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  • 2251.
    Österlind, Jane
    Ersta Sköndal University College, Department of Health Care Sciences.
    Hemmet på hemmet: att vårdas och vårda inom särskilda boendeformer för äldre. En beskrivning om livets sista tid på sjukhem och ålderdomshem ur ett personalperspektiv2002Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 2252.
    Österlind, Jane
    Ersta Sköndal University College, Department of palliative care research.
    När livsrummet krymper: vård och omsorg av äldre personer i livets slutskede2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This research focused on the life situation of older people, who had moved to a nursing home at the end of life, from the perspectives of the older people themselves, care managers and nursing staff. The thesis is based on an analysis of 446 care manager assessments and decisions, interviews with seven care managers, six older people and 28 nursing staff. The main fi ndings are: (I); that there was a statistically signifi cantly shorter waiting time for a move to a nursing home for older people who were in hospital compared to those who were living in their own home at the time of the decision. Seventy percent of the decisions made by care managers’ concerned women. The waiting period for men was fi ve days shorter compared to women. (II); that the care managers’ descriptions revealed that their assessments of the needs and wishes of the older people were infl uenced by whether or not it was clear that the older person had only a limited time left to live. The care managers’ way of reasoning has been conceptualised as two approaches, the medical and the natural path to death, where the former was characterised as fl exible and collaborative, whereas the latter was governed to a greater extent by a “wait and see attitude”. (III); that the older people’s experiences of living in a nursing home have been conceptualised into three themes: feeling like a stranger in an unfamiliar culture, being excluded from life, and living while waiting for death. The latter involved a deep insight that life would soon come to an end; a fact the staff appeared to take into account to only a minor extent. (IV); that dying and death was characterised by a discourse of silence, with tension between avoidance of and a confrontation with death. Staff members who expressed a fear of death held it at a distance by concentrating on practical tasks and avoiding close contact with older people who were dying. The thesis highlights the fact that the dying and death of older persons was characterised by a discourse of silence and several transitions. Death was not a topic that the staff members or older people generally talked about, and care in the fi nal phase of life was not actively or explicitly planned. In terms of access to a nursing home bed, only older people with an extensive need for care obtained such a place. These fi ndings imply that all older people can be said to be in need of palliative care. The older people in our study were in a liminal phase, and waiting for death. Feelings of social and existential loneliness and that their living space was shrinking were evident. It was also clear that the older people and staff members inhabit the same place but appear to be in two different sub-cultures, where the norms and values that guided the staff members’ attitudes were dominant. Keywords: transition, older people, end of life care, palliative care, nursing home, caring, care manager and staff

  • 2253.
    Österlind, Jane
    Ersta Sköndal University College, Department of palliative care research.
    Omvårdnadsbehov i livets slutskede2001In: Palliativ vård / [ed] Inger Fridegren, Susanne Lyckander, Stockholm: Liber, 2001, 1, p. 92-101Chapter in book (Other academic)
  • 2254.
    Österlind, Jane
    Ersta Sköndal University College, Department of palliative care research.
    Vårdkultur och självbestämmande i sjukhemsmiljö2007In: Hemmets vårdetik: om vård av äldre i livets slutskede / [ed] Gunilla Silfverberg, Lund: Studentlitteratur , 2007, p. 235-247Chapter in book (Other academic)
  • 2255.
    Österlind, Jane
    et al.
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences.
    Andersson, Janicke
    Institutionen för samhälls- och välfärdsstudier, LInköpings universitet.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Enheten för forskning i palliativ vård. Ersta Sköndal University College, Department of Health Care Sciences.
    Hellström, Ingrid
    Institutionen för samhälls- och välfärdsstudier, Linköpings universitet.
    A discourse of silence: professional carers resoning of death and dying in nursing homes2011In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 31, no 4, p. 529-544Article in journal (Other academic)
    Abstract [en]

