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  • 1. Andersson, B
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Being a hospice volunteer2005In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 19, p. 602-609Article in journal (Refereed)
  • 2. Bengtsson, J
    et al.
    Berndtsson, I
    Carlsson, N
    Claesson, S
    Friberg, F
    Johansson, E
    Öhlén, Joakim
    Göteborgs universitet.
    Pedagogic research with the life-world as a basis2000In: Nordisk Pedagogik, ISSN 0901-8050, E-ISSN 1504-2995, Vol. 20, p. 124-7Article in journal (Other academic)
  • 3.
    Berg, Linda
    et al.
    Sahlgrenska akademin, Göteborgs universitet.
    Nolbris, Margaretha Jenholt
    Sahlgrenska akademin, Göteborgs universitet.
    Koinberg, Ingalill
    Sahlgrenska akademin, Göteborgs universitet.
    Melin-Johansson, Christina
    Sahlgrenska akademin, Göteborgs universitet.
    Möller, Anders
    Ersta Sköndal University College, Department of Social Sciences. Sahlgrenska akademin, Göteborgs universitet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Sahlgrenska akademin, Göteborgs universitet.
    Characterisation of cancer support and rehabilitation programmes: a Swedish multiple case study.2014In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 8, article id TONURSJ-8-1Article in journal (Refereed)
    Abstract [en]

    Cancer support and rehabilitation are suggested to be an integral part of cancer care strategies. This study focuses on comparativeness of cancer support and rehabilitation programmes. The aim of this study was to analyse available cancer support and rehabilitation programmes in Sweden presented as complementary to cancer rehabilitation at cancer clinics. A multiple case study design was chosen in order to inquire the small number of existing supportive and rehabilitative cancer programmes. Based on the structures, processes and outcomes of the nine included programmes, three types of cancer support and rehabilitation programmes were identified: multimodal rehabilitation, comprehensive cancer support and art therapy. Cancer support and rehabilitation programmes offer a variety of activities and therapies which are highly valuable and relevant for people with cancer. The typology of cancer support and rehabilitation programmes and comparability between programmes need further inquiry.

  • 4.
    Bergius, Anki
    et al.
    Drottning Silvias barn- och ungdomssjukhus, Göteborg.
    Palmqvist, Gunilla
    Sahlgrenska universitetssjukhuset, Göteborg.
    Holm, Ann-Kristin
    Göteborgs universitet, Sahlgrenska universitetssjukhuset.
    Öhlén, Joakim
    Göteborgs universitet, Karolinska institutet.
    Stödverksamhet för barn som förlorat en förälder: En litteraturstudie2004In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 24, no 4, p. 41-44Article, review/survey (Other academic)
    Abstract [en]

    The aim with this literature review was to describe content, objectives, design, and outcomes of support groups for parentally bereaved children three to twelve years of age. In a support group with children in similar situation the children's thoughts, experiences and feelings will be normalised through different activities. Pedagogical methods include creative activities of different kinds, e.g. painting, writing letters and poems, reading stories, play and games. The purposes of the methods are to accept and understand the reality of the loss, to understand and work through the grieving, to enhance family communication, and to keep the memory of the death and go on living. Organisation and structure are described in relation to development levels and ages of children and youths. Outcomes of groups are characterized by clinical observations and a dearth of evaluative studies. All bereaved children should have the opportunity to participate in a support group when a parent, sibling or other relative dies. Well developed services for bereaved children should be a matter of health care policy and quality.

