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  • 51.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    A support group programme for relatives during the late palliative phase.2007Conference paper (Refereed)
  • 52.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    A supportgroup programme for family members during the late palliative phase.2008Conference paper (Refereed)
  • 53.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Effects of a support group programme for family caregivers2013Conference paper (Refereed)
  • 54.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Stöd för närstående till personer med livshotande sjukdom.2012Conference paper (Other academic)
  • 55.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Stödinterventioner till närstående under pågående vård2013In: Palliativ vård: Begrepp och perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt, Cecilia Håkansson, Lund: Studentlitteratur, 2013Chapter in book (Other academic)
  • 56.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Support for family members in palliative care2009Conference paper (Refereed)
  • 57.
    Henriksson (Alvariza), Anette
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Årestedt, Kristofer
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Feelings of Reward among Family Caregivers during Ongoing Palliative Care2014In: Palliative Medicine / [ed] Catherine Walshe, Sage Publications, 2014, p. 613-614Conference paper (Refereed)
    Abstract [en]

    Objectives: Palliative family caregivers appear to experience rewards of caregiving concurrent with burdens and negative feelings. Relatively few studies have especially attended to the positive and rewarding aspects in palliative family caregiving. In addition, most studies on rewards are retrospective and examine the experiences of bereaved family caregivers. This study aimed to describe feelings of rewards among family caregivers during ongoing palliative care. A further aim was to compare experience of rewards in relation to sex and age. Methods: The sample consisted of 125 family caregivers and the study took place in three specialist palliative care units and one hematology unit. Participants answered a questionnaire including demographic background questions and the Rewards of Caregiving Scale (RCS). Descriptive statistics were used to describe characteristics of the participants and the level of rewards. Mann-Whitney U test was used to compare differences between groups of different sex and age. Results: Palliative family caregivers reported in general high levels of reward.The largest source of rewards was feelings of being helpful to the patient. This was closely followed by rewards as a consequence of giving something to the patients that brought her/him happiness and being there for the patient. The smallest sources of rewards were personally growth, self-satisfaction and personal meaning. There was an association between rewards and age but not between men and women. Conclusions: Family caregivers experienced rewards of caregiving during ongoing palliative care despite their unique and stressful situation. Feelings of rewards seem to be about handling the situation in a satisfying way, to feel competent and confident to take care of the patient and thereby feel proud. Support could preferably be designed aiming to improve family caregiver’s ability to care and to facilitate rewards of caregiving and focus on strengths and resources.

  • 58.
    Henriksson (Alvariza), Anette
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Årestedt, Kristofer
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Feelings of rewards among family caregivers during ongoing palliative care2015In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 6, p. 1509-1517Article in journal (Refereed)
    Abstract [en]

    Objectives: Palliative family caregivers appear to experience the rewards of caregiving concurrent with burdens and negative feelings. Relatively few studies have attended to the positive and rewarding aspects in palliative family caregiving. In addition, most studies on rewards are retrospective and examine the experiences of bereaved family caregivers. The present study aimed at describing feelings of reward among family caregivers during ongoing palliative care. A further aim was to compare the experience of rewards in relation to sex and age. Methods: The sample consisted of 125 family caregivers and took place in three specialist palliative care units and one hematology unit. Participants answered a questionnaire including demographic background questions and the Rewards of Caregiving Scale (RCS). Descriptive statistics were employed to describe characteristics of the participants and the level of rewards. A Mann-Whitney U test was used to compare differences between groups of different sex and age. Results: Palliative family caregivers reported general high levels of reward. The greatest source of rewards involved feelings of being helpful to patients. This was closely followed by giving something to patients that brought them happiness and being there for them. The smallest sources of rewards were related to personal growth, self-satisfaction, and personal meaning. There was also an association between rewards and age but not between men and women. Significance of results: Family caregivers experienced the rewards of caregiving during ongoing palliative care despite their unique and stressful situation. Feelings of reward seem to be about handling a situation in a satisfying way, feeling competent and confident to take care of the patient and thereby feeling proud. Support could preferably be designed to improve a family caregiver's ability to care and to facilitate the positive aspects and rewards of caregiving and focus on strengths and resources.

