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  • 1. af Winklerfelt Hammarberg, Sandra
    et al.
    Hange, Dominique
    André, Malin
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Svenningsson, Irene
    Björkelund, Cecilia
    Petersson, Eva-Lisa
    Westman, Jeanette
    Care managers can be useful for patients with depression but their role must be clear: a qualitative study of GPs’ experiences2019In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 3, p. 273-282Article in journal (Refereed)
    Abstract [en]

    Objective: Explore general practitioners’ (GPs’) views on and experiences of working with care managers for patients treated for depression in primary care settings. Care managers are specially trained health care professionals, often specialist nurses, who coordinate care for patients with chronic diseases.

    Design: Qualitative content analysis of five focus-group discussions.

    Setting: Primary health care centers in the Region of Västra Götaland and Dalarna County, Sweden.

    Subjects: 29 GPs.

    Main outcome measures: GPs’ views and experiences of care managers for patients with depression.

    Results: GPs expressed a broad variety of views and experiences. Care managers could ensure care quality while freeing GPs from case management by providing support for patients and security and relief for GPs and by coordinating patient care. GPs could also express concern about role overlap; specifically, that GPs are already care managers, that too many caregivers disrupt patient contact, and that the roles of care managers and psychotherapists seem to compete. GPs thought care managers should be assigned to patients who need them the most (e.g. patients with life difficulties or severe mental health problems). They also found that transition to a chronic care model required change, including alterations in the way GPs worked and changes that made depression treatment more like treatment for other chronic diseases.

    Conclusion: GPs have varied experiences of care managers. As a complementary part of the primary health care team, care managers can be useful for patients with depression, but team members’ roles must be clear.

  • 2. Alexandersson, Karin
    et al.
    Nyström Svensk, Ingrid
    Olsson, Helén
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Försörjningsstöd som leverbröd - Det ekonomiska biståndets utveckling 2007-2008, i sex kommuner i Dalarna, i relation till förändringar i det svenska välfärdssystemet.2008Report (Other academic)
  • 3.
    Ayoub, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Randell, Eva
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Promoting social engagement for young adults living in social isolation: Social workers and health care professionals' perceptions of success factors2019Conference paper (Other academic)
    Abstract [en]

    Background: Today the global number of young adults not in employment, education or training seem to increase. A large proportion of the group are unemployed and disengaged and have not been in contact with any authority. Thus, they are invisible to many community services and official agencies. The situation standing outside the society may have negative long-term health effects and statistics shows that more than a third of the target group after ten years still not work or study. Socially withdrawn youth is a complex phenomenon and very few young adults seek help, often due to their lack of motivation. For this reason, unemployed and inactive young people are often described as being a difficult group to support and engage. Further, there is currently limited evidence on the effects of interventions directed to socially withdrawn youth not in employment or education and the use of evidence-based practice has to be improved.

    Aim: The aim of this study was to investigate social workers and health care professionals’ experiences of working with young adults living in social isolation, and to identify which interventions the professionals find most successful in supporting the young adults’ engagement in society.

    Methods: In this study a qualitative method was used. Ten semi-structured interviews were conducted that included thirteen employees from social services and outpatient psychiatric clinics in a Swedish county. Data were analyzed using thematic network analysis.

    Results: Analysis resulted in two general thematic networks: ”barriers of the transition into adulthood” and ”to manage complex needs”. Participants tended to associate the issues of young adults with difficulties related to transition into adulthood. Mental health problems, low self-esteem, school related problems and limited social networks also came out in the interviews as factors that characterized unemployed and disengaged socially withdrawn youths. Participants described that successful work to re-engage these young adults included an empowerment-oriented perspective with a focus on the individual strengths, integrated and coordinated interventions and a flexible working approach.

    Conclusion: Today the societal changes and the process of individualization place greater demands on individual resources and capabilities which might increase the risk of social exclusion. Participants indicated that the complex problems of socially isolated young adults and experiences of long-term disengagement may contribute to stable and persistent withdrawal from society. Early identification and support for youths at risk of social withdrawal, a holistic approach, multifaceted interventions and tailored and flexible activities is deemed crucial to help reintegrate these young people. Further investigation is required to examine the effects of interventions targeting socially withdrawn and inactive young adults.

     

  • 4. Björkelund, Cecilia
    et al.
    Svenningsson, Irene
    Hange, Dominique
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Petersson, Eva-Lisa
    Ariai, Nashmil
    Nejati, Shabnam
    Wessman, Catrin
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Göteborgs universitet; Karolinska institutet.
    Westman, Jeanette
    Clinical effectiveness of care managers in collaborative care for patients with depression in Swedish primary health care: a pragmatic cluster randomized controlled trial.2018In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 19, no 1, article id 28Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Depression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Our aim was to study clinical effectiveness of a care manager intervention in management of primary care patients with depression in Sweden.

    METHODS: In a pragmatic cluster randomized controlled trial 23 primary care centers (PCCs), urban and rural, included patients aged ≥ 18 years with a new (< 1 month) depression diagnosis. Intervention consisted of Care management including continuous contact between care manager and patient, a structured management plan, and behavioral activation, altogether around 6-7 contacts over 12 weeks. Control condition was care as usual (CAU).

    OUTCOME MEASURES: Depression symptoms (measured by Mongomery-Asberg depression score-self (MADRS-S) and BDI-II), quality of life (QoL) (EQ-5D), return to work and sick leave, service satisfaction, and antidepressant medication. Data were analyzed with the intention-to-treat principle.