  • 5. Berndtsson, I
    et al.
    Claesson, S
    Friberg, F
    Öhlén, Joakim
    Göteborgs universitet.
    Issues about thinking phenomenologically while doing phenomenology2007In: Journal of Phenomenological Psychology, ISSN 0047-2662, E-ISSN 1569-1624, Vol. 38, no 2, p. 256-77Article in journal (Refereed)
  • 6. Carlsson, E
    et al.
    Pettersson, M
    Hydén, LC
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Friberg, Febe
    University of Stavanger.
    Structure and content in consultations with patients undergoing surgery for colorectal cancer.2013In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, no 6, p. 820-826Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore the structure and content of pre-planned consultations as part of the care and treatment of patients undergoing surgery for colorectal cancer. Methods: The study was based on 50 transcripts of audio-recorded pre-planned consultations between seven patients and 36 healthcare professionals from the time of diagnosis, pre-operative consultation, discharge consultation and pathology report in a colorectal unit. Results: The spread of consultation time between professions was considerable. Total mean consultation time for patients during the care process (7 consultations/patient) was 111 mm (range 83-191). The mean consultation time for surgeons was 18 min (7-40), anaesthesiologists 12 min (5-18) and nurses 14 min (5-49). Patients took up 40% of the word space, healthcare professionals used 59% and significant others 1%. Word space changed in such a way that the patient became more active towards the final consultation. Neither during the diagnosis consultation nor during the pre-operative consultation did the patients meet the operating surgeon. Six major subjects emerged: general health, diagnosis, surgical procedure, pre-operative preparations, recovery and treatment and follow-up. Conclusions: There is a need for clearer structure in the consultations. Most consultations lacked a clear introduction to the subject of the conversation. The study makes it possible to develop methods and structure for supporting conversations in which the patient is given space to help with the difficult issues present after undergoing surgery for colorectal cancer. The study also contributes to providing knowledge of how to organise surgical consultations in order to optimise person-centeredness, teamwork and clinical efficiency.

  • 7. Edberg, A-K
    et al.
    Ehrenberg, AFriberg, FWallin, LÖhlén, JoakimGöteborgs universitet.
    Omvårdnadens grunder: En specialutgåva för sjuksköterskor2010Collection (editor) (Other academic)
  • 8. Edberg, Anna-Karin
    et al.
    Ehrenberg, AnnaFriberg, FebeWallin, LarsWijk, HelleÖhlén, JoakimErsta Sköndal University College, Palliative Research Centre, PRC.
    Omvårdnad på avancerad nivå: kärnkompetenser inom sjuksköterskans specialistområden2013Collection (editor) (Other academic)
  • 9.
    Ekman, Inger
    et al.
    Göteborgs universitet.
    Swedberg, Karl
    Göteborgs universitet.
    Taft, Charles
    Göteborgs universitet.
    Lindseth, Anders
    Göteborgs universitet; Bodø University College.
    Norberg, Astrid
    Ersta Sköndal University College, Enheten för forskning i palliativ vård. Göteborgs universitet; Umeå universitet.
    Brink, Eva
    Göteborgs universitet.
    Carlsson, Jane
    Göteborgs universitet.
    Dahlin-Ivanoff, Synneve
    Göteborgs universitet.
    Johansson, Inga-Lill
    Göteborgs universitet.
    Kjellgren, Karin
    Linköpings universitet.
    Lidén, Eva
    Göteborgs universitet.
    Öhlén, Joakim
    Institutionen för vårdvetenskap och hälsa, Sahlgrenska akademin, Göteborgs universitet.
    Olsson, Lars-Eric
    Göteborgs universitet.
    Rosén, Henrik
    Göteborgs universitet.
    Rydmark, Martin
    Göteborgs universitet.
    Stibrant Sunnerhagen, Katharina
    Göteborgs universitet.
    Person-centered care: Ready for prime time2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 4, p. 248-251Article in journal (Refereed)
    Abstract [en]

    Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.

  • 10. Elofsson Carling, L
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Meanings of living with chronic obstructive pulmonary disease in old age2004In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 8, p. 611-8Article in journal (Refereed)
  • 11. Friberg, F
    et al.
    Dahlberg, K
    Nyström Pettersson, M
    Öhlén, Joakim
    Göteborgs universitet.
    Context and methodological decontextualisation in nursing rsearch with examples from phenomenography2000In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, p. 37-43Article in journal (Refereed)
  • 12. Friberg, F
    et al.
    Lidén, E
    Håkanson, Cecilia
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Palliative Research Centre, PRC.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Medical consultations as arenas for patient learning: Exploration of strategies used by physicians2013Conference paper (Other academic)
  • 13. Friberg, F
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Kan vi tala om lärande i livets slut?: Berättelsen som pedagogiskt redskap inom palliativ vård2008In: Omsorg: Nordisk tidsskrift for Palliativ Medisin, ISSN 0800-7489, Vol. 25, no 2, p. 25-29Article in journal (Other (popular science, discussion, etc.))
  • 14. Friberg, F
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Omvårdnandens grunder: Perspektiv och förhållningssätt2009Book (Other academic)
  • 15. 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, p. 217-26Article in journal (Refereed)
  • 16. Friberg, F
    et al.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    The Development of a Clinical Intervention Model for Communication and Information: A Participatory Action Research Project in the Field of Palliative Cancer Care2012Conference paper (Refereed)
  • 17.
    Friberg, Febe
    et al.
    University of Stavanger, Göteborgs universitet.
    Lidén, Eva
    Göteborgs universitet.
    Håkanson, Cecilia
    Ersta Sköndal University College, Palliative Research Centre, PRC. Ersta sjukhus, Karolinska institutet.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Ersta sjukhus, Göteborgs universitet.
    Communicating bodily changes: Physicians' ways of enabling patient understanding in gastrointestinal cancer consultations2015In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 03, p. 661-671Article in journal (Refereed)
    Abstract [en]

