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  • 1.
    Anåker, Anna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Sustainability in nursing: a concept analysis2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 2, s. 381-389Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. The aim of this study was to describe, explore and explain the concept of sustainability in nursing.

    Background. Although researchers in nursing and medicine have emphasised the issue of sustainability and health, the concept of sustainability in nursing is undefined and poorly researched. A need exists for theoretical and empirical studies of sustainability in nursing.

    Design. Concept analysis as developed by Walker and Avant.

    Method. Data were derived from dictionaries, international healthcare organisations and literature searches in the CINAHL and MEDLINE databases. Inclusive years for the search ranged from 1990 to 2012. A total of fourteen articles were found that referred to sustainability in nursing.

    Results. Sustainability in nursing involves six defining attributes: ecology, environment, future, globalism, holism and maintenance. Antecedents of sustainability require climate change, environmental impact and awareness, confidence in the future, responsibility and a willingness to change. Consequences of sustainability in nursing include education in the areas of ecology, environment and sustainable development as well as sustainability as a part of nursing academic programs and in the description of the academic subject of nursing. Sustainability should also be part of national and international healthcare organisations. The concept was clarified herein by giving it a definition.

    Conclusion. Sustainability in nursing was explored and found to contribute to sustainable development, with the ultimate goal of maintaining an environment that does not harm current and future generations' opportunities for good health. This concept analysis provides recommendations for the healthcare sector to incorporate sustainability and provides recommendations for future research.

  • 2.
    Brorsson, Anna Lena
    et al.
    Karolinska institutet.
    Lindholm Olinder, Anna
    Wikblad, Karin
    Viklund, Gunnel
    Parent's perception of their children's health, quality of life and burden of diabetes: testing reliability and validity of 'Check your Health' by proxy.2017Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, nr 3, s. 497-504Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To test the validity and reliability of the 'Check your Health by proxy' instrument in parents to children with diabetes aged 8-17 years.

    METHODS: One hundred and ninety-one caregivers and their children, aged 8-17 years, were included. All completed the 'Check your Health' questionnaire measuring quality of life and burden of diabetes, DISABKIDS self- or proxy version, and 45 completed the same questionnaires 2 weeks later.

    RESULTS: Test-retest reliability on the 'Check your Health' questionnaire by proxy was moderate to strong (r = 0.48-0.74), p < 0.002). Convergent validity was weak to moderate (r = 0.15-0.49, p < 0.05). The instrument showed acceptable discriminant validity. Parents reported lower scores than the children on emotional health and social relations and higher scores on physical and emotional burden and higher burden on quality of life. Poorer social relationships and quality of life were associated with higher reported disease severity. The diabetes burden domain of the questionnaire correlated to perceived severity of diabetes and to perceived health. Discriminant validity showed that poorer social relationships and quality of life were associated with higher severity of the disease. The diabetes burden domain of 'Check your Health' by proxy showed discriminant validity on perceived severity of diabetes.

    CONCLUSIONS: The instrument 'Check your Health' by proxy showed acceptable psychometric characteristics in parents to young people (8-17 years of age) with diabetes. We also concluded that parents reported that their children had lower health and higher burden of diabetes than the children did, and it correlated to reported disease severity.

  • 3.
    Craftman, Åsa
    et al.
    Sophiahemmet Högskola.
    Westerbotn, Margareta
    Sophiahemmet Högskola.
    von Strauss, Eva
    Hillerås, Pernilla
    Sophiahemmet Högskola.
    Marmstål Hammar, Lena
    Mälardalens högskola.
    Older people's experience of utilisation and administration of medicines in a health- and social care context2015Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, nr 4, s. 760-768Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care.

    AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care.

    DESIGN: A qualitative descriptive study.

    METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used.

    FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process.

    CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine.

    RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.

  • 4.
    Ehrenberg, Anna
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Birgersson, C
    Nursing Documentation of Leg Ulcers. Adherence to Clinical Guidelines in a Swedish Primary Health Care District.2003Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, nr 3Artikkel i tidsskrift (Fagfellevurdert)
  • 5.
    Eldh, Ann Catrine
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ; School of Health and Medical Sciences, Orebro University.
    Carlsson, Eva
    Department of Quality and Patient safety, Lindesberg hospital and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Seeking a balance between employment and the care of an ageing parent2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 2, s. 285-293Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [sv]

    Rationale:  A growing number of middle-aged people are engaged in informal care of their parents while employed. To provide support as employers, co-workers or staff, health care professionals need insight into the experiences of people managing these responsibilities.

    Aim:  To elucidate the experience of providing informal care to an ageing parent while managing the responsibilities of a working life.

    Methods:  Narrative interviews were performed with 11 persons with experience of the phenomenon. Transcribed interviews were analysed with phenomenological hermeneutics.

    Ethics:  Informed consent was given prior to the interviews. The study was approved by a research ethics committee.