    RESULTS: One hundred ninety two patients with depression at PCCs with care managers were allocated to the intervention group, and 184 patients at control PCCs were allocated to the control group. Mean depression score measured by MADRS-S was 2.17 lower in the intervention vs. the control group (95% CI [0.56; 3.79], p = 0.009) at 3 months and 2.27 lower (95% CI [0.59; 3.95], p = 0.008) at 6 months; corresponding BDI-II scores were 1.96 lower (95% CI [- 0.19; 4.11], p = 0.07) in the intervention vs. control group at 6 months. Remission was significantly higher in the intervention group at 6 months (61% vs. 47%, p = 0.006). QoL showed a steeper increase in the intervention group at 3 months (p = 0.01). During the first 3 months, return to work was significantly higher in the intervention vs. the control group. Patients in the intervention group were more consistently on antidepressant medication than patients in the control group.

    CONCLUSIONS: Care managers for depression treatment have positive effects on depression course, return to work, remission frequency, antidepressant frequency, and quality of life compared to usual care and is valued by the patients.

    TRIAL REGISTRATION: Identifier: NCT02378272 . February 2, 2015. Retrospectively registered.

  • 5.
    Eilegård Wallin, Alexandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke högskola.
    Lövgren, Malin
    Ersta Sköndal Bräcke högskola.
    Cancer-bereaved siblings advice to peers: A nationwide follow-up survey2019Conference paper (Refereed)
  • 6.
    Eilegård Wallin, Alexandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke Högskola.
    Lövgren, Malin
    Ersta Sköndal Bräcke Högskola.
    Cancer-bereaved siblings' advice to peers: a nationwide follow-up survey2019In: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683Article in journal (Refereed)
    Abstract [en]

    The aim of this nationwide survey was to explore, based on an open-ended question, cancer-bereaved siblings’ advice to peers with a brother or sister with cancer. Half of the advice related to being with the ill sibling and cherishing the time together. Other advice related to the value of communicating about the situation, letting go of guilt, and living life as usual. The results highlight the importance of health care professionals, family, and others facilitating for siblings to spend time together and communicate openly.

  • 7.
    Ericson, Jenny
    et al.
    Uppsala University; Centre for Clinical Research Dalarna, Falun; Department of Paediatrics, Falu Hospital.
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Mothers' experiences of a telephone-based breastfeeding support intervention after discharge from neonatal intensive care units - a mixed-method study2017In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 12, no 1, article id 50Article in journal (Refereed)
    Abstract [en]

    Background: After discharge from a neonatal intensive care unit (NICU), many mothers of preterm infants (gestational age<37 weeks) experience a lack of support for breastfeeding. An intervention study was designed to evaluate the effects of proactive (a daily telephone call initiated by a member of a breastfeeding support team) and/or reactive (mothers could call the breastfeeding support team) telephone based breastfeeding support for mothers after discharge from the NICU. The mothers in the intervention group had access to both proactive and reactive support; the mothers in the control group only had access to reactive support. The aim of this study was to explore the mothers' experiences of the proactive and reactive telephone support.

    Methods: This study was a qualitatively driven, mixed-method evaluation using three data sources: questionnaires with qualitative open-ended questions, visual analogue scales and telephone interviews. In total, 365 mothers contributed data for this study. The qualitative data were analysed with an inductive thematic network analysis, while the quantitative data were analysed with Student's t-test and the chi-square test.

    Results: Proactive support contributed to greater satisfaction and involvement in breastfeeding support. The mothers who received proactive support reported that they felt strengthened, supported and secure, as a result of the continuous care provided by staff who were knowledgeable and experienced (i.e., in breastfeeding and preterm infants), which resulted in the global theme 'Empowered by proactive support'. The mothers who received reactive support experienced contradictory feelings; some felt secure because they had the opportunity to call for support, whereas others found it difficult to decide when and if they should use the service, which resulted in the global theme; 'Duality of reactive support'.

    Conclusion: There were positive aspects of both proactive (i.e., greater satisfaction and feelings of empowerment) and reactive support (i.e., the opportunity to call for support); however, the provision of reactive support alone may be inadequate for those with the greatest need for support as they are the least likely to access it.

  • 8. Henoch, Ingela
    et al.
    Browall, Maria
    Melin-Johansson, Christina
    Danielson, Ella
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Johansson Sundler, Annelie
    Björk, Maria
    Ek, Kristina
    Hammarlund, Kina
    Strang, Susann
    The Swedish version of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD): Aspects of validity and factors influencing nurses' and nursing students' attitudes2014In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 37, no 1Article in journal (Refereed)
    Abstract [en]

    Background: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language.

    Objectives: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients.

    Methods: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used.

    Results: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach [alpha]'s. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients.

    Conclusions: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients.

    Implication for Practice: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.

  • 9.
    Lövgren, Malin
    et al.
    Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Family talk intervention in paediatric oncology: a pilot study protocol2019In: BMJ Paediatrics Open, ISSN 2399-9772, Vol. 3, no 1, article id e000417Article in journal (Refereed)
    Abstract [en]

    Introduction: There is evidence that families with a child diagnosed with cancer need psychosocial support throughout the illness trajectory. Unfortunately, there is little research into psychosocial interventions for such families, especially interventions where the entire family is involved. The aim of this pilot study is therefore to evaluate a psychosocial intervention, the family talk intervention(FTI), in paediatric oncology in terms of study feasibility and potential effects.

