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  • 151.
    Arias, Pamela
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Stenfelt, Sari
    Ersta Sköndal University College, Department of Health Care Sciences.
    Att ge beröring i omvårdnad: en litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Touching exists in different forms and can be experienced through the skin. By touching oxytocin is released like a relaxing hormone which counteracts anxiety and depression. Therapeutic contact and healing touch are methods nurses’ uses to give positive feeling of serenity, warmth and wellbeing for the patients. Touching can be a method for communication and happiness when word is not enough. By touching can nurses notice if a patient is, for example, anxious. The hands of the nurse are important caring of the patient such as adequate touching calms and sooths anxiety and pain.

    Aim:  To describe the significance to give touch in nursing.

    Method: A literary summary of scientific articles published between 1995 until 2012, where seven of them have qualitative approach and three have quantitative and all of them found via the databases CINAHL and MEDLINE.

    Result: Nurses were describing how touching had positive significance for the patients. The nurses could by touching reduce the patient’s pain, anxiety and worries. Different sorts of touching was mentioned like massage. A general theme was touching by non-verbal communication which gave a sense of security to the patients. The nurses’ attitude to touch became a problem since the nurses only touched the patients when necessary, for example when caring by hygiene without respecting the patients’ integrity.

    Discussion: In the result discussion it was described how the limited knowledge by the nurses of touching. By training (and education) they could carry though touching with help of different types of touching, massage, tactile touching, therapeutic touch etc. It relieved the state of pain, anxiety, and it also created security, closeness, better sleep and well-being of the patient. The touch adapted to the patients’ needs was described as positive and meaningful. To build an interpersonal relationship was essential and fundamental before the nurse approached the patient.

  • 152.
    Arkenstrand, Emma
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Vikström, Ann
    Ersta Sköndal University College, Department of Health Care Sciences.
    Polyfarmacins påverkan på de äldres dagliga liv: En litteraturöversikt2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In the natural aging process, changes occur in the body that affect the elderly person's daily life. Aging often leads to diseases that require treatment in form of drugs. The term polypharmacy describes the use of multiple drugs. Medications are the most common form of treatment and may contribute to both positive and negative effects on elderly’s health.

    Aim: The aim was to illuminate nursing problems in elderly regarding polypharmacy.

    Method: A literature review was performed based on 11 quantitative scientific articles. Databases used were Cinahl, PubMed and MedLine. Among the keywords used were polypharmacy, aged, risk factors and nursing. The theoretical framework was nurse Carnevali’s model (1996) dealing with nursing diagnosis.

    Results: From the selected articles’ results revealed four main categories were: 1) fall and risk of falling, which relate to how the elderly’s risk of falling increases with intake of many medications and its consequences, 2) non- adherence highlights the reasons why prescriptions are not followed neither by patients nor healthcare professionals. 3) Nutritional status and malnutrition concerns how polypharmacy can affect the elderly’s nutritional status and as a consequence lead to for example malnutrition, and 4) functional decline and the elderly’s (dis)ability to function in daily life is the last major category that could be affected by polypharmacy.

    Discussion: A difficulty that emerges from the literature is that the definition of polypharmacy is not identified. Despite this, it appears the nursing problems related to drugs can also correlate with multimorbidity which is common in the natural aging process.

  • 153.
    Armonioso, Lola
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nurses' perceptions of complementary alternative medical care in clinical settings: A qualitative interview study with nurses in Karnataka, India2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Globally the use of complementary and alternative medicine (CAM) has dramatically increased in the last few decades. In India CAM is used both as medical treatment and health care methods enhancing wellness.

    Aim: To explore nurse’s experiences of complementary alternative medical care as care methods in clinical settings in Karnataka, India.

    Methods: A qualitative interview study with semi-structured interviews was carried out. Four individual interviews were conducted with nurses working in two clinical settings in Karnataka, India. The data was analysed using a content analysis. 

    Results: Two main themes emerged from the content analysis: Caring as a challenge and Dealing with challenges.

    Discussions: The result is discussed using Travelbee’s’ theory on interactions.

  • 154.
    Arnsvik, Elin
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Malm, Jenny
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Anhörigas upplevelse av att stötta sin partner med en kurativ cancersjukdom: en litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: A large number of individuals are affected by cancer disease every year, but due to improved treatment and early discovery many are cured. The illness, also affect the patient´s significant other and may increase their risk of own health-related problems.

    Aim: The aim was to describe significant others´ experiences when supporting a partner in curative phase of cancer disease.

    Method: The results are based on twelve scientific articles and categorized in seven themes. The Roy Adaptation model was used to discuss the result. Data were collected from the CINAHL and PUBMED databases, including articles from the years 2007-2017.

    Results: The results show that significant others´ own needs were put aside during their partner´s illness. Their identities were affected as they were adapting their everyday life to be able to support their partner. A partner´s illness also changed the couple’s roles as the couples responsibility changed within the relationship. If the significant other experienced the support as burdensome their health could be negatively affected. Significant others´ experienced their relationship to their partner to improve during the illness.

    Discussion: The four adaptation modes by Roy are related to each other and are hard to distinguish and the holistic view of each person is important. We conclude that it is important that the health care system also acknowledges the significant other´s needs and situations and thereby provide support needed to elude future health issues.

  • 155.
    Arrak, Milad
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Madlool, Aya
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Äldres upplevelse av depression: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In today's Sweden the rise of psychological illness has increased with eachpassing year, and is now one of the greatest ailments in our society. The maincontributer to this rise correlates to the diagnoses of depression. The latestfigures shows that 20 percent of our elders suffers from psychological illness.The origins of depression, both for young and old alike, may stem frombiological and social factors. The difficulty in establishing a diagnosis ofdepression with elderly - unlike with the young - is partly because elderlydepression manifests itself differently.

