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Gustafsson, A. W., Hommerberg, C. & Sandgren, A. (2019). Coping by metaphors: The versatile function of metaphors in blogs about living with advanced cancer. Medical Humanities
Åpne denne publikasjonen i ny fane eller vindu >>Coping by metaphors: The versatile function of metaphors in blogs about living with advanced cancer
2019 (engelsk)Inngår i: Medical Humanities, ISSN 1468-215X, E-ISSN 1473-4265Artikkel i tidsskrift (Fagfellevurdert) Epub ahead of print
Abstract [en]

Living with a life-limiting cancer illness can entail a turmoil of feelings such as constant fear of loss, suffering and dying. Because patients live longer with life-limiting illness, there is a need for enhanced understanding of how people make sense of and cope with the complicated aspects that this life situation brings on. In this article, we explore how bloggers with advanced cancer use metaphors as ways of making sense of their experiences. Our study is theoretically grounded in Conceptual Metaphor Theory, where metaphors are seen as a powerful phenomenon that both reflects and affects our thinking. The data consist of a corpus of blogs written in Swedish by individuals with advanced cancer, and the findings from our linguistic metaphor analysis are consistently interpreted against the backdrop of literature on coping. Our study thus highlights the intersection of linguistic metaphor analysis and psychological theories of coping by illustrating the many and complex functions metaphors can have as part of sense-making processes. Our hermeneutic approach enables us to show some differences among the three most pervasive metaphor domains in our material, battle, journey and imprisonment: the journey and imprisonment domains are more flexible than the battle domain in terms of the different kinds of coping strategies that are actualised by the bloggers’ use of metaphors. One particular finding from our analysis is the way in which the bloggers make use of metaphors to compartmentalise experiences and emotions. Our contention is that careful attention to the metaphors used by patients can improve communication in healthcare and enhance understanding of the complex role language use plays in coping processes more generally. By highlighting the relation between metaphor use and coping, our analysis also provides a way to discuss coping strategies based on the patient’s own use of language.

sted, utgiver, år, opplag, sider
London: BMJ Publishing Group Ltd, 2019
Emneord
cancer care, linguistics, metaphor, palliative care, patient narratives, psychology, psychotherapy palliative care, cancer care
HSV kategori
Forskningsprogram
Humaniora; Hälsovetenskap
Identifikatorer
urn:nbn:se:lnu:diva-87938 (URN)10.1136/medhum-2019-011656 (DOI)
Forskningsfinansiär
The Kamprad Family Foundation, 20150008
Tilgjengelig fra: 2019-08-14 Laget: 2019-08-14 Sist oppdatert: 2019-08-20
Bylund-Grenklo, T., Werkander Harstäde, C., Sandgren, A., Benzein, E. & Östlund, U. (2019). Dignity in life and care: the perspectives of Swedish patients in a palliative care context.. International Journal of Palliative Nursing, 25(4), 193-201
Åpne denne publikasjonen i ny fane eller vindu >>Dignity in life and care: the perspectives of Swedish patients in a palliative care context.
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2019 (engelsk)Inngår i: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 25, nr 4, s. 193-201Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: How patients preserve their sense of dignity in life is an important area of palliative care that remains to be explored.

AIMS: To describe patients' perspectives of what constitutes a dignified life within a palliative care context.

METHODS: Twelve palliative care patients were interviewed about their views on living with dignity. Data were analysed using qualitative content analysis.

RESULTS: What constitutes a dignified life during end-of-life care was captured by the theme 'I may be ill but I am still a human being' and presented under the categories 'preserving my everyday life and personhood', 'having my human value maintained by others through 'coherence' and 'being supported by society at large'.