    Findings:  Providing informal care to an ageing parent while also pursuing a working life implies seeking balance: a balance between providing support to the parent’s needs and one’s responsibilities at work. Being employed supports this balance as it provides both fulfilment and refuge. Being capable of managing both roles grants a sense of satisfaction, supporting one’s sense of balance in life. The balance can be supported by sharing the responsibility of caring for the ageing parent with others.

    Study limitations:  Despite perceived saturation and an effort to provide for the possibility to consider internal consistency, the findings should be considered as a contribution to the understanding of the phenomenon, as experienced by individuals in their life world.

    Conclusions:  It is essential to recognise the impact that providing care for an ageing parent may have on the lives of a growing number of people, particularly if they have employment responsibilities. Acknowledgement by others supports one’s ability to attain balance; as co-workers and managers, we can acknowledge the efforts of an informal caregiver and as health care staff recognise the valuable contribution made by people in mid-life who provide informal care for their ageing parents.

  • 6.
    Eldh, Ann Catrine
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska Institutet.
    van der Zijpp, T.
    Fontys University.
    McMullan, C.
    McCormack, B.
    Seers, K.
    Rycroft-Malone, J.
    "I have the world’s best job": staff experience of the advantages of caring for older people2016Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 2, s. 365-373Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Rationale

    Besides a growing demand for safe high-quality care for older people, long-term care (LTC) often struggles to recruit appropriately qualified nursing staff. Understanding what LTC staff value in their work may contribute to a more comprehensive understanding of what can attract staff and support person-centred care.

    Aim

    To explore staff experience of the advantages of working in LTC settings for older people.

    Methods

    Narrative descriptions of 85 LTC staff in Ireland, the Netherlands and Sweden on what they value in their work were analysed with qualitative content analysis.

    Ethics

    Ethical approval was obtained according to the requirements of each country, and participants provided informed consent prior to the individual interviews.

    Findings

    Working in LTC signifies bonding with the older people residing there, their next of kin and the team members. It means autonomy in one's daily tasks amalgamated with being a part of an affirmative team. Participants reported a sense of accomplishment and fulfilment; caring meant consideration and recognition of the older people and the relationships formed, which provided for professional and personal growth. The sharing of compassion between staff and residents indicated reciprocity of the relationship with residents.

    Study limitations

    The findings may be transferable to LTC in general although they address only the positive aspects of caring for older people and only the experiences of those staff who had consented to take part in the study.

    Conclusions

    The findings add to what underpins the quality of care in nursing homes: compassion in the nurse–resident relationship and person-centred care in LTC. They indicate reciprocity in the relations formed that may contribute to the empowerment of older people, but further studies are needed to explore this in more detail.

  • 7.
    Elf, Marie
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Poutilova, Maria
    Öhrn, Kerstin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Vårdvetenskap med inriktning mot munhälsa.
    A dynamic conceptual model of care planning2007Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, nr 4, s. 530-538Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article presents a conceptual model of the care planning process developed to identify the hypothetical links between structural, process and outcome factors important to the quality of the process. Based on existing literature, it was hypothesized that a thorough assessment of patients' health needs is an important prerequisite when making a rigorous diagnosis and preparing plans for various care interventions. Other important variables that are assumed to influence the quality of the process are the care culture and professional knowledge. The conceptual model was developed as a system dynamics causal loop diagram as a first essential step towards a computed model. System dynamics offers the potential to describe processes in a nonlinear, dynamic way and is suitable for exploring, comprehending, learning and communicating complex ideas about care processes.

  • 8. Erdner, A.
    et al.
    Nyström, M.
    Magnusson, A.
    Lützen, Kim
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Social and existential alienation experienced by people with long-term mental illness2005Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 4, s. 373-380Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    The aim of this study was to explore how people suffering from long-term mental illness and who live in the community experience their daily lives. The study was based on an ethnographic framework involving participant observations with 23 individuals from two rehabilitation centres and interviews with six women and two men. The observational notes and interviews were recorded, transcribed into the data and analysed based on the phases of hermeneutic interpretation. The process consisted of identifying tentative interpretations that highlighted various impediments that prevent people with long-term mental illness from having an active life. The impediments can also be interpreted as a form of alienation, an interpersonal phenomenon and a consequence due to of the lack of social acceptance towards mental illness. The participants expressed concern about the future and lack of hope. Viewing themselves as being 'odd' is not a symptom of mental illness, but rather evidence of experiencing existential and social alienation not only as a consequence of other people's reactions but also their own negative attitudes towards mental illness and effects of their cognitive dysfunction.

  • 9.
    Eriksson, Henrik
    et al.
    Röda Korset Högskola.
    Salzmann-Erikson, Martin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Supporting a caring fatherhood in cyberspace: an analysis of communication about caring within an online forum for fathers2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 1, s. 63-69Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:  Today’s parents seek out social support on the Internet. A key motivation behind the choice to go online is the need for more experience based information. In recent years, new fathers have increasingly taken on an active parental role. Men’s support for their caring activities for infants on the Internet needs attention.