  • 156. Arrbo Bodin, Tora
    et al.
    Arrbo Bodin, Viktor
    Döden som profession: Sjuksköterskans upplevelser av att vårda patienter i livets slut – en litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background The aim of palliative care is to improve the quality of life for both the patient and her next of kin during the patient’s end of life. Palliative care rests on the four cornerstones managing symptoms, communication and relationship, teamwork and relative support. The nurses’ task is to assess the patients’ physical, mental and spiritual needs according to these four cornerstones.Aim To assess nurses’ experiences of treating patients at the end of life.Method Eleven academic journals that respond to the aim has been analyzed and synthesized in a literature review in order to summarize current research on the subject. The result was reviewed and similarities and differences were analyzed. The result yielded five major themes.Result The result gave a comprehensive overview of different experiences of nurses caring for patients at the end of life. These experiences is described under the five major themes – nurses professional approach, nurses need for collegial support, the burdensome work in palliative care, nurses experiences of death and nurses and relationship with patients and their next of kin.Discussion In the discussion the result has been discussed using Partricia Benners theory From novice to expert which is a useful theory about the nurses’ development. It touches different aspects of the stages in which the nurse develop from beginner to expert. Also earlier research about the experiences of the nurse in palliative care is discussed in this part.Keywords Palliative care, end of life care, nurses, experiences.

  • 157.
    Arvid, Fröding
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Henriksson, Viktor
    Ersta Sköndal University College, Department of Health Care Sciences.
    Aspekter som påverkar sjuksköterskors attityder till substansmissbrukare: En litteraturöversikt2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There is no singular reason why a person ends up in substance abuse. Substance abuse poses health risks, which means that they will come in contact with health services. In the society the substance abusers are stigmatized which may affect the nurses’ behavior towards them.

    Aim: Highlighting the aspects that contribute to the nurse’s attitudes towards patients with a substance abuse problem and how the attitudes affect the health care.

    Method: The literature review is based on twelve scientific studies. The studies were analyzed toillustrate the similarities and differences. These were discussed and when the authors agreed it was written into the literature review's results.

    Results: The results showed that the nurse’s previous experiences had a big impact on how the nurses saw patients and how their attitudes influenced their expression. Previous experience contributed to fear and insecurity among many of the nurses. The professional competence turned out to have an impact because the nurse’s lack of knowledge of how an addiction affects prevented them to see the patient as a human being. Nurses with a high level of caring awareness managed this better.

    Discussion: The discussion includes Ericsson’s theory of suffering and the metaparadigm caring. Nurses’ attitudes affect the care relationship and that negative attitudes create an unnecessary suffering related to care and illness because there is a risk of information being overlooked. Social stigma affects how the nurses perceive the addict as a patient. A paternalistic approach may be necessary to increase the patients’ chances to have a future autonomy.

  • 158.
    Arvidsson, Marianne
    et al.
    Ersta Sköndal University College, Institutionen för omvårdnad.
    Svensson, Anna-Maria
    Ersta Sköndal University College, Institutionen för omvårdnad.
    Mångkulturell omvårdnad: sjuksköterskans möte med patienter med invandrarbakgrund2000Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 159.
    Arén, Anna
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Thunborg, Ewa
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sjuksköterskans erfarenheter av att vårda patienter med alkoholmissbruk2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 160.
    Asadi, Soudabeh
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskans omvårdnad för att minska aggressivitet hos personer med demenssjukdom: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [sv]

    Demenssjukdom är en av de största framtida sjukdomarna. 30 procent av inlagda patienter över 65 år lider av demenssjukdom. Medellivslängden ökar eftersom gruppen äldre ökar, vilket medför att även antalet personer med demenssjukdom ökar för varje år. Beteendemässiga och psykiska symptom vid demens (BPSD) är vanligt förekommande som en följd av demenssjukdom. Den sjuke visar ett beteende som är svårt att hantera för vårdgivare och det orsakar stor påverkan på den sjukes omgivning. Fysisk eller verbal aggressivitet inte ett helt ovanligt beteende hos dessa patienter. Syftet var att belysa sjuksköterskans omvårdnad för att minska aggressivitet hos personer med demenssjukdom. I resultatet framkom ett huvudtema och fyra underteman för förebyggande av aggressivitet. Vårdmiljöns betydelse, betydelsen av sjuksköterskans kunskap, betydelsen av sjuksköterskans kommunikation och betydelsen av drabbades livshistoria var förutom huvudtemat Förebyggande av aggressivitet, de fyra teman som belystes i resultatet.

  • 161.
    Asgedom, Dina
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Bogale, Serkalem
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Att vårda en person med HIV: Närståendes upplevelser2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Bakgrund: HIV is a chronic disease that affects people worldwide and is associated with shame, guilt and vulnerability. Both the person with an HIV and the related are physically and psychologically exposed. Studies have shown that relatives of the patients with chronic diseases are often neglected. In today's society, it has become more common for relatives to care - so it is important that their experiences are taken into consideration in order to be offered the right support. The nurse has a responsibility to include and support the related persons in order to maintain their role as carers. Aim: The aim of this literature study was to highlight the family caregivers’ experiences of caring for a person who has HIV. Method: A literature review consisting of ten scientific articles found in three different databases. The articles have both qualitative and mixed design. The content analysis was conducted according to Friberg. Results: The results exposed different categories and subcategories; The emotions of the family caregivers with the subcategories Fear, Frustration, Hope and hopelessness as well as the family caregivers’ positive experiences of caring; Consequences that family caregivers faced during caring for relatives with the subcategories Stress, Care burden and Responsibility as well as Stigmatization. The other main categories are Knowledge and lack of knowledge as well as support and luck of support. Discussion: The outcome discussion explains how stigmatism has different consequences for the relatives in association with the care of a person with HIV. The premises are primarily taken from Eriksson's caritative theory, focusing on the concepts of health and suffering. Knowledge and lack of knowledge for the relatives are also discussed based on the family caregiver’s conditions to care for the person who has HIV.

