Change search
Refine search result
43444546474849 2251 - 2300 of 5185
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 2251.
    Hjelm, Emma
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Björn, Karolina
    Ersta Sköndal University College, Department of Health Care Sciences.
    ”Skyll dig själv?” – en litteraturöversikt om sjuksköterskors attityder gentemot alkoholister: Vad påverkar attityderna?2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2252. Hjelm-Wallén, Lena
    et al.
    Ruin, Olof
    Trägårdh, Lars
    Ersta Sköndal Bräcke University College, Department of Social Sciences, The Institute for Civil Society Research.
    Baudin, Tobias
    Kommunalarbetareförbundet.
    Bengtsson, Håkan A.
    Arenagruppen.
    Bengtsson, Jesper
    Sohlman, Michael
    Rosenberg, Göran
    Säve-Söderbergh, Bengt
    Wingborg, Mats
    Det behövs mer än värnplikt2016In: Svenska dagbladet, ISSN 1101-2412, no 2016-10-07, p. 6-6Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Människors säkerhet handlar om mycket mer än det rent militära. Därför är det är dags att överväga att införa allmän medborgartjänst för alla medborgare kring tjugoårsåldern.

  • 2253. Hjelm-Wallén, Lena
    et al.
    Ruin, Olof
    Trägårdh, Lars
    Ersta Sköndal Bräcke University College, Department of Social Sciences, The Institute for Civil Society Research.
    Baudin, Tobias
    LO, Landsorganisationen i Sverige.
    Botström, Philip
    Sveriges Socialdemokratiska Ungdomsförbund, SSU.
    Sohlman, Michael
    Bengtsson, Håkan, A.
    Arenagruppen.
    Wingborg, Mats
    Säve-Söderbergh, Bengt
    Dags att införa en modern typ av värnplikt2016In: Svenska dagbladet, ISSN 1101-2412, no 2016-01-19Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Hoten mot dagens samhälle är betydligt bredare än det rent militära. Vi är väl medvetna om att civilsamhället gör stora insatser. Men än fler borde delta, skriver flera debattörer som vill att effekterna av någon form av medborgartjänst eller moderniserad värnplikt utreds.

  • 2254.
    Hjort, Lovisa
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Steinweg, Caroline
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sjuksköterskors attityder till patienter med HIV/HIDS2002Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2255.
    Hjorth, Elin
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Sejersen, Thomas
    Karolinska institutet.
    Jeppesen, Jørgen
    Danmark.
    Werlauff, Ulla
    Danmark.
    Rahbek, Jes
    Danmark.
    Lövgren, Malin
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Bereaved Parents More Satisfied With the Care Given to Their Child With Severe Spinal Muscular Atrophy Than Nonbereaved.2018In: Journal of Child Neurology, ISSN 0883-0738, E-ISSN 1708-8283, article id 883073818811544Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS:: Children with severe spinal muscular atrophy have complex care needs due to progressive muscle weakness, eventually leading to respiratory failure. To design a care system adapted to families' needs, more knowledge about parents' experience of care and its coordination between settings is required. This study explores (1) whether parents felt that health professionals took every opportunity to help the child feel as good as possible, (2) parents' satisfaction with various care settings, and (3) parents' satisfaction with coordination between settings.

    METHODS:: Data derive from nationwide Swedish and Danish surveys of bereaved and nonbereaved parents of children with severe spinal muscular atrophy born between 2000 and 2010 in Sweden and 2003 and 2013 in Denmark (N = 95, response rate = 84%). Descriptive statistics and content analysis were used.

    RESULTS:: Although most of the parents reported that care professionals had taken every opportunity to help the child feel as good as possible, one-third reported the opposite. Bereaved parents were significantly more satisfied with care than nonbereaved (81% vs 29%). The children received care at many different locations, for all of which parents rated high satisfaction. However, some were dissatisfied with care coordination, describing lack of knowledge and communication among staff, and how they as parents had to take the initiative in care management.

    CONCLUSIONS:: This study highlights the importance of improving disease-specific competence, communication and knowledge exchange among staff. For optimal care for these children and families, parents should be included in dialogues on care and staff should be more proactive and take care management initiatives.

  • 2256.
    Hjorth, Elin
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet, Astrid Lindgrens barnsjukhus.
    Sejersen, Thomas
    Karolinska institutet, Astrid Lindgrens barnsjukhus.
    Lövgren, Malin
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet, Astrid Lindgrens barnsjukhus.
    Parents' advice to healthcare professionals working with children who have spinal muscular atrophy2018In: European journal of paediatric neurology, ISSN 1090-3798, E-ISSN 1532-2130, Vol. 22, no 1, p. 128-134, article id S1090-3798(17)30897-8Article in journal (Refereed)
    Abstract [en]

    AIM: To explore parents' advice to healthcare professionals working with children with spinal muscular atrophy (SMA).

    MATERIALS AND METHODS: This study derives from a Swedish nationwide survey and uses content analysis to make inferences from answers to an open-ended question concerning parent's advice to healthcare professionals. Of eligible parents who had a child born in Sweden between 2000 and 2010, diagnosed with SMA type 1 or 2, and for whom respiratory support was considered in the first year of life, 61 participated in the study (response rate: 87%). Of these, 51 parents answered the question about advice to healthcare professionals working with children with SMA.

    RESULTS: More than half of the advice from parents was related to professional-family relations. The second most frequent type of advice related to two aspects of knowledge about SMA: desire that healthcare professionals possess knowledge, and desire that they provide knowledge. The parents also had advice concerning support in daily life, both to the parents and to the affected child. Other pieces of advice were related to organization of care and the parents' desire to be involved in the child's care.

    CONCLUSIONS: Parents advised healthcare professionals to increase their disease-specific knowledge, to treat the parents as experts on their child, and to treat the family with respect, particularly in situations where the child's case is used as an opportunity to improve healthcare professionals' competence. Increased practical support in daily life and a case coordinator is also among parents' advice to healthcare professionals.

  • 2257.
    Hjukström, Linda
    Ersta Sköndal University College, Department of Health Care Sciences.
    Närståendes upplevelser av palliativ vård i hemmet2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Palliative homecare is a growing phenomenon. Next of kins often participate in the care as informal caregivers, although it means a major impact on their lives. The goal of palliative care is to relieve and allow as good a life as possible, not only for the patients but also for their next of kins.

    Aim: The aim of the study was to shed light on how next of kins perceive their situation in palliative homecare.

    Methods: A literature study has been accomplished through searches in the databases Cinahl, Pubmed and Medline. Twelve articles were selected for the result. In seven of the articles qualitative method was used, in two articles quantitative method and and three articles both qualitative and quantitative method were used. Seven studies were Swedish and the others were from Canada, Italy, Japan and Australia.

