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  • 2351.
    Hvenmark, Johan
    et al.
    Ersta Sköndal University College, Institute for Civil Society Studies.
    Wijkström, Filip
    Handelshögskolan i Stockholm.
    The Popular Movement Marinade: The Dominant Civil Society Framework in Sweden2004Conference paper (Refereed)
  • 2352.
    Hyllman, Therese
    et al.
    Ersta Sköndal University College, Department of Social Sciences.
    Eriksson, Josefine
    Ersta Sköndal University College, Department of Social Sciences.
    Litteraturstudie om faktorer som påverkar familjehemsplacerade barns psykiska mående2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Placed children have a higher risk of mental illness and negative development but it does not mean one can predict that it will go in a certain way for a certain child. Children belonging to a risk group can do well and vice versa, but it is the community and family care to balance the risk of a negative development

    Purpose: In this paper, the authors want to draw attention to the problems of children placed children's mental-being. The focus is on three different factors to get a broader picture of what may affect the mental health of foster children.

    Method: Descriptive literature review of scientific articles and literature.

    Results: The factors that form the basis of our study is continuous / discontinuous contact with the biological parents, interrupted foster placement and school outcomes for foster children. Theories selected to connect the various factors related theory and risk and protective factors.

    The results that have emerged show that foster children and young people feel worse than other children and young people who have not been children placed. School results are adversely affected by foster placement which has emerged in our study, and it is of great importance to the social, school, and family home cooperating to act against this.

    Conclusion: Reports and literature has been quite agree that foster children feel worse than other children in the community. The various factors that the study has highlighted, there was very little empirical data to collect, why did the authors broaden and think internationally.

    It would be desirable if it could be researched further in this area of ​​research the more there are, the more knowledge is given to social workers who work with disadvantaged children in their everyday lives.

  • 2353.
    Hysing, Erik
    et al.
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Lundberg, Erik
    Örebro universitet, Institutionen för humaniora, utbildnings- och samhällsvetenskap.
    Making governance networks more democratic: lessons from the Swedish governmental commissions2016In: Critical Policy Studies, ISSN 1946-0171, E-ISSN 1946-018X, Vol. 10, no 1, p. 21-38Article in journal (Refereed)
    Abstract [en]

    Governance networks (GNs) are theorized as institutions for state–civil society interaction with important merits as well as shortcomings for effective and democratic governance. Here we compare GNs with a far less researched type of state–civil society interaction, the Swedish governmental commission (GC), critically discussing them in terms of organizational and functional features, the role of the state and democratic anchorage. Drawing on lessons from the institutional design of GCs, we contest the notion that well-functioning GNs require a low level of formal institutionalization and discuss how democratic problems with GNs could be addressed through a formal institutional framework that provides pre-established and generally applied ground rules, ensures elected politicians the final say on policy, and values broad participation and consultation. Recognizing that GNs are not a self-evident form for state–civil society interactions, traditional institutional designs should be more fully considered in the discussion and theorization of the democratic anchorage of GNs.

  • 2354.
    Häckner Posse, Joséphine
    Ersta Sköndal University College, St Lukas Educational Institute.
    Studerandes identitetsutforskande i övergången mellan högskola och yrkesliv2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Periods of more active identity exploration is assumed to be particularly in focus for the young adult individual. Several components of identity is consolidated during this phase of life, where finding a professional identity is central. For Young adult students completing a long higher education and facing the professional life, a process of exploration about potential future professional roles is likely to occur. The step into professional life can also be experienced as a further step into adulthood. The purpose of this study is to investigate how a selection of last year university students experiences this transition on the basis of phenomena like transition, identity exploration and adulthood. The research method is qualitative and data was collected through semi-structured individual interviews with six students in various engineering programs at The Royal Institute of Technology in Stockholm, Sweden. Data was analyzed through thematic analysis. The results show that students experience a significant change in this phase of life which makes them enter into a period of both hopes and doubts about the future. The life-phase also initiates a period of active identity exploration about potential future professional roles and the role as an adult. These experiences are presented in a descriptive part. A deeper analysis shows that students' experiences are ambivalent where their identity exploration can be described as dialectical movement between conflicting thoughts and emotions. These are referred to as three ambivalent themes: 1. Disorientation versus clarity. 2. Limited versus complete professional identity and 3. Responsibility versus permissiveness. The results are discussed based on theories of transition and emerging adulthood, but primarily cover both internal and external factors that are crucial in periods of identity exploration. The result is related to Marcia’s identity status model and also highlights the conflictual dynamics in identity development. Students' ambivalence is suggested to be understood as a phenomenon of individuation with a testing between autonomy and intimacy. A theme that is often central to identity development, especially for young adults.

  • 2355.
    Hägelstam, Jessica
    Ersta Sköndal University College, Department of Social Work.
    Våldsamma föräldrar - Barnets bästa?: en kvalitativ studie av hur lagen tillämpas i vårdnadstvister när det förekommer våld2007Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2356.
    Hägerstrand, Beatrice
    et al.
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Thyr Ropeter, Sara
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    “Hur effektivt det här egentligen är, det får tiden utvisa”: en kvalitativ studie om kuratorers syn på internetbaserade behandlingsmetoder inom det psykosociala arbetet2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study has been to increase the knowledge of how counsellors within health care view internet based treatment of patients who suffer from mental illnesses, to be able to describe and understand the possibilities and limitations with such forms of treatment. The study has been carried out through qualitative semi structured interviews with ten professional counsellors in eight different primary care units in Stockholm county. The transcripts of the interviews have been analysed by using the theory of symbolic interactionism. The result showed that the counsellors’ view of internet based treatment is ambivalent. The internet based treatment is complicated and the counsellors seeing both pros and cons indicates that there are both possibilities and limitations which such methods. The result also showed that the possibilities that the counsellors can identify in internet based treatment concerns availability and that such methods have the potential to be a valuable tool for those patient who desire such methods of treatment. When it comes to limitations the counsellors can see that treatment via internet make great demands on the patient’s own abilities and that written interaction is far less nuanced than the interactions of traditional treatment work. It is clear that the main reason for the counsellors’ hesitation about these methods is the lack of face-to-face interaction with the patient, as well as difficulties imagining the practical applications of the internet based treatment. Thus the internet based treatment work can not easily be compared with the traditional psychosocial work that occurs face-to-face, but should be considered as a potential complement to traditional treatments or even a complete new way of working.