CONCLUSION: Patients' sense of dignity can be preserved by their own attitudes and behaviours, by others and through public support. Health professionals need to adopt a dignity-conserving approach, for which awareness of their own attitudes and behaviours is crucial.

sted, utgiver, år, opplag, sider
Mark Allen Group, 2019
Emneord
Care of the dying, Dignity, Health professionals, Palliative care
HSV kategori
Forskningsprogram
Hälsovetenskap, Omvårdnad
Identifikatorer
urn:nbn:se:lnu:diva-82230 (URN)10.12968/ijpn.2019.25.4.193 (DOI)000464949000006 ()31013197 (PubMedID)2-s2.0-85064863576 (Scopus ID)
Forskningsfinansiär
The Kamprad Family Foundation, 20152002
Tilgjengelig fra: 2019-04-26 Laget: 2019-04-26 Sist oppdatert: 2019-08-29bibliografisk kontrollert
Moellerberg, M.-L., Årestedt, K., Swahnberg, K., Benzein, E. & Sandgren, A. (2019). Family sense of coherence and its associations with hope, anxiety and symptoms of depression in persons with cancer in palliative phase and their family members: A cross-sectional study. Palliative Medicine: A Multiprofessional Journal
Åpne denne publikasjonen i ny fane eller vindu >>Family sense of coherence and its associations with hope, anxiety and symptoms of depression in persons with cancer in palliative phase and their family members: A cross-sectional study
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2019 (engelsk)Inngår i: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030XArtikkel i tidsskrift (Fagfellevurdert) Epub ahead of print
Abstract [en]

Background: There is evidence indicating that family sense of coherence predicts quality of family life and promotes family well-being. In families living with the palliative phase of cancer, low hope, anxiety and symptoms of depression are common in both persons with cancer and their family members. Aim: To determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression, respectively, in persons with cancer in the palliative phase and their family members. Design: An observational, cross-sectional, multicentre study was conducted. Nested linear regression analyses were performed in two blocks to determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression. Setting/participants: Persons with cancer (n = 179) and their family members (n = 165) were recruited from two oncology clinics and two palliative centres in three regions in Sweden. Results: The main findings showed that family sense of coherence was significantly and independently associated with hope, anxiety and symptoms of depression. Stronger family sense of coherence was associated with higher hope and lower anxiety and symptoms of depression levels in both persons with cancer and their family members. Conclusion: Health care providers should strive to identify families with weak family sense of coherence, because of its associations with hope, anxiety and symptoms of depression, in order to offer them professional support and thereby achieve increased well-being during the palliative phase of cancer. Future studies should expand our knowledge of family sense of coherence and how to identify families at risk of lower levels of well-being.

sted, utgiver, år, opplag, sider
Sage Publications, 2019
Emneord
Anxiety, cancer patient, cross-sectional study, depression, family members, hope, multicentre study, palliative care, sense of coherence
HSV kategori
Forskningsprogram
Hälsovetenskap
Identifikatorer
urn:nbn:se:lnu:diva-88834 (URN)10.1177/0269216319866653 (DOI)000480022600001 ()31368844 (PubMedID)
Tilgjengelig fra: 2019-08-29 Laget: 2019-08-29 Sist oppdatert: 2019-08-29
Blomqvist, M., Ivarsson, A., Carlsson, I.-M., Sandgren, A. & Jormfeldt, H. (2019). Health Effects of an Individualized Lifestyle Intervention for People with Psychotic Disorders in Psychiatric Outpatient Services: A Two Year Follow-up. Issues in Mental Health Nursing
Åpne denne publikasjonen i ny fane eller vindu >>Health Effects of an Individualized Lifestyle Intervention for People with Psychotic Disorders in Psychiatric Outpatient Services: A Two Year Follow-up
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2019 (engelsk)Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673Artikkel i tidsskrift (Fagfellevurdert) Epub ahead of print
Abstract [en]

People with psychotic disorders experience to a great extent avoidable physical illnesses and early mortality. The aim of the study was to investigate the potential effects for this group of participating in a lifestyle intervention. A multi-component nurse-led lifestyle intervention using quasi-experimental design was performed. Changes in biomedical and clinical measurements, self-reported health, symptoms of illness and health behavior were investigated. Multilevel modeling was used to statistically test differences in changes over time. Statistically significant changes were found in physical activity, HbA1c and waist circumference. A lifestyle intervention for people with severe mental illness can be beneficial for increasing physical activity.