    Results: The result showed that informal caregivers had both positive and negative experiences of taking part in the care of the patient and they often felt insufficiency, uncertainty and fatigue, which caused other symptoms, both physical and psychological and spiritual. The result also showed that the informal caregivers had a great need to get support, information and training from the nurse in the professional care team both during treatment and after the patient had died.

    Discussion: There is often a difficult balance for the next of kins between taking care of the patient and their own personal needs of rest and personal time. Next of kins therefore need support from the professional care team to manage their role as informal caregivers. The nurse must be able to pay attention to the individuals unique needs and to assist in finding nursing interventions that can help next of kins to get the best possible balance in their daily lives despite the care burden. I consider that Carnevalis nursing model can be supportive in this work.

  • 2258.
    Hjulström, Susanne
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Liljestrand, Thérèse
    Ersta Sköndal University College, Department of Health Care Sciences.
    Petterson, Tine
    Ersta Sköndal University College, Department of Health Care Sciences.
    "Jag ska få besök, hoppas jag har orken": aspekter av betydelse för den palliativt vårdade patientens välbefinnande2004Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2259.
    Hjälmrud, Berno
    Ersta Sköndal University College, Department of Health Care Sciences.
    Upplevelser av motion hos personer med psykisk ohälsa: att vara en del av ett vinnande lag2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Fysisk aktivitet är något i princip alla människor behöver för att må bra fysiskt och mentalt. Några som är i extra stort behov av fysisk aktivitet är personer med psykisk ohälsa då de ofta också drabbas fysisk ohälsa. Bland annat beroende på att passivitet kan vara ett symtom och att en del psykofarmaka ger metabola störningar.  

    Syfte: Syftet var att belysa upplevelser av motion hos personer med psykisk ohälsa samt faktorer som kan vara motiverande.  

    Metod: En litteratursökning har genomförts för att skapa en översikt över vetenskapliga artiklar om   motiverande faktorer och upplevelser av fysisk aktivitet hos personer med psykisk ohälsa. Studien baseras på åtta kvalitativa artiklar som granskats och analyserats med influens av Willman & Stoltz (2012) samt Friberg (2012). Det vetenskapliga underlaget  är hämtat från Cinahl, psycinfo samt Pubmed och artiklarna är publicerade mellan 2000-2013.  

    Resultat: Dataanalysen gav tre huvudteman. Det första beskriver motion som inre tillfredsställelse med ett antal subteman som främst handlar om upplevelsen av fysisk aktivitet. Det andra huvudtemat är Gemenskap som stöd och trygghet som främst handlar om gruppen och hur brukaren kan bli delaktig . Det tredje temat är konsten att komma i form och beskriver självhjälpsstrategier, hinder och vikten av stöd för tillfrisknandet som process.  

    Diskusssion: Resultatet diskuterade möjligheterna att skapa ”empowerment” hos brukarna i form av delaktighet och självbestämmande. Dels genom brukarnas egna önskemål men också genom de Motiverande faktorer som upptäcktes. Här finns en möjlighet för vården att påskynda ett tillfrisknande.

  • 2260.
    Hjälte, Anna
    et al.
    Ersta Sköndal University College, Institutionen för omvårdnad.
    Holmström, Cecilia
    Ersta Sköndal University College, Institutionen för omvårdnad.
    Omvårdnadsdokumentation enligt SAUK-modellen för bekräftande omvårdnad1998Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2261.
    Hoffman Hansen, Isa
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Bång, Linnéa
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Upplevelser av att leva med venösa bensår: En litteraturöversikt med utgångspunkt i KASAM2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BackgroundVenous leg ulcers occur as a result of venous insufficiency. The condition is expected to increase in line with an aging population. Treatment may be time consuming and the adherence to treatment is low. The nurse plays an important role in the treatment of these persons. By highlighting people’s experiences of living with venous leg ulcers, knowledge necessary for the nurse to provide good care can be gained.

    Aim: To highlight people’s experiences of living with venous leg ulcers.

    MethodA literature review with directed content analysis. The analysis was based on the three key components in Antonovsky's theory of sense of coherence (SOC): comprehensiveness, manageability and meaningfulness. Searches were carried out in three databases. Keywords for to live with were combined with keywords for venous leg ulcers. Searches were limited to articles published between the 1st of January 2008 and the 31st of August 2018. Eleven scientific articles were selected for analysis.

    ResultsEight subcategories were presented under three main categories. The main categories were comprehensiveness, manageability and meaningfulness. The comprehensiveness category described experiences of suffering from venous leg ulcers, the significance of control and the importance of information. In the manageability category, the use of resources and strategies to handle life were described. In the meaningfulness category, the impact of leg ulcers on identity and self-image were described. The place of the ulcers in patients’ lives and descriptions of how life with leg ulcers was emotionally experienced were also presented.

    DiscussionAspects in relation to nursing and treatment were discussed. Time, adherence to treatment, information and knowledge were highlighted. This was discussed in the light of Antonovsky's core components as well as previous research.

  • 2262.
    Hoffmann, Evelina
    et al.
    Ersta Sköndal University College, Department of Social Sciences.
    Hedqvist, Lina
    Ersta Sköndal University College, Department of Social Sciences.
    Från monster till offer: En studie om barn och unga med ett sexuellt problembeteende2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    During the 1990’s it was first discovered that children could sexually abuse other children. This made the care staff stand lost towards the task to help these children. This was something that had not previously been talked about and there were not much knowledge in the area. When Börje Svensson and Anders Nyman started a project with Rädda Barnen, a treatment program started to develop. Svensson and Nyman started to treat young girls and boys who had problematic sexual behaviors. After this treatment program started to slowly develop and is a process that continues today.     

    The purpose of this thesis is to look at the implications of scientific studies in the practical work when it comes to children and adolescents with problematic sexual behaviors. We have chosen to talk to professionals who meet these children and young people, to hear their thoughts on what it is that makes a child or a young person develop this type of behavior and how you best treat it. We then compared the results from the interviews against the already existing researches.

    The first part of the thesis consists the existing state of knowledge on treatment and causal explanations in children and adolescents with problematic sexual behaviors.

    The second part consists the results of the interviews with seven professional’s working in this field and their opinions as well as their views on treatment and causal explanations.

    The last part contains a comparative analysis between the scientific researches and the working professional’s knowledge. The analysis conducts the institutional theories of organizations.

  • 2263.
    Hoffsten, Kristin
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Wingbo, Maria
    Ersta Sköndal University College, Department of Health Care Sciences.
    Upplevelser av massage hos patienter med långvarig smärta: En litteraturöversikt2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund:Sjuksköterskan ska se och möta patientens lidande och med adekvata omvårdnadsåtgärder lindra så lång det är möjligt. Beröring är en viktig del iomvårdnaden och kan ske i syfte att lindra, trösta, bekräfta och behandlapatienten. Beröring kan ske på många olika sätt varav massage, somomvårdnadsåtgärd är en metod som kan lindra patientens lidande, ochforskning visar att patienter med bland annat smärta kan uppleva att smärtalindras av massage. Många patienter som vårdas inom institutioner lider avlångvarig smärta och det kan skapa konsekvenser som trötthet,nedstämdhet och depression.