    Objective: To explore how physicians communicatively enable patients' understanding of bodily changes in gastrointestinal cancer care consultations.

    Method: Two datasets were used. The first consisted of transcribed video-recorded palliative care consultations with three oncologists and six patients diagnosed with advanced gastrointestinal cancer, in the context of outpatient palliative care. The second dataset was audio-recorded transcriptions from diagnostic consultations with six surgeons and seven patients diagnosed with colorectal cancer, in the context of cancer surgery. An inductively driven and iterative analysis of interaction was performed, guided by Wetherell et al. (2001).

    Results: Two overarching communicative strategies were identified: (1) “visualizing strategies,” with the dimensions: visible strategies (visualizing with what you actually or potentially can see), sensory strategies (visualizing with what is possible to feel), and imaginative strategies; and (2) “contrasting strategies,” with the dimensions: contrasting subjective experiences and contrasting between the patient and other people.

    Significance of results: The visualizing and contrasting communicative strategies form parts of physicians' tacit and experience-based knowledge. The strategies employed by physicians reveal clear potentials to enable patients' understanding and sense making of bodily changes. However, these strategies need to be explicated and problematized as parts of both consultation practice and basic medical education. By means of increased awareness, physicians can more easily identify turning points in patients' levels of understanding, thereby enriching ordinary medical consultations with reflected pedagogical strategies and skills in how to dialogue in a person-centered manner.

  • 18.
    Friberg, Febe
    et al.
    University of Stavanger.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Fenomenologi och hermeneutik2012In: Vetenskaplig teori och metod: från idé till examination inom omvårdnad / [ed] Maria Henricson, Lund: Studentlitteratur, 2012, 1, p. 345-370Chapter in book (Other academic)
  • 19. Friberg, Febe
    et al.
    Öhlén, JoakimErsta Sköndal University College, Palliative Reserch Centre, PRC.
    Omvårdnadens grunder: perspektiv och förhållningssätt2014Collection (editor) (Other academic)
  • 20.
    Friberg, Febe
    et al.
    University of Stavanger.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Göteborgs universitet.
    Reflective exploration of Beekman's "participant experience"2010In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 20, no 2, p. 273-80Article in journal (Refereed)
  • 21. Frid, I
    et al.
    Haljamäe, H
    Öhlén, Joakim
    Göteborgs universitet.
    Bergbom, I
    Brain death: close relatives' use of imagery as a descriptor of experience2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 58, no 1, p. 63-71Article in journal (Refereed)
  • 22. Frid, I
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Bergbom, I
    On the use of narratives in nursing research2000In: Australian Journal of Advanced Nursing, ISSN 0813-0531, E-ISSN 1447-4328, Vol. 32, no 3, p. 695-703Article in journal (Refereed)
  • 23.
    Fridh, Isabell
    et al.
    Högskolan i Borås, Göteborgs universitet.
    Kenne Sarenmalm, Elisabeth
    Ersta Sköndal University College, Palliative Research Centre, PRC. Skaraborgs sjukhus.
    Falk, Kristin
    Göteborgs universitet.
    Henoch, Ingela
    Göteborgs universitet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Ozanne, Anneli
    Göteborgs universitet.
    Jakobsson Ung, Eva
    Göteborgs universitet.
    Extensive human suffering: a point prevalence survey of patients' most distressing concerns during inpatient care2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, p. 444-453Article in journal (Refereed)
    Abstract [en]

    AIM: To explore patients' most distressing concerns during a hospital stay.

    BACKGROUND: The characteristics of hospitalised patients have changed. Care is provided at a higher age, lengths of stay have fallen and the nursing workload is increasing. It is presumed that hospitalised patients are more seriously ill and have more palliative needs than previously. Studies show that inpatients suffer from more distress than similar outpatients although there is a lack of overall knowledge about inpatients' distress and major concerns, regardless of age, diagnosis or care setting.