    Aim:  The aim was to describe communication about caring activities for infants among men who visited an Internet-based forum for fathers and elaborate on the dimensions of support available in the forum.

    Method:  An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online: “nethnography”. A total of 1203 pages of data from an Internet forum for fathers were gathered and analysed.

    Result:  Support for a caring fatherhood in cyberspace can be understood as fathers’ communicating encouragement, confirmation and advice. The findings show that important ways of providing support through the forum included a reciprocal sharing of concerns – how to be a better father – in relation to caring for an infant. Concerns for their child’s well-being and shared feelings of joy and distress in everyday life were recurrent supportive themes in the communication. Information gained from contacting others in similar situations is one important reason for the fathers’ use of the Internet.

    Discussion:  Support offered in this kind of forum can be considered as a complement to formal support. Professionals can use it to provide choices for fathers who are developing themselves as caregivers without downplaying the parental support offered by formal health care regimes.

    Further research:  Online support will probably be one of the main supporting strategies for fathers in Scandinavia. Caring and nursing researchers need to closely monitor support activities that develop, and over time, as these ill likely become an important source of support for people.

  • 10.
    Friman, Anne
    et al.
    Karolinska Institutet.
    Klang, Birgitta
    Röda Korsets Högskola.
    Ebbeskog, Britt
    Karolinska Institutet.
    Wound care by district nurses at primary healthcare centres: A challenging task without authority or resources2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 3, s. 426-434Artikkel i tidsskrift (Fagfellevurdert)
  • 11.
    From, Ingrid
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Nordström, G.
    Wilde-Larsson, B.
    Johansson, I.
    Caregivers in older peoples’ care: perception of quality of care, working conditions, competence and personal health2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 3, s. 704-714Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to describe and compare nursing assistants’, enrolled nurses’ and registered nurses’ perceptions of quality of care, working conditions, competence and personal health in older peoples’ care. Altogether 70 nursing assistants, 163 enrolled nurses and 198 registered nurses completed a questionnaire comprising Quality from the Patient’s Perspective modified for caregivers, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items on education and competence and Health Index. The caregivers reported higher perceived reality of quality of care in medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere. In subjective importance, the highest rating was assessed in one of the physical-technical items. The organisational climate was for three of the dimensions rather close/reached the value for a creative climate, for seven dimensions close to a stagnant climate. In perceived stress of conscience, there were low values. Nursing assistants had lower values than enrolled nurses and registered nurses. The caregivers reported highest values regarding previous education making them feel safe at work and lowest value on the item about education increasing the ability for a scientific attitude. Registered nurses could use knowledge in practice and to a higher degree than nursing assistants/enrolled nurses reported a need to gain knowledge, but the latter more often received education during working hours. The health index among caregivers was high, but registered nurses scored lower on emotional well-being than nursing assistants/enrolled nurses. The caregivers’ different perceptions of quality of care and work climate need further attention. Although stress of conscience was low, it is important to acknowledge what affected the caregivers work in a negative way. Attention should be paid to the greater need for competence development among registered nurses during working hours. © 2012 Nordic College of Caring Science.

  • 12. Göransson, Katarina
    et al.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Marklund, Bertil
    Ehnfors, Margareta
    Accuracy and concordance of nurses in emergency department triage2005Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 4, s. 432-438Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In the emergency department (ED) Registered Nurses (RNs) often perform triage, i.e. the sorting and prioritizing of patients. The allocation of acuity ratings is commonly based on a triage scale. To date, three reliable 5-level triage scales exist, of which the Canadian Triage and Acuity Scale (CTAS) is one. In Sweden, few studies on ED triage have been conducted and the organization of triage has been found to vary considerably with no common triage scale. The aim of this study was to investigate the accuracy and concordance of emergency nurses acuity ratings of patient scenarios in the ED setting. Totally, 423 RNs from 48 (62%) Swedish EDs each triaged 18 patient scenarios using the CTAS. Of the 7550 triage ratings, 57.6% were triaged in concordance with the expected outcome and no scenario was triaged into the same triage level by all RNs. Inter-rater agreement for all RNs was kappa = 0.46 (unweighted) and kappa = 0.71 (weighted). The fact that the kappa-values are only moderate to good and the low concordance between the RNs call for further studies, especially from a patient safety perspective.