  • 59.
    Henriksson (Alvariza), Anette
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Årestedt, Kristofer
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Exploring factors and caregiver outcomes associated with feelings of preparedness for caregiving in family caregivers in palliative care: A correlational, cross-sectional study2013In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 27, no 7, p. 639-646Article in journal (Refereed)
    Abstract [en]

    Background: Family caregivers in palliative care often report feeling insufficiently prepared to handle the caregiver role. Preparedness has been confirmed as a variable that may actually protect family caregiver well-being. Preparedness refers to how ready family caregivers perceive they are for the tasks and demands in the caregiving role.

    Aim: The aim of this study was to explore factors associated with preparedness and to further investigate whether preparedness is associated with caregiver outcomes.

    Design: This was a correlational study using a cross-sectional design.

    Setting/participants: The study took place in three specialist palliative care units and one haematology unit. A total of 125 family caregivers of patients with life-threatening illness participated.

    Result: Preparedness was significantly associated with higher levels of hope and reward and with a lower level of anxiety. In contrast, preparedness was not associated with depression or health. Being female and cohabiting with the patient were significantly associated with a higher level of preparedness. The relationship to the patient was significantly associated with preparedness, while social support, place of care, time since diagnosis and age of the patients showed no association.

    Conclusion:Feelings of preparedness seem to be important for how family caregivers experience the unique situation when caring for a patient who is severely ill and close to death. Our findings support the inclusion of preparedness in support models for family caregivers in palliative care. Psycho-educational interventions could preferably be designed aiming to increase family caregiver’s preparedness to care, including practical care, communication and emotional support.

  • 60.
    Henriksson (Alvariza), Anette
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Årestedt, Kristofer
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Exploring factors and caregiver outcomes associated with feelings of preparedness for caregiving in family caregivers in palliative care: A cross-sectional study2013Conference paper (Refereed)
  • 61.
    Henriksson (Alvariza), Anette
    et al.
    Örebro universitet.
    Årestedt, Kristofer
    Linköping universitet, Linne universitet.
    Benzein, Eva
    Ersta Sköndal University College, Palliative Research Centre, PRC. Linnéuniversitetet.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet, Stockholms sjukhem.
    Andershed, Birgitta
    Ersta Sköndal University College, Palliative Research Centre, PRC. Gjøvik University College, Norway.
    Effects of a support group programme for patients with life-threatening illness during ongoing palliative care2013In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 27, no 3, p. 257-264Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health care systems in many countries are moving towards outpatient care in which family members are central in providing care for patients with life-threatening illness. Several studies show that family members report a lack of preparation, knowledge and the ability to handle the caregiver role, and a need for information and psychosocial support. 

    AIM: The aim was to investigate the effects of a support group programme for family members of patients with life-threatening illness during ongoing palliative care.

    DESIGN: A prospective quasi-experimental design, including an intervention group and a comparison group, was used.

    SETTINGS/PARTICIPANTS: A support group programme was offered to family members during ongoing palliative care at three intervention settings: two specialist palliative care units and one haematology unit. A fourth setting, a specialist palliative care unit, was used for comparisons.

    RESULTS: Family members taking part in the support group programme significantly increased their perceptions of preparedness for caregiving, competence for caregiving, and rewards of caregiving. Hope, anxiety, depression symptoms and health showed no significant changes.

    CONCLUSIONS: The intervention, including a support group programme delivered to family members of patients with life-threatening illness during ongoing palliative care, proved to be effective in certain domains of caregiving. No negative outcomes were detected. The results indicate that this intervention could be implemented and delivered to family members during ongoing palliative care.

  • 62.
    Holm, Maja
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Karolinska Institutet.
    To prepare for family caregiving in specialized palliative home care: an ongoing process2014Conference paper (Other academic)
  • 63.
    Holm, Maja
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Fürst, Carl-Johan
    Lunds universitet.
    Wengström, Yvonne
    Karolinska institutet, Örebro universitet.
    Årestedt, Kristofer
    Linköpings universitet, Linnéuniversitetet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet, Capio Geriatrik, Dalen, Stockholm.
    Delivering and participating in a psycho-educational intervention for family caregivers during palliative home care: A qualitative study from the perspectives of health professionals and family caregivers2015In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 14, no 16Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 64.
    Holm, Maja
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Wengström, Yvonne
    Karolinska Institutet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Preparing for family caregiving in specialized palliative home care: an ongoing process2014In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 3, p. 767-775Article in journal (Refereed)
  • 65.
    Holm, Maja
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Wengström, Yvonne
    Karolinska Institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    The Process of Preparedness for Caregiving among Family Members in Palliative Home Care2014In: Palliative Medicine / [ed] Catherine Walshe, Sage Publications, 2014, p. 622-623Conference paper (Refereed)
    Abstract [en]

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

  • 66.
    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.