    METHODS: This study was part of a point prevalence survey (PPS) concerning symptom prevalence. Of the 710 patients who participated in the PPS, 678 (95%) answered an open-ended question in a questionnaire: What is your main concern or what is most distressing or troublesome for you at present? Using a life-world approach, the text was analysed qualitatively and patients' concerns were interpreted in two main dimensions, an intersubjective dimension and a temporal dimension.

    FINDINGS: The patients reported extensive suffering due to illness, symptoms and failing health. Patients were concerned about family members, existential issues and the future. Three aspects of the patients' most distressing concerns were interpreted: The suffering self, The suffering person in close relations and The suffering person in a threatening world.

    CONCLUSION: Hospitalised patients are affected by severe illness, distressing symptoms and existential quandaries, revealing extensive human suffering in the midst of the demanding activities that take place during an ordinary day in a hospital. To support patients and alleviate suffering, hospital staff need to be more sensitive to patients' most distressing concerns. This presupposes a hospital environment in which the value system supports caring and comforting behaviour.

  • 24. Geman Millberg, L
    et al.
    Berg, L
    Lindström, I
    Petzäll, K
    Öhlén, Joakim
    Göteborgs universitet.
    Tensions related to implementation of postgraduate degree projects in specialist nursing education2011In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 31, no 3, p. 283-8Article in journal (Refereed)
  • 25. Gunnarsson, H
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Spouses grief before the patient's death: retrospective experiences related to palliative home care in urban Sweden2006In: Mortality, ISSN 1357-6275, E-ISSN 1469-9885, Vol. 11, no 4, p. 336-51Article in journal (Refereed)
  • 26. Henoch, I
    et al.
    Jakobsson Ung, E
    Ozanne, A
    Falk, H
    Falk, K
    Kenne Sarenmalm, Elisabeth
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Fridh, I
    Nursing students' experiences of involvement in clinical research: An exploratory study2013In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223Article in journal (Refereed)
  • 27. Henoch, Ingela
    et al.
    Sawatzky, Richard
    Falk, Hanna
    Fridh, Isabell
    Jakobsson Ung, Eva
    Kenne Sarenmalm, Elisabeth
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Ozanne, Anneli
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Falk, Kristin
    Symptom distress profiles in hospitalized patients in sweden: a cross-sectional study.2014In: Research in Nursing & Health, ISSN 0160-6891, E-ISSN 1098-240X, Vol. 37, no 6, p. 512-523Article in journal (Refereed)
    Abstract [en]

    Symptom distress profiles of patients with a variety of diagnoses at two hospitals in Sweden were examined using a point-prevalence cross-sectional survey design. The sample included 710 patients present on internal medicine, surgery, geriatric, and oncology acute care hospital wards of each hospital on a single day. Symptom distress data were collected via structured interviews using a 0-10 numeric rating scale (NRS). Fatigue was the most prevalent symptom, experienced by 76.2% of the patients, followed by pain (65.2%) and sleeping difficulties (52.8%). Symptoms were fairly distressing (median NRS 5-6). Patients experiencing high distress from fatigue and pain were more likely to be female, living alone, and to have more symptoms. Latent class analysis revealed three symptom distress profiles that differed with respect to the degree of distress and number of symptoms. The profiles were not substantially differentiated by diagnoses. Symptom distress needs to be assessed and treated on an individual basis, rather than predicting distress levels based on diagnosis alone. © 2014 Wiley Periodicals, Inc.

  • 28.
    Holm, Maja
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Fürst, Carl-Johan
    Lunds universitet.
    Wengström, Yvonne
    Karolinska institutet, Örebro universitet.
    Årestedt, Kristofer
    Linköpings universitet, Linnéuniversitetet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet, Capio Geriatrik, Dalen, Stockholm.
    Delivering and participating in a psycho-educational intervention for family caregivers during palliative home care: A qualitative study from the perspectives of health professionals and family caregivers2015In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 14, no 16Article in journal (Refereed)
    Abstract [en]

    Background: Family caregivers in palliative care have a need for knowledge and practical support from health professionals, resulting in the need for educational and supportive interventions. However, research has mainly focused on the experiences of family caregivers taking part in interventions. To gain an increased understanding of complex interventions, it is necessary to integrate the perspectives of health professionals and family caregivers. Hence, the aim of this study is to explore the perspectives of health professionals and family caregivers of delivering and participating in a psycho-educational intervention in specialized palliative home care.