    Methods and analysis: This pretest/post-test intervention pilot study is based on families with a child diagnosed with cancer. All families that include at least one child aged 6–19 years (ill child and/or sibling) at one of the six paediatric oncology centres in Sweden between September 2018 and September 2019 will be asked about participation. The intervention consists of six meetings with the family (part of the family or the entire family), led by two interventionists. The core elements in the interventionare to support the families in talking about the illness and related subjects, support the parents in understandingthe needs of their children and how to support them and support the families in identifying their strengths and howto use them best. Mixed methods are used to evaluatethe intervention (web-based questionnaires, interviews, field notes and observations). Self-reported data from all family members are collected at baseline, directly after the intervention and 6 months later. Study outcomes are family communication, knowledge about the illness, resilience, quality of life and grief.

    Ethics and dissemination: The study has been approved by the Regional Ethical Review Board in Stockholm (Dnr 2018/250-31/2 and 2018/1852–32). Data are processed in coded form, accessible only to the research team and stored at Ersta Sköndal Bräcke University College in a secure server.

    Trial registration: ClinicalTrials. gov IdentifierNCT03650530, registered in August 2018.

  • 10.
    Lövgren, Malin
    et al.
    Ersta Sköndal Bräcke högskola.
    Melin-Johansson, Christina
    Ersta Sköndal Bräcke Högskola.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work. Ersta Sköndal Bräcke Högskola; Ctr Clin Res Dalarna.
    Sveen, Josefin
    Ersta Sköndal Bräcke högskola.
    Telling the truth to dying children — end-of-life communication with families2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed)
    Abstract [en]

    Communicating a terminal prognosis is challenging for patients, families and healthcare professionals. However, positive effects have been reported when children are told about their diagnosis and prognosis, including fewer symptoms of anxiety and depression and enhanced adherence to treatment (1). When research about prognostic communication was first published in the 1950s and 1960s, it recommended protecting children from bad news. By the late 1960s, a more open approach was recommended and by the late 1980s the advice was to always tell children. There has been a growing awareness of the complexity of prognostic disclosure and the need to balance often competing factors, such as hope and patient and family considerations, on a case-to-case basis (2).

  • 11.
    Melin-Johansson, Christina
    et al.
    Ersta Sköndal Bräcke högskola.
    Lagerin, Annika
    Ersta Sköndal Bräcke högskola.
    Lind, Susanne
    Ersta Sköndal Bräcke högskola.
    Lövgren, Malin
    Ersta Sköndal Bräcke högskola.
    Sveen, Josefin
    Ersta Sköndal Bräcke högskola.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    End-of-life communication from a life cycle perspective: a register study2019Conference paper (Refereed)
  • 12.
    Olsen, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Boström, Anne-Marie
    Institutionen för Neurobiologi, Vårdvetenskap och Samhälle, Karolinska Institutet.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Older people’s views on the important values in home help provision: a Swedish study2018Conference paper (Refereed)
    Abstract [en]

    Little is known about the values that older people consider important in receipt of home help. Therefore, this study aimed to explore which values older people hold in relation to home help services and their experiences of how these values are reflected in the delivery of help. Interviews were conducted from November 2015 to March 2016 with 16 older persons (age ≥65 years) who received home help at the time of the study. Data were analysed using qualitative content analysis. Results identified values that older people find important in home help and suggest behaviours that should underpin home help, such as supporting the older person’s independence, building a reciprocal relationship and promoting a sense of safety and security (e.g., by providing information about what home help entails for the recipient). We conclude that it is important that care staff recognise and integrate these values into their actions on an interpersonal level in daily care, adopting a relation-oriented rather than a task-focused approach in the provision of home help for older people.

  • 13.
    Olsen, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Older people´s views on the core values of home care2015Conference paper (Other academic)
    Abstract [en]

    The care of older people and the underpinning values of care of older people in a recent government report on dignity in care. Care of older people should be based on six aspects of dignity which is the foundation for a dignified life. These are: integrity, such as privacy and bodily integrity; Self-determination; involvement in decisions about their care; individualized care; good health and social care; and a good interaction to the older person and their families.

    Despite a strong policy agenda on individually adapted care and values, social care research has usually not been undertaken from the perspective of the older care-receiver themselves. Even less is known about preferences of older care receivers with dementia, despite that they compose approximately 34 percent of older care receivers who have support from home help.

    Such pronouncements raise a question regarding the extent to which proposed ‘core values’ of social care are based on the actual values of the users, that is, the older care receivers.

    The study will be undertaken by means of a qualitative cross-sectional study, with semi-structured interviews.

     The population will include two groups: older care receivers (65 years or older) with or without dementia. The sample size is estimated to approximately 20-30 participants in each group.

    The interviews will be analyzed with content analysis. 

    This study will provide an increased understanding of older care receivers’ preferences and create conditions for a more individualized and person-centered care. This study will also contribute to strengthening the evidence-based practice in social care.

     

  • 14.
    Olsen, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Understanding older people’s experiences of home care through the capability approach2015Conference paper (Other academic)
    Abstract [en]

    The core concepts of CA

    In the theoretical framework of CA, well-being is constituted by a person’s unique way of functioning and capabilities. This means that a person's well-being is personal and involves freedom of choice which in turn means they have a number of options. Although many people may have the same resources, it is of importance to study how these resources are converted into how they function. Thus, wellbeing is about the person's freedom to achieve in general and the capabilities to function in particular (Sen, 1995).

    Strength of the capability approach

    The capability approach is a useful tool for matching objective evaluations with subjective metrics. Furthermore, although one’s individual abilities are in focus, contextual factors, and subjective perceptions and experiences, are taken into consideration.

    Critiques against the CA

    The capability approach has been criticized for being too individual-centered and not taking sufficient account to social structures in society. It is difficult to know what a person would choose to do if other options were available. Therefore, to operationalize abilities involves uncertainties.