    Nursing homes are a setting in which death and dying is common. How death and dying is articulated and the actions that take place in a nursing home constitute adiscourse that guides the staff in their work. The aim of this studywas to explore thediscourse of death and dying in nursing homes from the perspective and understandingof the staff. The study draws on Foucault’s discourse analysis. Data arefrom fivefocus-group discussions held with 28 staff of four different nursing homes in Sweden. The findings show that the discourse had three characteristics :(a) dying was silent and silenced, (b) emotions were pushed into the background,and (c) attentiveness to death arose after the moment of the elderly person’s death. The structure of the discourse was characterised by a movement between twopositions, avoiding and confronting death, themain focus being on avoidance. Thearticulation and practices of silence highlight a need to regard dying as a processthat requires attention. One way to ensure appropriate attention could be to instil the philosophy of palliative care in nursing homes, including training and supportfor the staff in their work. The study demonstrates that nursing-home staff needmore knowledge and support to enable them to feel that they do a good job.

  • 2256.
    Österlind, Jane
    et al.
    Ersta Sköndal University College, Department of palliative care research.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences.
    Lantz, Göran
    Ersta Sköndal University College, Department of Health Care Sciences.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Pathways in end-of-life care for older people: care managers' reasoning.2008In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 14, no 9, p. 420-5Article in journal (Refereed)
    Abstract [en]

    Seven care managers employed by a large municipality in Sweden were interviewed concerning their reasoning regarding end-of-life care for older people. Data were analyzed using a hermeneutic approach. The results showed that end-of-life care was considered to constitute a small part of the care managers' work and was something they did not focus on in general when assessing care needs. Two different pathways to death--the natural and the medical--were identified. In the natural pathway, death was invisible and the care was more routine-oriented. In the medical pathway, death was visualised and the care more individualised. Neither of the pathways paid attention to communication or existential needs. Thus, there is a need for a palliative pathway to death based on the philosophy of palliative care, which could provide guidance for care managers and promote opportunities for older people to achieve a dignified dying and death.

  • 2257.
    Österlind, Jane
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Prahl, Charlotte
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Westin, Lars
    Högskolan i Skövde.
    Strang, Susann
    Göteborgs universitet, Angereds närsjukhus.
    Bergh, Ingrid
    Högskolan i Skövde.
    Henoch, Ingela
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Angereds närsjukhus, Göteborgs universitet.
    Hammarlund, Kina
    Högskolan i Skövde.
    Ek, Kristina
    Högskolan i Skövde.
    Nursing students' perceptions of caring for dying people, after one year in nursing school.2016In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 41, p. 12-16, article id S0260-6917(16)00122-2Article in journal (Refereed)
    Abstract [en]

    AIM: To describe Swedish nursing students' perceptions of caring for dying people after the first year of a three year in a nursing programme at three university nursing schools in Sweden.

    METHODS: Interviews (n=17) were undertaken with nursing students at the end of their first year. A phenomenographic approach was used to design and structure the analysis of the nursing students' perceptions.

    RESULTS: The analysis resulted in five categories: 1) from abstract to reality, 2) from scary to natural, 3) increased knowledge can give bad conscience, 4) time limits versus fear of end-of-life conversations, and 5) meeting with relatives.

    CONCLUSION: Nursing students need to be prepared both theoretically and within practice to encounter death and dying and to care for dying persons. By combining their theoretical knowledge of dying and death with their own encounters of death and dying people in practice, the students can be supported to develop an understanding of dying and death as a natural part of life rather than something frightening.

  • 2258.
    Österlind, Jane
    et al.
    Ersta Sköndal University College, Department of palliative care research. Ersta Sköndal University College, Department of Health Care Sciences.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Enheten för forskning i palliativ vård. Karolinska institutet.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Hellström, Ingrid
    Ersta Sköndal University College, Department of palliative care research. Ersta Sköndal University College, Department of Health Care Sciences. Linköpings universitet.
    Feeling lonely in an unfamiliar place: older peoples experiences of life close to death in a nursing home2017In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 12, no 1, p. 1-8, article id e12129Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the study was to deepen the understanding of how older persons living in a nursing home experience life close to death.

    Background: A move to and a life in a nursing home while being close to death is a reality for many older people in Sweden. Being able to express thoughts and feelings about death has been described as both crucial for sustaining personhood as well as for establishing a meaningful existence at the end of life. Important are the experiences of older people living in nursing homes who are approaching death.