  • 13.
    Iversen, Marjolein M.
    et al.
    Bergen Univ Coll, Fac Hlth & Social Sci, Ctr Evidence Based Practice, Bergen, Norway.;Stavanger Univ Hosp, Endocrinol Sect, Dept Med, Stavanger, Norway..
    Graue, Marit
    Bergen Univ Coll, Fac Hlth & Social Sci, Ctr Evidence Based Practice, Bergen, Norway.;Haukeland Hosp, Dept Pediat, Bergen, Norway..
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Smide, Bibbi
    Uppsala Univ, Dept Med Sci, Uppsala, Sweden..
    Zoffmann, Vibeke
    Rigshosp, Univ Copenhagen Hosp, Juliane Marie Ctr, Res Womens & Childrens Hlth, Copenhagen, Denmark..
    Sigurdardottir, Arun K.
    Univ Akureyri, Sch Hlth Sci, Akureyri, Iceland..
    Characteristics of nursing studies in diabetes research published over three decades in Sweden, Norway, Denmark and Iceland: a narrative review of the literature2016Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 2, s. 241-249Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Similarities and differences across borders of Nordic countries constitute a suitable context for investigating and discussing factors related to the development of diabetes nursing research over the last three decades. The present study reviewed the entire body of contemporary diabetes nursing research literature originating in four Nordic countries: Norway, Sweden, Denmark and Iceland. Our aims were (i) to catalogue and characterise trends in research designs and research areas of these studies published over time and (ii) to describe how research involving nurses in Nordic countries has contributed to diabetes research overall. The larger goal of our analyses was to produce a comprehensive picture of this research in order to guide future studies in the field. We conducted a narrative literature review by systematically searching Medline, Medline in process, EMBASE, CINAHL, PsycINFO and Cochrane databases. These searches were limited to studies published between 1979 and 2009 that had an abstract available in English or a Nordic language. Two researchers independently selected studies for analysis, leading to the inclusion of 164 relevant publications for analysis. In summary, Nordic nurse researchers have contributed to the development of new knowledge in self-management of diabetes in childhood, adolescence and adulthood, and to some extent also in the treatment and care of diabetes foot ulcers. Future research may benefit from (i) larger nurse-led research programmes organised in networks in order to share knowledge and expertise across national groups and borders, (ii) more multidisciplinary collaborations in order to promote patient-centred care and (iii) further research directed towards improving the dissemination and implementation of research findings. Using complex intervention designs and a mix of research methods will enrich the research.

  • 14.
    Koistinen, Susanne
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Örebro universitet.
    Olai, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Ståhlnacke, Katri
    Folktandvårdens Folkhälsoenhet, Region Örebro län.
    Anna, Fält
    Klinisk epidemiologi och biostatistik, Institutionen för medicinska vetenskaper, Örebro universitet.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Oral health and oral care in short-term care: prevalence, related factors, and coherence between older peoples and professionals assessments2019Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, nr 3, s. 712-722Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Oral health is important for well-being and overall health. Older peoples oral health is well described in the residential care context, but remains understudied in short-term care.

    Objective: The aim of this study was to describe oral health, daily oral care and related factors among older people in short-term care and to compare self-perceived oral health with professional assessment.

    Materials and methods: This cross-sectional study included 391 older people in 36 short-term units in 19 Swedish municipalities. Oral health was assessed professionally by clinical oral assessment and the Revised Oral Assessment Guide (ROAG). The older peoples’ perceptions of their own oral health were measured with a global question on self-perceived oral health. Self-care ability was assessed with Katz Index of Activities of Daily Living (Katz-ADL).

    Results: Mean age was 82.9 years, 19% of participants were totally edentulous, and 43% had ≥20 teeth. Almost 60% had coating or food debris on their teeth, but only 19% received help with daily oral care. Those who were dependent on help with self-care had around a sixfold higher risk of having oral problems. There was a low level of agreement between the clinical assessment based on ROAG and self-perceived oral health.

    Conclusion: Professionals’ assessments of oral health differed considerably from the older peoples own assessments. A higher risk of oral problems and more occurrence of coating or food debris or broken teeth were seen among those dependent on help with self-care (ADL). This study indicates that in order to improve older peoples oral health and oral care we need to provide person-centred oral care and to develop a close collaboration between nursing and dental staff.

  • 15.
    Kullberg, Kerstin
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Döbelnsgatan, Uppsala.
    Björklund, Anita
    Department of Rehabilitation, School of Health Sciences.
    Sidenvall, Birgitta
    Department of Nursing Science, School of Health Sciences, Jönköping.
    Åberg, Anna Cristina
    Department of Public Health and Caring Sciences, Uppsala University, Döbelnsgatan, Uppsala.
    'I start my day by thinking about what we're going to have for dinner': a qualitative study on approaches to food-related activities among elderly men with somatic diseases2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 2, s. 227-234Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to address the question of how older men with somatic diseases living in their own home approach the question of food-related activities (FRA). Further, any adaptations of these activities necessitated by effects of diseases and of altered life circumstances were explored. Interviews were conducted with a purposeful sample of 18 co-living and single-living men, 64-84 years old. They were diagnosed with Parkinson's disease, rheumatoid arthritis or stroke. In the analysis, a thematic framework was used. The findings revealed three food-related approaches, namely 'Cooking as a pleasure', describing joy in cooking; 'Cooking as a need', indicating no habits or skills in cooking; and 'Food is served', that is, being served meals by a partner. It was found that gender-related roles in particular, but also changed life circumstances, activity limitations, personal interests, and a wish to maintain continuity and independence, affected the men's approaches to these activities. This knowledge may be useful in attempts to facilitate and support FRA among elderly men with diseases. Health care efforts to promote FRA should preferably be individualised in respect to older men's approaches to these activities.