  • 15. Svenningsson, I
    et al.
    Petersson, E-L
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Westman, J
    Björkelund, C
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Center for Clinical Research; Karolinska institutet, Göteborgs universitet.
    Process evaluation of a cluster randomised intervention in Swedish primary care: using care managers in collaborative care to improve care quality for patients with depression.2019In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 20, no 1, article id 108Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The collaborative care model with a care manager has previously generated beneficial results for patients with depression in terms of decreased burden of depression symptoms. A care manager function has been tested in Sweden in the PRIM-CARE RCT with successful results. The aim of the present study was to evaluate the process of implementing care managers in collaborative care for patients with depression in Swedish primary health care in the PRIM-CARE RCT.

    METHODS: The study followed UK Medical Research Council guidance for process evaluation. Field notes from the implementation of the PRIM - CARE RCT were used, as well as data collected from five focus group discussions with General Practitioners (n = 29) and three focus group discussions with care managers (n = 11). Data were analysed with content analysis.

    RESULTS: Training sessions, careful preparation and extensive initial support to the care manager and staff at the Primary Care Centres were important ingredients in the implementation. The close access to facilitators, the recurrent peer support meetings, and the weekly newsletter strengthened the care manager function.

    CONCLUSIONS: A complex intervention adapted to the Swedish primary care context focusing on a care manager function for patients with depression could be performed through a stepwise implementation process. Financial support from the health care regions included in the study helped to reduce the impact of identified barriers. This process evaluation has revealed new and important knowledge for primary care development concerning infrastructure and organization building, knowledge sharing, and facilitating factors and barriers.

    TRIAL REGISTRATION: NCT02378272 Care Manager - Coordinating Care for Person Centered Management of Depression in Primary Care (PRIM - CARE). Registered March 4 2015. Retrospectively registered.

  • 16.
    Svenningsson, Irene
    et al.
    Sahlgrenska Akademin, Göteborgs universitet.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Westman, Jeanette
    Nejati, Shabnam
    Hange, Dominique
    Björkelund, Cecilia
    Petersson, Eva-Lisa
    Creating a safety net for patients with depression inprimary care: a qualitative study of care managers’ experiences2018In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 36, no 4, p. 355-362Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to explore nurses’experiences and perceptions of working as care managers at primary care centers.

    Design: Qualitative, focus group study. Malterud’s method of systematic text condensation was used to analyse the data.

    Setting: Primary health care in the region of Västra Götaland and region of Dalarna in Sweden.

    Subjects: Eight nurses were trained during three days including treatment of depression and how to work as care managers. The training was followed by continuous support in the method.

    Main outcome measures: The nurses’s experiences and perceptions of working as care managers at primary care centers.

    Results: The care managers described their role as providing additional support to the already existing care at the primary care center, working in teams with a person-centered focus, where they were given the opportunity to follow, support, and constitute a safety net for patients with depression. Further, they perceived that the care manager increased continuity and accessibility to primary care for patients with depression. 

    Conclusion: The nurses perceived that working as care managers enabled them to follow and support patients with depression and to maintain close contact during the illness.  The care manager function helped to provide continuity in care which is a main task of primary health care. 

  • 17.
    Udo, Camilla
    Dalarna University, School of Health and Social Studies, Social Work.
    Existential issues in surgical care: Nurses’ experiences and attitudes in caring for patients with cancer2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to explore surgical nurses’ experiences of being confronted with patients’ existential issues when caring for patients with cancer, and to examine whether an educational intervention may support nurses in addressing existential needs when caring for patients with cancer. Previously recorded discussions from supervision sessions with eight healthcare professionals were analysed (I), written descriptions of critical incidents were collected from 10 nurses, and interviews with open questions were conducted (II). An educational intervention on existential issues was pilot tested and is presented in Studies III and IV. The intervention was the basis of a pilot study with the purpose of testing whether the whole design of the educational intervention, including measurements instruments, is appropriate. In Study III and IV interviews with 11 nurses were conducted and 42 nurses were included in the quantitative measurements of four questionnaires, which were distributed and collected. Data was analysed using qualitative secondary analysis (I), hermeneutical analysis (II), and mixed methods using qualitative content analysis and statistical analyses (III-IV). Results in all studies show that existential issues are part of caring at surgical wards. However, although the nurses were aware of them, they found it difficult to acknowledge these issues owing to for example insecurity (I-III), a strict medical focus (II) and/or lacking strategies (I-III) for communicating on these issues. Modest results from the pilot study are reported and suggest beneficial influences of a support in communication on existential issues (III). The results indicate that the educational intervention may enhance nurses’ understanding for the patient’s situation (IV), help them deal with own insecurity and powerlessness in communication (III), and increase the value of caring for severely ill and dying patients (III) in addition to reducing work-related stress (IV). An outcome of all the studies in this thesis was that surgical nurses consider it crucial to have time and opportunity to reflect on caring situations together with colleagues. In addition, descriptions in Studies III and IV show the value of relating reflection to a theory or philosophy in order for attitudes to be brought to awareness and for new strategies to be developed.

  • 18.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work. CKF, Centrum för Klinisk Forskning.
    The concept and relevance of existential issues in healthcare encounters2014Conference paper (Refereed)
    Abstract [en]

    Rationale: Existential issues are relevant, not only in healthcare research, but also in healthcare practice as patients express needs relating to emotional and/or existential aspects of the new and often unexpected life situation they find themselves in. In critical situations, such as being diagnosed with a life-threatening illness, where a previously envisioned future and one’s basic security come under threat, existential issues often arise. Therefore, as a threat to existence, medical problems also become existential problems involving suffering and issues of life and death. Healthcare professionals need to be prepared for this. Thus, there is a need for clarification of what existential issues might.