    Method: Six older people were interviewed on one to four occasions. A total of 16 interviews were conducted with the participants. An interpretative approach was chosen.

    Findings: The main interpretation, Feeling lonely in an unfamiliar place, is based on three themes (i) Waiting for death, with the subthemes death as a release and thinking of oneself as dead; (ii) Subordinate oneself to values and norms of the staff, with the subthemes feeling offended and feeling trapped; and (iii) Keep the courage up. The older people's lives were characterised by feelings of aloneness in an unfamiliar place which contributed to a sense of existential loneliness. They experienced few opportunities to discuss their thoughts of life and death, including preparations for passing away.

    Conclusion and implication for practice: It is of importance for professionals to be able to meet older people as they are and respect them as human beings in their transitions, before, during and after the move to a nursing home. It is important to find ways to support older people's wellbeing and identity near death.

  • 2259. Östlinder, Gerthrud
    et al.
    Söderberg, SivÖhlén, JoakimGöteborgs universitet.
    Omvårdnad som akademiskt ämne: Rapport från arbetande konferens2009Conference proceedings (editor) (Other academic)
  • 2260. Almqvist, E W (Contributor)
    A randomized, placebo-controlled trial of coenzyme Q10 and remacemide in Huntington's disease.2001In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 57, no 3, p. 397-404Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To determine whether chronic treatment with coenzyme Q10 or remacemide hydrochloride slows the functional decline of early Huntington's disease (HD).

    METHODS: The authors conducted a multicenter, parallel group, double-blind, 2 x 2 factorial, randomized clinical trial. Research participants with early HD (n = 347) were randomized to receive coenzyme Q10 300 mg twice daily, remacemide hydrochloride 200 mg three times daily, both, or neither treatment, and were evaluated every 4 to 5 months for a total of 30 months on assigned treatment. The prespecified primary measure of efficacy was the change in total functional capacity (TFC) between baseline and 30 months. Safety measures included the frequency of clinical adverse events.

    RESULTS: Neither intervention significantly altered the decline in TFC. Patients treated with coenzyme Q10 showed a trend toward slowing in TFC decline (13%) over 30 months (2.40- versus 2.74-point decline, p = 0.15), as well as beneficial trends in some secondary measures. There was increased frequency of nausea, vomiting, and dizziness with remacemide and increased frequency of stomach upset with coenzyme Q10.

    CONCLUSIONS: Neither remacemide nor coenzyme Q10, at the dosages studied, produced significant slowing in functional decline in early HD.

  • 2261. Almqvist, E W (Contributor)
    Dosage effects of riluzole in Huntington's disease: a multicenter placebo-controlled study.2003In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 61, no 11, p. 1551-6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Riluzole retards striatal glutamate release and pathologic consequences in neurotoxic animal models of Huntington's disease (HD).

    OBJECTIVE: To determine the dosage-related impact of riluzole on chorea in HD.

    METHODS: An 8-week double-blind dose-ranging multicenter study of riluzole was conducted in 63 subjects (32 women, 31 men) with HD who were randomized to receive placebo, riluzole 100 mg/day, or riluzole 200 mg/day. The prespecified outcome measure was change in the total maximal chorea score of the Unified Huntington's Disease Rating Scale (UHDRS).

    RESULTS: Fifty-six (89%) subjects completed the study. A reduction (p < 0.01) in chorea at 8 weeks was found using a linear trend test with dose. Comparing the groups individually, the reduction in chorea for the riluzole 200-mg/day group (-2.2 +/- 3.3) was different (p = 0.01) from placebo (+0.7 +/- 3.4), but the riluzole 100-mg/day group (-0.2 +/- 2.9) was not. Riluzole did not improve other motor, cognitive, behavioral, or functional components of the UHDRS. Alanine aminotransferase was elevated in a dosage-dependent fashion (p = 0.01).

    CONCLUSIONS: Over 8 weeks of treatment, riluzole 200 mg/day ameliorated chorea intensity in HD without improving functional capacity or other clinical features of illness. Riluzole 200 mg/day was attended by reversible liver transaminase abnormalities that would require monitoring in long-term studies.

43444546 2251 - 2261 of 2261
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