  • 2357.
    Hägg, Lisa
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Safiri, Leila
    Ersta Sköndal University College, Department of Health Care Sciences.
    Äldre kvinnors upplevelse av att leva med urininkontinens:  2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2358.
    Häggblom, Ingrid
    Ersta Sköndal University College, Department of Social Sciences.
    "To help others": An explorative case study about how help is described and defined by volunteer tourists working with children and teenagers in Brazil.2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Volunteer tourism is a popular way for young Westerners to discover the world and at the same take on the role as an international aid worker. For a short time they get an opportunity to improve the life conditions of people in development countries and get to know a new culture. The discourse of “making a difference” is dominating the marketing and promotion of the volunteer trips, yet little research is to be found about what the volunteers contribute with and what “help”, provided by them consist of. The main purpose of this study was to explore eventual post-colonial legacies or structures in the practice of volunteer tourism by exploring how help, in the actual context is described and defined by the volunteer tourists themselves. The thesis is based on a field study, conducted during two months in Rio de Janeiro, Brazil. Data was collected through 14 semi-structured interviews with volunteer tourists and observations at the volunteer sites. The data was further analysed by using terms and perspectives from post-colonial theory. The analysis show that the help from the volunteer tourists principally were supposed to compensate for deficiencies in the host community and that it was directed towards individual advancement for the kids that the volunteers encountered in the projects. Tendencies that the help-actions sometimes were based on assumptions, rather than facts about the conditions in the host community were also identified. Furthermore that the actions taken on by the volunteers sometimes implied simplified notions on ways to achieve development.

  • 2359.
    Häggblom, Johanna
    Ersta Sköndal University College, Department of Diaconal Studies, Church Music and Theology.
    "Därför att vi inte gärna kan begära något mindre": Kvinnors röster i debatten om kvinnliga präster 1957–19592016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Jag har forskat om kvinnors röster i debatten om kvinnliga präster under åren 1957–1959. Detta har gjorts utifrån materialet bestående av tidskrifterna Svensk kyrkotidning, Svensk pastoraltidskrift, Vår kyrka, Herta samt Kyrkomötet. Dessa år var debatten intensiv då beslutet om kvinnans tillträde till prästerlig tjänst röstades igenom 1958. Mina frågeställningar var hur kvinnorna är representerade inom respektive materielgrupp, vilka argument kvinnorna framförde, om det i materialet går att urskilja en kvinnlig linje och på vilket sätt man kan urskilja den samt om det sker någon förändring i respektive materielgrupp och/eller i debatten som helhet. Kvinnorna hade som mest utrymme i tidskriften Hertha och Vår kyrka, dessa två källor presenterade också en mer mångsidig bild av frågan och hade andra inslag än teologiska. Kvinnornas representation i tidskrifterna är relativt stabila under åren 1957–1959, om än på olika sätt. I kyrkomötet ökade deltagandet med två kvinnor till tolv från år 1957 till 1958. Den kvinnliga linje i materialet som helhet vilken går att urskilja är att ingen kvinna var emot att kvinnor skulle arbeta i församlingarna, däremot var vissa mer för den tilltänkta särskilda kvinnliga tjänsten än prästämbetet. Det fanns också olika åsikter om av vilken karaktär frågan om kvinnliga präster var, dvs om den var av politisk, teologisk eller av kvinnosaks/jämställdhetskaraktär. Några av de mest framträdande argumenten för kvinnliga präster var att Jesu apostlaval och Paulus ord om kvinnans ställning i församlingen måste ses utifrån sin historiska kontext och inte som för evigt gällande ord. Några visade på att det i andra länder redan fanns kvinnliga präster och att det fungerade utan att störa vare sig församlingsliv eller ekumeniska samarbeten. Argument förekom om att Svenska kyrkan var på väg att bli romersk-katolsk och några presenterade ett lutherskt synsätt på frågan, vilket torde möjliggöra kvinnliga präster. Många argumenterade emot den oro i församlingarna och kyrkliga splittring som det från nej-sidan hade varnats för, om utfallet skulle bli ja till kvinnliga präster. De menade att det egentligen handlade om manliga prästers oro, inte församlingarnas och folkets, och att en splittring lika väl kunde ske om kyrkomötet röstade nej till kvinnliga präster.

  • 2360.
    Hägglund, Maria
    Ersta Sköndal University College, Department of Social Sciences.
    Forms of Resistance: A study of understandings regarding intimate partner violence among women in Ethiopia2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Of all the countries studied in the large-scale WHO Multi-country Study on Women´s Health and Domestic Violence against Women (2005), Ethiopian women had the highest numbers of acceptance of intimate partner violence. And according to previous research on the subject, Ethiopian women have a high tolerance for and acceptance of the violence they endure. Yet when I interviewed women in Ethiopia (all of whom had been victims of violence) I discovered multiple forms of resistance to - rather than acceptance of - violence. Rather than confirming how women come to accept violence, my study uncovers many ways in which women resist violence, even in contexts where the available means of resistance are extremely limited.The aim of my inductive study is to begin to do justice to these forms of resistance, which are easily overlooked. First, as I argue in the analyses of my interviews with the women, our ability to discern forms of resistance in situations of intimate partner violence requires a more capacious notion of resistance than the one usually employed. Second, as I argue through my engagement with the previous research and the analyses of my interviews with women’s organizations in Ethiopia, the inability to discern multiple and varied forms of resistance leads one to underestimate the degree of non-acceptance and active resistance in situations of intimate partner violence. Thus, while my limited study does not permit general conclusions about violence against women in Ethiopia, I conclude by suggesting that my findings have two important implications for social work, one theoretical and one practical.

  • 2361.
    Häggström, Elisabeth
    et al.
    Högskolan i Gävle; Karolinska institutet.
    Skovdahl, Kirsti
    Karolinska institutet; Örebro universitet.
    Fläckman, Birgitta
    Högskolan i Gävle; Karolinska institutet.
    Kihlgren, Annica Larsson
    Karolinska institutet; Örebro universitet.
    Kihlgren, Mona
    Karolinska institutet; Örebro universitet.
    To feel betrayed and to feel that you are betraying the older residents: caregivers' experiences at a newly opened nursing home2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 6, p. 687-696Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In Sweden and internationally, little research has focused on the working situation of Enrolled Nurses and Nurses' Aides who form the majority of workers in geriatric care today. With this in mind, it is important to focus on how these occupational groups experience their working situation with older residents in municipal care.