  • 162.
    Askergren, Julieta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Taya, Nora
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sjuksköterskans kommunikation med patienter från etniska minoriteter inom palliativ vård - Vilka faktorer påverkar?2005Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 163. Asp, Margareta
    et al.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Developing Concepts in Caring Science Based on a Lifeworld Perspective2005In: International Journal of Qualitative Methods, ISSN 1609-4069, E-ISSN 1609-4069, Vol. 4, no 2, p. 57-67Article in journal (Refereed)
    Abstract [en]

    Concept development is a significant form of inquiry to expand and develop the knowledge base in caring science. The authors’ aim in this article is to illuminate the possibility of working with concept development, based on a life world perspective, especially Merleau-Ponty’s philosophy of language, wherein phenomenological, semiological, and pragmatic dimensions are included. The theoretical discussion shows that it is possible to create methodological principles for concept development based on epistemological foundations that are consistent with ontological assumptions in caring science

  • 164. Asp, Margareta
    et al.
    Fagerberg, Ingegerd
    Mälardalens högskola.
    The woven fabric – a metaphor of nursing care: the major subject in nursing education2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 2, p. 115-121Article in journal (Refereed)
    Abstract [en]

    Society’s future needs regarding health care present challenges to traditional nursing education. Today, the ambition is to create a nursing role that is appropriate to people’s health care needs rather than the needs of the health care system. In nursing education, the major subject – nursing care – is central. Accordingly, there is a need for a consistent and clear articulation of this subject as well as the nursing profession. The aim of the present study was to interpret and describe the major subject, its content and structure in the nursing programme at Mälardalen University. With a hermeneutic approach an interpretation and application emerged as a metaphor of nursing care – the woven fabric. In this structure concepts function as bridges linking theory and practice, whereby it is possible to integrate different aspects of knowledge in order to think, feel and act nursing care.

  • 165.
    Asperheim, Therese
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Heda, Kolleta
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Fysiska aktiviteter och välbefinnande hos patienter med reumatisk artrit: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Rheumatic arthritis is an inflammatory disease that affects man both mentally, physically and socially. The disease causes the presence of pain, stiffness and fatigue which affects patient's level of activity and sense of well-being. The consequence of rheumatic arthritis means life changes as well as adjustments to the disease and reduced level of physical activity.

    Aim: To highlight how physical activity affects well-being in patients with rheumatic arthritis.

    Method: A literature review was conducted and based on ten scientific articles. Included articles consisted of eight quantitative articles, a qualitative as well as a mixed design article. The analysis was conducted using Friberg (2017) and resulted in two themes.

    Results: The result showed that physical activity gave patients greater well-being. Factors for motivation and limitation of physical activity were identified. Physical activity was feasible and accepted for patients with rheumatic arthritis. Disease activity was not affected by increased physical activity and therefore motivated patients to be active and maintain physical activities.

    Discussion: Patients needed knowledge about the management of the disease's symptoms and how inactivity affected wellbeing. Sedentary behavior was common in patients with rheumatic arthritis, where the nurse's ability to detect this was important. Adapting to life with rheumatic arthritis was important to increase well-being and maintain the balance between activity and rest. Self-efficacy motivated patients to maintain physical activity.

  • 166.
    Asplund, Johanna
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Brengesjö, Ellinor
    Ersta Sköndal University College, Department of Health Care Sciences.
    Transsexuella personers upplevelser av identitet och förkroppsligande: En litteraturstudie utifrån teorin om livsvärlden och den levda kroppen2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning/abstract

    Bakgrund: En transsexuell person upplever sig tillhöra det motsatta könet och vill oftast korrigera sin kropp genom hormonbehandling och kirurgi så att den stämmer överens med det kön som personen identifierar sig med. Enligt den vårdvetenskapliga livsvärldsteorin är en människas kropp inte bara säte för hennes upplevelser utan också för hennes identitet. Genom kroppens sinnen skapar man en bild av sig själv och sin omvärld. Detta medför att om kroppen förändras, förändras även identiteten och tillgången till världen. Kunskapen om transsexuella personer hos personal inom hälso- och sjukvården är mycket bristfällig. Transsexuella personer utsätts inte sällan för diskriminering, intolerans och utanförskap.

    Syfte: Syftet med vår uppsats är att belysa transsexuella personers upplevelser av identitet och förkroppsligande.

    Metod: En litteraturstudie baserad på åtta vetenskapliga kvalitativa artiklar utfördes. Innehållsanalysen av datan gjordes enligt Granheim och Lundman.

    Resultat: Fyra kategorier framkom ur analysprocessen, dessa är: Den kroppsliga transitionen, som behandlar de transsexuella personernas upplevelser av kroppens förändring i relation till en könsbytesprocess. Inre och yttre identitet, som handlar om upplevelser av överensstämmelse mellan den kropp man fötts i och den inre identiteten. Familjerelationer som behandlar olika positiva och negativa aspekter av familj och vänners reaktioner på den transexuella familjemedlemmen. Den sista kategorin Att vara transsexuell i samhället och det offentliga rummet handlar om hur transsexuella personer upplever det bemötande de får och hur samhället ser på dem.

    Diskussion: Det som diskuteras i resultatdiskussionen är betydelsen av att se på kroppen som ”levd” för att förstå den kroppsliga transitionen, inkongruensen som uppstår mellan den inre känslan av könsidentitet och det yttre biologiska könet och att vara transsexuell i ett heteronormativt vårdsammanhang och samhälle. Detta diskuteras utifrån livsvärldsteorin och teorin om den levda kroppen och lyfts ytterligare genom begreppet Othering. Även etiska förhållningssätt diskuteras i samband med frågan om vården och samhällets heteronormativitet.

    Nyckelord: Transsexualitet, identitet, förkroppsligande, livsvärld, narrativ

    Keywords: Transsexual, identity, embodiment, lifeworld, narrative analysis

  • 167.
    Asplund, Kenneth
    Mittuniversitetet.
    Demensvård förr, nu och i framtiden (Dementia care in the past, now and in the future)1998In: Vård : utbildning, utveckling, forskning, ISSN 0281-921X, no 2, p. 2-8Article in journal (Other academic)
  • 168.
    Asplund, Kenneth
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Omvårdnad: ett i grunden omstritt begrepp (Nursing : a fundamentally controversial concept)1994In: Omvårdaren, ISSN 0280-4123, Vol. 41, no 4, p. 4-5Article in journal (Other academic)
  • 169. Asplund, Kenneth
    et al.
    Adolfsson, R
    Lundgren, K
    Rönnbäck, E
    Sandman, P-O
    Wimo, A
    Åström, S
    Gruppboende för åldersdementa: erfarenheter efter två år1988In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 85, no 9, p. 734-737Article in journal (Other academic)
  • 170.
    Asplund, Kenneth
    et al.
    University of Tromsø, Norway.
    Jansson, Lilian
    Umeå universitet.
    Norberg, Astrid
    Umeå universitet.
    Facial Expressions of Patients With Dementia: A Comparison of Two Methods of Interpretation1995In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 7, no 4, p. 527-534Article in journal (Refereed)
    Abstract [en]