  • 16.
    Leksell, Janeth
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Funnell, Martha
    Sandberg, Gun
    Smide, Bibbi
    Viklund, Gunnel
    Wikblad, Karin
    Psychometric properties of the Swedish Diabetes Empowerment Scale2007Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, nr 2, s. 247-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: This study was conducted to determine the psychometric properties of the Swedish version of the Diabetes Empowerment Scale (Swe-DES-23). 

    Research design and methods: A convenience sample of 195 patients with type I and type 2 diabetes completed the Swe-DES-23 questionnaire. To establish discriminant validity, Swe-DES subscales were compared with the Semantic Differential in Diabetes scale (SDD) and a general health scale (EVGFP). Construct validity was tested using factor analyses. To determine unidimensionality of the subscales, interitem correlations were calculated. Internal consistency was tested by the use of the Crohnbach-alpha coefficient. 

    Results: The factor analysis resulted in four factors (empowerment subscales) with eigenvalues > 1.0, explaining 60% of the variance. The four empowerment subscales: goal achievement, self-awareness, stress management and readiness to change showed Crohnbach-alpha values ranging from 0.68 to 0.91. Patients with good self-reported health and low burden of diabetes scored significantly higher on almost all empowerment subscales. Only weak correlations were found between metabolic control and the empowerment subscales. 

    Conclusions: The SWE-DES-23 scale had acceptable validity and reliability and, thus, could be a suitable tool in evaluating empowerment-based education programmes. Further testing is needed to shorten the questionnaire.

  • 17.
    Magnusson, Annabella
    et al.
    Ersta Sköndal University College.
    Lützen, Kim
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Factors that influence collaboration between psychiatric care and CSSs: Experiences of working together in the interest of persons with long-term mental illness living in the community2009Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, nr 1, s. 140-145Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Since de-institutionalization of psychiatric care (PC) took place in Sweden during the second half of the 20th century, the intended collaboration between the two organizations, PC and community social service (CSS) has been evaluated as inadequate in providing care for persons with long-term mental illness living in the community.

    Aim: The aim of this explorative study was to examine factors that influence interdisciplinary teamwork between PC and CSSs based on the experience of nursing staff within two separate organizations.

    Method: Five focus groups were selected as an appropriate method to collect data. Two of these groups were recruited from the PC and three from the CSSs. The focus groups consisted of psychiatric nurses and mental healthcare workers. A qualitative content analysis was used to identify major themes in the data.

    Findings: Two main themes were found, external organizational factors and interpersonal factors that deter or enhance collaboration between PC and CSS. Separate care plans, unclear times for meetings were found to be a plausible reason for communication failure. The focus groups representing each of the two organizations viewed themselves as 'us and them'. Different ideologies and goals for caring and service and how to use each other's competence seemed to be explanations as well as consequences of not finding ways to work together.

    Conclusion: The results of this study points to the need for the two organizations to find ways to work more effectively together to realize a joint responsibility for the patient/client. 

  • 18.
    Marmstål Hammar, Lena
    et al.
    Mälardalens högskola.
    Emami, Azita
    College of Nursing, University of Seattle, USA.
    Engström, Gabriella
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Götell, Eva
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Communicating through caregiver singing during morning care situations in dementia care2011Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 1, s. 160-168Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    It is well known that persons with dementia (PWD) have problems expressing and interpreting communication, making interaction with others difficult. Interaction between PWD and their caregivers is crucial, and several strategies have been investigated to facilitate communication during caregiving. Music therapeutic caregiving (MTC) - when caregivers sing for or together with PWD during caregiving activities - has been shown to enhance communication for PWD, evoking more vitality and positive emotions. The aim of this study was to describe how PWD and their caregivers express verbal and nonverbal communication and make eye contact during the care activity 'getting dressed', during morning care situations without and with MTC. Findings revealed that during the situations without MTC, the caregivers led the dressing procedure with verbal instructions and body movements and seldom invited the PWD to communicate or participate in getting dressed. Patterns in responses to caregivers' instructions included both active and compliant responses and reactions that were resistant and aggressive, confused, and disruptive. In contrast to the 'ordinary' morning care situation, during MTC, the caregivers seemed interested in communicating with the PWD and solicited their mutual engagement. Although verbal communication consisted of singing about things other than getting dressed, e.g. dancing, love, sailing, God, the PWD mostly responded to caregivers in a composed manner, by being active, compliant, and relaxed, though some were also resistant or incongruent. The authors conclude that MTC could be a way for PWD and their caregivers to successfully interact and co-operate during caring situations, as it seems to evoke enhanced communication for both partners in this context

  • 19. Nilsson, Madeleine
    et al.
    From, Ingrid
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Lindwall, Lillemor
    The significance of patient participation in nursing care - a concept analysis2019Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, nr 1, s. 244-251Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The purpose of this study was to report on a concept analysis of the meaning of patients' participation. Participation is commonplace in many areas of health care and has become an important issue in healthcare services. Participation is essential when giving nursing care. Challenges exist throughout clinical practice to make the patient a participant in their own care. The study had a caring science perspective.