sted, utgiver, år, opplag, sider
Taylor & Francis Group, 2019
HSV kategori
Forskningsprogram
Hälsovetenskap, Omvårdnad
Identifikatorer
urn:nbn:se:lnu:diva-88828 (URN)10.1080/01612840.2019.1642425 (DOI)000481062200001 ()31393742 (PubMedID)
Tilgjengelig fra: 2019-08-29 Laget: 2019-08-29 Sist oppdatert: 2019-08-29
Lindmark, U., Bülow, P. H., Mårtensson, J. & Rönning, H. (2019). The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review. Nursing Open, 1-12
Åpne denne publikasjonen i ny fane eller vindu >>The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review
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2019 (engelsk)Inngår i: Nursing Open, E-ISSN 2054-1058, s. 1-12Artikkel i tidsskrift (Fagfellevurdert) Epub ahead of print
Abstract [en]

Aims: To continuing the quest of the concept of transition in nursing research and toexplore how the concept of transition is used in occupational therapy, oral health andsocial work as well as in interdisciplinary studies in health and welfare, between2003–2013.Design: An integrative literature review.Methods: PubMed, CINAHL, PsycINFO, DOSS, SocIndex, Social Science Citation Indexand AMED databases from 2003–2013 were used. Identification of 350 articles includingthe concept of transition in relation to disciplines included. Assessment of articlesare in accordance to Meleis’ typologies of transition by experts in each discipline.Chosen key factors were entered into Statistical Package for the Social Sciences (SPSS).Results: Meleis’ four typologies were found in all studied disciplines, except developmentin oral health. The health‐illness type was the most commonly explored,whereas in social work and in occupation therapy, situational transitions dominated.

sted, utgiver, år, opplag, sider
Wiley-Blackwell, 2019
Emneord
literature review, nursing theory, occupational therapy, oral health, social welfare, social work, theory–practice gap, transition
HSV kategori
Forskningsprogram
Hälsovetenskap, Omvårdnad
Identifikatorer
urn:nbn:se:lnu:diva-81382 (URN)10.1002/nop2.249 (DOI)000476917700002 ()31367388 (PubMedID)
Tilgjengelig fra: 2019-03-29 Laget: 2019-03-29 Sist oppdatert: 2019-08-28
Wallerstedt, B., Benzein, E., Schildmeijer, K. & Sandgren, A. (2019). What is palliative care?: Perceptions of healthcare professionals. Scandinavian Journal of Caring Sciences, 33(1), 77-84
Åpne denne publikasjonen i ny fane eller vindu >>What is palliative care?: Perceptions of healthcare professionals
2019 (engelsk)Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, nr 1, s. 77-84Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background Despite increased attention and knowledge in palliative care, there is still confusion concerning how to interpret the concept of palliative care and implement it in practice. This can result in difficulties for healthcare professionals in identifying patients whom would benefit from palliative care, which, in turn, could lead to a delay in meeting patients' needs. Aim To explore healthcare professionals' perceptions of palliative care. Method Data were collected through twelve interprofessional focus group interviews in community care and hospital wards in south Sweden (n = 74). All interviews were analysed with latent content analysis. Results Three domains were revealed: first, a blurred conceptual understanding as participants described palliative care using synonyms, diagnoses, phases, natural care and holism; second, a challenge to communicate transitions concerned the importance of how and when the transition to palliative care was communicated and documented; finally, a need for interprofessional collaboration was described as well as the consequences for severely ill persons, relatives and healthcare professionals when it was not established. Conclusion The perceptions about how to interpret palliative care differed as well as when palliative care should be offered and decided, which might have practical consequences. How long a person has left to live is of great significance for decision-making, caregiving and preparation in palliative care. The challenge is to use interprofessional communication to promote understanding and collaborate across varied care levels. Integrating palliative care across diverse care levels could be one way to reduce the ambiguity of palliative care.