    AIMS AND OBJECTIVES: The aim of the study was to investigate the deeper meaning of work satisfaction and work dissatisfaction at a newly opened nursing home for older residents. The study focused on the narratives supplied by the caregivers at the nursing home. The participants included: one Registered Nurse, sixteen Enrolled Nurses, and three Nurses' Aides. All were directly involved in patient care.

    DESIGN: The present study is part of a larger longitudinal study within the municipal geriatric care system in Sweden, with a quasi-experimental design.

    METHOD: The interviews were analysed with a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur.

    RESULT: The caregivers experiences of work satisfaction and work dissatisfaction was expressed in four themes: (i) 'Experience of betrayal' describes how the staff felt let down in several ways; (ii) 'Experience of failing others' describes how the staff felt that they did not pay enough attention to older people, in several different ways; (iii) 'Experience of insufficiency' describes how the staff encountered overwhelming demands from several directions; (iv) 'Experience of work satisfaction' describes how the staff felt that they were given support in various ways. Each theme emerged from several subthemes that originated from the caregivers' narratives.

    CONCLUSIONS: The study shows that the caregivers' experience of work dissatisfaction overshadows their experience of work satisfaction. It also suggests that their feelings of failing the older residents are connected to their own experiences of feeling betrayed.

    RELEVANCE TO CLINICAL PRACTICE: The findings can be used when other nursing homes in municipal care are opened, as a means of preventing work dissatisfaction and increasing work satisfaction among future employees.

  • 2362.
    Häggström, Elisabeth
    et al.
    Högskolan i Gävle; Karolinska institutet.
    Skovdahl, Kirsti
    Karolinska institutet; Örebro universitet .
    Fläckman, Birgitta
    Högskolan i Gävle; Karolinska institutet.
    Kihlgren, Annika L
    Karolinska institutet; Örebro universitet.
    Kihlgren, Mona
    Karolinska institutet; Örebro universitet.
    Work satisfaction and dissatisfaction: caregivers' experiences after a two-year intervention in a newly opened nursing home2005In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 14, no 1, p. 9-19Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of the study was to investigate, from the narratives of nine enrolled nurses and one nurses' aide directly involved in patient care, the deeper meaning of work satisfaction and dissatisfaction when working with the older people.

    BACKGROUND: Both nationally and internationally, there is little research documented regarding the working situation of the enrolled nurses and nurses' aides who make up the majority of care for older people today. With this in mind, it is important to focus on how these occupational groups experience their work with the older residents in municipal care, following a two-year intervention.

    DESIGN: The study is part of a larger longitudinal study, with a quasi-experimental design within the municipal system of care for older people in Sweden. The investigation was carried out following a two-year intervention, which included: education, support and clinical supervision.

    METHOD: The interviews were performed 12 and 24 months after start of the intervention and were analysed with a phenomenological-hermeneutic method inspired by Ricoeur's philosophy.

    RESULTS: The findings from these narratives illustrated a change compared with the findings from the first interviews, when the nursing home had just opened. There was a shift from a dominance of dissatisfaction with work, to a dominance of work satisfaction and this was expressed in the following themes: experience of a changed perspective, experience of open doors, and experience of closed doors. Each theme emerged from several different subthemes and each subtheme that had been expressed in the caregivers' narratives was interpreted.

    CONCLUSIONS: The study shows that the caregivers' experience of work satisfaction in the workplace exceeded their experience of dissatisfaction and that the intervention, consisting of: education, support, and supervision might have facilitated this positive development where the older residents were prioritized. It also shows that communication and understanding between management and staff had increased as the nursing home had opened.

    RELEVANCE TO CLINICAL PRACTICE: The findings can be used to help to prevent work dissatisfaction, and thereby increase work satisfaction for caregivers working in nursing homes.

  • 2363.
    Häggström, Marie
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Kristiansen, Lisbeth
    Mittuniversitetet.
    How can nurses facilitate patient's transitions from intensive care?: A grounded theory of nursing2012In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 28, no 4, p. 224-233Article in journal (Refereed)
    Abstract [en]

    Objectives: Intensive care patients often experience feelings of powerlessness and vulnerability when being transferred from an intensive care unit to a general ward. The aim of this study was to develop a grounded theory of nurses care for patients in the ICU transitional care process. Methods: Group interviews, individual interviews and participant observations were conducted with nurses in two hospitals in Sweden and were analysed using grounded theory. Result: The substantive theory shows the process of nursing care activities — from the contexts of the ICU and the general ward. The main concern was to achieve a coordinated, strengthening, person-centered standard of care to facilitate patient transitions. The core category ‘‘being perceptive and adjustable’’ was a strategy to individualise, that was related to the other categories; ‘‘preparing for a change’’ and ‘‘promoting the recovery’’. However, the nurses were forced to ‘‘balance between patient needs and the caregivers’ resources’’ and consequently were compromising their care. Conclusions: To facilitate an ICU-patient’s transition, individual care planning is needed. It is also essential that the patients are adequately prepared for the change to facilitate the transitional care. Knowledge about transitional needs, empowerment and patient-education seems to be important issues for facilitating transitions.

  • 2364.
    Häggström, Marie
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Kristiansen, Lisbeth
    Mittuniversitetet.
    Important quality aspects in the transfer process2014In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 27, no 2, p. 123-139Article in journal (Refereed)
    Abstract [en]

    Purpose: Admission to and transfer from an intensive care unit affects not only the patient but also his or her relatives. The authors aimed to investigate relatives' perceptions of quality of care during a patient's transfer process from an intensive care unit to a general ward.

    Design/methodology/approach: The study had a mixed method design that included quantitative data and answers to open questions. The participants were 65 relatives of patients who received care in an ICU. They were recruited from two hospitals in Sweden.

    Findings: A majority perceived the transfer process as important, but analysis also showed that the participants rated it as an area for improvements. The relatives wanted participation, personal insight and control, respectful encounters, proximity, reassurance, continuous quality, reconnection and feedback. The relatives' participation in the transfer process was perceived as inadequate by 61 per cent, and the support that was received after the ICU discharge was perceived as inadequate by 53 per cent. The patients' length of stay in the ICU affected the relatives' perceptions of the quality of care. Overall, the relatives seemed to desire that the transfer process includes a continuous care, a competent staff, available information throughout the transfer process and personal involvement in the care, both before and after the transfer from the ICU.

    Research limitations/implications: The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.

    Practical implications: The conclusion of this study is that relatives' needs and seeking for a well-planned ICU transitional process organisation with continuous quality before and after transfer, informational strategies that encourage the relatives to be involved and an organisation with competence throughout the healthcare chain are vital for quality.