  • 67.
    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)
  • 68.
    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)
  • 69.
    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)
  • 70.
    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.

  • 71.
    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.

  • 72.
    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.

  • 73.
    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)
  • 74.
    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.

  • 75.
    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.

  • 76. Israelsson, Johan
    et al.
    Persson, Carina
    Strömberg, Anna
    Årestedt, Kristofer
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Linnéuniversitetet.
    Is there a difference in survival between men and women suffering in-hospital cardiac arrest?2014In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 43, no 6, p. 510-515Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To describe in-hospital cardiac arrest (CA) events with regard to sex and to investigate if sex is associated with survival.

    BACKGROUND: Previous studies exploring differences between sexes are incongruent with regard to clinical outcomes. In order to provide equality and improve care, further investigations into these aspects are warranted.

    METHODS: This registry study included 286 CAs. To investigate if sex was associated with survival, logistic regression analyses were performed.

    RESULTS: The proportion of CA with a resuscitation attempt compared to CA without resuscitation was higher among men. There were no associations between sex and survival when controlling for previously known predictors and interaction effects.

    CONCLUSIONS: Sex does not appear to be a predictor for survival among patients suffering CA where resuscitation is attempted. The difference regarding proportion of resuscitation attempts requires more attention. It is important to consider possible interaction effects when studying the sex perspective.

  • 77. Jakobsson, Eva
    et al.
    Andersson, Magdalena
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Livets slutskede2014In: Omvårdnadens grunder: perspektiv och förhållningssätt / [ed] Febe Friberg, Joakim Öhlén, Lund: Studentlitteratur AB, 2014, 2, p. 179-212Chapter in book (Other academic)
  • 78.
    Johansson, Anita
    et al.
    Örebro universitet, Skaraborg sjukhus, Skövde.
    Ewertzon, Mats
    Ersta Sköndal University College, Department of Health Care Sciences. Swedish National Family Care Competence Centre, Kalmar, Sweden.
    Andershed, Birgitta
    Ersta Sköndal University College, Palliative Research Centre, PRC. Gjøvik University College, Gjøvik, Norway.
    Anderzen-Carlsson, Agneta
    Örebro universitet, Centre for Health Care Sciences, Örebro, Sweden.
    Nasic, Salmir
    Skaraborg sjukhus, Skövde.
    Ahlin, Arne
    National Board of Institutional Care, SiS Ungdomshem Margretelund, Lidkoping, Sweden.
    Health-Related Quality of Life: From the Perspekctive of Mothers and Fathers of Adult Children Suffering From Long-Term Mental Disorders2015In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 29, no 3, p. 180-185Article in journal (Refereed)
    Abstract [en]

    There is a lack of studies on mothers' and fathers' experiences of Health-Related Quality of Life (HRQOL) associated with caregiving of adult children suffering from mental disorder. A cross-sectional study was therefore carried out with 108 mothers and 43 fathers. Data were collected by means of the Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale (HADS), the Family Involvement and Alienation Questionnaire (FIAQ) and the Burden Assessment Scale (BAS). Mothers' HRQOL was affected more than fathers' and lower compared to Swedish age related norms. HRQOL was predominantly related to ratings on HADS and BAS.

  • 79.
    Juthberg, Christina
    et al.
    Umeå universitet.
    Eriksson, Sture
    Umeå universitet.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Umeå universitet.
    Sundin, Karin
    Umeå universitet.
    Perceptions of conscience, stress of conscience and burnout among nursing staff in residential elder care2010In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 66, no 8, p. 1708-1718Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study of patterns of perceptions of conscience, stress of conscience and burnout in relation to occupational belonging among Registered Nurses and nursing assistants in municipal residential care of older people.

    BACKGROUND: Stress and burnout among healthcare personnel and experiences of ethical difficulties are associated with troubled conscience. In elder care the experience of a troubled conscience seems to be connected to occupational role, but little is known about how Registered Nurses and nursing assistants perceive their conscience, stress of conscience and burnout.

    METHOD: Results of previous analyses of data collected in 2003, where 50 Registered Nurses and 96 nursing assistants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire and Maslach Burnout Inventory, led to a request for further analysis. In this study Partial Least Square Regression was used to detect statistical predictive patterns.