    Two methods of interpreting the videotaped facial expressions of four patients with severe dementia of the Alzheimer type were compared. Interpretations of facial expressions performed by means of unstructured naturalistic judgements revealed episodes when the four patients exhibited anger, disgust, happiness, sadness, and surprise. When these episodes were assessed by use of modified version of the Facial Action Coding System, there was, in total, 48% agreement between the two methods. The highest agreement, 98%, occurred for happiness shown by one patient. It was concluded that more emotions could be judged by means of the unstructured naturalistic method, which is based on an awareness of the total situation that facilitates imputing meaning into the patients' cues. It is a difficult task to find a balance between imputing too much meaning into the severely demented patients' sparse and unclear cues and ignoring the possibility that there is some meaning to be interpreted.

  • 171.
    Asplund, Kenneth
    et al.
    University of Tromsø, Norway.
    Norberg, Astrid
    Umeå universitet.
    Caregivers' Reactions to the Physical Appearance of a Person in the Final Stage of Dementia as Measured by Semantic Differentials1993In: The International Journal of Aging & Human Development, ISSN 0091-4150, E-ISSN 1541-3535, Vol. 37, no 3, p. 205-215Article in journal (Refereed)
    Abstract [en]

    The semantic differential (SeD) technique was applied to 158 caregivers from a nursing home in the northern part of Sweden. The questionnaire contained fifty-eight bipolar scales of adjective pairs and the interviewees indicated then-reactions to a described picture of a severely demented person: A factor analysis revealed three dimensions; an ethical one, an esthetical one, and one about the person's own feelings. The fifty-eight scales were mostly rated toward the negative poles. The severely demented person was rated as painful, apathetic, suffering, weak, afraid, sad, cold, dark, rough, and ugly.

    Four years later a comparable group of caregivers (n = 93) answered a revised questionnaire containing the 26 SeD scales with factor loadings > .50 for the picture of the severely demented person. The result was nearly identical and alternative interpretations are discussed.

  • 172.
    Asplund, Kenneth
    et al.
    Umeå universitet.
    Norberg, Astrid
    Adolfsson, Rolf
    The Sucking Behaviour of Two Patients in the Final Stage of Dementia of the Alzheimer Type1991In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 5, no 3, p. 141-147Article in journal (Refereed)
    Abstract [en]

    Two patients in the final stage of dementia of the Alzheimer type (DAT), who could no longer be given nutrition by assisted feeding, were given fluids by means of the sucking ability they still retained. They sucked more slowly under nutritive than under non-nutritive sucking conditions. The sucking efficiency of one of them improved during training. The status of the patients in the final stage of their dementia differed from one another, which might explain the difference in outcome. It is therefore suggested, that the use of the patients' sucking ability could serve as a complement and/or an alternative feeding technique when assisted spoon-feeding becomes extremely difficult or impossible. It is considered to be more gentle and natural than the present feeding techniques.

  • 173. Asplund, Kenneth
    et al.
    Norberg, Astrid
    Adolfsson, Rolf
    Waxman, Howard M.
    Facial expressions in severely demented patients: a stimulus-response study of four patients with dementia of the Alzheimer type1991In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 6, no 8, p. 599-606Article in journal (Refereed)
    Abstract [en]

    The ability to exhibit facial expressions was studied in four patients with severe dementia of the Alzheimer type (SDAT), by means of the Facial Action Coding System (FACS) and physiological responses (heart rate, respiration, skin temperature) under pleasant and unpleasant stimulus conditions. Complex facial expressions that could be interpreted as expressions of emotions were not seen. An increase in the number of facial movements and changes in the physiological responses were seen most markedly under the unpleasant stimulus condition. The patients' reactions during the assumed pleasant stimulus conditions indicated comfort. Different reactions were obtained among the patients. The importance of developing further methods to identify and interpret facial movements in nurse-patient relationships is emphasized.

  • 174.
    Asplund, Kenneth
    et al.
    Umeå universitet.
    Wimo, Anders
    Lundgren, Kjerstin
    Aggressivitet och motoriska problem tvingar dementa lämna gruppboende1990In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 87, no 18, p. 1555-1556Article in journal (Other academic)
  • 175.
    Astvik, Elin
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Andersson, Amanda
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Filipino nurses’ experiences of nursing in the public health care settings in the Philippines: A qualitative interview study2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The Philippines gained independency year 1946. Health services in the country were decentralized year 1991 and was moved from a national level to local government. The public health care system still appears obscure among the growing population and concerns over the public health care settings’ accessibility and quality remain. Religion is significant for the 95 percent Christians who lives in the country and the population obtain a deep faith in God. As the leading exporter of health workforce, nurses that remain in the public health care setting face challenges of workload in a challenging work environment. This study has been made to obtain deeper understanding of Filipino nurses’ experiences of practicing nursing in the public health care settings in the Philippines.

    Aim: The aim was to describe Filipino nurses’ experiences of practice nursing in the public health care settings in the Philippines.

    Method: The design is a descriptive qualitative interview study consisting of semi-structured interviews with nine nurses in Palawan, Philippines. The material was analyzed using qualitative content analysis with an inductive approach.

    Result: Nurses in this study experience challenges caused by lack of resources and restricted budget. This results in an increased workload and an inadequate nurse to patient ratio which in order create experiences of threatened patient’s safety. Nurses experience feelings of insufficiency in the profession and therefore, have an increased risk of burnout and errors.

    Discussion: The discussion addresses nurses’ challenges of practice nursing in public health care settings. The nurses are not able to deliver the care they want due to an oppressive workload and time constraint which in order affect the interaction with patients. Several nurses’ experience patient safety being threatened and mention their way of practicing nursing as unsafe which cause feelings of being helpless and insufficient among the nurses in this study. Christianity plays a significant role for the participants in practicing nursing. Nurses coming on and off shifts have daily prayers together which is experienced as energizing for the nurses, as they find strength and wisdom through the beliefs in God.