    Aim: To illuminate and clarify the concept of existential issues in relation to nursing research and nursing practice.

    Method: Literature was searched in philosophical literature, PubMed, Cinahl and Psycinfo.

    Results: The concept of existential has its origin in philosophy and is common for all humans regardless of culture or religion. Existential issues often concern meaning, death, existential isolation and freedom. Although healthcare professionals are often aware of what existential issues may be, they feel unsure to communicate with patients and their loved ones about existential issues.

    Conclusion: Although acting in the professional capacity, the healthcare encounter is still primarily a human encounter where existential issues must be acknowledged and handled in order to support the patient to find meaning and thus relieve suffering. Further education with reflective discussions for healthcare professionals on challenging and difficult caring situations is important to support a deeper understanding of existential issues and to facilitate integration between phronesis-based and episteme-based knowledge. This in turn seems to enable communication about existential issues in caring situations.

  • 19.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    The concept and relevance of existential issues in nursing2014In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 4, p. 347-354Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to illuminate and clarify the concept existential issues in relation to nursing research and nursing practice.

    Methods: This article is a theoretical analysis of existential issues in relation to nursing.

    Results: Existential issues are becoming more commonly discussed and investigated in nursing research. Thus, it is important to clarify the concept.

    Conclusions: A clarification of existential issues may contribute to health care quality by increasing awareness of what existential issues are and drawing attention to the importance of discussing and reflecting on these issues, since practitioners in a caring profession will most likely encounter them.

  • 20.
    Udo, Camilla
    et al.
    Dalarna University, School of Health and Social Studies, Social Work.
    Danielson, Ella
    Sahlgrenska Akademien, Göteborgs Universitet; Mittuniversitetet.
    Henoch, Ingela
    Sahlgrenska Akademien, Göteborgs Universitet.
    Melin-Johansson, Christina
    Mittuniversitetet.
    Surgical nurses’ work-related stress when caring for severely ill and dying patients after participating in an educational intervention on existential issues2013In: The 7th International Conference on Social Work in Health and Mental Health: Pathways to Client-Centered Care: Oral Presentation Abstracts, 2013Conference paper (Refereed)
    Abstract [en]

    The aim was to describe surgical nurses’ perceived work-related stress in care of severely ill and dying patients after participating in an educational intervention on existential issues supervised by a clinical social worker.

    The concurrent data collections in this mixed methods study consisted of repeated interviews and questionnaires distributed on four occasions.

    Directly after the educational intervention, the nurses described working under high time pressure. They described being hindered in caring because of discrepancies between their caring intentions and what was possible in the surgical care context. Six months later, the nurses described a change in decision making, and a shift in the caring to make it more in line with their own intentions and patients’ needs rather than the organizational structure. At the same time they reported decreased feelings of work-related stress, decreased stress associated with work-load and feeling less disappointed at work.

    Results indicate that it may be possible to influence nurses’ work-related stress through an educational intervention. Reflection on ways of caring for severely ill and dying patients, from an existential perspective, had contributed to nurses’ enhanced independent decision-making in caring. This in turn appears to have decreased their feelings of work-related stress and disappointment at work.

  • 21.
    Udo, Camilla
    et al.
    Mid Sweden University, Department of Health Sciences, Östersund, Sweden, Health Care Sciences Post Graduate School, Karolinska Institute, Stockholm, Sweden.
    Danielson, Ella
    Henoch, Ingela
    Melin-Johansson, Christina
    Surgical nurses' work-related stress when caring for severely ill and dying patients with cancer after participating in an educational intervention on existential issues2013In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, no 5Article in journal (Refereed)
    Abstract [en]

    Aim

    The aim of this study was to describe surgical nurses' perceived work-related stress in the care of severely ill and dying patients with cancer after participating in an educational intervention on existential issues.

    Methods and sample

    This article reports a mixed methods pilot study of an education programme consisting of lectures and supervised discussions conducted in 2009–2010 in three surgical wards in a county hospital in Sweden. The concurrent data collections consisted of repeated interviews with eleven nurses in an educational group, and questionnaires were distributed to 42 nurses on four occasions.

    Results

    Directly after the educational intervention, the nurses described working under high time pressure. They also described being hindered in caring because of discrepancies between their caring intentions and what was possible in the surgical care context. Six months later, the nurses described a change in decision making, and a shift in the caring to make it more in line with their own intentions and patients' needs rather than the organizational structure. They also reported decreased feelings of work-related stress, decreased stress associated with work-load and feeling less disappointed at work.

    Conclusions

    Results indicate that it may be possible to influence nurses' work-related stress through an educational intervention. According to nurses' descriptions, reflecting on their ways of caring for severely ill and dying patients, many of whom had cancer, from an existential perspective, had contributed to enhanced independent decision making in caring. This in turn appears to have decreased their feelings of work-related stress and disappointment at work.

  • 22.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Mittuniversitetet, Institutionen för hälsovetenskap; Karolinska institutet.
    Danielson, Ella
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Melin Johansson, Christina
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Existential Reflections among Nurses in Surgical Care2010In: Journal of Palliative Care, ISSN 0825-8597, Vol. 26, no 3, p. 228-229Article in journal (Refereed)
    Abstract [en]

    Objectives: To gain a deeper understanding of surgical nurses’ experiences of existential issues in cancer care.

    Methods: Written critical incidents were used to collect nurses’ descriptions and reflections of critical care situations involving existential issues. Individual face-to-face interviews were conducted as follow-up using semi-structured questions which were analysed with hermeneutical analysis.

