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Möllerberg, M.-L., Årestedt, K., Sandgren, A., Benzein, E. & Swahnberg, K. (2020). Adaptation and psychometric evaluation of the short version of Family Sense of Coherence Scale in a sample of persons with cancer in the palliative stage and their family members. Palliative & Supportive Care, 18(1), 24-32
Open this publication in new window or tab >>Adaptation and psychometric evaluation of the short version of Family Sense of Coherence Scale in a sample of persons with cancer in the palliative stage and their family members
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2020 (English)In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 18, no 1, p. 24-32Article in journal (Refereed) Published
Abstract [en]

Objectives For patients' entire families, it can be challenging to live with cancer during the palliative stage. However, a sense of coherence buffers stress and could help health professionals identify families that require support. Therefore, the short version of the Family Sense of Coherence Scale (FSOC-S) was translated, culturally adapted, and validated in a Swedish sample. Methods Translation and cross-cultural adaptation of the FSOC-S into Swedish was conducted in accordance with the World Health Organization's Process for Translation and Adaptation of Research Instruments guidelines. Participants were recruited from two oncology clinics and two palliative centers in Sweden. Results Content validity was supported by experts (n = 7), persons with cancer (n = 179), and family members (n = 165). Homogeneity among items was satisfactory for persons with cancer and family members (item-total correlations were 0.45-0.70 and 0.55-0.72, respectively) as well as internal consistency (ordinal alpha = 0.91 and 0.91, respectively). Factor analyses supported unidimensionality. FSOC-S correlated (r(s) > 0.3) with hope, anxiety, and symptoms of depression, which supported convergent validity. The test-retest reliability for items ranged between fair and good (k(w) = 0.37-0.61).

Place, publisher, year, edition, pages
Cambridge University Press, 2020
Keywords
cancer, family, sense of coherence, palliative care, validation
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-92866 (URN)10.1017/S1478951519000592 (DOI)000513203900005 ()31495345 (PubMedID)
Available from: 2020-03-12 Created: 2020-03-12 Last updated: 2020-03-12Bibliographically approved
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
Open this publication in new window or tab >>Coping by metaphors: The versatile function of metaphors in blogs about living with advanced cancer
2019 (English)In: Medical Humanities, ISSN 1468-215X, E-ISSN 1473-4265Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
London: BMJ Publishing Group Ltd, 2019
Keywords
cancer care, linguistics, metaphor, palliative care, patient narratives, psychology, psychotherapy palliative care, cancer care
National Category
General Language Studies and Linguistics Other Health Sciences
Research subject
Humanities; Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-87938 (URN)10.1136/medhum-2019-011656 (DOI)
Funder
The Kamprad Family Foundation, 20150008
Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2020-03-12
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
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, 40(10), 839-850
Open this publication in new window or tab >>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 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 10, p. 839-850Article in journal (Refereed) Published
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.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-88828 (URN)10.1080/01612840.2019.1642425 (DOI)000481062200001 ()31393742 (PubMedID)
Available from: 2019-08-29 Created: 2019-08-29 Last updated: 2019-11-26Bibliographically approved
Lindmark, U., Bülow, P. H., Mårtensson, J., Rönning, H., Ahlstrand, I., Broström, A., . . . Sandgren, A. (2019). The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review. Nursing Open, 6(3), 664-675
Open this publication in new window or tab >>The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review
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2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 664-675Article in journal (Refereed) Published
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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
literature review, nursing theory, occupational therapy, oral health, social welfare, social work, theory–practice gap, transition
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
urn:nbn:se:lnu:diva-81382 (URN)10.1002/nop2.249 (DOI)000476917700002 ()31367388 (PubMedID)
Available from: 2019-03-29 Created: 2019-03-29 Last updated: 2020-01-15Bibliographically approved
Reigada, C., Martin-Utrilla, S., Perez-Ros, P., Centeno, C., Sandgren, A. & Gomez-Baceiredo, B. (2019). Understanding illnesses through a film festival: An observational study. Heliyon, 5(8), 1-8, Article ID e02196.
Open this publication in new window or tab >>Understanding illnesses through a film festival: An observational study
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2019 (English)In: Heliyon, E-ISSN 2405-8440, Vol. 5, no 8, p. 1-8, article id e02196Article in journal (Refereed) Published
Abstract [en]

Audio-visual materials play a fundamental role in the context of education, care and clinical treatment, as they seem to have a high impact on public awareness. This study aims to describe what messages are perceived by the society at an International Festival of Short Films and Art on Diseases that may help to understand difficult topics, such as illness, dying and suffering. Through an observational, descriptive, cross-sectional study, using full participant observation and an open, self-administered questionnaire, 32 short films were analysed during a healthcare art festival. Categories were developed using inductive content analysis. The message perceived by the participants, after the viewing of the shorts and reflection of the debates among the attendees, were considered in four categories: i) creative and positive education is possible; ii) awareness of preconception and practical duties; iii) meaning of life changes the experience of illness; iv) family and caregivers also experienced suffering. The short films are considered as an excellent tool to generate social dialogue and debate. Public events can be understood as an opportunity to acquire, in an emotional and critical manner, other competencies for public awareness. Together, they are capable of communicating difficult messages through a fast, positive, and creative way.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Education, Sociology, Public awareness, Audio-visual, Observation, Healthcare, Illness
National Category
Other Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-89317 (URN)10.1016/j.heliyon.2019.e02196 (DOI)000484391200203 ()31453393 (PubMedID)
Available from: 2019-09-26 Created: 2019-09-26 Last updated: 2019-09-26Bibliographically 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
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
Open this publication in new window or tab >>Caring in Palliative Care: A Phenomenological Study of Nurses' Lived Experiences
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2018 (English)In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 20, no 2, p. 180-186Article in journal (Refereed) 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.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
Keywords
end-of-life care, palliative care, phenomenology, professional burnout, qualitative research
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-72293 (URN)10.1097/NJH.0000000000000428 (DOI)000427794800011 ()2-s2.0-85044021531 (Scopus ID)
Available from: 2018-04-06 Created: 2018-04-06 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
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3155-575x

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