatives.

  • 12.
    Seiger- Cronfalk, Berit
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska Institutet, Stockholm, Sweden, Stord Haugesund University College, Haugesund, Norway.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska Institutet, Stockholm, Sweden .
    Franklin Larsson, Lise-Lotte
    Ersta Sköndal University College, Palliative Research Centre, PRC. Sophiahemmet University College, Stockholm, Sweden.
    Henriksen, Eva
    Stockholm County Council, Research and Development FOUnu, Stockholm, Sweden.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Research Centre, PRC. Umeå University, Sweden.
    Österlind, Jane
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Utilization of palliative care principles in nursing home care: Educational interventions2015In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 6, 1745-1753 p.Article in journal (Refereed)
    Abstract [en]

    Objective: This study is part of the overarching PVIS (Palliative Care in Nursing Homes) project aimed at building competence in palliative care for nursing home staff. Our objective was to describe nursing home staff's attitudes to competence-building programs in palliative care.

    Method: Three different programs were developed by specialist staff from three local palliative care teams. In all, 852 staff at 37 nursing homes in the greater Stockholm area participated. Staff from 7 nursing homes participated in 11 focus-group discussions. Variation in size between the seven nursing homes initiated purposeful selection of staff to take part in the discussions, and descriptive content analysis was used.

    Results: The results suggest that staff reported positive experiences as they gained new knowledge and insight into palliative care. The experiences seemed to be similar independent of the educational program design. Our results also show that staff experienced difficulties in talking about death. Enrolled nurses and care assistants felt that they carried out advanced care without the necessary theoretical and practical knowledge. Further, the results also suggest that lack of support from ward managers and insufficient collaboration and of a common language between different professions caused tension in situations involved in caring for dying people.

    Significance of results: Nursing home staff experienced competence-building programs in palliative care as useful. Even so, further competence is needed, as is long-term implementation strategies and development of broader communication skills among all professions working in nursing homes.

  • 13.
    Seiger Cronfalk, Berit
    et al.
    Ersta Sköndal University College, Department of palliative care research. Karolinska institutet.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Strang, Peter
    Karolinska institutet.
    Soft tissue massage: early intervention for relatives whose family members died in palliative cancer care2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 7-8, 1040-1048 p.Article in journal (Refereed)
    Abstract [en]

    Aim and objectives.  This paper explores how bereaved relatives experienced soft tissue massage during the first four months after the death of a family member who was in palliative cancer care.

    Background.  Death of a close family member or friend is recognised as being an emotional and existential turning point in life. Previous studies emphasise need for various support strategies to assist relatives while they are grieving.

    Design.  Qualitative design.

    Method.  Eighteen bereaved relatives (11 women and seven men) received soft tissue massage (25 minutes, hand or foot) once a week for eight weeks. In-depth interviews were conducted after the end of the eight-week periods. Interviews were analysed using a qualitative descriptive content analysis method.

    Results.  Soft tissue massage proved to be helpful and to generate feelings of consolation in the first four months of grieving. The main findings were organised into four categories: (1) a helping hand at the right time, (2) something to rely on, (3) moments of rest and (4) moments of retaining energy. The categories were then conceptualised into this theme: feelings of consolation and help in learning to restructure everyday life.

    Conclusions.  Soft tissue massage was experienced as a commendable source of consolation support during the grieving process. An assumption is that massage facilitates a transition toward rebuilding identity, but more studies in this area are needed.

    Relevance to clinical practice.  Soft tissue massage appears to be a worthy, early, grieving-process support option for bereaved family members whose relatives are in palliative care.

  • 14.
    Seiger Cronfalk, Berit
    et al.
    Ersta Sköndal University College, Department of palliative care research.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Strang, Peter
    Friedrichsen, Maria
    The existential experiences of receiving soft tissue massage in palliative home care: an intervention2009In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 17, no 9, 1203-1211 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Soft tissue massage is currently used in palliative care for the relief of anxiety and pain. Only few studies have focused on patients' deeper experience of receiving the massage.

    AIM: The purpose of this study was to explore how patients with cancer in palliative home care experienced soft tissue massage.

    MATERIALS AND METHODS: Twenty-two patients received soft tissue massage (hand or foot) nine times over a period of 2 weeks. Each session lasted for 25 min. Following the last massage session, a qualitative interview was conducted. The analysis was performed using a hermeneutic approach.

    FINDINGS: Soft tissue massage generated feelings of existential respite with perceptions of being released from illness for a while. Two categories constituted the basis of the experiences: (1) "an experience of thoughtful attention" and (2) "a sensation of complete tranquility" resulting in the overarching theme "A time of existential respite."

    CONCLUSION: The patients experienced the massage to give meaning and to be important as it generated feelings of an inner respite.

    RELEVANCE TO CLINICAL PRACTICE: Soft tissue massage appears to be an appreciated source of support to dying patients in palliative home care. The method is easy to comprehend and relatively short (25 min) which may imply that it is a suitable complement in nursing care for this patient group.

  • 15. Seiger, Åke
    et al.
    Seiger Cronfalk, Berit
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Palliativ vård i förändring: Exempel på svenska utvecklingsprojekt2013In: Omsorg: Nordisk tidsskrift for Palliativ Medisin, ISSN 0800-7489, Vol. 30, no 2, 13-17 p.Article in journal (Refereed)
1 - 15 of 15
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