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Rahmqvist Linnarsson, J., Benzein, E. & Erlingsson, C. (2019). Challenges of caring for victims of violence and their family members in the emergency department. International Emergency Nursing, 42, 2-6
Open this publication in new window or tab >>Challenges of caring for victims of violence and their family members in the emergency department
2019 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 42, p. 2-6Article in journal (Refereed) Published
Abstract [en]

Introduction

Interpersonal violence causes illness and suffering for victims and their family members. Emergency nurses are often given responsibility for forensic patients and their family members, but there is limited knowledge of their experiences regarding this task. This study aimed to describe nurses' experiences when caring for victims of violence and their family members in the emergency department.

Methods

Individual interviews were conducted with twelve nurses from seven emergency departments. Data were analyzed using qualitative content analysis.

Results

The analysis resulted in the theme: a challenge to create a caring encounter. Hindering factors comprising this challenge are described under four categories: struggling to intervene and talk about violence; contradictions when caring for family members; being helped by forensic guidelines but needing more knowledge; and dealing with one’s own strong emotions towards violence.

Discussion

Creating a caring encounter is perceived as a prerequisite to providing forensic care. Nurses often felt hindered to act and forensic issues were left unaddressed. Family members are offered little or no support in the aftermath of violence. The hindering factors must be overcome to ensure forensic care for victims of all types of violence.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Victims of violence, Family, Emergency, Nursing, Forensic care, Experiences
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-78753 (URN)10.1016/j.ienj.2018.10.007 (DOI)000455920300002 ()30392921 (PubMedID)2-s2.0-85055739266 (Scopus ID)
Available from: 2018-11-10 Created: 2018-11-10 Last updated: 2019-08-29Bibliographically approved
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
Open this publication in new window or tab >>Dignity in life and care: the perspectives of Swedish patients in a palliative care context.
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2019 (English)In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 25, no 4, p. 193-201Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
Mark Allen Group, 2019
Keywords
Care of the dying, Dignity, Health professionals, Palliative care
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-82230 (URN)10.12968/ijpn.2019.25.4.193 (DOI)000464949000006 ()31013197 (PubMedID)2-s2.0-85064863576 (Scopus ID)
Funder
The Kamprad Family Foundation, 20152002
Available from: 2019-04-26 Created: 2019-04-26 Last updated: 2019-08-29Bibliographically approved
Möllerberg, 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, 33(10), 1310-1318
Open this publication in new window or tab >>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 (English)In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 33, no 10, p. 1310-1318Article in journal (Refereed) Published
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.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Anxiety, cancer patient, cross-sectional study, depression, family members, hope, multicentre study, palliative care, sense of coherence
National Category
Other Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-88834 (URN)10.1177/0269216319866653 (DOI)000480022600001 ()31368844 (PubMedID)
Available from: 2019-08-29 Created: 2019-08-29 Last updated: 2019-12-06Bibliographically approved
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
Open this publication in new window or tab >>What is palliative care?: Perceptions of healthcare professionals
2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 1, p. 77-84Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
palliative care, perceptions, healthcare professionals, focus group interviews, conceptual definition, communication, collaboration
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-81850 (URN)10.1111/scs.12603 (DOI)000462154100007 ()30101989 (PubMedID)2-s2.0-85053198936 (Scopus ID)
Available from: 2019-04-12 Created: 2019-04-12 Last updated: 2019-08-29Bibliographically approved
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.
Open this publication in new window or tab >>Conversations about Death and Dying with Older People: An Ethnographic Study in Nursing Homes
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2018 (English)In: Healthcare, E-ISSN 2227-9032, Vol. 6, no 2, article id 63Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
MDPI, 2018
Keywords
auxiliary nurse, existential communication, frailty, ethnographic approach, life-limiting disease, older, aged, palliative care, residential care, end-of-life
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-79499 (URN)10.3390/healthcare6020063 (DOI)000436494800036 ()29899220 (PubMedID)
Available from: 2019-01-15 Created: 2019-01-15 Last updated: 2019-01-15Bibliographically approved
Werkander Harstäde, C., Blomberg, K., Benzein, E. & Östlund, U. (2018). Dignity-conserving care actions in palliative care: an integrative review of Swedish research. Scandinavian Journal of Caring Sciences, 32(1), 8-23
Open this publication in new window or tab >>Dignity-conserving care actions in palliative care: an integrative review of Swedish research
2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 8-23Article in journal (Refereed) Published
Abstract [en]

Background: Previous research has proposed that persons in need of palliative care often have a loss of functions and roles that affects social and existential self-image. Moreover, these individuals also commonly suffer from complex multisymptoms. This, together with the situation of facing an impending death, can lead to a loss of dignity. Therefore, supporting these persons’ dignity is a crucial challenge for professional nurses. The ‘Dignity Care Intervention’ addresses the multidimensionality of dignity by identifying patients’ dignity-related concerns and suggests care actions to address them. At the present, the Dignity Care Intervention is adapted for implementation in Swedish care settings. Because expressions of dignity are influenced by culture, and an overview of care actions in a Swedish context is lacking, this integrative review aimed to find suggestions from Swedish research literature on what kind of care actions can preserve dignity.