  • 176.
    Athena, Karapidaki
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Skantz, Lina
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Patienter med substansberoende och deras upplevelser av bemötandet i vården: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Substance addiction is a growing problem in the society which affects the users physically and mentally but it also has an effect on a societal level. Nurses have an obligation to encounter patients with a correct ethical standpoint and a critical approach. Nurses experience that they are not properly fitted to treat these patients and requested more knowledge within this field. To investigate how patients with substance addiction experiences nurses’ encounter. The study is a literature review where ten scientific articles of qualitative method were analysed according to Friberg (2017) where the differences and the similarities conducted the themes of the result. The results showed variable positive and negative experiences of health care professionals treatment/encounter which were divided into categories. The categories are presented as Experiences of being judged, Experiences of being treated with a lack of knowledge, Experiences of not being taken seriously and Experiences of trusting relationship. The result was discussed out of Phil Barker’s Tidal Model, the study’s background, scientific literature and the authors own point of view.

  • 177.
    Athley, Annika
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Jonsson, Helén
    Ersta Sköndal University College, Department of Health Care Sciences.
    Att möta närstående i deras föregripande sorg: ett omvårdnadsperspektiv2001Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 178.
    Athlin, Elsy
    et al.
    Umeå universitet.
    Norberg, Astrid
    Umeå universitet.
    Asplund, Kenneth
    Umeå universitet.
    Caregivers' perceptions and interpretations of severely demented patients during feeding in a task assignment system.1990In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 4, no 4, p. 147-155Article in journal (Refereed)
    Abstract [en]

    Ninety-one focused interviews concerning the feeding of 23 severely demented patients were performed with 62 caregivers who fed the patients in a task assignment system. The aim was to increase the understanding about how caregivers perceive and interpret severely demented patients' behaviour and experiences during feeding. Content analysis showed that the caregivers' commitment or lack of commitment constituted a superior level that determined whether the patient was seen as a subject or as an object. Subcategories that were found were knowledge of the patient's disease and personal history, intuition, identification, empathy, generalisation and routinisation.

  • 179.
    Athlin, Elsy
    et al.
    Umeå universitet.
    Norberg, Astrid
    Umeå universitet.
    Asplund, Kenneth
    Umeå universitet.
    Jansson, Lilian
    Feeding problems in severely demented patients seen from task and relationship aspects1989In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 3, no 3, p. 113-121Article in journal (Refereed)
    Abstract [en]

    This study aimed at increasing the understanding of feeding problems in severely demented patients cared for in a task assignment system. Twenty-three video-recordings made during the feeding of 15 severely demented patients and 55 focused interviews with 45 caregivers, who fed the 15 patients during that period were analysed regarding the feeding problems seen from a task aspect and from a relationship aspect. The result indicated that the problems were partly of a more constant nature and partly fluctuated from meal to meal. Feeding problems regarding the task aspect were mentioned first by the caregivers in the interviews in spite of the fact that the patients had severe communication problems which could be expected to cause great problems in the relationship between the patient and his caregiver. Reasons for these findings are suggested.

     

  • 180.
    Athlin, Elsy
    et al.
    Umeå universitet.
    Norberg, Astrid
    Umeå universitet.
    Asplund, Kenneth
    Umeå universitet.
    Jansson, Lilian
    Probleme des Essenseingebens bei schwer dementen Patientinnen unter den Aspekten "Verrichtung" und "Beziehung"1993In: Pflege, Die wissenschaftliche Zeitschrift für Pflegeberufe, ISSN 1012-5302, E-ISSN 1664-283X, Vol. 6, no 2, p. 120-128Article in journal (Refereed)
  • 181.
    Audulv, Åsa
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Norbergh, Karl-Gustaf
    Mittuniversitetet.
    Being free of symptoms or experiencing mental wellbeing – different ways of understanding wellness among people living with chronic illness2009Conference paper (Refereed)
  • 182.
    Audulv, Åsa
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Asplund, Kenneth
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Norbergh, Karl-Gustaf
    Mittuniversitetet, Institutionen för hälsovetenskap.
    The impact of illness - Various ways of perceiving illness influences on self-management among people living with chronic disease2010In: The impact of illness - Various ways of perceiving illness influences on self-management among people living with chronic disease, 2010Conference paper (Refereed)
  • 183.
    Audulv, Åsa
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet, Universitetet i Tromsø, Norge.
    Norbergh, Karl-Gustaf
    Mittuniversitetet.
    The influence of illness perspectives on self-management of chronic disease2011In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 3, no 2, p. 109-118Article in journal (Refereed)
    Abstract [en]

    Aim: To explore people’s illness perspectives and related self-management of chronic disease.

    Background: Individuals’ illness beliefs and perspectives have been suggested to influence their self-management behaviour. However, research that has examined the influence of illness perspectives on chronic disease self-management has been largely quantitative and has focused on selected elements of self-management. How individuals’ illness perspectives influence their whole of self-management has not been investigated in depth.

    Method: The phenomenographic research study entailed 26 narrative interviews with Swedish adults with a variety of chronic diseases. Data were collected mostly during 2006.

    Results: The participants described two illness perspectives; being life-oriented meant to focus upon how to live a good life with disease, whereas a diseaseoriented illness perspective emphasised the medical and physiological aspects of disease. The participants attested to one of the two illness perspectives as a main perspective, although they shifted between the perspectives depending of context and illness experience. The participants’ illness perspectives were reflected in their understandings of self-management. Participants with a dominant life-oriented illness perspective performed self-management in order to continue living a ‘normal’ life (e.g. facilitate activity and mental well-being). When holding a disease-oriented illness perspective, self-management was focused upon controlling disease (e.g. symptom management and avoiding disease related complications).

    Conclusions: People with chronic illness hold a dominant illness perspective that determines how they understand and enact self-management. These perspectives 2011 Blackwell Publishing Ltd 109 are not static; instead individuals tend to shift between the perspectives under specific circumstances.

    Relevance to clinical practice: Health-care providers shall acknowledge that individuals’ with chronic illness shift between a life-oriented and a disease-oriented illness perspective. The results of the current study can be used by health-care providers in order to launch a dialogue in order to support individuals’ self-management.