sted, utgiver, år, opplag, sider
Wiley-Blackwell, 2019
Emneord
palliative care, perceptions, healthcare professionals, focus group interviews, conceptual definition, communication, collaboration
HSV kategori
Forskningsprogram
Hälsovetenskap, Omvårdnad
Identifikatorer
urn:nbn:se:lnu:diva-81850 (URN)10.1111/scs.12603 (DOI)000462154100007 ()30101989 (PubMedID)2-s2.0-85053198936 (Scopus ID)
Tilgjengelig fra: 2019-04-12 Laget: 2019-04-12 Sist oppdatert: 2019-08-29bibliografisk kontrollert
Parola, V., Coelho, A., Sandgren, A., Fernandes, O. & Apostolo, J. (2018). Caring in Palliative Care: A Phenomenological Study of Nurses' Lived Experiences. Journal of Hospice and Palliative Nursing, 20(2), 180-186
Åpne denne publikasjonen i ny fane eller vindu >>Caring in Palliative Care: A Phenomenological Study of Nurses' Lived Experiences
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2018 (engelsk)Inngår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 20, nr 2, s. 180-186Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Providing palliative care involves serious challenges for nurses, such as end-of-life decisions, contact with people's suffering and dying, and increased risk of burnout. However, studies have revealed that the burnout level of health professionals working in palliative care is lower than that of health professionals working in other settings. This study aimed to describe the lived experiences of nurses caring in a palliative care unit. A phenomenological descriptive study was undertaken. Nine nurses were recruited from a palliative care unit in Portugal. Data were collected using individual interviews and analyzed following the method of Giorgi. Five themes reflect the essence of the lived experience: (1) experience centered on the relationship with the other (ie, the patient and the family), (2) experience centered on the relationship with one's own self, (3) exhausting experience, (4) rewarding experience, and (5) the team as a pillar. These findings can be valuable for understanding the challenges and strategies experienced by nurses caring in palliative care and for designing interventions that focus on reducing the risk of burnout among nursesnot only those working in palliative care but also those working in other contexts who experience regular contact with suffering and death.

sted, utgiver, år, opplag, sider
Lippincott Williams & Wilkins, 2018
Emneord
end-of-life care, palliative care, phenomenology, professional burnout, qualitative research
HSV kategori
Forskningsprogram
Hälsovetenskap
Identifikatorer
urn:nbn:se:lnu:diva-72293 (URN)10.1097/NJH.0000000000000428 (DOI)000427794800011 ()2-s2.0-85044021531 (Scopus ID)
Tilgjengelig fra: 2018-04-06 Laget: 2018-04-06 Sist oppdatert: 2019-08-29bibliografisk kontrollert
Alftberg, Å., Ahlström, G., Nilsen, P., Behm, L., Sandgren, A., Benzein, E., . . . Rasmussen, B. H. (2018). Conversations about Death and Dying with Older People: An Ethnographic Study in Nursing Homes. Healthcare, 6(2), Article ID 63.
Åpne denne publikasjonen i ny fane eller vindu >>Conversations about Death and Dying with Older People: An Ethnographic Study in Nursing Homes
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2018 (engelsk)Inngår i: Healthcare, E-ISSN 2227-9032, Vol. 6, nr 2, artikkel-id 63Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Nursing homes are often places where older persons come to die. Despite this, death and dying are seldom articulated or talked about. The aim of this study was to explore assistant nurses' experiences of conversations about death and dying with nursing home residents. This study is part of an implementation project through a knowledge-based educational intervention based on palliative care principles. An ethnographic study design was applied in seven nursing homes, where eight assistant nurses were interviewed and followed in their daily assignments through participant observations. The assistant nurses stated that they had the knowledge and tools to conduct such conversations, even though they lacked the time and felt that emotional strain could be a hinder for conversations about death and dying. The assistant nurses used the strategies of distracting, comforting, and disregarding either when they perceived that residents' reflections on death and dying were part of their illness and disease or when there was a lack of alignment between the residents' contemplations and the concept of dying well. They indicated that ambivalence and ambiguity toward conversations about death and dying should be taken into consideration in future implementations of knowledge-based palliative care that take place in nursing homes after this project is finalized.