    Originality/value: The findings have important implications for nursing and nursing management. A relative's perception of the quality of care before and after transfer from ICU may be a valuable source to evaluate the ICU transitional care.

  • 2365.
    Häggström, Marie
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Kristiansen, Lisbeth
    Mittuniversitetet.
    Struggle with a gap between intensive care units and general wards2009In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 4, no 3, p. 181-192Article in journal (Refereed)
    Abstract [en]

    Nursing critically ill patients includes planning and performing safe discharges from Intensive Care Units (ICU) to the general wards. The aim of this study was to obtain a deeper understanding of the main concern in the ICU transitional process-the care before, during, and after the transfer of ICU patients. Interviews were conducted with 35 Swedish nurses and analysed according to grounded theory. The main concern was the nurses' "struggling with a gap." The "gap" was caused by differences in the altered level of care and contributed to difficulties for nurses encountering an overlap during the transitional care. The categories: Sheltering, seeking organizational intertwining and striving for control are related to the core category and were used to generate a theory. The nurses sought improved collaboration, and employed patient-centred routines. They wanted access to necessary tools; they relayed or questioned their own competence and sought assurance of the patients' ability to be transferred. If the nurses felt a loss of control, lack of intertwining and lack of collaboration, they sheltered their patients and themselves. Intertwining was more difficult to perform, but actually even more important to do. With knowledge about ICU transitional care, collaboration, routines, and with an organization that provides an educational environment, the process could be improved.

  • 2366.
    Häggström, Marie
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Kristiansen, Lisbeth
    Mittuniversitetet.
    To reduce technology prior discharge from intensive care – important but difficult?: A grounded theory2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 506-515Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to provide a deeperunderstanding of the experience of intensive care staffregarding the reduction in the use of medical technologyprior to patients’ transfer from the ICU.Background: The goal of ICU transitional care, provided forintensive care patients before, during and after the transferfrom the ICU to another care unit, is to ensure minimaldisruption and optimal continuity of care for the patient.To smooth this transition, there is a need to prepare for aless technological environment and therefore also a needfor a gradual reduction in the use of monitoring equipment.Method: Group interviews and individual interviews, togetherwith participant observations, were conducted withICU staff in two hospitals in Sweden. The data wereanalysed using classic grounded theory.Results: The main concern was the ICU staff’s ambiguityregarding whether and how to reduce the use of medicaltechnology devices. Insecurity about weaning patientsfrom medical equipment combined with a lack of standardizedroutines made it difficult for staff to reduce thetechnical support. The core category describes how theambiguity was solved primarily by ’prioritizing control’.However, this often caused the ICU staff to use advancedtechnology while the patients were in the ICU until theward staff arrived, even if this should have been handledotherwise. Why and how the ICU staff used the strategy of’prioritizing control’ is further explained in the categories’being affected by cultural/contextual aspects’, ’searching forguidance and a shared understanding’ and ’weighing advantageswith more v s less technology’.Conclusion: It is important to consider ICU staff ambiguityconcerning the reduction in technology and to establishstrategies for a safe and structured transitional phase withstep-down procedures in which technology and monitoringis gradually reduced prior to transfer from ICU.

  • 2367. Häggström-Nordin, Elisabet
    et al.
    Sandberg, Jonas
    Mälardalens högskola.
    Hanson, Ulf
    Tydén, Tanja
    'It's everywhere!' young Swedish people's thoughts and reflections about pornography.2006In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, no 4, p. 386-93Article in journal (Refereed)
    Abstract [en]

    Pornography is one of the most sought-after topics on the Internet, and is easily available for anyone, including children and adolescents. At youth centres, nurse-midwives have noticed that young people have different kinds of questions about sexual practices compared with a few years ago. The aim of this study was to gain an understanding of thoughts and reflections about pornography consumption, and its possible influence on sexual practices, among young women and men. The staff at a youth centre in a city in central Sweden asked the visitors if they had seen pornography and if they wanted to be interviewed about their experiences. Ten young women and eight men, aged 16-23 years, participated. In-depth interviews were performed and open-ended questions about pornography and sexuality were posed. The interviews were tape-recorded and transcribed verbatim. Data were analysed according to grounded theory. The core category 'Living with the current sexual norm' depicted how pornography created sexual expectations and demands, for instance, to perform certain sexual acts. The informants expressed contradictory feelings towards pornography and felt that sexuality was separated from intimacy. A moral attitude was described and examples of stereotypic gender roles were given. To deal with the current sexual norm, informants had different individual handling strategies and attitudes to pornography, namely liberal, normalization, distance, feminist or conservative. Limitations of this study were the small sample size and that results from a qualitative research study cannot be generalized. The results contribute to an understanding of how pornographic material can influence young peoples' thoughts, reflections and sexual behaviour. This indicates the importance, for personnel at youth centres and schools, to discuss sexual behaviour and how sexuality is portrayed in pornographic material with young people.

  • 2368.
    Hällberg, Carina
    Ersta Sköndal University College, Department of Social Work.
    När pappa misshandlar mamma: barns berättelser om våld i hemmet2003Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 2369.
    Härnbro, Simon
    et al.
    Linköpings universitet.
    Börjeson, Martin
    Linköpings universitet.
    Utveckling av servicetjänster i Linköpings kommun: Beskrivning av verksamheter2014Report (Other academic)
    Abstract [sv]

    Syftet med detta arbetsnotat är att beskriva de verksamheter som kommer att studeras inom projektet och till vis del även en reflektion kring vägarna till serviceinsatser. Ambitionen är också att detta arbetsnotat ska kunna fungera som ett redskap i och inför kommande skeenden i forskningsprocessen.

  • 2370.
    Härnbro, Simon
    et al.
    Linköpings universitet.
    Börjeson, Martin
    Linköpings universitet.
    Utveckling av servicetjänster i Linköpings kommun: En bakgrundsbeskrivning2014Report (Other academic)
    Abstract [sv]

    Linköpings kommun har sedan flera år arbetat för att utveckla en lättillgänglig socialtjänst med god kvalitet och en mångfald sociala stödinsatser för den enskilde att välja mellan. Det innebär bl.a. att de flesta stödinsatser inte kräver biståndsbeslut utan den enskilde kan själv direkt kontakta verksamheter som erbjuder stöd, t ex missbruksvård, familjebehandling och boendestöd. Denna form av serviceinsatser har prövats också i andra kommuner, men det är än så länge ett arbetssätt som endast i begränsad utsträckning studerats.