    RESULT: Perceptions of conscience and stress of conscience explained 41.9% of the variance in occupational belonging. A statistical predictive pattern for Registered Nurses was stress of conscience in relation to falling short of expectations and demands and to perception of conscience as demanding sensitivity. A statistical predictive pattern for nursing assistants was perceptions that conscience is an authority and an asset in their work. Burnout did not contribute to the explained variance in occupational belonging.

    CONCLUSION: Both occupational groups viewed conscience as an asset and not a burden. Registered Nurses seemed to exhibit sensitivity to expectations and demands and nursing assistants used their conscience as a source of guidance in their work. Structured group supervision with personnel from different occupations is needed so that staff can gain better understanding about their own occupational situation as well as the situation of other occupational groups.

  • 80. Karlsson, Magdalena
    et al.
    Friberg, Febe
    University of Stavanger.
    Wallengren, Catarina
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Meanings of existential uncertainty and certainty for people diagnosed with cancer and receiving palliative treatment: A life-world phenomenological study2014In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, ISSN 1472-684X, Vol. 13, no 28Article in journal (Refereed)
    Abstract [en]

    Background

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

    Methods

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

    Results

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

    Conclusions

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

  • 81.
    Lind, Susanne
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Nationellt vårdprogram för palliativ vård 2012-20142012In: Omsorg: Nordisk tidsskrift for Palliativ Medisin, ISSN 0800-7489, no 2, p. 67-70Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    I En nationell cancerstrategi (1) beskrivs utarbetandet av ett nationellt vårdprogram för palliativ vård som särskilt angeläget. En multiprofessionell/multidisciplinär nationell vårdprogramgrupp med drygt 70 personer har medverkat. Arbetet har utförts i samarbete med Svenska Palliativregistret, Socialstyrelsen och med ekonomiskt stöd från Sveriges Kommuner och Landsting (SKL). Det Nationella vårdprogrammet för palliativ vård har utarbetats för att ge ökad kunskap och är ett sammanhållet dokument för all palliativ vård oberoende av diagnos, ålder, etnicitet, bakgrund eller bostadsort.  Det fokuserar på palliativ vård i livets slutskede men är till stora delar giltigt för all palliativ vård. Innehållet beskriver bl.a. värdegrund, etiska principer, kvalitetsarbetet, omvårdnad och symtomlindring. Förhoppningen är att vårdprogrammet medverkar till att alla som vårdas i livets slutskede ska få en kompetent, säker och ändamålsenlig palliativ vård. 

  • 82.
    Lind, Susanne
    et al.
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society .
    Adolfsson, Jan
    Karolinska Institutet, Department of Clinical Science, Intervention and Technology.
    Axelsson, Bertil
    University of Umeå, Department of Radiation Sciences.
    Fürst, Carl Johan
    Lund University, Department of Clinical Sciences.
    Quality indicators for palliative and end of life care: a review of Swedish policy documents2013In: BMJ Supportive & Palliative Care, ISSN 2045-435X, E-ISSN 2045-4368, Vol. 3, no 2, p. 174-180Article in journal (Refereed)
    Abstract [en]

    Background All patients with palliative and end of life care needs should be guaranteed equal and safe treatment and care, regardless of their disease or site of care. The inclusion of quality indicators in national guidelines and other guiding documents supports quality assurance and improvement in provision of care. The aim of this paper was to review existing quality indicators in national Swedish policy documents relevant to palliative and end of life care.

    Methods We reviewed existing guidelines for diseases expected to require palliative care issued by the National Board of Health and Welfare, existing regional clinical practice guidelines and the annual report of the Swedish Register of Palliative Care (SRPC) up until 2010.

    Results We found 11 quality indicators pertinent to palliative and end of life care in the guidelines for cancer diseases and ‘The care and nursing of the elderly’. The indicators included assessment and treatment of pain, communication with the patient and the family, documentation in the patient record and registration in the SRPC. In the national guidelines for cardiology, pulmonary diseases, stroke, diabetes and dementia, there were no indicators relevant for palliative or end of life care.

    Conclusions In the existing Swedish national guidelines for many different diseases, there is still a great need to define clinically relevant and feasible outcome measures of quality of palliative and end of life care.