    Methods: A psycho-educational intervention was designed for family caregivers based on a theoretical framework describing family caregiver’s educational, emotional and practical involvement as knowing, being and doing. The intervention was delivered over three sessions, each of which included a presentation to family caregivers by healthcare professionals from an intervention manual based on the theoretical framework. For the qualitative data collection, an interpretive descriptive design was chosen. Data were collected through focus group discussions with health professionals and individual interviews with family caregivers. Data were analysed using framework analysis.

    Results: From the perspectives of both health professionals and family caregivers, the delivering and participating in the intervention was described as a positive experience. Although the content was not always adjusted to the family caregivers’ individual situation, it was perceived as valuable. Consistently, the intervention was regarded as something that could make family caregivers better prepared for caregiving. Health professionals found that the work with the intervention demanded time and engagement from them and that the manual needed to be adjusted to suit group characteristics, but the experience of delivering the intervention was still something that gave them satisfaction and contributed to them finding insights into their work.

    Conclusions: The theoretical framework of knowing, being and doing used in this study seems appropriate to use for the design of interventions to support family caregivers. In the perspectives of health professionals and family caregivers, the psycho-educational intervention had important benefits and there was congruence between the two groups in that it provided reward and support. In order for health professionals to carry out psycho-educational interventions, they may be in need of support and supervision as well as securing appropriate time and resources in their everyday work.

  • 29.
    Holm, Maja
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Wengström, Yvonne
    Karolinska Institutet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Preparing for family caregiving in specialized palliative home care: an ongoing process2014In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 3, p. 767-775Article in journal (Refereed)
  • 30.
    Holm, Maja
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Wengström, Yvonne
    Karolinska Institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    The Process of Preparedness for Caregiving among Family Members in Palliative Home Care2014In: Palliative Medicine / [ed] Catherine Walshe, Sage Publications, 2014, p. 622-623Conference paper (Refereed)
    Abstract [en]

    Background: Preparedness for caregiving has been found to be an important concept in palliative home care where family members are taking a great responsibility for the patient’s care. Low preparedness has been linked to negative consequences and a greater burden for these family members. Preparedness has been defined as the perceived readiness to provide care and could be seen as a continuous process rather than a static condition. Aim: The aim of the study was to describe the process of preparedness for caregiving among family members in palliative home care. Method: An interpretive descriptive design was chosen. A strategic sampling method was applied and 12 family members of patients in specialised palliative home care were interviewed, using a semi-structured interview guide. The interviews were analysed by constant comparative analysis, using the software program NVivo. Results: The process of preparedness for caregiving included three patterns: Awaring, adjusting and grieving. The process was not described as linear but rather a continuous process where the family members were moving between the patterns during the trajectory. In all three patterns, grief was an important factor, affecting the caregiver role and the family members´ preparedness for caregiving. Conclusion: Exploring the process of preparedness for caregiving in family members could bring a greater understanding for this group and provide health professionals with new insights in how to support them.

  • 31.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Palliative Research Centre, PRC.
    Christiansen, Mats
    Ekstedt, Mirjam
    Sandberg, Jonas
    Kenne Sarenmalm, Elisabeth
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Experience-based knowledge in the care of homeless people with severe illness and complex care needs2014Conference paper (Other academic)
  • 32.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Sandberg, Jonas
    Jönköpings universitet .
    Ekstedt, Mirjam
    Kungliga tekniska högskolan, Stockholm.
    Kenne Sarenmalm, Elisabeth
    Skaraborgs sjukhus.
    Christiansen, Mats
    Karolinska institutet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Providing Palliative Care in a Swedish Support Home for People Who Are Homeless.2015In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557Article in journal (Refereed)
  • 33.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Connectedness at the end of life among people admitted to inpatient palliative care2014In: The American Journal of Hospice and Palliative Medicine, ISSN 1049-9091, Vol. 33, no 1, p. 47-54Article in journal (Refereed)
    Abstract [en]

    The significance of connectedness for well-being is well known. At the end of life however, illness and body decline may challenge a person’s ability of staying and feeling connected. The aim of this phenomenological study was to interpret meanings of connectedness, through narrative interviews with persons admitted to inpatient palliative care in Sweden. Results involving connectedness through the body, connectedness to, and uncanniness toward other patients, and connectedness to significant others and society are discussed. The study underscores the importance of connectedness until death. However, in inpatient palliative care this is complex. Patients can cocreate or challenge each other’s sense of connectedness through the symbolism of illness and diseased bodies. Moreover, the capability of connectedness is influenced by illness, spatiality, atmosphere, activities, and resources in the care place.