    Linköpings kommun har i samarbete med CKS, Linköpings Universitet tagit initiativitet till att finansiera ett forskningsprojekt i ledning av Martin Börjesson, docent i socialt arbete. Projekt är planerat att genomföras under en treårsperiod med start januari 2014. Målsättningen med detta projekt är att planera och genomföra en bred upplagd utvärdering av arbetet med servicetjänster. Studien har för avsikt att försöka beskriva vilken betydelse arbetet med sociala servicetjänster har för det sociala arbetet och brukaren/medborgaren.

    Syftet med detta arbetsnotat är att ge en bakgrundsbeskrivning till utvecklingen av servicetjänster i Linköpings kommun och placera studien i ett sammanhang. Ambitionen är också att detta arbetsnotat ska kunna fungera som ett redskap i och inför kommande skeenden i forskningsprocessen.

  • 2371.
    Härnbro, Simon
    et al.
    Linköpings universitet.
    Börjeson, Martin
    Linköpings universitet.
    Utveckling av servicetjänster i Linköpings kommun: en redogörelse för, och diskussion kring, utvärderingens uppläggning2015Report (Other academic)
  • 2372.
    Hågebrand, Hanna
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Toomson, Helena
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nytt perspektiv på sjuksköterskans yrkesroll: åsikter från sjuksköterskor som avslutat sina studier vårterminen 20042005Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2373.
    Håkanson, Cecilia
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Karolinska Institutet, NVS.
    Everyday life, health care and self care management among people with irritable bowel syndrome: An integrative review of qualitative research2013In: Gastroenterology Nursing, ISSN 1042-895X, E-ISSN 1538-9766, Vol. 37, no 3, p. 217-225Article in journal (Refereed)
    Abstract [en]

    Irritable bowel syndrome is a commonly recognized chronic disease in all healthcare settings. This integrative review investigated current knowledge about adults' illness-related experiences of this disease from the perspectives of everyday life, healthcare, and self-care management. The overarching findings related to everyday life with irritable bowel syndrome were life-limiting experiences of the body-self as unfamiliar and of the body and symptoms as shameful and unpredictable. The limitations manifested as lack of ability to move about freely, fulfill ambitions or commitments at work, maintain social activities, uphold or develop close and/or sexual relationships and parenting, and live a life with spontaneity. Physical condition, knowledge about disease/illness-related matters, and one's own perceived ability to find adequate strategies were significant for the ability of self-care management. Healthcare was experienced as being unsupportive and not providing information and guidance for enabling self-care management. These results suggest a need for controlled intervention trials of healthcare models that take as their point of departure the individual's experience of illness, needs, and life situation, and that enable learning and sharing of illness experiences, combined with the provision of scientific knowledge and advice from healthcare professionals.

  • 2374.
    Håkanson, Cecilia
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Kroppslighet och kroppslig omvårdnad2014In: Omvårdnadens grunder: perspektiv och förhållningssätt / [ed] Febe Friberg, Joakim Öhlén, Lund: Studentlitteratur AB, 2014, 2, p. 213-236Chapter in book (Other academic)
  • 2375.
    Håkanson, Cecilia
    Ersta Sköndal University College, Enheten för forskning i palliativ vård. Ersta Sköndal University College, Department of Health Care Sciences.
    Learning to live with irritable bowel syndrome: Experiences of a group-based patient education program2010Article in journal (Refereed)
  • 2376.
    Håkanson, Cecilia
    Ersta Sköndal University College, Enheten för forskning i palliativ vård. Ersta Sköndal University College, Department of Health Care Sciences.
    Living with irritable bowel syndrome: A patient perspective on everyday life, health care encounters and patient education2010Doctoral thesis, comprehensive summary (Other academic)
  • 2377.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Palliative Research Centre, PRC.
    Christiansen, Mats
    Ekstedt, Mirjam
    Sandberg, Jonas
    Kenne Sarenmalm, Elisabeth
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Experience-based knowledge in the care of homeless people with severe illness and complex care needs2014Conference paper (Other academic)
  • 2378.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Sahlberg-Blom, Eva
    Örebro universitet.
    Nyhlin, Henry
    Karolinska universitetssjukhuset Huddinge.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Learning to live with irritable bowel syndrome.: The influence of a group-based patient education programme on peoples’ ability to manage illness in everyday life.2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 491-498Article in journal (Refereed)
    Abstract [en]

    Background: Living with chronic irritable bowel syndrome sets limitations in peoples’ everyday lives. This is due to bad health and the difficulty to find strategies that will manage their problem. In encounters with health care providers, these people feel that they are not getting the appropriate support to manage their illness-related troubles, and they perceive themselves to be insufficiently informed about the disease.

    Aim: To evaluate the influence of a group-based patient education programme about irritable bowel syndrome, on people’s ability to manage their illness in everyday life.

    Methods: The study used an evaluative research design. Fifty-one individuals with irritable bowel syndrome completed the ways of coping questionnaire, and the irritable bowel syndrome severity scoring system, before and after participating in a multidisciplinary group-based patient education programme.

    Results: In the participants’ self assessments, statistical significances (p > 0.05) were found for the mean frequency of efforts used on the coping strategies distancing and escape-avoidance. Distancing was used more often after the education programme, while escape-avoidance, was used more seldom. The proportional use of the strategy self-controlling (relative score) was enhanced after the education programme. The participants’ overall severity of symptoms was significantly reduced after the education programme. The individuals with a clinically noteworthy improvement in symptom severity (decrease £ 50) had greater changes in relative score values than those that showed a lesser improvement in symptom severity.

    Conclusion: Coping patterns were changed and symptoms were scored significantly less severe among the participants who participated in the education programme. Controlled studies following individuals over a longer period are suggested to establish the validity and sustainability of these changes, and qualitative interview studies would provide additional understanding about the significance of the separate parts of the education programme, and about the meaning of the programme to peoples’ everyday lives as a whole.

  • 2379.
    Håkanson, Cecilia
    et al.
    Örebro universitet & Ersta sjukhus.
    Sahlberg-Blom, Eva
    Ersta Sköndal University College, Department of palliative care research. Örebro universitet.
    Nyhlin, Henry
    Ersta sjukhus.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Enheten för forskning i palliativ vård. Örebro universitet.
    Struggling with an unfamiliar and unreliable body: the experience of irritable bowel syndrome2009In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, Vol. 1, no 1, p. 29-38Article in journal (Refereed)
    Abstract [en]

    Aim: To describe the phenomenon living with irritable bowel syndrome from a life-world perspective.