  • 83. Lindahl, Elisabeth
    et al.
    Gilje, Fredricka
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Söderberg, Anna
    Nurses' ethical reflections on caring for people with malodorous exuding ulcers.2010In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 17, no 6, p. 777-790Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate nurses' reflections on obstacles to and possibilities for providing care as desired by people with malodorous exuding ulcers. Six nurses who took part in a previous study were interviewed. The participants were shown an illustration with findings from a study that elucidated the meaning of living with malodorous exuding ulcers. They were asked to reflect on the obstacles to and possibilities of providing the care desired by the patients. Twelve audio-recorded transcribed interviews were analysed using qualitative content analysis. Our interpretations of participants' reflections on the obstacles and possibilities while caring for such patients revealed one theme: striving to 'do good' and 'be good'. The obstacles were formulated as subthemes: experiencing clinical competence constraints, experiencing organizational constraints, experiencing ineffective communication, fearing failure, and experiencing powerlessness. The possibilities were formulated by the subthemes: spreading knowledge about ulcer treatments, considering wholeness, and creating clear channels of communication. A multiprofessional team could overcome the identified obstacles and provide structure, competencies, commitment and support to 'do good' for patients and 'be good' nurses.

  • 84.
    Lundberg, Tina
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska Institutet.
    Olsson, Mariann
    Fürst, Carl Johan
    The perspectives of bereaved family members on their experiences of support in palliative care2013In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 19, no 6, p. 282-288Article in journal (Refereed)
    Abstract [en]

    Aim: To explore family members’ supportive interactions in palliative care and the emotional experiences that they associate with these interactions. Methods: Qualitative individual interviews were performed with bereaved family members recruited from an urban palliative care service in Sweden. The interviews were analysed using inductive qualitative content analysis. Results: Five categories of supportive interactions with staff members were linked with emotional consequences: informational support, supportive encounters, professional focus of staff, a supportive environment, and bereavement support. Having a dialogue with family members nurtured certainty and security, supportive encounters gave a warm and comforting feeling, and bereavement support contributed to feelings of strength. Environmental factors contributed to dignity. Conclusion: Supportive interactions with staff and within a home-like environment help to build resilience if tailored to the family member’s own needs.

  • 85. Lundman, Berit
    et al.
    Aléx, Lena
    Jonsén, Elisabeth
    Lövheim, Hugo
    Nygren, Björn
    Santamäki Fischer, Regina
    Strandberg, Gunilla
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Inner strength in relation to functional status, disease, living arrangements, and social relationships among people aged 85 years and older2012In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 33, no 3, p. 167-176Article in journal (Refereed)
  • 86.
    Lundman, Berit
    et al.
    Umeå universitet.
    Aléx, Lena
    Umeå universitet.
    Jonsén, Elisabeth
    Umeå universitet.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Umeå universitet.
    Nygren, Björn
    Umeå universitet.
    Santamäki Fischer, Regina
    Umeå universitet.
    Strandberg, Gunilla
    Umeå universitet.
    Inner strength: A theoretical analysis of salutogenic concepts2010In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 47, no 2, p. 251-260Article in journal (Refereed)
    Abstract [en]

    Background

    Theoretical and empirical overlaps between the concepts of resilience, sense of coherence, hardiness, purpose in life, and self-transcendence have earlier been described as some kind of inner strength, but no studies have been found that focus on what attributes these concepts have in common.

    Objectives

    The objective of this study was to perform a theoretical analysis of the concepts of resilience, sense of coherence, hardiness, purpose in life, and self-transcendence, in order to identify their core dimensions in an attempt to get an overarching understanding of inner strength.

    Print method

    An analysis inspired by the procedure of meta-theory construction was performed. The main questions underlying the development of the concepts, the major paradigms and the most prominent assumptions, the critical attributes and the characteristics of the various concepts were identified.

    Results

    The analysis resulted in the identification of four core dimensions of inner strength and the understanding that inner strength relies on the interaction of these dimensions: connectedness, firmness, flexibility, and creativity. These dimensions were validated through comparison with the original descriptions of the concepts.

    Conclusion

    An overarching understanding of inner strength is that it means both to stand steady, to be firm, with both feet on the ground and to be connected to; family, friends, society, nature and spiritual dimensions and to be able to transcend. Having inner strength is to be creative and stretchable, which is to believe in own possibilities to act and to make choices and influence life's trajectory in a perceived meaningful direction. Inner strength is to shoulder responsibility for oneself and others, to endure and deal with difficulties and adversities. This knowledge about inner strength will raise the awareness of the concept and, in turn, hopefully increase our potential to support people's inner strength.