  • 184.
    Audulv, Åsa
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet, Universitetet i Tromsö, Norge.
    Norbergh, Karl-Gustaf
    Länssjukhuset i Sundsvall.
    Who's in charge? The role of responsibility attribution in self-management among people with chronic illness2010In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 81, no 1, p. 94-100Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore how responsibility attribution influences self-management regimens among people with chronic illness.

    METHODS: This qualitative content analysis included 26 interviews with people living with chronic illness.

    RESULTS: The participants attributed responsibility to internal, external or a combination of these factors, meaning that they either assumed responsibility for self-management or considered other people or factors responsible. Internal responsibility was associated with a multifaceted self-management regimen, whereas external responsibility was related to "conventional" self-management such as taking medication, managing symptoms and lifestyle changes.

    CONCLUSION: How responsibility is attributed is vital for the way in which individuals perform self-management. In this study, those who attributed responsibility to external factors mainly performed recommended behaviours to control their illness. In contrast, to take charge of their illness and be an active participant in the care, individuals must take responsibility for themselves, i.e. internal responsibility.

    PRACTICE IMPLICATIONS: Health-care providers should acknowledge and support individuals' wishes about various levels of responsibility as well as different kinds of patient-provider relationships.

  • 185.
    Audulv, Åsa
    et al.
    Mittuniversitetet.
    Norbergh, Karl-Gustaf
    Sundsvalls sjukhus.
    Asplund, Kenneth
    Mittuniversitetet, Universitetet i Tromsø.
    Hörnsten, Åsa
    Umeå universitet.
    An ongoing process of inner negotiation – a Grounded Theory study of self-management among people living with chronic illness2009In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 1, no 4, p. 283-293Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to better understand the main concern of self-management processes among people with chronic illness.

    Background: One aspect of living with chronic illness is self-management that can reduce the illness impact on daily life and promote future health. Although factors that influence self-management have been identified in previous research, little attention has been brought to the process of making self-management decisions. In clinical settings, use of a theory could facilitate patient-empowering approaches.

    Method: The data collection for this Grounded Theory was mostly conducted in 2006. Data were collected by interviews with 26 adults with a variety of chronic illnesses, including rheumatoid arthritis, diabetes mellitus, inflammatory bowel syndrome, multiple sclerosis, ischaemic heart disease and chronic kidney failure.

    Results: Individuals are conflicted by competing preferences when taking decisions about self-management. Consequently, the decision-making process can be understood as an ongoing inner negotiation between different incompatible perspectives, e.g. social needs vs. medical needs. The process of negotiating self-management starts with the individual’s considering beliefs about health and illness, which make the individual face illness threats and the need for self-management. Several aspects influence negotiating self-management namely, assessing effects of self-management; evaluating own capacity; perceiving normality or stigmatisation; and experiencing support and external resources. The process has been demonstrated in a model.

    Conclusions: The process of negotiating self-management is an ongoing inner debate rather than a one-time decision. This opens up new ways of understanding, and communicating with, patients. The described model also links behavioural theories and research findings in a comprehensive understanding.

    Relevance to clinical practice: This model could be applicable as a communication tool for health-care providers in identifying barriers to, and resources in, self-management behaviour among individuals with chronic illness.

  • 186.
    Augustsson, Jessica
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Ingnäs, Erika
    Ersta Sköndal University College, Department of Health Care Sciences.
    Äldres rädsla för fall: en litteraturstudie om hur rädsla kan uppstå, samt dess konsekvenser för individen2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 187.
    Augustsson, Linnea
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Chamoun, Carolina
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Riskfaktorer för depression och sjuksköterskors möjligheter att identifiera depression hos äldre: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Depression is becoming more common but only half of the cases are getting diagnosed. The difficulties of getting a diagnose increases with age and the elderly have more somatic symptoms of depression. There is a huge knowledge gap within healthcare sector relating to the identification of depression and the risk factors that influence it.

    Aim: The aim is to highlight the risk factors that may influence the development of depression among the elderly and the opportunities nurses have to identify depression among the older people.

    Method: A litterature review was made on the chosen topic. Studies were searched through the databases: MEDLINE, CINAHL Complete, ASSIA and Psychology and Behavioral Sciences Collection. The keywords that were used was: depression, older adults, older, nurse/nurses, identify, recognize, risk factors and elderly. Friberg’s analytical method was used to analys the articles.

    Results: Two categories were presented in the result. The first category descibes the risk factors that may effect depression among the elderly and the second category describes the nurses possibilities to identify depression. The risk factors that may effect a depression are: quality of life and somatic impact. The nurses ability to identify depression among elderly were compiled into knowledge, education and time for dialog.

    Discussion: Strength and weaknesses are discussed in the method discussion while the results are discussed in relation to the purpose, background and Barkers tidalmodel in the result discussion.

  • 188.
    Augutis, Marika
    et al.
    Karolinska institutet, Länssjukhuset i Sundsvall.
    Levi, Richard
    Karolinska institutet, Rehab station Stockholm.
    Asplund, Kenneth
    Mittuniversitetet.
    Berg-Kelly, Kristina
    Göteborgs universitet.
    Psychosocial aspects of traumatic spinal cord injury with onset during adolescence: A qualitative study2007In: Journal of Spinal Cord Medicine (JSCM), ISSN 1079-0268, E-ISSN 2045-7723, Vol. 30, no Suppl1, p. 55-64Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVE: Spinal cord injury (SCI) occurring during adolescence poses additional challenges because of the concurrent age-specific bio-psychosocial development. Full understanding of the psychosocial dimensions of rehabilitation requires exploration of the patient perspective. The objective of this study was to focus on psychosocial factors from the patient perspective in persons who had previously sustained a SCI during early and mid-adolescence (11-15 years of age).

    METHODS: Twenty-four of the 28 persons who had sustained a SCI in Sweden from 1985 to 1996 participated in the study. Semistructured interviews were made an average of 10 years after injury. Narratives were analyzed qualitatively according to content analysis.

    RESULTS: Parents and peers were found to have formed a crucial network. Parents frequently acted as advocates in interactions with health care providers, as supporters, and as containers of sorrow, frustration, and anger. Peers acted as promoters of activity and identity development. However, health care providers were perceived as not making sufficient use of this network.

    CONCLUSIONS: Rehabilitation professionals might be encouraged to increase their knowledge of adolescence medicine to better meet the specific needs and demands of persons in this age group. It is further suggested that parents and peers be considered important partners in the joint rehabilitation effort.