    METHOD: A literature study based on Walker and Avant's method was used with eight steps. Data were collected using several databases covering the years 1995-2017. The analysis covered fifteen articles, dissertations, reports and textbooks.

    FINDINGS: Patients' participation may be defined as a concept that relates to and includes the three caring science concepts: learning, caring relationship and reciprocity (defining attributes).

    CONCLUSION: Participation is a concept with vague meaning that is prevalent in nursing practice. Patients' participation is a complex concept. By using the attributes, it could be more visible in nursing care. The next question for research in this area is how these three attributes can best practically be achieved in a clinical context.

  • 20.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Wallinder, Maria
    von Koch, Lena
    Wijk, Helle
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    The physical environment, activity and interaction in residential care facilities for older people: a comparative case study2017Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, nr 4, s. 727-738Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The physical environment is of particular importance for supporting activities and interactions among older people living in residential care facilities (RCFs) who spend most of their time inside the facility. More knowledge is needed regarding the complex relationships between older people and environmental aspects in long-term care. The present study aimed to explore how the physical environment influences resident activities and interactions at two RCFs by using a mixed-method approach. Environmental assessments were conducted via the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM), and resident activities, interactions and locations were assessed through an adapted version of the Dementia Care Mapping (DCM). The Observed Emotion Rating Scale (OERS) was used to assess residents’ affective states. Field notes and walk-along interviews were also used. Findings indicate that the design of the physical environment influenced the residents’ activities and interactions. Private apartments and dining areas showed high environmental quality at both RCFs, whereas the overall layout had lower quality. Safety was highly supported. Despite high environmental quality in general, several factors restricted resident activities. To optimise care for older people, the design process must clearly focus on accessible environments that provide options for residents to use the facility independently.

  • 21.
    Olsson, Helén
    et al.
    Mittuniversitetet.
    Strand, Susanne
    Kristiansen, Lisbeth
    Reaching a turning point--how patients in forensic care describe trajectories of recovery.2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 3, s. 505-14Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In Sweden, the duration of treatment is increasing for patients admitted to forensic psychiatric care. To reduce the length of stay, it is important for the forensic rehabilitation and recovery process to be effective and safe. Not much is known about how the process of recovery and transition begins and how it is described by the forensic patients. The purpose of this study was to explore how forensic patients with a history of high risk for violence experienced the turn towards recovery. A qualitative content analysis was used to analyse interviews with 10 patients who had decreased their assessed risk for violence on the risk assessment instrument HCR-20 and who were successfully managed a lower level of security. Three themes were identified: (i) the high-risk phase: facing intense negative emotions and feelings (ii) the turning point phase: reflecting on and approaching oneself and life in a new way (iii) the recovery phase: recognising, accepting and maturing. In the high-risk phase, chaotic and overwhelming feelings were experienced. The turning point phase was experienced as a sensitive stage, and it was marked by being forced to find a new, constructive way of being. The recovery phase was characterised by recognising personal circumstances in life, including accepting the need for structure, a feeling of maturity and a sense of responsibility for their own life. In order to ensure a successful recovery, the forensic nursing staff needs to recognise and support processes related to treatment motivation and turning points. Recommendations for best nursing practice are given accordingly.

  • 22.
    Persson, Margareta
    et al.
    Umeå universitet.
    Winkvist, Anna
    Mogren, Ingrid
    'From stun to gradual balance' - women's experiences of living with gestational diabetes mellitus2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 3, s. 454-62Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND AIM: In most parts of the western world, screening routines for gestational diabetes mellitus (GDM) are implemented, however, knowledge of the impact GDM has on the experience of pregnancy and life situation is sparse. The aim of this study was to describe pregnant women's experiences of acquiring and living with GDM during pregnancy.

    METHOD: A Grounded Theory approach was used. Ten pregnant women diagnosed with GDM in current pregnancy were interviewed. Data collection was performed in the north of Sweden over two periods; a first set of interviews in 1998-2000 and additional interviews in 2006 to further explore the experience and reach saturation.

    FINDINGS: 'From stun to gradual balance' emerged as the core category, encompassing of the categories 'Struck by lightning', 'Having a personal responsibility', 'Being under surveillance', 'Struggling for protection', 'Feeling socially apart', 'Being sufficiently supported', 'Changing the self-image', 'Adapting to a new situation' and 'Waiting for the 'Moment of truth''. Our findings indicated that the diagnosis of GDM initiated a number of challenges and demands for the pregnant women. Further, being diagnosed with GDM was not only perceived as a medical complication threatening the pregnancy, moreover as an indicator of a future diabetes mellitus.