  • 87. Lundman, Berit
    et al.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Santamäki Fischer, Regina
    Aléx, Lena
    Syn på åldrande och äldre personer2012In: Det goda åldrandet / [ed] Astrid Norberg, Berit Lundman, Regina Santamäki Fischer, Lund: Studentlitteratur, 2012, 1, p. 17-40Chapter in book (Other academic)
  • 88.
    Lundman, Berit
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Viglund, Kerstin
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Aléx, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Jonsén, Elisabeth
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC. Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Santamäki Fischer, Regina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Strandberg, Gunilla
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Nygren, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Development and psychometric properties of the Inner Strength Scale2011In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 48, no 10, p. 1266-1274Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Four dimensions of inner strength were previously identified in a meta-theoretical analysis: firmness, creativity, connectedness, and flexibility.

    OBJECTIVE: The aim of this study was to develop an Inner Strength Scale (ISS) based on those four dimensions and to evaluate its psychometric properties.

    METHOD: An initial version of ISS was distributed for validation purpose with the Rosenberg Self-Esteem Scale, the resilience scale, and the sense of Coherence Scale. A convenience sample of 391 adults, aged 19-90 years participated. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were used in the process of exploring, evaluating, and reducing the 63-item ISS to the 20-item ISS. Cronbach's alpha and test-retest were used to measure reliability.

    RESULTS: CFA showed satisfactory goodness-of-fit for the 20-item ISS. The analysis supported a fourfactor solution explaining 51% of the variance. Cronbach's alpha on the 20-item ISS was 0.86, and the test-retest showed stability over time (r=0.79).

    CONCLUSION: The ISS was found to be a valid and reliable instrument for capturing a multifaceted understanding of inner strength. Further tests of psychometric properties of the ISS will be performed in forthcoming studies.

  • 89.
    Melcher, Ulrica
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Henriksson (Alvariza), Anette
    Ersta Sköndal University College, Palliative Research Centre, PRC. Capio Geriatrics, Palliative Care Unit, Stockholm, Sweden.
    Sandell, Rolf
    Ersta Sköndal University College, Palliative Research Centre, PRC. Lunds universitet.
    Teenagers with a Dying Parent: A Qualitative Retrospective Study2014In: Abstracts of the 8th World Research Congress of the European Association for Palliative Care (EAPC) Lleida, Spain 5–7 June 2014, 2014, Vol. 28, no 6, p. 797-797, article id Abstract number: P413Conference paper (Other academic)
    Abstract [en]

    Background: Beeing a teenager living with a dying parent is well known to be distressing with a significant impact on teenagers psychological well-beeing. To support teenagers and prevent long-term psychological consequences we need to find out more about teenagers experiences. Aim: The aim was to explore teenagers experiences from living with a severely ill dying parent. Method: Repeated qualitative interviews were conducted with ten teenagers that had lost a parent within a year. The parent had received specialist palliative care by the time of death. Qualitative content analyses were used for analyses. Results: Preliminary results show that teenagers carry a great responsibility in the care of the sick parent and the healthy parent, siblings and general ordinary family matters. While carrying this responsibility they experience loneliness and try to adjust to the situation in different ways by being loyal to their parents. In their process to understand that the parent is dying they prepare by observing and trying to make sense of the illness symptoms they notice. Feeling trust to and support from the parents makes them feel more involved and less lonely and responsible. Conclusion: This study contributed with knowledge about great feelings of responsibility and loneliness among teenagers who has a dying parent. Healthcare professionals in palliative care could work to acknowledge and try to support the teenagers to feel involved, less lonely and less burdened by responsibility. An important aspect is also to support the healthy parent enough and thereby reduce the responsibility from the teenager.

  • 90. Millberg, Lena German
    et al.
    Berg, Linda
    Brämberg, Elisabeth Björk
    Nordström, Gun
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Academic learning for specialist nurses: A grounded theory study2014In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 6, p. 714-721Article in journal (Refereed)
    Abstract [en]

    The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care. These changes have influenced specialist nursing programmes and consequently the profession. Grounded Theory guided the study. Data were collected by means of a questionnaire with open-ended questions distributed at the end of specialist nursing programmes in 2009 and 2010. Five universities were included. Further, individual, pair and group interviews were used to collect data from 12 specialist nurses, 5-14 months after graduation. A major concern for specialist nurses was that academic learning should be "meaningful" for their professional future. The specialist nurses' "meaningful academic learning process" was characterised by an ambivalence of partly believing in and partly being hesitant about the significance of academic learning and partly receiving but also lacking support. Specialist nurses were influenced by factors in two areas: curriculum and healthcare context. They felt that the outcome of contribution to professional confidence was critical in making academic learning meaningful.