  • 34.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Meanings and experiential outcomes of bodily care in a specialist palliative context2015In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 3, p. 625-633Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of this study was to enhance the depth of existing knowledge about meanings and experiential outcomes of bodily care in the context of an inpatient specialist palliative setting.

    Method: Interpretative phenomenology was chosen as the study sought to explore individuals' lived experiences related to bodily care. Nine participants (five women, four men) of various ages and with various metastasized cancers and bodily-care needs, all from one specialist palliative care ward, participated. Data were collected with repeated narrative interviews and supplementary participating observations. Analysis was informed by van Manen's approach.

    Results: The following meanings and experiential outcomes of bodily care were revealed by our study: maintaining and losing body capability, breaching borders of bodily integrity, being comforted and relieved in bodily-care situations, and being left in distress with unmet needs. These meanings overlap and shape the nature of each other and involve comforting and distressing experiences related to what can be described as conditional dimensions: the particular situation, one's own experiences of the body, and healthcare professionals' approaches.

    Significance of results: The results, based on specialist palliative care patients' experiences, outline the meanings and outcomes that relate to the quintessence and complexity of palliative care, deriving from dying persons' blend of both basic and symptom-oriented bodily-care needs. Moreover, the results outline how these two dimensions of care equally influence whether comfort and well-being are facilitated or not. Considering this, specialist palliative care may consider how to best integrate and acknowledge the value of skilled basic nursing care as part of and complementary to expertise in symptom relief during the trajectories of illness and dying.

  • 35.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Palliative Research Centre, PRC.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Receiving Bodily Care at the End of Life2014Conference paper (Other academic)
  • 36.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Morin, Lucas
    Karolinska institutet.
    Cohen, Joachim
    Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium .
    A population-level study of place of death and associated factors in Sweden2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 7, p. 744-751Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were to examine, on a population level, where people die in Sweden, and to investigate associations between place of death and underlying cause of death, socioeconomic and environmental characteristics, with a particular interest in people dying from life-limiting conditions typically in need of palliative care. Methods: This population-level study is based on death certificate data for all deceased individuals in Sweden in 2012, with a registered place of death (n=83,712). Multivariable logistic regression was performed to investigate associations between place of death and individual, socioeconomic and environmental characteristics. Results: The results show that, in 2012, 42.1% of all deaths occurred in hospitals, 17.8% occurred at home and 38.1% in nursing home facilities. Individuals dying of conditions indicative of potential palliative care needs were less likely to die in hospital than those dying of other conditions (OR = 0.73; 95% CI = 0.70–0.77). Living at home in urban areas was associated with higher likelihood of dying in hospital or in a nursing home (OR = 1.04 and 1.09 respectively). Educational attainment and marital status were found to be somewhat associated with the place of death. Conclusions: The majority of deaths in Sweden occur in institutional settings, with comparatively larger proportions of nursing home deaths than most countries. Associations between place of death and other variables point to inequalities in availability and/or utilization of health services at the end of life.

  • 37. Jakobsson, E
    et al.
    Andersson, M
    Öhlén, Joakim
    Göteborgs universitet.
    Palliation2009In: Omvårdnadens grunder: perspektiv och förhållningssätt / [ed] F. Friberg, Joakim Öhlén m fl, Lund: Studentlitteratur, 2009, p. 328-54Chapter in book (Other academic)
  • 38. Jakobsson, E
    et al.
    Bergh, I
    Gaston-Johansson, F
    Stolt, C-M
    Öhlén, Joakim
    Göteborgs universitet.
    The turning point: clinical identification of dying and reorientation of care2006In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 9, no 6, p. 1348-58Article in journal (Refereed)
  • 39. Jakobsson, E
    et al.
    Bergh, I
    Öhlén, Joakim
    Göteborgs universitet.
    The turning point: Identifying end-of-life care in everyday health-care practice2007In: Contemporary Nurse: health care across the lifespan, ISSN 1037-6178, E-ISSN 1839-3535, Vol. 27, no 1, p. 107-18Article in journal (Refereed)
  • 40. Jakobsson, E
    et al.
    Bergh, I
    Öhlén, Joakim
    Göteborgs universitet.
    Odén, A
    Gaston-Johansson, F
    Utilization of health-care services at the end-of-life2006In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 82, no 3, p. 276-87Article in journal (Refereed)
  • 41. Jakobsson, E
    et al.
    Gaston-Johansson, F
    Öhlén, Joakim
    Göteborgs universitet.
    Bergh, I
    Clinical problems at the end-of-life in a Swedish population including the role of advancing age and physical and cognitive function2008In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, no 2, p. 177-182Article in journal (Refereed)
    Abstract [en]