  • 189.
    Awel, Fadumo
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Hassan, Naima
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Personens upplevelse av att leva med schizofreni: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 190.
    Axberg, Thuy
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Kazemi, Fatemeh
    Ersta Sköndal University College, Department of Health Care Sciences.
    Ät- och sväljningsproblem efter stroke: En litteraturstudie om äldres upplevelser av matsituationen efter stroke2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 191.
    Axelson, Helene
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Mattson, Liselott
    Ersta Sköndal University College, Department of Health Care Sciences.
    Att bemästra och leva med kronisk sjukdom såsom Multipel skleros2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 192.
    Axelsson, Anna
    et al.
    Ersta Sköndal University College, Institutionen för omvårdnad.
    Olofsson, Terese
    Ersta Sköndal University College, Institutionen för omvårdnad.
    Kvinnor med fibromyalgi och sjuksköterskans omvårdnadshandlingar1998Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 193.
    Axelsson, Anna-Karin
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Åstradsson, Sandra
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskors upplevelser och erfarenheter av att en patient suiciderat under pågående psykiatrisk vård: En intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Annually, about 1500 people die in Sweden as a result of suicide. Approximately one third of the people who commit suicide have an ongoing contact with the psychiatric care. Therefore, a larger group of nurses are left emotionally affected.

    Aim: The aim of this study was to describe nurses' experiences of a patient suicide during ongoing psychiatric care.

    Method:

    The study has a qualitative design with an inductive approach. Twelve nurses who all experienced that a patient they cared for died through suicide was interviewed with a semi-structured questionnaire. Collected data was then analyzed with qualitative content analysis according to Elo and Kyngäs. As a theoretical framework Barker and Buchanan-Barker's tidal model have been used in the discussion of the result.

    Results: Analyzed data resulted in six main categories; Emotional impact, What did we do wrong?, The importance of post-event support, How the event affected the professional role, Suicide leave marks and The perception of suicide along with 13 associated subcategories. A patient suicide often generated an emotional impact for the nurse. Questioning one's own expertise and organization was common. The importance of personalized support after the event is significant. Without sufficient support, there was a risk of negative consequences. The event could generate feelings of discomfort, but in the aftermath also increased security in one's own professional role, increased competence and increased commitment.

    Conclusions: A patient suicide during ongoing psychiatric care affects the nurse emotionally and professionally. The incident not only affects the nurse but also the entire workplace. The need for support after the incident is individual and if it´s perceived as lacking the incident may have negative consequences for the nurse. There is a need to broach this topic and we need an ongoing forum for these issues.

  • 194.
    Axelsson, Joel
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Geijer, Carolina
    Ersta Sköndal University College, Department of Health Care Sciences.
    Den osynliga vården: Att som anhörig vårda en närstående med demenssjukdom2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Dementia is the fourth most common endemic disease in Sweden and the number of people diagnosed with dementia is estimated to increase. Dementia includes diseases that affect the brain with symptoms on memory function, mood and communication skills. Several people with dementia is cared for at home by family members. Being an informal caregiver is a large responsibility and affects the whole family.

    Aim: To describe relative’s experiences of caring for a family member with dementia.

    Method: A literature review based on the analysis of ten scientific articles with qualitative design.

    Results: The results showed both positive and negative experiences. Some relatives expressed the feeling of becoming stronger and more resilient as a result of caring for their loved one but there where feelings of anger and frustration as well. The results showed that the relatives where in need of social and formal support but often had a hard time asking for help due to the feeling of being a burden for others and the society. Many experienced that their family member’s identity changed with the disease, which caused a change in the relationship as well. Some expressed role changes within the family and the lack of social and emotional closeness, while others expressed a feeling of becoming closer to each other.

    Discussions: It became clear that there was a complexity in relative’s attitude to social and formal support and nurses in contact with informal caregivers should be aware of this. Knowledge about informal caregiver’s perceived burden and what they perceive as their strength is an important key part for nurses in their work with dementia patients and their relatives. Nurses need to be aware of the occurrence of feelings of anger and frustration in relatives to be able to spot these and make sure the patient welfare is not compromised. Due to differences in men and women’s experiences it could be useful for the nurse to have a gender aspect in their meeting and caring for informal caregivers. The results were discussed from the perspective of Dorothea Orems self-care theory.

  • 195.
    Axelsson, Karin
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Viktorsson, Karolina
    Ersta Sköndal University College, Department of Health Care Sciences.
    En god död: omständigheter som kan bidra till en god respektive en dålig död för patienten2004Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 196.
    Axelsson, Lena
    et al.
    Sophiahemmet högskola, Karolinska institutet.
    Klang, Birgitta
    Karolinska institutet.
    Lundh Hagelin, Carina
    Sophiahemmet högskola, Karolinska institutet, Stiftelsen Stockholms sjukhem.
    Jacobson, Stefan H
    Karolinska institutet, Danderyds sjukhus.
    Gleissman, Sissel Andreassen
    Sophiahemmet högskola, Karolinska institutet, Danderyds sjukhus.
    End of life of patients treated with haemodialysis as narrated by their close relatives.2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 776-84Article in journal (Refereed)
    Abstract [en]

    AIM: The study aimed to describe end of life for patients treated with maintenance haemodialysis as narrated by their close relatives.

    INTRODUCTION: Many patients undergoing haemodialysis are older, have several comorbidities and underestimated symptoms and are in their last year of life. To improve care, we need to know more about their end-of-life situation.

    DESIGN: Qualitative and descriptive.

    METHODS: Qualitative retrospective interviews were conducted with 14 close relatives of deceased haemodialysis patients (3-13 months after death). Data were analysed using qualitative content analysis. The study is ethically approved.

    FINDINGS: In the last months, a gradual deterioration in health with acute episodes necessitating hospital admissions was described. This involved diminishing living space and expressions of dejection, but also of joy. Three patterns emerged in the last weeks: uncertain anticipation of death as life fades away; awaiting death after haemodialysis withdrawal; and sudden but not unexpected death following intensive care. Findings show complexities of decisions on haemodialysis withdrawal.