    CONCLUSION: The experience of being diagnosed with and living with GDM during pregnancy may be understood as a process 'from stun to gradual balance'. The experience comprises positive and negative dimensions. Despite the challenges, the inconveniences and the changes involved, gradually adapting to a lifestyle and balancing the every day life is the prize most of these women are willing to pay in order to secure optimal maternal and foetal health. Knowledge of the experiences of women diagnosed with GDM may enable midwives to provide increased support as well as provide information and preventive measures in order to delay future diabetes mellitus.

  • 23.
    Schytt, Erica
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Waldenström, Ulla
    Olsson, Pia
    Self-rated health – what does it capture at one year after childbirth?: Investigation of a survey question employing thinkaloud interviews2009Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, nr 4, s. 711-720Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. This paper reports an investigation of how the survey question ‘How would you summarize your state of health at present’ is interpreted and what it captures when asked at one year after childbirth.

    Background. Self-rated health measured by a single item question is a well-established patient outcome since it predicts morbidity and the use of health services. However, there is limited understanding of what the question captures in early motherhood.

    Method. A qualitative design combining data collection by means of a short form, concurrent and retrospective thinkaloud interviews, and a semi-structured interview, with 26 Swedish women during 2005 was employed. The text was analysed by qualitative content analysis. A theoretical framework describing four cognitive tasks usually performed when a respondent answers a survey question guided the analysis: interpretation of the question, retrieval of information, forming a judgment and giving a response.

    Findings. The questions of self-rated health left open for the new mothers to evaluate what was most important for her. It captured a woman’s total life situation, such as family functioning and wellbeing, relationship with partner, combining motherhood and professional work, energy, physical symptoms and emotional problems affecting daily life, stressful life events, chronic disease with ongoing symptoms, body image, physical exercise and happiness. Neither childbirth-related events nor childbirth-related symptoms were included in the responses. Less than ‘good’ self-rated health represented a high burden of health problems.

    Conclusion. Our results showed that the question on self-rated health was a measure of women’s general health and wellbeing in their present life situation, but it did not seem to measure recovery after childbirth specifically.

  • 24.
    Schön, Ulla-Karin
    Stockholms universitet, Institutionen för socialt arbete - Socialhögskolan.
    Recovery from mental illness, a gender perspective2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 3, s. 557-564Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and research objectives: Recovery from mental illness is an individual process characterized by regaining a positive sense of self and developing a new meaning. Knowledge concerning differences between male and female recovery processes is, however, limited. The objective of this study was to determine gender diversity in what individuals described as decisive factors for their recovery.

     

    Subjects and methods:  In this qualitative study based on grounded theory 30 first-person accounts of recovery from mental illness are examined. After informed consent data were collected through in-depth interviews with people in recovery from psychosis, bipolar disorders or personality disorders.

     

    Results: The results show that in spite of structural gender inequalities, female gender norms seem to be an advantage in the recovery process. The female participants were focused on making sense and meaning in their recovery process, while the male participants were focused on control over symptoms and reinforcement of traditional roles such as occupation and independence. Another result showed psychiatric hospitalization to mainly contribute to male recovery processes.

     

    Conclusion: These results provide new insights into gender as an important factor in understanding recovery processes and in providing care to facilitate these processes.

  • 25.
    Summer Meranius, Martina
    et al.
    Mälardalens högskola, Hälsa och välfärd.
    Marmstål Hammar, Lena
    Mälardalens högskola.
    How does the healthcare system affect medication self-management among older adults with multimorbidity?2016Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 1, s. 91-98Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Individuals with multimorbidity commonly have several concurrent prescriptions and experience healthcare obstacles related to managing different diagnoses and medications. This study aimed to provide a deeper understanding of how older adults with multimorbidity experience medication self-management and how this is affected by the healthcare system. The National Board of Research Ethics approved the study, and 20 older adults with multimorbidity participated in in-depth interviews that were analysed using a hermeneutic approach. Three levels of interpretation emerged. At the first level, lack of participation in healthcare communication hinders adherence and safety, and feeling abandoned to self-care leads to health risk-taking. At the second level, the healthcare organisation is seen as an obstacle to medication self-management. The overall interpretation was a system of repairing ‘parts’ but not enabling the experience of health. This study shows that the healthcare system is able to treat and relieve an individual's symptoms, but seems unable to help them achieve and promote good health, or to provide the support they need to function in everyday life.

  • 26. Thoroddsen, Asta
    et al.
    Sigurjonsdottir, G
    Ehnfors, Margareta
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Accuracy, completeness and comprehensiveness of information on pressure ulcers recorded in the patient record2013Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, nr 1, s. 84-91Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim:  To describe the accuracy, completeness and comprehensiveness of information on pressure ulcers documented in patient records.