    Aims: To improve the understanding of specific clinical problems at the end of life, including the role of advancing age, physical function and cognitive function.

    Methods: The study is part of an explorative survey of data relevant to end-of-life healthcare services during the last 3 months of life of a randomly selected sample of the population of a Swedish county. Data were selected through retrospective reviews of death certificates and medical records, and comprise information from 12 municipalities and 229 individuals.

    Results: A range of prevalent concerns was found. Overall deterioration, urinary incontinence, constipation, impaired skin integrity, anxiety and sleep disturbances were significantly associated with dependency on others for activities of daily living; pulmonary rattles and swallowing disturbances were associated with cognitive disorientation; excepting cough, advancing age did not have significant impacts on these prevalent clinical concerns.

    Conclusions: A range of distressing conditions constitute a common pathway for many individuals at or near the end of life. The incorporation of health promotion as a principle of palliative care will probably benefit individuals at the end of life, and includes a proactive focus and emphasis on enhanced well-being at the time of diagnosis of a life-threatening illness. For individuals with physical and cognitive limitations imparting a state of dependency, it is reasonable to provide assurance of care for individuals' specific needs by professionals with both training for and competence in this special and sometimes unique clinical environment.

  • 42. Jakobsson, Eva
    et al.
    Andersson, Magdalena
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Livets slutskede2014In: Omvårdnadens grunder: perspektiv och förhållningssätt / [ed] Febe Friberg, Joakim Öhlén, Lund: Studentlitteratur AB, 2014, 2, p. 179-212Chapter in book (Other academic)
  • 43. Karlsson, Magdalena
    et al.
    Friberg, Febe
    University of Stavanger.
    Wallengren, Catarina
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Meanings of existential uncertainty and certainty for people diagnosed with cancer and receiving palliative treatment: A life-world phenomenological study2014In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, ISSN 1472-684X, Vol. 13, no 28Article in journal (Refereed)
    Abstract [en]

    Background

    Many people around the world are getting cancer and living longer with the disease. Thanks to improved treatment options in healthcare, patients diagnosed with advanced gastrointestinal cancer can increasingly live for longer. Living with cancer creates existential uncertainty, but what does this situation mean for the individual? The purpose of the study is to interpret meanings of existential uncertainty and certainty for people diagnosed with advanced gastrointestinal cancer and receiving palliative treatment.

    Methods

    This study is part of a larger project in which 7 men and 7 women aged between 49 and 79 participated in a study of information and communication for people with advanced gastrointestinal cancer. A total of 66 interviews were conducted with participants who were followed up over time. The narrative interviews were transcribed verbatim and the texts were analysed in three steps: naive reading, structural analysis and interpreted whole by utilizing a phenomenological life-world approach.

    Results

    This study has identified different spheres in which people diagnosed with advanced gastrointestinal cancer vacillate between existential uncertainty and certainty: bodily changes, everyday situations, companionship with others, healthcare situations and the natural environment. Existing in the move between existential uncertainty and certainty appears to change people’s lives in a decisive manner. The interview transcripts reveal aspects that both create existential certainty and counteract uncertainty. They also reveal that participants appear to start reflecting on how the new and uncertain aspects of their lives will manifest themselves –a new experience that lays the foundation for development of knowledge, personal learning and growth.

    Conclusions

    People diagnosed with advanced gastrointestinal cancer and receiving palliative care expressed thoughts about personal learning initiated by the struggle of living with an uncertain future despite their efforts to live in the present. Their personal learning was experienced through a changed life for themselves and having to confront their own pending death and develop self-insight regarding finality of life. Healthcare professionals can try to support people receiving palliative treatment for cancer by diversifying avenues for their personal growth, thus helping them manage their existential uncertainty and gravitate towards greater existential certainty.