    Preliminary results: The analysis showed that nurses in surgical care experience caring from different positions. Nurses either focus on the patient as a whole in the caring process or nurses focus more on medical information in the caring process. When focusing on the patient as a whole existential issues are considered to be a natural part of the caring process and nurses’ personal experiences help to enable encounters with the patients. When focusing more on the medical information in the caring process there was a transfer of responsibility to others, mainly the physicians.

    Preliminary conclusions: This study highlights that existential issues are indeed part of surgical cancer care derived from existential care situations. Nurses’ focus in the caring process differs. Nurses express different positions in caring and not all acknowledge patients’ existential issues as part of nurses’ responsibility. When lacking common strategies in the organization nurses derive existential caring strategies from personal experiences.

  • 23.
    Udo, Camilla
    et al.
    Department of Health Sciences, Mid Sweden University, Östersund, Sweden, and Health Care Sciences Post Graduate School at Karolinska Institute, Stockholm, Sweden.
    Danielson, Ella
    Mittuniversitetet, Inst. för Hälsovetenskap; Sahlgrenska Akademien, Götebrogs universitet.
    Melin-Johansson, Christina
    Mittuniversitetet, Inst. för Hälsovetenskap.
    Existential issues among nurses in surgical care - a hermeneutical study of critical incidents2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 3, p. 569-577Article in journal (Refereed)
    Abstract [en]

    Aims.

    To report a qualitative study conducted to gain a deeper understanding of surgical nurses’ experiences of existential care situations.

    Background.

    Existential issues are common for all humans irrespective of culture or religion and constitute man’s ultimate concerns of life. Nurses often lack the strategies to deal with patients’ existential issues even if they are aware of them.

    Design.

    This is a qualitative study where critical incidents were collected and analysed hermeneutically.

    Methods.

    During June 2010, ten surgical nurses presented 41 critical incidents, which were collected for the study. The nurses were first asked to describe existential care incidents in writing, including their own emotions, thoughts, and reactions. After 1–2 weeks, individual interviews were conducted with the same nurses, in which they reflected on their written incidents. A hermeneutic analysis was used.

    Findings.

    The majority of incidents concerned nurses’ experiences of caring for patients’ dying of cancer. In the analysis, three themes were identified, emphasizing the impact of integration between nurses’ personal self and professional role in existential care situations: inner dialogues for meaningful caring, searching for the right path in caring, and barriers in accompanying patients beyond medical care.

    Conclusion.

    Findings are interpreted and discussed in the framework of Buber’s philosophy of the relationships I-Thou and I-It, emphasizing nurses’ different relationships with patients during the process of caring. Some nurses integrate their personal self into caring whereas others do not. The most important finding and new knowledge are that some nurses felt insecure and were caught somewhere in between I-Thou and I-It.

  • 24.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Danielson, Ella
    Melin-Johansson, Titti
    Existential Reflections among Nurses in Surgical Care2010In: 18th International Congress on Palliative Care, October 5-8, 2010, Montréal, Canada, Montréal, Canada, 2010Conference paper (Refereed)
    Abstract [en]

    Objectives: To gain a deeper understanding of surgical nurses’ experiences of existential issues in cancer care. Methods: Written critical incidents were used to collect nurses’ descriptions and reflections of critical care situations involving existential issues. Individual face-to-face interviews were conducted as follow-up using semi-structured questions which were analysed with hermeneutical analysis. Preliminary results: The analysis showed that nurses in surgical care experience caring from different positions. Nurses either focus on the patient as a whole in the caring process or nurses focus more on medical information in the caring process. When focusing on the patient as a whole existential issues are considered to be a natural part of the caring process and nurses’ personal experiences help to enable encounters with the patients. When focusing more on the medical information in the caring process there was a transfer of responsibility to others, mainly the physicians. Preliminary conclusions: This study highlights that existential issues are indeed part of surgical cancer care derived from existential care situations. Nurses’ focus in the caring process differs. Nurses express different positions in caring and not all acknowledge patients’ existential issues as part of nurses’ responsibility. When lacking common strategies in the organization nurses derive existential caring strategies from personal experiences.

  • 25.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jensfelt, Marcus
    Flink, Maria
    Perceptions of knowledge, research use and evidence-based practice among Swedish medical social workers – a qualitative study2019Conference paper (Refereed)
    Abstract [en]

    Background and aim: With the intention to do more good than harm, it is important to rely on practice that is rooted in evidence-based guidelines so that clients are given the exact care they need. Thus, from a client safety perspective, the social worker needs to apply evidence-based practice (EBP). Learning more about the medical social workers’ perceptions of EBP has the potential to contribute to an increased understanding of how best available knowledge can be implemented in medical social work settings to provide high quality and safe practice to clients. Therefore the aim of this study was to explore medical social workers’ perceptions of evidence-based practice (EBP), including factors relevant for the successful implementation of evidence into medical social work practice.

    Methods: This is a qualitative study. Eight focus group interviews were conducted that included 27 medical social workers. Data were analyzed using qualitative content analysis.

    Results: Analysis resulted in two categories: “knowledge in practice” and “challenges in relation to the implementation of EBP” and four subcategories: “practice based on research evidence or experience”, “obtaining new evidence of practice”, “research and the social work context”, and “barriers and facilitating factors”. Participants tended to perceive EBP as theoretical and positivistic while perceiving their own knowledge as eclectic and experience-based. Although they perceived the relevance of research findings to their practice, they expressed a need for support to translate research into policy and practice. They also reported that studies about their specific work were scarce.