    Syfte:Syftet med litteraturstudien är att beskriva upplevelsen av massage hos patienter med långvarig smärta.

    Metod:En litteraturstudie där sökningen utfördes i databaserna Cinahl, MEDLINE, Pubmed och AMED. Sökord bestod av massage, long-term pain och chronicpain m.m. Sökningen resulterade i tre kvalitativa och fem kvantitativavetenskapliga artiklar som analyserades enligt Fribergs (2006) tre analyssteg.

    Resultat:Majoriteten av patienterna upplevde att smärtintensiteten minskade tillfälligt efter massage. Patienterna upplevde även att rörligheten och motivationen tillaktivitet ökade samt bidrog massage till en upplevelse av ökad förbindelsemellan kropp och själ. I två studier upplevde patienterna att ångesten minskadetillfälligt för att sedan återgå till det ursprungliga.

    Diskussion:Vad det beror på att patienterna upplever att massage kan lindra smärta, öka rörligheten, öka motivationen till aktivitet och minska ångest kan förklarasmed olika faktorer. Ökning av oxytocin och minskning av kortisol är enfysiologisk förklaring medan vårdrelationen som skapas mellan patient ochsjuksköterska vid massage kan bidra till att patienten känner tillit, trygghet ochkänner sig bekräftad, vilket kan lindra lidande och främja hälsa.

  • 2264.
    Hofgren, Caisa
    et al.
    Göteborgs Universitet.
    Björkdahl, Ann
    Göteborgs Universitet.
    Esbjörnsson, Eva
    Göteborgs Universitet.
    Stibrant Sunnerhagen, Katharina
    Göteborgs Universitet.
    Recovery after stroke: cognition, ADL function and return to work.2007In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 115, no 2, p. 73-80Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To examine the recovery of cognitive function, activities of daily living (ADL) ability and vocational situation after stroke.

    MATERIALS AND METHODS: Subjects below 65 years of age were included. Cognitive function and personal and instrumental ADL were assessed at discharge and at 1 year. Pre-stroke vocational situation was recorded at baseline and at 1 and 3 years after discharge.

    RESULTS: Fifty-eight patients participated. During the first year after discharge, cognitive function and ADL ability improved. At 1 year after discharge, 83% still had cognitive dysfunction, 20% were dependent in ADL and few had returned to work. Only 20% returned to gainful employment 3 years later.

    CONCLUSIONS: There was a recovery of cognition and ADL function after stroke but few persons returned to work. Good neurological status was found to be a significant factor and recovery of cognitive function a near-significant factor for return to work.

  • 2265.
    Holgersson, Charlotte
    et al.
    KTH.
    Hvenmark, Johan
    Ersta Sköndal Bräcke University College, Department of Social Sciences, Institute for Civil Society Research.
    Reading nonprofit leadership from a gender perspective2019In: Reframing nonprofit organizations: Democracy, inclusion and social change / [ed] Angela M. Eikenberry, Roseanne M. Mirabella, Billie Sandberg, Irvine, CA: Melvin & Leigh, Publishers , 2019, p. 92-105Chapter in book (Other academic)
    Abstract [en]

    Drawing on feminist theory and critique, this chapter explores how gender and gender inequalities are accounted for in mainstream scholarly writings on nonprofit leadership, and discusses the way this affects our understanding of leaders and leadership in nonprofit organizations (NPOs). By this we hope you will have an opportunity to expand your perspective of leadership and at the same time help you obtain a few tools for how to understand this particular topic not only in texts, but also in real life.

  • 2266.
    Holgersson, Charlotte
    et al.
    Kungliga tekniska högskolan.
    Höök, Pia
    Kungliga tekniska högskolan.
    Linghag, Sophie
    Kungliga tekniska högskolan.
    Regnö, Klara
    Kungliga tekniska högskolan.
    Wahl, Anna
    Kungliga tekniska högskolan.
    Könsmärkta villkor styr synen på kvinnligt och manligt chefskap2013In: Leda mot det nya: En forskningsantologi om chefskap och innovation / [ed] Martin Kreuger, Lucia Crevani, Kristina Larsen, Stockholm: Vinnova , 2013, p. 155-174Chapter in book (Other academic)
  • 2267.
    Holgersson, Karolina
    Ersta Sköndal University College, Institutionen för socialvetenskap.
    Is There Anybody Out There?: Illegal Abortion, Social Work, Advocacy and Interventions in the Philippines2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Unsafe abortion is a worldwide reproductive health issue and a contributing factor of high numbers of maternal death in the developing world. Many international conferences and assemblies acknowledge the issue and urge governments to take action. Abortion is a phenomenon surrounded by strong opinions, many times regulated by restrictive laws as well as socio-ethical, religious and cultural norms. Factors often active in making abortion a clandestine procedure which take place under unsafe conditions.The Philippines have one of the most restrictive laws on abortion in the world, but it does not diminish the occurrence of abortion in the country. There is unmet need for family planning that in turn makes way for unwanted pregnancies ending in unsafe abortion. Attempts in congress aiming at providing universal reproductive health service are being opposed and the issue of abortion is surrounded by its criminal ban and a great social stigma. The Roman Catholic Church is very present in the Philippine society and also offers a powerful voice against abortion and equally rejects modern contraception.This study look into how the issue of abortion – under its criminal ban – is being dealt with and if there are any actors/groups/organisations of social work, within the reproductive health sector or women’s organisations acting upon this, making abortion an issue and a part of their work. It asks if there is any advocacy for abortion in the Philippines and any interventions for the women concerned. If so, how is abortion spoken about and understood and how is that notion put into action? Groups are identified as either anti-abortion or pro-abortion, two discourses addressing abortion as a public health issue in fundamentally different ways.There are groups that might not be public about their opinion being pro-abortion, as they do not wish to get on the wrong side of the general opinion or negatively affect their reputation. Some pro-abortion groups are found acting against the law by providing safe abortions for these women. Trough social constructivist glasses this study look at the structure surrounding abortion in the Philippines, analysing how these discourses are being reconstructed and transferred under different postulations as anti-abortion or pro-abortion.

  • 2268.
    Holm, Annika
    et al.
    Ersta Sköndal University College, Department of Social Work. Ersta Sköndal University College, Sköndalsinstitutet.
    Sedell, Carina
    Ersta Sköndal University College, Department of Social Work. Ersta Sköndal University College, Sköndalsinstitutet.
    Vuxna fosterbarn: en intervjuundersökning om övergången till ett liv på egen hand1998Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2269.
    Holm, Camilla
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Johansson, Jeanette
    Ersta Sköndal University College, Department of Health Care Sciences.
    Närstående till patienter med cancer: vilka behov har närstående och hur kan sjuksköterskan bemöta dessa2005Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2270.
    Holm, Cecilia
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Söderhäll, Emma
    Ersta Sköndal University College, Department of Health Care Sciences.
    Att möta smärta: En litteraturöversikt om sjuksköterskors erfarenheter av att vårda patienter med smärta inom palliativ vård.2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Smärta är ett mångfacetterat begrepp och det vanligaste symtomet inom palliativ vård. Begreppet innefattar såväl fysisk, psykisk, social som existentiell smärta. För att uppnå en individanpassad smärtlindring bör sjuksköterskan ta hänsyn till smärtans alla dimensioner genom såväl subtila tecken som direkta uppmaningar på hjälp.