sted, utgiver, år, opplag, sider
MDPI, 2018
Emneord
auxiliary nurse, existential communication, frailty, ethnographic approach, life-limiting disease, older, aged, palliative care, residential care, end-of-life
HSV kategori
Forskningsprogram
Hälsovetenskap
Identifikatorer
urn:nbn:se:lnu:diva-79499 (URN)10.3390/healthcare6020063 (DOI)000436494800036 ()29899220 (PubMedID)
Tilgjengelig fra: 2019-01-15 Laget: 2019-01-15 Sist oppdatert: 2019-01-15bibliografisk kontrollert
Persson, H. A., Sandgren, A., Furst, C.-J., Ahlström, G. & Behm, L. (2018). Early and late signs that precede dying among older persons in nursing homes: the multidisciplinary team's perspective. BMC Geriatrics, 18, Article ID 134.
Åpne denne publikasjonen i ny fane eller vindu >>Early and late signs that precede dying among older persons in nursing homes: the multidisciplinary team's perspective
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2018 (engelsk)Inngår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, artikkel-id 134Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Nursing home residents in Sweden are old, frail and usually have multiple morbidities which often make dying a prolonged suffering. It has been found that older persons at nursing homes receive far less palliative care than younger persons, partly because it is difficult to identify when the final stage of life begins. The identification may help the staff to enable the older person and their families to participate in planning the care in accordance with their own preferences and values. With this in mind the aim was to explore the experiences of early and late signs preceding dying in older persons in nursing homes from the multidisciplinary team's perspective. Methods: The focus group method was used to interview 20 health-care professionals on the basis of semi-structured questions. Four focus groups were conducted at four nursing homes in two counties in southern Sweden. The groups included different professionals such as assistant nurses, registered nurses, occupational therapists, physiotherapists, social workers and unit managers. The analysis was conducted according to the focus group method developed by Kruger and Casey. Results: The analysis revealed one major theme, from unawareness to obviousness, which illustrates that the participants experienced dying as a happening, not a process, and found it difficult to identify early signs. Even though it was a new way of thinking, several suggestions of early signs were presented. The main category "Going into a bubble" illustrates early signs, which meant that the older person showed signs of wanting to withdraw from the outside world. The main category "The body begins to shut down" illustrates late signs, which meant that the older person showed signs that indicate that the body starts to prepare for death. Conclusions: This study conveys new knowledge concerning the multidisciplinary team's collective experience of early and late signs that precede dying. This knowledge can increase the understanding of when a palliative care approach needs to be in place at nursing homes. The use of a palliative care approach in care planning requires consensus in the perception of the dying process of frail older persons.

sted, utgiver, år, opplag, sider
BioMed Central, 2018
Emneord
Dying, Multidisciplinary team, Nursing home, Older persons, Palliative care, Signs
HSV kategori
Forskningsprogram
Hälsovetenskap, Omvårdnad
Identifikatorer
urn:nbn:se:lnu:diva-76878 (URN)10.1186/s12877-018-0825-0 (DOI)000435391600003 ()29898674 (PubMedID)2-s2.0-85048634189 (Scopus ID)
Tilgjengelig fra: 2018-07-17 Laget: 2018-07-17 Sist oppdatert: 2019-08-29bibliografisk kontrollert
Blomqvist, M., Sandgren, A., Carlsson, I.-M. & Jormfeldt, H. (2018). Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services. International Journal of Mental Health Nursing, 27(1), 236-246
Åpne denne publikasjonen i ny fane eller vindu >>Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services
2018 (engelsk)Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, nr 1, s. 236-246Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

It is well known that people with severe mental illness have a reduced life expectancy and a greater risk of being affected by preventable physical illnesses such as metabolic syndrome, cardiovascular disease and type 2 diabetes. There are still, however, only a few published studies focusing on what enables healthy living for this group. This study thus aimed to describe what enables healthy living among people with severe mental illness in psychiatric outpatient services. The data were collected in qualitative interviews (n=16) and content analysis was used to analyze the data. The interviews resulted in an overall theme Being regarded as a whole human being by self and others, which showed the multidimensional nature of health and the issues that enable healthy living among people with severe mental illness. Three categories emerged: (i) everyday structure (ii), motivating life events and (iii) support from significant others. The results indicate that a person with severe mental illness needs to be encountered as a whole person if healthy living is to be enabled. Attaining healthy living requires collaboration between the providers of care, help and support. Health care organizations need to work together to develop and provide interventions to enable healthy living and to reduce poor physical health among people with severe mental illness.

sted, utgiver, år, opplag, sider
Wiley-Blackwell, 2018
Emneord
healthy living, mental health nursing, patient's experiences, qualitative content analysis, severe mental illness
HSV kategori
Forskningsprogram
Hälsovetenskap
Identifikatorer
urn:nbn:se:lnu:diva-70245 (URN)10.1111/inm.12313 (DOI)000419717100023 ()28160392 (PubMedID)2-s2.0-85013104680 (Scopus ID)
Tilgjengelig fra: 2018-01-30 Laget: 2018-01-30 Sist oppdatert: 2019-08-29bibliografisk kontrollert
Organisasjoner
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-3155-575x