Methods: An integrative literature review was conducted using the databases SwePub and SweMed+. Articles published from 2006 to 2015 and theses published from 2000 to 2015 were searched for using the terms ‘dignity’ and ‘palliative care’. Result sections of articles and theses were reviewed for dignity-conserving care actions synthesised by thematic analysis and categorised under themes and subthemes in Chochinov’s model of dignity.

Results: Fifteen articles and 18 theses were included together providing suggestions of care actions in all themes and subthemes in the dignity model. Suggested care actions included listening, communication, information, symptom control, facilitating daily living and including patients in decision-making. Additionally, nurses’ perceptiveness towards the patients was a core approach.

Conclusion: The review offers culturally relevant suggestions on how to address specific dignity-related concerns. The adapted Dignity Care Intervention will be a way for Swedish nurses to provide person-centred palliative care that will conserve patients’ dignity

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
Keywords
Chochinov’s model of dignity, Dignity, End-of-life care, Integrative review, Palliative care, the Dignity Care Intervention
National Category
Other Medical Sciences not elsewhere specified
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-68993 (URN)10.1111/scs.12433 (DOI)000426524200002 ()28509335 (PubMedID)2-s2.0-85019609481 (Scopus ID)
Available from: 2017-11-24 Created: 2017-11-24 Last updated: 2019-08-29Bibliographically approved
Årestedt, L., Persson, C., Ramgard, M. & Benzein, E. (2018). Experiences of encounters with healthcare professionals through the lenses of families living with chronic illness. Journal of Clinical Nursing, 27(3-4), 836-847
Open this publication in new window or tab >>Experiences of encounters with healthcare professionals through the lenses of families living with chronic illness
2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 3-4, p. 836-847Article in journal (Refereed) Published
Abstract [en]

Aims and objectivesTo describe and explore the experience of healthcare encounters in families living with chronic illness. BackgroundLiving with chronic illness is a family concern and often includes frequent encounters with healthcare professionals. These encounters affect how persons with illness and family members handle everyday life. Disease-related explanations are perceived by healthcare professionals as being of higher importance than the actual experience of illness, even though patients are concerned with issues involving their everyday life. DesignA descriptive design with a qualitative approach. MethodsNarrative family interviews were conducted with twelve families, using a qualitative content analysis. ResultsOne main category was indicated following analysis, specifically The impact of an accompanying family member. Additionally, three subcategories were revealed; The importance of collaboration, Mutual understanding, A desire to be confirmed in one's illness. Conclusions and relevance to clinical practiceHaving a participating family member increased the sense of power in families during encounters with healthcare professionals. This participation constitutes a level of support, making it easier for families to handle everyday life due to illness. Family members are, in most cases, included in discussions and decisions, both before and after encounters, and it should be a natural for healthcare professionals to invite them to the encounter too. This is an offer that may not fit every family, but the person with illness or the family should at least have the opportunity to choose.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2018
Keywords
content analysis, experiences, family, family systems nursing, healthcare encounters, healthcare professionals, Swedish
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-71447 (URN)10.1111/jocn.14126 (DOI)000425733600065 ()29076223 (PubMedID)2-s2.0-85042299413 (Scopus ID)
Available from: 2018-03-09 Created: 2018-03-09 Last updated: 2019-08-29Bibliographically approved
Tryselius, K., Benzein, E. & Persson, C. (2018). Ideas of home in palliative care research: a concept analysis. Nursing Forum, 53(3), 383-391
Open this publication in new window or tab >>Ideas of home in palliative care research: a concept analysis
2018 (English)In: Nursing Forum, ISSN 0029-6473, Vol. 53, no 3, p. 383-391Article in journal (Refereed) Published
Abstract [en]

1 Aim

To explore the concept of home and its' expressed spatialities in current palliative care research.

2 Background

Home is a central environment for living, caring, and dying. However, pure investigations of the sets of ideas linked to the concept seemed missing. Although identified as an important location, spatial perspectives expressed through the concept of home appeared unexplored.

3 Design

Rodgers' evolutionary concept analysis.

4 Data sources

Scientific articles published between January 2009 and September 2015.

5 Review methods

Rodgers' evolutionary concept analysis. Resulting attributes were explored from two geographically informed spatial perspectives.

6 Results

As main results, six attributes were identified and explored: Home as actor—capable of acting; emotional environment—something people have feelings for; place—a part of personal identity and a location; space—complex and relational spatial connections and a site for care; setting—passive background and absolute space; becoming—a fluid spatiality constantly folded. Examples of attributes and suggestions for further concept development were identified.