  • 91.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Livet med avancerad demenssjukdom2013In: Palliativ vård: Begrepp och perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt, Cecilia Håkansson, Lund: Studentlitteratur, 2013, p. 369-378Chapter in book (Other academic)
  • 92.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Personcentrerad vård: teori och tillämpning2013In: Omvårdnad på avancerad nivå: kärnkompetenser inom sjuksköterskans specialistområden / [ed] Edberg, Anna-Karin; Ehrenberg, Anna; Friberg, Febe; Wallin, Lars; Wijk, Helle; Öhlén, Joakim, Lund: Studentlitteratur, 2013, p. 29-62Chapter in book (Other academic)
  • 93.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Tröst2013In: Palliativ vård: Begrepp och perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt, Cecilia Håkansson, Lund: Studentlitteratur, 2013, p. 269-278Chapter in book (Other academic)
  • 94.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Upplevelse av identitet hos personer med demenssjukdom2011In: Att möta personer med demens / [ed] Edberg, Anna-Karin, Studentlitteratur, 2011, 2, p. 55-67Chapter in book (Other academic)
  • 95.
    Norberg, Astrid
    et al.
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Aléx, Lena
    Utveckling av identitet under livsloppet2012In: Det goda åldrandet / [ed] Astrid Norberg, Berit Lundman, Regina Santamäki Fischer, Lund: Studentlitteratur, 2012, 1, p. 43-63Chapter in book (Other academic)
  • 96.
    Norberg, Astrid
    et al.
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Jonsén, Elisabeth
    Santamäki Fischer, Regina
    Andlighet och åldrande2012In: Det goda åldrandet / [ed] Astrid Norberg, Berit Lundman, Regina Santamäki Fischer, Lund: Studentlitteratur, 2012, 1, p. 121-146Chapter in book (Other academic)
  • 97.
    Norberg, Astrid
    et al.
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Lundman, Berit
    Nygren, Björn
    Santamäki Fischer, Regina
    Transitioner under åldrandet2012In: Det goda åldrandet / [ed] Astrid Norberg, Berit Lundman, Regina Santamäki Fischer, Lund: Studentlitteratur, 2012, 1, p. 79-119Chapter in book (Other academic)
  • 98.
    Norberg, Astrid
    et al.
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    Lundman, BeritUmeå universitet.Santamäki Fischer, ReginaUmeå universitet.
    Det goda åldrandet2012Collection (editor) (Other academic)
    Abstract [sv]

    Boken syftar till att belysa ett gott åldrande och hot mot ett gott åldrande ur ett salutogent perspektiv samt till att spegla komplexiteten i åldrandet.

    Huvudbudskapet är att många äldre personer har det bra under åldrandet, men att det är möjligt att främja upplevelse av hälsa även hos de som lever med olika former av illabefinnande i samband med förluster, ohälsa eller under den sista tiden i livet. Att främja hälsa handlar om att ta tillvara yttre och inre resurser hos äldre personer, hos deras närmaste och i samhället samt att ge adekvat vård och omsorg, medicinsk behandling och rehabilitering.

    I boken medverkar 13 forskare inom arbetsterapi, geriatrik, omvårdnad och sjukgymnastik. Alla har omfattande erfarenhet av forskning om äldre personer. De olika perspektiven ger en bild av aktuell forskning om äldre personers situation.

    Boken är i första hand avsedd för studenter på grundläggande nivå och för vidareutbildning av personal inom vård och omsorg, men den är också lämplig att använda inom praktisk verksamhet.

  • 99.
    Norberg, Astrid
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Jämlikhet inför döden2013In: Palliativ vård: Begrepp och perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt, Cecilia Håkansson, Lund: Studentlitteratur, 2013, p. 47-60Chapter in book (Other academic)
  • 100.
    Norberg, Astrid
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Jämlikhet inför döden: Finns den?2013In: Acceptabel ojämlikhet? / [ed] Gunilla Silfverberg, Stockholm: Ersta Sköndal högskola , 2013, p. 143-170Chapter in book (Other academic)
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