    Syfte: Att belysa sjuksköterskors erfarenheter av att vårda patienter med smärta inom palliativ vård.

    Metod: En litteraturöversikt baserad på elva artiklar har använts. De vetenskapliga artiklarna är hämtade i databasen Cinahl with full text och har granskats och analyserats enligt Fribergs modell (2012).

    Resultat: Resultatet av analysen presenteras i fyra huvudkategorier. Den första kategorin är Rädsla ett hinder i patientens smärtlindring och belyser en rädsla hos såväl patienter som sjuksköterskor och närstående. I Kunskapens betydelse för tillfredsställande smärtlindring beskrivs en osäkerhet hos sjuksköterskorna vid kunskapsbrist. Den tredje kategorin Sjuksköterskors erfarenheter av att ge en individanpassad smärtlindring visar på svårigheter och hinder vid smärtbedömning och smärtlindring. I Samarbetets betydelse för patientens smärtlindring framkommer sjuksköterskans centrala roll som patientens ombud vid smärtlindring

    Diskussion: Resultatet knyts an till Travelbees omvårdnadsteori om den mellanmänskliga relationen. Sambandet mellan rädsla och okunskap diskuteras, likaså kommunikationens olika uttryck och betydelse samt vikten av en fungerande vårdrelation.

  • 2271.
    Holm, Lena
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Sjuksköterskor inom psykiatrisk vård och deras sätt att identifiera och ha ett stödjande bemötande av äldre patienter med livsleda2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: It has been shown that elderly, in the western world, is the age group who commits the most suicides. An elderly person has a lower capacity and a lesser ability to come to terms with trying circumstances. The aging process influences psychological quickness, ability to adjust and sense of memory. Elderly are often subjected to depression, which is the most common treatable risk factor for weariness of life. Anguish is often experienced simultaneously. Reasons for weariness of life could be a separation from a partner or spouse, to go through a dramatic life phase or physical illness. Often an existential life crises is experienced and a feeling of standing on one’s own in life. Suicidal patients who experience a life crises demand special care when hospitalized. Nursing staff perceive it as important to treat patients who experience weariness of life but they do not always feel that they have the capacity to do so due to stress and lack of time and knowledge.

    Aim: To describe nurse ́s experiences of identifying and caring for elderly patients in psychiatric care who experience weariness of life and who might no longer want to live.

    Method: Five semi structured interviews were done with nurses on a ward specialized on psychiatric care of the elderly. Inductive content analysis has been used to analyze the interviews.

    Results: The analysis resulted in two categories: Identifying patients who experience weariness of life and Supporting patients who experience weariness of life. Three subcategories Verbal - and nonverbal communication, The signification of aging and Wishing to die are included in the category Identifying patients who experience weariness of life. Subcategories Acceptance, Caring and Environmental influence belong to the category Supporting patients who experience weariness of life. The informants in the study understood the elderly patient’s feeling of weariness of life and cared for them with psychiatric and somatic nursing. Through supporting conversation, a sensitive and empathic approach to the needs and conditions of the elderly, they encouraged them to become more active on their own terms. The informants treated the elderly with pedagogical sensitivity to support them in their existential crisis.

    Discussion: The results are discussed in relation to articles and literature and also in relation to the chosen theoretical basis of the study.

  • 2272.
    Holm, Maja
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Karolinska Institutet.
    To prepare for family caregiving in specialized palliative home care: an ongoing process2014Conference paper (Other academic)
  • 2273.
    Holm, Maja
    et al.
    Sophiahemmet högskola.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Capio palliativ vård Dalens sjukhus Stockholm, Karolinska institutet.
    Fürst, Carl-Johan
    Lunds universitet.
    Wengström, Yvonne
    Karolinska institutet.
    Årestedt, Kristofer
    Linnéuniversitetet.
    Öhlen, Joakim
    Göteborgs universitet.
    Goliath, Ida
    Karolinska institutet.
    Recruiting participants to a randomized controlled trial testing an intervention in palliative cancer care - The perspectives of health care professionals.2017In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 31, p. 6-11, article id S1462-3889(17)30205-3Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The recruitment of participants to randomized controlled trials (RCTs) in palliative cancer care by health care professionals is often unsuccessful, which could result in failure to achieve study power. The purpose of this paper is to describe how health care professionals experienced recruiting patients and family caregivers to an RCT in palliative cancer care.

    METHODS: The study had a qualitative explorative design. Ten palliative home care settings were involved in the RCT and data were generated through focus group discussions and interviews with health care professionals who were responsible for the recruitment. The transcripts were analyzed with interpretive descriptive principles.

    RESULTS: The experiences of the health care professionals reveal that communicating the RCT-design to patients and family caregivers was a challenging part of the recruitment but was considered a process of learning over time. The delicate situation that participants were living under added to the challenge and health care professionals believed that the randomized design was contrary to their normal approach to always offer the best possible support.

    CONCLUSIONS: The results contribute valuable knowledge for future trials in palliative cancer care. To promote successful recruitment, health care professionals may be in need of more training to improve their communication skills and it may be necessary to consider other research designs than the RCT.

  • 2274.
    Holm, Maja
    et al.
    Sophiahemmet högskola.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Capio Palliativ vård Dalen .
    Fürst, Carl-Johan
    Lunds universitet.
    Öhlen, Joakim
    Göteborgs universitet.
    Årestedt, Kristofer
    Linnéuniversitetet, Region Kalmar län.
    Psychometric evaluation of the anticipatory grief scale in a sample of family caregivers in the context of palliative care.2019In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 17, no 1, article id 42Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: In palliative care, family caregivers are often faced with experiences of grief in anticipation of the loss of a close person. An instrument designed to measure this form of grief is the Anticipatory Grief Scale, which includes 27 items and has been used in several studies in various contexts. However, the instrument has not been validated.

    AIM: The aim was to evaluate the psychometric properties, focusing on the factor structure, of the Anticipatory Grief Scale in a sample of family caregivers in palliative care.

    METHODS: The study had a cross-sectional design. Data were collected from an intervention study in palliative home care that took place between 2013 and 2014. In total, 270 family caregivers in palliative care completed a baseline questionnaire, including the Anticipatory Grief Scale. The factor structure of the scale was evaluated using exploratory factor analysis.