    Background: Ten to twenty per cent of the adult population in the world is known to live with irritable bowel syndrome. The life-world experience of people with irritable bowel syndrome has been paid little attention. A deeper understanding about the phenomenon living with irritable bowel syndrome is of interest for the future development of care.

    Design and methods: The study was performed using a phenomenological method. Data was collected by in-depth, open interviews performed in 2006, with nine persons between 25–55 years, diagnosed with irritable bowel syndrome. The interviews were analysed according to the method of Giorgi.

    Results: Six interrelated key constituents have been identified: Having an altered self-image, feeling ashamed, distrusting the body, feeling tired, blaming oneself, and finding solutions. A structure has been formulated, describing that living with irritable bowel syndrome means struggling with an unfamiliar and unreliable body. Tiredness, distrust, and feelings of shame towards the body bring about limitations in everyday life. At the same time, living with irritable bowel syndrome means having a strong will to exceed the limitations and become familiar with one self.

    Conclusion: This study suggests that living with irritable bowel syndrome means to struggle with an unfamiliar and unreliable body that brings about changes of self-image and limitations in every day life. Feelings of distrust, shame and embarrassment towards troublesome symptoms, are important contributions to the limitations experienced.

    Relevance to clinical practice: Nurses have a major role to play in the care for people with irritable bowel syndrome. A caring perspective, in which the life-world is central, is an important approach to care for these persons. Using the dialogue as a forum where patients can share their unique life-world experiences lets nurses gather knowledge that is essential in helping patients identify and acknowledge new and positive understandings of the lived body.

  • 2380.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Sahlberg-Blom, Eva
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Being in the patient position: experiences of health care among people with irritable bowel syndrome2010In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 20, no 8, p. 1116-27Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to gain in-depth understanding of what it is like for a person with irritable bowel syndrome to be in the patient position in encounters with health care providers. We conducted qualitative interviews with nine individuals. Our analysis, guided by interpretive description, revealed experiences of unsupportive and supportive encounters. Unsupportive encounters were shaped by humiliation, insignificance, and abandonment. Not feeling believed and acknowledged as persons made the participants lose trust in their own experience, which enhanced their unfamiliar mood of being in the world. Supportive encounters were less prominent. These were characterized by openness and acknowledgment of the patient's lifeworld. Feeling significant and being listened to promoted feelings of being in a partnered, cocreating relationship. It is reasonable to assume that care originating in the patient's lifeworld would support the patients to use their strength to manage illness and regain familiarity in everyday life.

  • 2381.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Sahlberg-Blom, Eva
    Örebro universitet.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Nyhlin, Henry
    Karolinska Institutet.
    Learning about oneself through others: experiences of a groupbased patient education programme about irritable bowel syndrome2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 4, p. 738-46Article in journal (Refereed)
    Abstract [en]

    Background: People with irritable bowel syndrome (IBS) often experience severe illness-related troubles in their everyday lives. Many persons also perceive their disease-related knowledge to be insufficient, and they feel dissatisfied with their inability to improve well-being. Previous research about patient education and IBS has emphasized biomedical outcomes of symptoms,health-promoting behaviours, coping and health-related quality of life, rather than people’s experiences.

    Aim: To explore people’s experiences of participating in a multidisciplinary group-based patient education programme about IBS and of the influence of this programme on everyday life with illness.

    Methods: Focus group interviews were performed with 31

    persons after their participation in the patient education programme. Interpretive description guided the inductive analysis of data. The study was approved by the local research ethics committee.

    Findings: The analysis revealed four patterns; being part of a safe community, learning about oneself through others, understanding and controlling the body and illness as awhole, and being outside of the community. The pattern of learning about oneself through others can be described as a reciprocal activity of learning by listening to, telling andobserving others. Being among similar others had created feelings among most of the focus group participants of being part of a safe community where taboo subjects related to IBS-symptoms could be outspoken. Understanding the body and illness as a whole had enhanced their ability to interpret bodily signals and to handle trouble some situations with greater self-confidence, and this regained their access to the social everyday world.

    Conclusion: The combination of reciprocal sharing of experiences and the provision of professional scientific knowledge during the patient education programme together contributed to a growing readiness to improve well-being in everyday life, for most of the participating individuals. This was based on new understandings of the body and illness as a whole and of new abilities to make knowledgebased decisions about what strategies to use in overcoming illness-related troubles.

  • 2382.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Sandberg, Jonas
    Jönköpings universitet .
    Ekstedt, Mirjam
    Kungliga tekniska högskolan, Stockholm.
    Kenne Sarenmalm, Elisabeth
    Skaraborgs sjukhus.
    Christiansen, Mats
    Karolinska institutet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Providing Palliative Care in a Swedish Support Home for People Who Are Homeless.2015In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557Article in journal (Refereed)
  • 2383.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden.
    Seiger Cronfalk, Berit
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Oncology/Pathology, Karolinska Institutet, Stockholm, Sweden, Stord Haugesund University College, Norway.
    Henrikssen, Eva
    Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden, FOUnu, Stockholm County Council, Stockholm, Sweden.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Nursing, Umeå University, Umeå, Sweden.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Neurobiology, Care science and Society, Karolinska Institutet, Stockholm, Sweden, Stockholms Sjukhem foundation, Research, Development and Education Unit, Stockholm, Sweden.
    Sandberg, Jonas
    Ersta Sköndal University College, Palliative Research Centre, PRC. Department of Nursing, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care2014In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 8, p. 71-78Article in journal (Refereed)
    Abstract [en]

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

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

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

  • 2384.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Connectedness at the end of life among people admitted to inpatient palliative care2014In: The American Journal of Hospice and Palliative Medicine, ISSN 1049-9091, Vol. 33, no 1, p. 47-54Article in journal (Refereed)
    Abstract [en]

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

  • 2385.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Meanings and experiential outcomes of bodily care in a specialist palliative context2015In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 3, p. 625-633Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 2386.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlén, Joakim
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Göteborgs universitet.
    Illness narratives of people who are homeless.2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, no 1, article id 32924Article in journal (Refereed)
    Abstract [en]