    Conclusion and implications: The facilitating factors suggested by the medical social workers which concerned, e.g., a specially designated person responsible for supporting the increased use of research findings, support for prioritization of time, increased opportunities for the sharing of knowledge, and time for consultations, need to be considered when promoting the implementation of EBP within medical social work settings. The medical social workers’ suggestion for the facilitation of knowledge exchange needs further investigation.

  • 26.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jensfelt, Marcus
    Karolinska University Hospital.
    Flink, Maria
    Karolinska University Hospital; Karolinska Institutet.
    Research use and evidence-based practice among Swedish medical social workers: a qualitative study2019In: Clinical social work journal, ISSN 0091-1674, E-ISSN 1573-3343, Vol. 47, no 3, p. 258-265Article in journal (Refereed)
  • 27.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke högskola.
    Axelsson, Bertil
    Björk, Olle
    Lövgren, Malin
    Ersta Sköndal Bräcke högskola.
    Physicians working in oncology identified challenges and factors that facilitated communication with families when children could not be cured2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed)
    Abstract [en]

    Aim: We explored physicians’ experiences of communicating with families when their child had cancer and a cure was no longer an option, by focusing on barriers and facilitating factors.

    Methods: Physicians from the six cancer centres in Sweden took part in focus group discussions from December 2017 and May 2018 and the data were analysed using qualitative content analysis. Focus groups enabled us to gather individual and shared perspectives.

    Results: The 35 physicians (20 male) had a mean age of 47 (range 31-74) and a mean of 11 years’ experience in oncology, ranging from under one year to 43 years. They reported communication challenges when a cure was not possible, namely: emotional and mental drain, lack of mutual understanding and uncertainty about communication skills. They also reported facilitating factors: flexibility in complex conversations, the child’s position in the conversations, continuity and trusting relationships, support from colleagues and having discussed the potentially life-threatening nature of cancer from the very start of treatment.

    Conclusion: Physicians working in paediatric oncology perceived challenges and facilitating factors in their communication with families when a cure was not an option. Training to overcome communication issues could support the early integration of palliative care and curative treatment.

  • 28.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. CKF, Centre for Clinical Research Dalarna, County Council of Dalarna, Falun.
    Lövgren, M
    Lundquist, G
    Axelsson, B
    Palliative care physicians' experiences of end-of-life communication: A focus group study2018In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 27, no 1, article id e12728Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore palliative home care physicians' experiences regarding end-of-life breakpoint communication (BPC). This is a qualitative study where focus group interviews were conducted and analysed using qualitative content analysis. The results show that the participants saw themselves as being responsible for accomplishing BPC, and they were convinced that it should be regarded as a process of communication initiated at an early stage, i.e. proactively. However, BPC was often conducted as a reaction to the patient's sudden deterioration or sometimes not at all. The barriers to achieving proactive BPC included physicians' uncertainty regarding the timing of BPC, primarily due to difficulties in prognostication in terms of time of death, and uncertainty as to what BPC should include and how it should best be approached. Furthermore, there was insufficient documentation regarding previous BPC, which impeded proactive BPC. Although our study shows that physicians are ambitious when it comes to the communication of information to patients and families, there is a need for further training in how to conduct BPC and when to initiate the BPC process. Furthermore, there should be documentation that different professionals can access as this would appear to facilitate a proactive BPC process.

  • 29.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Lövgren, Malin
    P033 Physicians’ Perceptions of End-of-Life Breakpoint Communication: A Focus Group Study2016In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 52, no 6, p. e73-e74Article in journal (Refereed)
  • 30.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. CKF (Centre of Clinical Research) County Council of Dalarna, Falun, Sweden.
    Lövgren, Malin
    The Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden. .
    Lundquist, Gunilla
    CKF (Centre of Clinical Research) County Council of Dalarna, Falun, Sweden.
    Axelsson, Bertil
    Research unit Östersund hospital, Department of Radiation Sciences, Umeå University, Umeå, Sweden.
    Physicians’ perceptions of end-of-life breakpoint communication: A focus group study2016Conference paper (Refereed)
  • 31.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. CKF; Ersta Sköndal University College.
    Lövgren, Malin
    Ersta Sköndal University College; Karolinska.
    Sveen, Josefin
    Ersta Sköndal University College; Uppsala universitet.
    Bylund Grenklo, Tove
    Karolinska institutet.
    Alvariza, Anette
    Ersta Sköndal University College.
    Kreicbergs, Ulrika
    Ersta Sköndal University College.
    A nationwide study of young adults’ perspectives on participation in bereavement research2019In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Young adults represent a minority in research; they are often considered too young or too old for participation. There is sparse information, especially in bereavement research, regarding how this age group perceives research participation and what they consider beneficial or harmful.

    AIM:

    To explore how parentally bereaved and nonbereaved young adults perceive research participation.

    DESIGN:

    Qualitative analysis of free-text comments collected in a Swedish nation-wide survey.

    SETTING/PARTICIPANTS:

    Parentally cancer-bereaved and nonbereaved young adults between 18 and 25 years old living in Sweden.

    RESULTS:

    Five categories were identified from the free-text comments, three among the cancer-bereaved: (1) therapeutic to remember the deceased, (2) valuable to help others and improve care, and (3) short-term distressful-long-term beneficial, and two among the nonbereaved: (1) increased reflection and awareness about life, and (2) an opportunity to help others.

    CONCLUSIONS:

    It is important to invite young adults to participate in bereavement research. The results suggest that potential harm is minimal and that participating in bereavement research can have a beneficial effect on young adults.