    RESULTS: The initial factor analysis suggested a four-factor solution, but, due to weak communalities, extensive crossloadings, and item inconsistencies, the model was problematic. Further analysis supported that the scale should be reduced to 13 items and two factors. The two subscales captured the behavioral and emotional reactions of grief in family caregivers in palliative care and were named Behavioral reactions and Emotional reactions. This modified version will hereafter be named AGS-13.

    CONCLUSIONS: This validation study of the Anticipatory Grief Scale resulted in a revised two-factor model, AGS-13, that appears to be promising for use in palliative care but needs to be tested further.

  • 2275.
    Holm, Maja
    et al.
    Sophiahemmet högskola.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Capio Palliativ vård Dalen.
    Fürst, Carl-Johan
    Lunds universitet.
    Öhlen, Joakim
    Göteborgs universitet.
    Årestedt, Kristofer
    Linnéuniversitetet, Länssjukhuset i Kalmar.
    Psychometric evaluation of the Texas revised inventory of grief in a sample of bereaved family caregivers.2018In: Research in Nursing & Health, ISSN 0160-6891, E-ISSN 1098-240X, Vol. 41, no 5, p. 480-488Article in journal (Refereed)
    Abstract [en]

    The Texas Revised Inventory of Grief (TRIG) was developed to measure the intensity of grief after the death of a close person. It consists of two scales: TRIG I (past behaviors) and TRIG II (present feelings). Because of inconsistencies in previous validations, the instrument needs to be further validated, hence the aim of this study was to evaluate the psychometric properties of the TRIG in a sample of bereaved family caregivers in Sweden. The TRIG was translated to Swedish according to standard principles, and 129 bereaved family caregivers completed the questionnaire. Parallel analysis was used to decide the number of factors to extract, followed by confirmatory factor analysis. An ordinal version of Cronbach's alpha was used to evaluate the internal consistency of the scales. Construct validity was tested against the Hospital Anxiety and Depression Scale (HADS). The factor analyses resulted in one factor being retained for both scales. The internal consistency was excellent (α > 0.9) for both scales. Construct validity was supported by strong correlations between TRIG I and TRIG II as well as moderate correlations between the TRIG scales and HADS. In conclusion, the TRIG has sound psychometric qualities and the two scales should be treated as unidimensional measures of grief. Hence, the instrument is suited to be used in the context of palliative care.

  • 2276.
    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.

  • 2277.
    Holm, Maja
    et al.
    Mälardalens högskola.
    Goliath, Ida
    Karolinska Institutet.
    Södlind, Hanna
    Palliative Care Unit, Solna Sundbyberg, Stockholm, Sweden.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Leading an intervention for family caregivers: a part of nursing in palliative care2017In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 23, no 4, p. 166-172Article in journal (Refereed)
    Abstract [en]

    Professional leadership has been highlighted as an important part of successful intervention delivery. The aim of this study is to explore the narratives of nurses involved in leading a group intervention for family caregivers in palliative care. Nurses were interviewed about their experiences as group leaders in a psycho-educational group intervention, which was delivered at 10 specialised palliative home care settings, with the help of an intervention manual. Data were analysed with interpretive descriptive methodology. Three themes were identified in the analysis: embracing the leading role, developing qualities as a group leader, and professional and personal development. The results showed that the role as group leader initially was a challenge for the nurses, but that they gradually were able to develop the professional and personal skills that were required. The nurses believed that their profession was best suited to lead this kind of supportive intervention.

  • 2278.
    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)
  • 2279.
    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.

  • 2280.
    Holm, Maja
    et al.
    Sophiahemmet högskola.
    Årestedt, Kristofer
    Linnéuniversitetet & Region Kalmar län.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Capio Palliativ vård Dalen.
    Associations between Predeath and Postdeath Grief in Family Caregivers in Palliative Home Care.2019In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740Article in journal (Refereed)
    Abstract [en]

    Background: Family caregivers in palliative care may be placed in a complicated emotional situation wherein they suffer the risk of grief reactions both pre- and postbereavement and may also experience symptoms of anxiety and depression. Objective: The aim of this study was to investigate (1) associations between predeath grief and postdeath grief and (2) whether these are moderated by symptoms of anxiety and depression. Design: This was a prospective correlational study. Linear regression analysis in three blocks was used to investigate associations between pre- and postdeath grief and moderation effects of anxiety and depression. Postdeath grief was used as the outcome variable and predeath grief was used as the explanatory variable in block I. The moderator variables, symptoms of anxiety, and symptoms of depression were added as covariates in block II. A multiplicative interaction term between predeath grief and anxiety/depression was added to the model in block III. Setting/Subjects: Data were collected at 10 facilities specialized in palliative home care where health care professionals provided advanced care to patients with various diagnoses in their own homes. Measurements: The anticipatory grief scale and the Texas Revised Inventory of Grief were used to measure pre- and postdeath grief, respectively. To measure symptoms of anxiety and depression, the Hospital Anxiety and Depression scale was used. Results: A total of 128 family caregivers were included. Significant associations were found between predeath grief and postdeath grief and this association remained when controlled against symptoms of anxiety or depression. We found no moderation effect of anxiety or depression on the association between pre- and postdeath grief. Conclusions: In conclusion, grief before and after an expected death can be regarded as parts of the same grief process. Hence, knowing the intensity of predeath grief could be a way to predict the levels of postdeath grief.

  • 2281.
    Holm, Maja
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Årestedt, Kristofer
    Linnéuniversitetet.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Fürst, Carl-Johan
    Lund universitet.
    Wengström, Yvonne
    Karolinska institutet, Örebro universitet .
    Öhlen, Joakim
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Göteborgs universitet.
    Alvariza, Anette
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet, Capio Palliativ vård Dalen, Stockholm.
    Short-term and long-term effects of a psycho-educational group intervention for family caregivers in palliative home care - results from a randomized control trial.2016In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 25, no 7, p. 795-802Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Family caregivers in cancer and palliative care often face heavy responsibilities and feel insufficiently prepared for the situation as caregivers. This study evaluates short-term and long-term effects of a psycho-educational group intervention aiming to increase preparedness for family caregiving in specialized palliative home care.

    METHODS: The study design was a randomized control trial where family caregivers were allocated either to an intervention or control group. The intervention was delivered as a program including three sessions by health professionals (physician, nurse, and social worker/priest). Family caregivers from 10 specialized palliative home care settings were included. Questionnaires with validated instruments at baseline, upon completion, and 2 months following the intervention were used to measure effects of the intervention. The primary outcome was preparedness for caregiving in family caregivers.

    RESULTS: In total, 21 intervention programs were delivered, and 119 family caregivers completed all three measurements. The intervention group had significantly increased their preparedness for caregiving in both the short-term and long-term follow-up compared with the control group. The intervention group also reported significantly increased competence for caregiving in short-term but not long. No effects of the intervention were found on rewards for caregiving, caregiver burden, health, anxiety, or depression.