7 Conclusions

The concept reflects various sets of ideas as well as expressing both relational and absolute perspectives of space. The most challenging for nursing research and practice seems to be investigation, operationalization, and testing the implementation of sets of ideas reflecting a relational thinking of space.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
home, nursing, palliative care research, Rodgers' evolutionary concept analysis, space
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-78775 (URN)10.1111/nuf.12257 (DOI)000445762700015 ()29687445 (PubMedID)2-s2.0-85045846909 (Scopus ID)
Available from: 2018-11-12 Created: 2018-11-12 Last updated: 2019-08-29Bibliographically approved
Ahlström, G., Nilsen, P., Benzein, E., Behm, L., Wallerstedt, B., Persson, M. & Sandgren, A. (2018). Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design: a study protocol. BMC Palliative Care, 17, Article ID 52.
Open this publication in new window or tab >>Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design: a study protocol
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2018 (English)In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 17, article id 52Article in journal (Refereed) Published
Abstract [en]

Background: The demography of the world is changing as the population is ageing. Because of this change to a higher proportion of older people, the WHO has called for improved palliative care for older persons. A large number of all deaths in the industrialised world occur while older people are living in nursing homes and therefore a key question becomes how the principles of palliative care can be implemented in that context. The aims of this study are: a) to describe a model of an educational intervention with the goal of implementing knowledge-based palliative care in nursing homes, and b) to describe the design of the evaluation of the effectiveness regarding the implementation of knowledge-based palliative care. Methods/design: A complex intervention is evaluated by means of a cross-over design. An educational intervention concerning palliative care consisting of five seminars during 6 months for staff and managers has been developed and conducted in 20 nursing homes in two counties. Before the intervention started, the feasibility was tested in a pilot study conducted in nursing homes not included in the main study. The intervention is evaluated through a non-randomized experimental design with intervention and control groups and pre- and post-assessments. The evaluation includes older persons living in nursing homes, next-of-kin, staff and managers. Data collection consists of quantitative methods such as questionnaires and register data and qualitative methods in the form of individual interviews, focus-group interviews and participant observations. Discussion: The research will contribute to new knowledge about how to implement knowledge-based palliative care in a nursing home setting. A strength of this project is that the Medical Research Council framework of complex intervention is applied. The four recommended stages, Development, Feasibility and piloting, Evaluation and Implementation, are combined for the educational intervention, which functions as a strategy to achieve knowledge-based palliative care in the nursing homes. Implementation is always a question of change and a good theoretical understanding is needed for drawing valid conclusions about the causal mechanisms of change. The topic is highly relevant considering the world's ageing population. The data collection is completed and the analysis is ongoing.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Complex intervention, Cross-over design, Elderly care, Evaluation, Frail elderly, Implementation, Implementation theory, Palliative care, Quality improvement, Residential care home, Staff education
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-72689 (URN)10.1186/s12904-018-0308-2 (DOI)000428245000001 ()29566688 (PubMedID)2-s2.0-85044252204 (Scopus ID)
Available from: 2018-04-13 Created: 2018-04-13 Last updated: 2019-08-29Bibliographically approved
Wallerstedt, B., Behm, L., Alftberg, Å., Sandgren, A., Benzein, E., Nilsen, P. & Ahlström, G. (2018). Striking a Balance: A Qualitative Study of Next of Kin Participation in the Care of Older Persons in Nursing Homes in Sweden. Healthcare, 6(2), Article ID 46.
Open this publication in new window or tab >>Striking a Balance: A Qualitative Study of Next of Kin Participation in the Care of Older Persons in Nursing Homes in Sweden
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2018 (English)In: Healthcare, E-ISSN 2227-9032, Vol. 6, no 2, article id 46Article in journal (Refereed) Published
Abstract [en]

Most of the care in nursing homes is palliative in nature, as it is the oldest and the frailest people who live in nursing homes. The aim of this study was to explore next of kin's experiences of participating in the care of older persons at nursing homes. A qualitative design was used, based on semi-structured interviews with 40 next of kin, and analyzed using qualitative content analysis. An overarching theme emerged, a balancing act consisting of three categories: (1) visiting the nursing home; (2) building and maintaining relationships; and (3) gathering and conveying information. The next of kin have to balance their own responsibility for the older person's wellbeing by taking part in their care and their need to leave the responsibility to the staff due to critical health conditions. The next of kin wanted to participate in care meetings and conversations, not only in practical issues. The findings indicate the need to improve the next of kin's participation in the care as an equal partner. Increased knowledge about palliative care and decision-making of limiting life-prolonging treatment may lead to a higher quality of care.

Place, publisher, year, edition, pages
MDPI, 2018
Keywords
end-of-life care, family member, involvement, life-limiting disease, next of kin, palliative care, participation, sheltered housing, significant others, relatives
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-79501 (URN)10.3390/healthcare6020046 (DOI)000436494800019 ()29751660 (PubMedID)
Available from: 2019-01-17 Created: 2019-01-17 Last updated: 2019-01-17Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9714-4056

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