  • 32.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Melin Johansson, Christina
    Danielson, Ella
    Health care staff’s discussions of existential issues in cancer care2010In: Changing Health. 6th International Conference on Social Work in Health and Mental Health. 28th June - 2nd July 2010, Dublin, Ireland, Dublin, Ireland, 2010Conference paper (Refereed)
    Abstract [en]

    Objectives: A qualitative study was made to explore healthcare staff’s discussions about existential issues when caring for patients with cancer on a surgical ward, as described in supervision sessions. Methods: Secondary content analysis of twelve tape-recorded supervision sessions was used. The sessions lasted for two hours every third week during one year. The supervision sessions were conducted at a surgical clinic in a county hospital in the middle of Sweden. Twenty-one participants, 25 to 55 years of age (MD=38) who had worked on a surgical clinic for 1 to 30 years (MD=10) participated. Findings: The analysis showed that reflections about existential issues do exist among healthcare staff in surgical wards. There are barriers, in staff themselves as well as in the organisation hindering them to encounter patients’ existential needs which is illustrated by the domain: “Health care staff’s discussions of their existential dilemmas” and the themes “feelings of powerlessness”, “identifying with patients”, and “getting close or keeping a distance”. Staff observed that patients have existential needs which are illustrated by the domain: “Health care staff’s discussions of patients’ existential distress” and the themes “being in despair” and “feelings of isolation”. Conclusions: This study shows that healthcare staff in surgical wards is conscious of patients’ existential distress. Yet staff lack strategies to encounter patients’ existential issues. There is a need for knowledge about the meaning of existential issues and education for staff working in a surgical ward and how to encounter patients’ existential needs.

  • 33.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Melin-Johansson, Christina
    Danielson, Ella
    Existential issues among health care staff in surgical cancer care: Discussions in supervision sessions2011In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 15, no 5, p. 447-453Article in journal (Refereed)
    Abstract [en]

    Purpose The aim was, through analysis of dialogues in supervision sessions, to explore if health care staff in surgical care discussed existential issues when caring for cancer patients. Method A secondary analysis of the content of twelve tape-recorded supervision sessions (18 h) was conducted. The study analysed the dialogue content in supervision sessions involving a group of eight participants who worked at a surgical clinic at a county hospital in central Sweden. The sessions were held every third week during the course of one year. Results The analysis showed that surgical health care staff contemplates existential issues. The staff discussed their existential dilemmas, which hindered them from meeting and dealing with patients’ existential questions. This is illustrated in the themes: “feelings of powerlessness”, “identifying with patients”, and “getting close or keeping one’s distance”. The staff also discussed the fact that patients expressed existential distress, which is illustrated in the themes: “feelings of despair” and “feelings of isolation”. Conclusions This study shows that there are existential issues at a surgical clinic which health care staff need to acknowledge. The staff find themselves exposed to existential dilemmas when caring for cancer patients. They are conscious of patients’ existential issues, but lack strategies for dealing with this. This study highlights a need to provide support to staff for developing an existential approach, which will boost their confidence in their encounters with patients.

  • 34.
    Udo, Camilla
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Melin-Johansson, Christina
    Henoch, Ingela
    Axelsson, Bertil
    Danielson, Ella
    Surgical nurses€™ attitudes towards caring for patients dying of cancer: a pilot study of an educational intervention on existential issues2014In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 23, no 4, p. 426-440Article in journal (Refereed)
  • 35.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Center for Clinical Research Dalarna, Falun.
    Neljesjö, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet; Chalmers University of Technology.
    A qualitative study of assistant nurses’ experiences of palliative care in residential care2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 4, p. 527-535Article in journal (Refereed)
    Abstract [sv]

    Aim

    To explore assistant nurses' experiences and perceptions of both positive and negative aspects of providing palliative care for older people in residential care facilities.

    Design

    A qualitative explorative study.

    Methods

    Critical incidents were collected through semi‐structured face‐to‐face interviews and analysed by performing a qualitative content analysis.

    Results

    A total of 40 critical incidents from daily work was described by assistant nurses. The results showed that close cooperation between unlicensed and licensed professionals was crucial to provide good care but was sometimes negatively affected by the organizational structure. The availability of professionals was identified as a critical factor in providing good care at the end of life in a consultative organization. The most prominent findings were those that indicated that, especially in a consultative organization, there seems to be a need for clear roles, comprehensive and clear care plans and a solid support structure to ensure continuity of care.

  • 36.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Neljesjö, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Assistant nurses’ experiences and perceptions of palliative care situations in residential care2016Conference paper (Refereed)
  • 37.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Neljesjö, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    P177 Assistant Nurses’ Experiences and Perceptions of Palliative Care Situations in Residential Care2016In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 52, no 6Article in journal (Refereed)
  • 38.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Center for Clinical Research Dalarna.
    Svenningsson, Irene
    Björkelund, Cecilia
    Hange, Dominique
    Jerlock, Margareta
    Petersson, Eva-Lisa
    An interview study of the care manager function: Opening the door to continuity of care for patients with depression in primary care2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 974-982Article in journal (Refereed)
    Abstract [en]

    Aim: To explore experiences among patients with depression of contact with a care manager at a primary care centre.

    Design: A qualitative explorative study.

    Methods: During spring and summer 2016, 20 individual face-to-face interviews were conducted with patients with experience of care manager contact. The material was analysed using systematic text condensation.

    Results: The participants described that having contact with a care manager was a support in their recovery process. Care became more available, and the structured continuous contact and the care manager's availability contributed to a trusting relationship. Having someone to share their burden with was a relief. However, it was described as negative when the care manager was perceived as inflexible and not open to issues that the participants felt a need to discuss. For the care manager contact to be successful, there is a need for flexibility and individually tailored contact.

1 - 38 of 38
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