    CONCLUSIONS: The psycho-educational intervention has the potential to be used by health professionals to improve preparedness for caregiving among family caregivers in palliative care both in short and long terms. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  • 2282.
    Holm, Maja
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Årestedt, Kristofer
    Linköpings universitet, Linnéuniversitetet.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Wengström, Yvonne
    Karolinska Institutet, Örebro universitet.
    Öhlen, Joakim
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Göteborgs universitet.
    Alvariza, Anette
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska Institutet, Capio Dalen sjukhus, Stockholm.
    Characteristics of the Family Caregivers Who Did Not Benefit From a Successful Psychoeducational Group Intervention During Palliative Cancer Care: A Prospective Correlational Study.2017In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 40, no 1, p. 76-83Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although there has been a steady increase in intervention studies aimed toward supporting family caregivers in palliative cancer care, they often report modest effect sizes and there is a lack of knowledge about possible barriers to intervention effectiveness.

    OBJECTIVE: The aim of this study is to explore the characteristics of family caregivers who did not benefit from a successful psychoeducational group intervention compared with the characteristics of those who did.

    INTERVENTION/METHODS: A psychoeducational intervention for family caregivers was delivered at 10 palliative settings in Sweden. Questionnaires were used to collect data at baseline and following the intervention. The Preparedness for Caregiving Scale was the main outcome for the study and was used to decide whether or not the family caregiver had benefited from the intervention (Preparedness for Caregiving Scale difference score ≤ 0 vs ≥ 1).

    RESULTS: A total of 82 family caregivers completed the intervention and follow-up. Caregivers who did not benefit from the intervention had significantly higher ratings of their preparedness and competence for caregiving and their health at baseline compared with the group who benefited. They also experienced lower levels of environmental burden and a trend toward fewer symptoms of depression.

    CONCLUSIONS: Family caregivers who did not benefit from the intervention tended to be less vulnerable at baseline. Hence, the potential to improve their ratings was smaller than for the group who did benefit.

    IMPLICATIONS FOR PRACTICE: Determining family caregivers in cancer and palliative care who are more likely to benefit from an intervention needs to be explored further in research.

  • 2283.
    Holm, Maja
    et al.
    Sophiahemmet högskola.
    Årestedt, Kristofer
    Linnéuniversitetet, Region Kalmar län.
    Öhlen, Joakim
    Göteborgs universitet.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Capio Palliativ vård Dalen.
    Variations in grief, anxiety, depression, and health among family caregivers before and after the death of a close person in the context of palliative home care.2019In: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683, p. 1-9Article in journal (Refereed)
    Abstract [en]

    This article investigates longitudinal variations in grief, self-rated health, and symptoms of anxiety and depression among family caregivers in palliative care. Data were taken from a randomized psycho-educational intervention trial and were collected at four time-points; at baseline, upon completion, 2 months later, and 6 months after the patient's death. In total, 117 family caregivers completed all questionnaires. The participants' grief was stable across the measurements, while anxiety, depression, and health varied significantly (p < 0.05). No significant differences were found between the intervention or control group. In conclusion, grief emerged as a constant phenomenon, distinct from symptoms of anxiety and depression.

  • 2284.
    Holm, Malin
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sörensen, Wilhmine
    Ersta Sköndal University College, Department of Health Care Sciences.
    Omsorg som befrämjar autonomi hos äldre på äldreboenden: litteraturstudie baserad på Kari Martinsens omsorgsteori2001Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2285.
    Holmberg, Angelica
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Temse, Caroline
    Ersta Sköndal University College, Department of Health Care Sciences.
    Betydelsen av vårdarkontinuitet för patient och personal2001Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2286.
    Holmberg, Bodil
    Ersta Sköndal University College, Department of Health Care Sciences.
    Undersköterskors erfarenheter av att ge omvårdnad till äldre personer under livets sista tid på särskilt boende: En intervjustudie2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Since increasing life expectance causes more persons to live longer with multiple diagnoses, we have a growing need of a well-functioning elderly-care. After the ”ÄDEL-reform” in Sweden, in 1992, when the responsibility for long-term medical care for elderly people was transferred from the county councils to the local authorities, an increasing number of older people die in nursing homes. This leads to an interest of studying the nursing care being given there.  The aim of the study was therefore to describe assistant nurses experiences of providing nursing care to older people during the last time of life in a nursing home. The study has been conducted by a content analysis based upon Seven interviews with assistant nurses having at least three years’ experience of working in a nursing home.

    In the results of this study three themes appeared; a natural pathway towards death, the older person as a starting point for the nursing care and reciprocity and collaboration in spite of limiting conditions.

    The assistant nurses consider dying at old age as a natural process, which they do not wish to hinder. They do not even talk to each other about it.  Instead they strive to be pliable to the process and responsive to the desires of the older people in order to provide them the best possible level of wellbeing during their last time of life. Inadequate staffing is partly hindering to this, but the problem is being avoided due to collaboration with the significant others of the older person.  Summarised, the nurse assistants nourish an underlying, at times explicit ambition to provide a person centred nursing care, which partly corresponds to a model of person centered palliative care, The 6 S:s. The results of this study are useful to nurses, since they are responsible of the nursing care given by assistant nurses. The results also elucidate the importance of the nursing care given by assistant nurses in a nursing home. Furthermore it would be of interest to study older persons experiences of receiving nursing care during their last time of life in a nursing home.

     

  • 2287.
    Holmberg, Bodil
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Hellström, Ingrid
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Linköpings universitet.
    Norberg, Astrid
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Umeå universitet.
    Österlind, Jane
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Assenting to exposedness - meanings of receiving assisted bodily care in a nursing home as narrated by older persons.2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Most older persons moving to a nursing home need to receive assisted bodily care, which means being in a position of vulnerability. However, few studies have explicitly focused on the meanings of receiving assisted bodily care from the older persons' perspective. This study aimed to elucidate meanings of receiving assisted bodily care, as narrated by older persons living in a nursing home. Twelve men and women, aged 80 or older, living in a Swedish nursing home, participated in the study. Data were generated by narrative interviews and analysed with a phenomenological-hermeneutical method. The regional ethics committee approved the study. In the analysis, one main theme emerged: 'Assenting to exposedness'. This theme comprised five themes, 'To have hope in hopelessness', 'To relinquish one's body into others' hands', 'To be between power and powerlessness', 'To oscillate between one's own responsibility and demands', 'To be in an ongoing interaction', and ten subthemes. In conclusion, receiving assisted bodily care means to be exposed, but not passively. Rather, it means to be self-determinant for as long as possible, to perceive the body as lived. When the body must be relinquished to others, it might be objectified, leading to care-suffering. To avoid this, the older persons use a certain competence, acquired through life, to decide when to take action or when to assent. However, this is but one of the several possible interpretations, which may be considered a limitation.