    Design and setting:  A cross-sectional descriptive study performed in 29 wards at a university hospital in Iceland. The study included skin assessment of patients and retrospective audits of records of patients identified with pressure ulcers.

    Participants:  A sample of 219 patients was inspected for signs of pressure ulcers on 1 day in 2008. Records of patients identified with pressure ulcers were audited (n = 45) retrospectively.

    Results:  The prevalence of pressure ulcers was 21%. Information in patient records lacked accuracy, completeness and comprehensiveness. Only 60% of the identified pressure ulcers were documented in the patient records. The lack of accuracy was most prevalent for stage I pressure ulcers.

    Conclusions:  The purpose of documentation to record, communicate and support the flow of information in the patient record was not met. The patient records lacked accuracy, completeness and comprehensiveness, which can jeopardise patient safety, continuity and quality of care. The information on pressure ulcers in patient records was found not to be a reliable source for the evaluation of quality in health care. To improve accuracy, completeness and comprehensiveness of data in the patient record, a systematic risk assessment for pressure ulcers and assessment and treatment of existing pressure ulcers based on evidence-based guidelines need to be implemented and recorded in clinical practice. Health information technology, including the electronic health record with decision support, has shown promising results to facilitate and improve documentation of pressure ulcers.

  • 27.
    Wikblad, Karin
    et al.
    Department of Medical Sciences, Uppsala University, Uppsala.
    Smide, Bibbi
    Department of Medical Sciences, Uppsala University, Uppsala.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Check your health, validity and reliability of a measure of health and burden of diabetes2014Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, nr 1, s. 139-145Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Check Your Health was constructed as four-two-sided vertical thermometers (0–100) measuring physical and emotional health, social well-being and quality of life today and before onset of diabetes. Burden of diabetes was calculated as the difference between the two scores (today and before onset of diabetes). The aim was to examine concurrent and discriminant validity and reliability of Check Your Health in a convenience sample of 180 people with diabetes, who visited the diabetes clinic during a 3-month period. A randomly selected subsample of 43 of the 180 patients responded to the questionnaire twice (test–retest). Besides Check Your Health, three additional questionnaires were mailed to the patients, the EVGFP scale (EVGFP stands for Excellent–Very good–Good–Fair–Poor health) for measuring concurrent validity, the Diabetes Empowerment Scale (Swe-DES-23) and an attitude measure, Semantic Differential in Diabetes (SDD) for calculation of discriminant validity. There was significant agreement between Check Your Health and the five EVGFP health groups. The instrument discriminated well between patients with and without late diabetic complications. The measure on burden of diabetes showed that the higher the burden of diabetes, the lower the quality of life. The same pattern was found for both Swe-DES 23 and SDD; the higher the burden, the lower the sense of empowerment and the lower the burden, the more positive the attitudes towards diabetes. Check Your Health showed good stability (0.88–0.68). The results indicate that Check Your Health can be used as an acceptable and sufficiently accurate method for detecting health distress in people with diabetes.

  • 28.
    Zakrisson, Ann-Britt
    et al.
    Family Medicine Research Centre, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Hägglund, Doris
    Family Medicine Research Centre, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    The asthma/COPD nurses’ experience of educating patients with chronic obstructive pulmonary disease in primary health care2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 1, s. 147-155Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The number of patients with chronic obstructive pulmonary disease (COPD) is increasing. These patients need nursing care, including education in self-care, which has a positive effect on their physical and psychoemotional well-being. The aim of this study was to describe the experiences of asthma/COPD nurses' in primary health care (PHC) of educating patients with COPD. A descriptive, qualitative study was conducted, with interviews of 12 asthma/COPD nurses. The data were analysed using qualitative content analysis. The findings are presented in two themes: Theme 1, receiving support results in a feeling of security, which enables the development of patient education; and Theme 2, a lack of support results in a feeling of insecurity, which makes it difficult to develop patient education. The asthma/COPD nurses were individual orientated with individualization of care, but the patient's mood, the varying support of those around and the nurses' varying degrees of security affected the education. The conclusion is that the asthma/COPD nurses' experience of patient education fluctuated between insecurity and security. The nurses' feeling of insecurity in their patient education can be strengthened through support from colleagues and by increased knowledge in promoting the learning of others. Collaborative teamwork with a well-functioning asthma/COPD clinic in PHC can facilitate and improve patient services; these initiatives can enable the asthma/COPD nurses to reach their full potential.

  • 29.
    Österlund-Efraimsson, Eva
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Hillervik, Charlotte
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Ehrenberg, Anna
    Högskolan Dalarna, Akademin Hälsa och samhälle, Omvårdnad.
    Effects of COPD self-care management education at a nurse-led primary health care clinic2008Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, nr 2, s. 178-185Artikkel i tidsskrift (Fagfellevurdert)
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