    Multiple illnesses are common in all homeless populations. While most previous studies have focused on experiences of mental illness, there is a scarcity of studies about experiences of bodily illness among people who are homeless. This study aimed to explore illness narratives of people who are homeless, and how homelessness as a social context shapes the experience of multiple and/or advancing somatic conditions. The design was a qualitative single-case study, using interpretive description. Data were generated through interviews, with nine participants who were homeless rough sleepers in Stockholm, Sweden, recruited while receiving care in a support home for homeless people with complex care needs. The findings revealed experiences of illness embedded in narratives about falling ill, being ill, and the future. The particularity of these illness narratives and the way that they are shaped by homelessness give rise to several observations: the necessity of a capable body for survival; chaos and profound solitude in illness and self-care management; ambiguous feelings about receiving care, transitioning from independence, and "freedom" in the streets to dependency and being institutionalized; and finally, the absence of hope and desire for recovery or a better future. The narratives are discussed from the perspective of Frank's four types of illness stories (restitution, chaos, quest, and testimony). The findings stress that to provide appropriate care and support to people who are homeless and have multiple and/or advancing somatic conditions, health care professionals need to be informed both about the individual's biography and about the circumstances under which illness and self-care takes place in the streets.

  • 2387.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Palliative Research Centre, PRC.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Receiving Bodily Care at the End of Life2014Conference paper (Other academic)
  • 2388.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlén, Joakim
    Göteborgs universitet.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Cardenas-Turanzas, Marylou
    USA.
    Wilson, Donna M
    Kanada.
    Loucka, Martin
    Tjeckien.
    Frache, Sandra
    Frankrike.
    Giovannetti, Lucia
    Italien.
    Naylor, Wayne
    Nya Zeeland.
    Rhee, YongJoo
    Sydkorea.
    Ramos, Miguel Ruiz
    Spanien.
    Teno, Joan
    Belgien.
    Beernaert, Kim
    Belgien.
    Deliens, Luc
    Belgien.
    Houttekier, Dirk
    Belgien.
    Cohen, Joachim
    Belgien.
    Place of death of children with complex chronic conditions: cross-national study of 11 countries.2017In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 176, no 3, p. 327-335Article in journal (Refereed)
    Abstract [en]

    Cross-national understanding of place of death is crucial for health service systems for their provision of efficient and equal access to paediatric palliative care. The objectives of this population-level study were to examine where children with complex chronic conditions (CCC) die and to investigate associations between places of death and sex, cause of death and country. The study used death certificate data of all deceased 1- to 17-year-old children (n = 40,624) who died in 2008, in 11 European and non-European countries. Multivariable logistic regression was performed to determine associations between place of death and other factors. Between 24.4 and 75.3% of all children 1-17 years in the countries died of CCC. Of these, between 6.7 and 42.4% died at home. In Belgium and the USA, all deaths caused by CCC other than malignancies were less likely to occur at home, whereas in Mexico and South Korea, deaths caused by neuromuscular diseases were more likely to occur at home than malignancies. In Mexico (OR = 0.91, 95% CI: 0.83-1.00) and Sweden (OR = 0.35, 95% CI: 0.15-0.83), girls had a significantly lower chance of dying at home than boys.

    CONCLUSION: This study shows large cross-national variations in place of death. These variations may relate to health system-related infrastructures and policies, and differences in cultural values related to place of death, although this needs further investigation. The patterns found in this study can inform the development of paediatric palliative care programs internationally. What is known: • There is a scarcity of population-level studies investigating where children with CCC die in different countries. • Cross-national understanding of place of death provides information to health care systems for providing efficient and equal access to paediatric palliative care. What is new : • There are large cross-national variations in the place of death of children with CCC, with few deathsoccuring at home in some countries whereas hospital deaths are generally most common. • In general, deaths caused by neuromuscular diseases and malignancies occur at home more often thanother CCC.

  • 2389.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Morin, Lucas
    Karolinska institutet.
    Cohen, Joachim
    Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium .
    A population-level study of place of death and associated factors in Sweden2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 7, p. 744-751Article in journal (Refereed)
    Abstract [en]

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

  • 2390.
    Håkansson, Annika
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Eriksson, Brittmarie
    Ersta Sköndal University College, Department of Health Care Sciences.
    En fördjupningsstudie i processorienterad handledning: sjuksköterskans profession2002Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2391.
    Håkansson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Seiger Cronfalk, Berit
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Henriksen, Eva
    Karolinska institutet.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Sandberg, Jonas
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    First-line managers’ views on leadership and palliative care in Swedish nursing homes2014In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 8, p. 71-78Article in journal (Refereed)
    Abstract [en]

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

  • 2392.
    Håkansson, Per
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Olsson, Liselotte
    Ersta Sköndal University College, Department of Health Care Sciences.
    Hiv och aids, inte bara en fråga om omvårdnad: Sjuksköterskors erfarenheter av att vårda patienter med hiv och aids2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2393.
    Håkansson-Chaves, Solveig
    et al.
    Ersta Sköndal University College, Institutionen för omvårdnad.
    Kling, Eva
    Ersta Sköndal University College, Institutionen för omvårdnad.
    Möte med sorgen: sjuksköterskans handlingsberedskap i mötet med närstående efter plötslig och oväntad död på sjukhus1998Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2394.
    Hållenius, Susanne
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Tjälldén, Thérèse
    Ersta Sköndal University College, Department of Health Care Sciences.
    Hur sjuksköterskan kan ge omvårdnad till patienter med psykosomatiska besvär: en litteraturstudie2006Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2395.
    Högberg, Cecilia
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Patienters erfarenheter av att använda Integrated Palliative care Outcome Scale: En intervjustudie från specialicerad palliativ hemsjukvård2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: The Integrated Palliative care Outcome Scale (IPOS) is intended to provide a multidimensional view of patients’ concerns. IPOS can be used with the purpose of assessing patients’ perceptions of their functional status and wellbeing. Few studies have undertaken the patients’ perspective when exploring experiences of using IPOS.

    Aim: To explore patients’ experiences of using the Integrated Palliative care Outcome Scale during specialized palliative home care.

    Method: The study adopted a qualitative approach with an interpretive descriptive design. The patients were recruited from three different specialized palliative home care settings. Interviews were performed with 10 patients, seven men and three women, with a mean age of 72 years. A majority of the patients were diagnosed with incurable cancer. Data were analysed using interpretive description, as described by Sally Thorne.

    Results: Patients experienced that the use of IPOS entailed secure care as it facilitated nurses in making accurate assessments of patient care needs. IPOS helped to plan the care according to patients’ specific needs, making them feel confident that the care provided was tailored to them, giving a sense of security. Patients expressed that IPOS facilitated discussions between them and the nurse about care needs. They believed that using IPOS enabled opportunities for reflection on their wellbeing and life situation. Doing so with a nurse present was enriching, providing new perspectives.

    Conclusions: Patients experienced that using IPOS was beneficial. It can be concluded that IPOS provide an effective way to enable person-centred care and with advantage could be used in specialized palliative home care.

  • 2396.
    Högberg, Cecilia
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Capio palliativ vård Dalen.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Capio palliativ vård Dalen.
    Beck, Ingela
    Lunds universitet & Högskolan Kristianstad.
    Patients' experiences of using the Integrated Palliative care Outcome Scale for a person-centered care: A qualitative study in the specialized palliative home-care context.2019In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, article id e12297Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore patients' experiences of using the Integrated Palliative care Outcome Scale (IPOS) during specialized palliative home care. The study adopted a qualitative approach with an interpretive descriptive design. Interviews were performed with 10 patients, of whom a majority were diagnosed with incurable cancer. Our findings suggest that the use of IPOS as a basis for conversation promotes safe care by making the patients feel confident that the care provided was adapted to them which gives them a sense of safety. IPOS facilitated discussions between patients and nurses about care needs. The patients believed that using IPOS enabled reflection on their well-being and life situation. In conclusion, the study finds that using IPOS is beneficial and provide ways to enable person-centered care and with advantage could be used in specialized palliative home care. The results may help overcome barriers and facilitate the use of patient-reported outcome measures (PROMs). To enable the use of PROMs such as IPOS in palliative home care, nurses need education and opportunities to develop routines that enable patients' voice to be heard and thereby compose a basis for care.

  • 2397.
    Högberg, Cecilia
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nylander, Ida
    Ersta Sköndal University College, Department of Health Care Sciences.
    Autonomi hos äldre personer beroende av vård och omsorg2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2398. Högberg, Torbjörn
    et al.
    Magnusson, Annabella
    Ersta Sköndal University College, Department of Health Care Sciences.
    Ewertzon, Mats
    Ersta Sköndal University College, Department of Health Care Sciences.
    Lützén, Kim
    Attitudes towards mental illness in Sweden: Adaptation and development of the Community Attitudes towards Mental Illness questionnaire2008In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 17, no 5, p. 302-310Article in journal (Refereed)
    Abstract [en]

    The main purpose for the expansion of supported community care for persons with serious mental illness in Sweden was to ensure the right for these persons to live as citizens in the community. However, earlier research shows that negative attitudes towards mental illness present an obstacle for social integration of persons with serious mental illness. The aim of this study, conducted in Sweden, was to evaluate an existing instrument's (Community Attitudes towards Mental Illness, CAMI), validity and reliability. An additional aim was to adapt and develop the questionnaire to Swedish circumstances. After translation and modification of the original CAMI, the Swedish version of the questionnaire (CAMI-S) was distributed to all student nurses at three different universities in Sweden. The overall Cronbach's alpha coefficient was 0.90 of the original CAMI-S. A corrected inter-item total correlation excluded 20 items because they showed loading <0.43. The overall Cronbach's alpha coefficient on the 20 items (new CAMI-S) that showed loading, >0.43, was 0.903. A factor analysis of these items revealed that the data could be extracted in three factors labelled as: open-minded and pro-integration, fear and avoidance and community mental health ideology. Finally, in order to reach reliable results in attitude research, it is important to measure the respondent's attitude towards the object in common as well as the respondent's attitude to interact with the object. Accordingly, it is important to add behavioural intention items to the ‘new CAMI-S’. Statements exemplifying how something ‘ought to be’ in an impersonal way have a good degree of stability over time and place.

  • 2399. Högberg, Torbjörn
    et al.
    Magnusson, Annabella
    Karolinska institutet.
    Lützén, Kim
    Ersta Sköndal University College, Department of Health Care Sciences.
    Living by themselves?: Psychiatric nurses’ views on supported housing for persons with severe and persistent mental illness2006In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 13, no 6, p. 735-741Article in journal (Refereed)
    Abstract [en]

    The main principle directing the development of supported dwellings for persons with long-term mental illness is that to live in the community would improve their quality of life. The aim of this study was to describe psychiatric nurses’ experiences of different types of supported dwelling for persons with long-term mental illness, and their views on what they consider to be important principles to provide for in order to facilitate their social integration into the community. Nine psychiatric nurses were interviewed. A qualitative content analysis revealed ‘attempting to uphold the principle, respect for the patient’s right to self-determination’ as the main theme, which was linked to three sub-themes: the nurses’ view on their moral responsibility; the nurses’ views on social norms that patients must follow in order to be accepted by their neighbours; and the nurses’ views on supported dwelling of good quality. The nurses perceived that personal contact between the neighbour and the mentally ill person was one essential way to reduce fear of the mentally ill person. They viewed themselves as a link between the mentally ill person and other neighbours. Without the personal contact between the mentally ill person and the neighbours, there may be a risk that the integration will fail no matter how excellent the supported dwelling is framed.

  • 2400. Högberg, Torbjörn
    et al.
    Magnusson, Annabella
    Karolinska institutet.
    Lützén, Kim
    Ersta Sköndal University College, Department of Health Care Sciences.
    To be a nurse or a neighbour?: A moral concern for psychiatric nurses living next door to individuals with a mental illness2005In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 12, no 5, p. 468-478Article in journal (Refereed)
    Abstract [en]

    Several studies reveal that positive attitudes towards individuals with a mental illness are correlated with knowledge about mental illness. The aim of this study was to explore and describe psychiatric nurses' experiences of living next to people with mental health problems. In addition, it sought to identify and describe how they handle situations arising in a neighbourhood where people with a mental illness live. Two men and seven women participated in the study. The constant comparative method of grounded theory was used for data collection and analysis. The process of 'behaving as a nurse or not' was identified as a core category. Four subcategories were identified: 'receiving involuntary information', 'to take action or not', 'behaving as a mediator in the neighbourhood' and 'the freedom of choice'. The findings show that psychiatric nurses with professional knowledge about mental illness have moral concerns about their role as nurses during their leisure time. In conclusion, it is not obvious that psychiatric nurses want to live in the same neighbourhood as persons with a mental illness. However, this study shows that their knowledge about mental illness creates for them a moral dilemma consisting of a conflict between whether to care for these mentally ill persons or to preserve their own leisure time.

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