  • 2288.
    Holmberg, Bodil
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Hellström, Ingrid
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Linköpings universitet.
    Österlind, Jane
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Being a Companion at a Natural Pathway towards Death2017In: EAPC 2017: 15th World Congress of the European Association for Palliative Care. Progressing Palliative Care, Milano: EAPC , 2017, p. 1091-1091, article id P02-436Conference paper (Refereed)
    Abstract [en]

    Background: Dying in old age tends to be slow and characterized by frailty and bodily needs. In Sweden a large proportion of deaths occur in nursing homes where bodily care is foremost provided by assistant nurses (ANs) who have high school education. Due to lack of places, admission to a nursing home is seldom granted until the older person has complex care needs, meeting death within a year.

    Aim: The aim of the study was to describe ANs experiences of providing bodily care to older persons during the last time of their lives in a nursing home.

    Method: The study had a qualitative design. Data was collected by individual interviews with ANs (n=7). The transcribed interviews were analyzed using an inductive qualitative content analysis.

    Results: In the analysis one main theme emerged; “Being a companion at a natural pathway towards death”. The ANs perceived dying at old age expected as a natural end to a long life. This meant not to hinder what happened, but to be pliable to bodily signs of gradual deterioration of the older person, using intuition, experience and teamwork. The bodily care strived to relieve oppressive symptoms and increase quality of life. This was made possible by teamwork with a holistic approach meaning that bodily care was not only to care for the body, but the whole person. Thus, ANs also described a wish to bring a sense of security and well-being to the older person by being present, creating an atmosphere of closeness outgoing from a companionship built upon a mutual and familiar relationship. 

    Conclusion: ANs strived to supply a bodily care aimed to strengthen the older persons self-image. This goal was closely linked to a person-centred palliative care that highlights self-image as fundamental to health, wellbeing and a good death. This may indicate a need of further education in palliative care in order to strengthen the ANs as professionals but also to develop an evidence-based bodily care.

  • 2289.
    Holmberg, Bodil
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Hellström, Ingrid
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Linköpings universitet.
    Österlind, Jane
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    End-of-life care in a nursing home: Assistant nurses' perspectives.2018In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, article id 969733018779199Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Worldwide, older persons lack access to palliative care. In Sweden, many older persons die in nursing homes where care is provided foremost by assistant nurses. Due to a lack of beds, admission is seldom granted until the older persons have complex care needs and are already in a palliative phase when they move in.

    OBJECTIVE: To describe assistant nurses' perspectives of providing care to older persons at the end of life in a nursing home.

    RESEARCH DESIGN: Data were collected in semi-structured individual interviews and analyzed with inductive qualitative content analysis. Participants and research context: Seven assistant nurses from a nursing home in Sweden were randomly selected. Ethical consideration: The research was approved by the local ethics committee.

    RESULTS: Three main categories emerged; "Death a natural part of life"; "The older person's well-being"; and "Care in the moment of death"; and seven sub-categories. The assistant nurses described themselves as knowing the older persons well enough to provide good end-of-life care. This was achieved by making small-talk while providing daily care. Relying on experience-based knowledge, they strove to provide end-of-life care built upon respect and engagement with the ambition to strengthen older persons' dignity, for example, by lowering the tempo of care at the end of life, in spite of organizational restrictions.

    DISCUSSION: The assistant nurses offered attentive end-of-life care, focusing upon bodily care. The existential needs of the older persons were not foregrounded.

    CONCLUSION: To develop their work, and to promote an ethical foundation for such care, assistant nurses might need support and education to be able to offer a care more in line with the aims of palliative care. Furthermore, the organization of care needs to promote, not impede, the realization of this development.

  • 2290.
    Holmberg, Carin
    Ersta Sköndal University College, Department of Social Work.
    Aspekter av kvinnosynen i missbruksbehandling: empiriska exempel och teoretiska funderingar2000Report (Other academic)
  • 2291.
    Holmberg, Katarina
    Ersta Sköndal University College, Department of Social Work.
    Asocialitet och kön: en studie om förekomsten av könsspecifika risk- och skyddsfaktorer2004Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2292.
    Holmberg, Magdalena
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Edlund, Petra
    Ersta Sköndal University College, Department of Health Care Sciences.
    Vad gör gott när det gör ont?: Patienters upplevelser av vad som är viktigt vid obotlig cancersjukdom i palliativt skede - en litteraturstudie.2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2293. Holmberg, Mats
    et al.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    The encounter with the unknown:: Nurses lived experiencesof their responsibility for the care of the patient in the Swedish ambulance service2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2631, Vol. 5, no 2, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Registered nurses (RNs) have, according to the Swedish National Board of Health andWelfare, the overall responsibility for the medical care in the ambulance care setting. Bringing RNs into the ambulance service are judged, according to earlier studies, to lead to a degree of professionalism with a higher quality of medical care. Implicitly in earlier studies, the work in the ambulance service involves interpersonal skills. The aim of this study was to describe RNs’ experiences of being responsible for the care of the patient in the Swedish ambulance service. A reflective lifeworld approach within the perspective of caring science was used. Five RNs with at least five years experience from care in the ambulance care setting were interviewed. The findings show that the essence of the phenomenon is to prepare and create conditions for care and to accomplish care close to the patient. Three meaning constituents emerged in the descriptions: prepare and create conditions for the nursing care, to be there for the patient and significant others and create comfort for the patient and significant others. The responsibility is a complex phenomenon, with a caring perspective, emerging from the encounter with the unique human being.

  • 2294.
    Holmberg, Mats
    et al.
    Mälardalens högskola, Uppsala universitet, Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Wahlberg, Anna-Carin
    Karolinska institutet.
    The knowledge desired by emergency medica lservice managers of their ambulance clinicians - A modified Delphi study2017In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 34, p. 23-28Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of the study was to identify the types of knowledge that Swedish Emergency Medical Service (EMS) managers considered desirable in their Ambulance Clinicians.

    BACKGROUND: Emergency medical service managers are responsible for organisational tasking and in this are dependent on the knowledge possessed by their ambulance clinicians. It would therefore be of value to explore EMS managers' approach to this knowledge.

    DESIGN: A modified Delphi method in three rounds.

    METHODS: In total thirty-six EMS managers participated, and twenty-four finished all three rounds. They were encouraged to rate each sub-category, and the ten with the highest mean were interdependently ranked in the final round.

    RESULTS: Five categories and twenty-six sub-categories emerged in the first round, covering knowledge related to; contextual aspects, medical and holistic assessments, formal education and organisational issues. Eventually, the sub-category 'Knowledge to assess the patient's situation from a holistic perspective' was the highest ranked, followed by 'Medical knowledge to assess and care for different diseases' and 'Knowledge to be able to care for critically ill patients'.

    CONCLUSIONS: Taken together the knowledge areas address essentially medical care, contextual aspects and nursing. The boundaries between these can sometimes be seen as elusive, calling for ambulance clinicians to balance these areas of knowledge.