    CONCLUSIONS: Different end-of-life patterns all involved increasingly complex care needs and existential issues. Findings show a need for earlier care planning. The identification of organisational factors to facilitate continuity and whole person care to meet these patients' specific care needs with their complex symptom burdens and comorbidities is needed. Findings indicate the need for integration of a palliative care approach in the treatment of patients in haemodialysis care.

  • 197.
    Axelsson, Lena
    et al.
    Sophiahemmet högskola, Karolinska Institutet.
    Klang, Birgitta
    Karolinska institutet.
    Lundh Hagelin, Carina
    Sophiahemmet högskola, Karolinska institutet.
    Jacobson, Stefan H
    Danderyds sjukhus, Karolinska institutet.
    Gleissman, Sissel Andreassen
    Sophiahemmet högskola, Danderyds sjukhus, Karolinska institutet.
    Meanings of being a close relative of a family member treated with haemodialysis approaching end of life.2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 3-4, p. 447-56Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe and elucidate the meanings of being a close relative of a severely ill family member treated with maintenance haemodialysis approaching the end of life.

    BACKGROUND: End-stage renal disease together with comorbidities, haemodialysis treatment and high mortality rates also affects the lives of close relatives, who report burdens and impaired quality of life. To improve care, more understanding is needed of close relatives' experiences during these patients' end of life.

    DESIGN: This study has a qualitative interpretative design.

    METHODS: Fourteen retrospective qualitative interviews were conducted with close relatives (aged 48-93 years) of deceased patients who had been treated with haemodialysis. The interview text was interpreted using a phenomenological hermeneutical method in three phases.

    RESULTS: The findings of the structural analysis were formulated as six themes: Striving to be supportive and helpful without doing harm to the ill person's self; Needing increasing strength and support; Balancing the will to help with one's own ongoing life; Increasing responsibility involving dilemmas; Striving for a good life together in the present and Living with awareness of death.

    CONCLUSIONS: Close relatives strive for balance and well-being accompanying their ill family member through the end of life. They are facing moral dilemmas and growing demands as their responsibility increases with the deterioration of their family member. Support from and interaction with the healthcare professionals is then of significance.

    RELEVANCE TO CLINICAL PRACTICE: Findings challenge healthcare professionals in haemodialysis settings to identify close relatives' individual resources and needs towards the patients' end of life. Healthcare professionals in haemodialysis settings need to offer close relatives opportunities to talk about the future and what may be expected at end of life, with or without haemodialysis. They should also contact the closest relative after the death as they may need confirmation and closure.

  • 198.
    Axelsson, Lena
    et al.
    Sophiahemmet högskola, Karolinska institutet.
    Randers, Ingrid
    Sophiahemmet högskola, Karolinska institutet.
    Lundh Hagelin, Carina
    Sophiahemmet högskola, Karolinska institutet.
    Jacobson, Stefan H
    Karolinska institutet, Danderyds sjukhus.
    Klang, Birgitta
    Karolinska institutet.
    Thoughts on death and dying when living with haemodialysis approaching end of life.2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 15-16, p. 2149-59Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe inner thoughts and feelings relating to death and dying when living with haemodialysis approaching end of life.

    BACKGROUND: Patients who undergo maintenance haemodialysis suffer a significant symptom burden and an impaired quality of life. The high mortality rate in these patients indicates that about one-fourth of them are in their last year of life, suggesting the presence of death and dying in the haemodialysis unit.

    DESIGN: A qualitative descriptive design was used. Methods.  A total of 31 qualitative interviews were conducted with eight patients (aged 66-87) over a period of 12 months. Qualitative content analysis was used to analyse data.

    RESULTS: The analysis revealed 10 subthemes that were sorted into three main themes. Being aware that death may be near comprises being reminded of death and dying by the deteriorating body, by the worsening conditions and deaths of fellow patients, and by knowing haemodialysis treatment as a border to death. Adapting to approaching death comprises looking upon death as natural, preparing to face death, hoping for a quick death and repressing thoughts of death and dying. Being alone with existential thoughts comprises a wish to avoid burdening family, lack of communication with healthcare professionals and reflections on haemodialysis withdrawal as an hypothetic option.

    CONCLUSIONS: Living with haemodialysis approaching, the end of life involves significant and complex existential issues and suffering, and patients are often alone with their existential thoughts.

    RELEVANCE TO CLINICAL PRACTICE: Nurses and other healthcare professionals in haemodialysis settings need to combine technical and medical abilities with committed listening and communication skills and be open to talking about death and dying, with sensitivity to individual and changeable needs.

  • 199.
    Axelsson, Mikaela
    Ersta Sköndal University College, Department of Health Care Sciences.
    Att leva med diabetes typ 2 - en livslång utmaning: En litteraturöversikt2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Type 2 diabetes is a chronic disease that vigorously increases worldwide. The disease can affect the entire everyday life which usually results in major lifestyle change. The treatment consists largely of self care which the patient itself has great responsibility for. The nurses have an important role in supporting, guiding and teaching the patients. Since every patient is unique the nurse would benefit from an increased knowledge about the patients experiences of what promotes and prevents self care in type 2 diabetes.

     

    Aim: The aim was, from a patient perspective, describe the experience of what promotes and prevents a self care in type 2 diabetes.

     

    Methods: A literature review based on nine scientific articles gathered from the databases CINAHL plus with full text, PubMed and Medline. The articles were analyzed and common denominators were identified and themes created.

     

    Results: The patients promoting and preventing experiences were presented in two main themes with associated subthemes. To live with type 2 diabetes enlightes the patients experiences of personal perception, integration, driving force and interact with the surroundings. To meet healthcare illustrated the patients experiences of the caregivers supporting and informative role.

     

    Discussions: This study's results are discussed, developed and strengthened with other scientific studies, Dorothea E. Orem´s theory of self care, this study´s background and the author´s own reflections. It is revealed that no patient is the other alike and they should be treated as the unique individuals they are to enable the self care to be integrated in their life.

     

    Keywords: Diabetes mellitus type 2, self care, experience and patient

  • 200.
    Aychiluhim, Hanna
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Stevenson, Åsa
    Ersta Sköndal University College, Department of Health Care Sciences.
    Faktorer som leder till etiskt betingad stress och sjuksköterskors hantering av fenomenet i omvårdnadsarbete: En uppsats med inriktning mot vårdetik2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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