  • 44. Kelvered, M
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Åkesdotter Gustafsson, B
    Operating theatre nurses' experience of patient-related, intraoperative nursing care2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 3, no 3, p. 449-457Article in journal (Refereed)
  • 45. Kenne Sarenmalm, E
    et al.
    Odén, A
    Öhlén, Joakim
    Göteborgs universitet.
    Gaston-Johansson, F
    Holmberg, S
    Bernhard, J
    Changes in health-related quality of life may predict recurrent breast cancer2009In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 13, no 5, p. 323-9Article in journal (Refereed)
  • 46. Kenne Sarenmalm, E
    et al.
    Thorén-Jönsson, A-L
    Gaston-Johansson, F
    Öhlén, Joakim
    Göteborgs universitet.
    Making sense of living under the shadow of death: adjusting to a recurrent breast cancer illness2009In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 19, no 8, p. 1116-1130Article in journal (Refereed)
    Abstract [en]

    Women with recurrent breast cancer face many difficulties and challenges, from clinical symptoms of disease progression and treatment to a range of emotional responses. Guided by grounded theory methodology, we explored the main concerns of women with recurrent breast cancer, and how they were dealing with their situations. Data were collected from 40 in-depth interviews with 20 women diagnosed with recurrent breast cancer. The core category illustrated the process of “making sense of living under the shadow of death,” and was based on the women's experiences of adjusting to living with a persistent life-threatening illness. Confronting a recurrence of breast cancer was a life-altering event. Moving through a difficult and challenging time, women eased their distress by letting go of losses and reassessing important values. Through a personal transition women transcended living with a life-threatening illness. These findings emphasize the importance of recognizing existential distress in clinical practice.

  • 47. Kenne Sarenmalm, Elisabeth
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Jonsson, T
    Gaston-Johansson, F
    Coping with recurrent breast cancer: predictors of distressing symptoms and health-related quality of life2007In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 34, no 1, p. 24-39Article in journal (Refereed)
    Abstract [en]

    Little is known about how postmenopausal women with recurrent breast cancer cope with distressing symptoms and which factors predict health-related quality of life (HRQOL). In the present study, 56 consecutively enrolled patients completed questionnaires measuring symptom occurrence, coping capacity, coping efforts, and HRQOL at the time of recurrence. Results from this study illustrate that women with recurrent breast cancer suffer from multiple, concurrent, and interrelated symptoms of illness, anxiety, depression, and fatigue. Highly prevalent symptoms are lack of energy, difficulty sleeping, pain, worrying, problems with sexual interest, feeling sad, and dry mouth. The most frequently occurring symptom is problem with sexual interest, and the most severe symptom is worrying. The most distressing symptom experienced is pain. The majority of the women report 10–23 symptoms. Women who experience multiple symptoms also report higher levels of symptom distress. The experience of distressing symptoms is predicted by coping capacity, and the coping efforts experienced predict HRQOL. Patients with lower coping capacity report higher prevalence of symptoms, experience higher levels of distress, and experience worse perceived health, which in turn may decrease their HRQOL. To help women manage recurrent breast cancer, it is important to use multidimensional measurement to identify, evaluate, and treat distressing symptoms, and not assess single symptoms only. Care must be based upon the awareness of critical factors that exacerbate vulnerability to distress, as well as the ability to adapt to a recurrent breast cancer disease.

  • 48.
    Kenne Sarenmalm, Elisabeth
    et al.
    Göteborgs universitet.
    Öhlén, Joakim
    Göteborgs universitet.
    Odén, A
    Gaston-Johansson, F
    Experience and predictors of symptoms, distress and health-related quality of life over time in postmenopausal women with recurrrent breast cancer2008In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 17, no 5, p. 497-505Article in journal (Refereed)
  • 49. Lehtinen, U
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Asplund, K
    Grundforskning: Något för omvårdnad?2002Book (Other academic)
  • 50. Lehtinen, U
    et al.
    Öhlén, Joakim
    Göteborgs universitet.
    Asplund, K
    Some remarks on the relevance of basic research in nursing inquiry2005In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 6, p. 43-50Article in journal (Refereed)
12 1 - 50 of 99
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