  • 2295.
    Holmberg, Mats
    et al.
    Karolinska institutet.
    Forslund, Kerstin
    Örebro universitet.
    Wahlberg, Anna Carin
    Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    To surrender in dependence of another: the relationship with the ambulance clinicians as experienced by patients2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, p. 544-551Article in journal (Refereed)
    Abstract [en]

    Historically, the ambulance care has focused on acute transports and medical treatment, although ambulance care has also been reported as complex, encompassing more than just medical treatment and transports. Previous studies, on ambulance clinicians, have pointed out the importance of interpersonal caring activities complementary to the medical treatment. Those activities can be understood as taking part in the relationship between patients and ambulance clinicians, earlier described as essential and a core component of care. The aim of this study was to elucidate the meaning of the relationship with the ambulance clinicians as experienced by patients. Twenty ambulance patients were interviewed in the study. The interviews were transcribed verbatim and analysed with a phenomenological hermeneutical method to grasp meanings in the patients' experiences. The regional ethical committee approved the study. In the result emerged one main theme: To surrender in dependence of another. The main theme includes four themes: Being in the hands of another, Being in a caring temporary presence, Being important while involved and Being powerless while insignificant, and the themes comprise eleven subthemes. The main theme meant to have no other option than to surrender and to put their life into the hand of another. This surrender also meant to adapt to the clinicians' views even if not shared. This is experienced as excessive care. Summarised, the patients' experiences were both positive and negative and the findings provide a complex understanding of the relationship between the patient and the ambulance clinicians. Overall, the relationship embraces the whole person without reducing the patient to be a recipient of an objectified ambulance care.

  • 2296.
    Holmberg, Mats
    et al.
    Karolinska institutet, Uppsala universitet.
    Forslund, Kerstin
    Örebro universitet.
    Wahlberg, Anna-Carin
    Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    The relationship with ambulance clinicians as experienced by significant others.2016In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 21, no 4, p. 1-8Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Interpersonal relationships between clinicians and patients are important aspects of the ambulance care, requiring a balance between objectified acute medical treatment and a holistic care. Being a significant other (SO) in the ambulance care setting is described as being caught between hope and dread. Little research has focused on SOs' experiences of the relationship with the ambulanceclinicians.

    AIM: To elucidate meanings of the relationship with the clinicians in the ambulance care setting as experienced by the patients' SOs.

    DESIGN: Qualitative lifeworld design.

    METHODS: Data was collected using open-ended interviews with nine SOs. The verbatim transcribed interviews were analysed with a phenomenological hermeneutic method.

    FINDINGS: The structural analysis resulted in one main theme: 'Being lonely together'. The main theme comprises three themes: 'Being in a shared struggle', 'To hand over the affected person in trust' and 'Being the second person in focus' and six subthemes. The main theme is for the SOs to share the struggles of the affected person with the ambulance clinicians and to be comforted while handing over the responsibility for the affected person. Hence the SO is excluded and lonely and on his/her own, while not the primary focus of the ambulance clinicians.

    CONCLUSIONS: The relationship with the ambulance clinicians from the perspective of the SOs can be understood as complex, involving both being lonely and together at the same time. The findings support a holistic approach towards the ambulance care involving SOs.

    RELEVANCE FOR CLINICAL PRACTICE: This study outlines the importance of an emergency ambulance care involving SOs as affected persons and supports a balance between emergency medical treatment to the patient and a holistic care, involving the SOs' suffering.

  • 2297.
    Holmberg, Mats
    et al.
    Karolinska institutet, Uppsala universitet.
    Wahlberg, Anna-Carin
    Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Forslund, Kerstin
    Örebro universitet.
    Ambulance clinicians' experiences of relationships with patients and significant others.2016In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 21, no 4, p. 16-23Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Ambulance clinicians (ACs) have to provide advanced care and treatment to patients in a challenging and emotionally demanding environment, therefore they establish interpersonal relationships embracing both patients and significant others. Relationships in emergency care were earlier found to be short-lived and lacking a holistic understanding of the patient. In their relationship with the ambulanceclinicians, it is for patients to surrender and become dependent, which may be interpreted as both a negative and a positive experience.

    AIM: The aim of this study was to elucidate ambulance clinicians' experiences of relationships with patients and significant others.

    METHODS: Data were collected from four focus group conversations, with a total of 18 participating ambulance clinicians. An inductive qualitative content analysis method was chosen.

    FINDINGS: The analysis resulted in one main category: 'To be personal in a professional role' and three generic categories: 'To be there for the affected person', 'To be personally involved' and 'To have a professional mission'. There were subsequently nine sub-categories. The main category was described as intertwining the experience of being both personal and professional. The ambulance clinicians adapt to a situation while having the affected person in focus. They involve themselves as persons but at the same time use the power of their professional role.

    CONCLUSION:The relationship with patients and significant others from the ambulance clinicians' perspective can be understood as embracing both personal and professional aspects.

    RELEVANCE TO CLINICAL PRACTICE: This study provides an understanding of the ambulance clinicians' professional role as embracing a personal perspective, which is important when developing an emergency ambulance service focusing on care that involves more than just emergency medical treatment.

  • 2298.
    Holmdin, Katarina
    Ersta Sköndal University College, Department of Social Work. Ersta Sköndal University College, Sköndalsinstitutet.
    Att bli berörd: en uppsats om massage mot våld1999Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2299.
    Holmgren, G
    et al.
    Department of: Clinical Genetics, University Hospital, Umeå, Sweden..
    Almqvist, E W
    Anvret, M
    Conneally, M
    Hobbs, W
    Mattsson, B
    Wahlström, J
    Winblad, B
    Gusella, J F
    Linkage of G8 (D4S10) in two Swedish families with Huntington's disease.1987In: Clinical Genetics, ISSN 0009-9163, E-ISSN 1399-0004, Vol. 32, no 5, p. 289-94Article in journal (Refereed)
    Abstract [en]

    Two Swedish families with Huntington's disease (HD) have been investigated for linkage with G8 (D4S10). In one family from northern Sweden (Family 1) 48 family members were examined, and in another family from the southwestern part of Sweden (Family 2) 14 family members were examined. The lod scores were 1.531 for Family 1 and 2.057 for Family 2, and the combined lod score was 3.59. The HD gene was segregating with the haplotype C in Family 1 and with haplotype A in Family 2. The predictive value of the test was obvious. Before the testing with the G8 probe, 84.2% of the family members in Family 1 had a theoretical risk of 25% or 50% of having the HD gene. After the testing with the G8 probe, only 23.7% of the family members remained at the same risk, and it could also be certified that 63.2% had no or little risk of having the HD gene. Only one asymptomatic person was predicted to have HD.

  • 2300.
    Holmgren, Malin
    Ersta Sköndal University College, Department of Social Work.
    Identitet och självbild ur ett socialkonstruktionistiskt perspektiv2003Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
43444546474849 2251 - 2300 of 5185
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf