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  • 1.
    Coelho, Adriana
    et al.
    Univ Porto, Portugal;Portugal Ctr Evidence Based Practice, Portugal.
    Parola, Vitor
    Univ Porto, Portugal;Portugal Ctr Evidence Based Practice, Portugal.
    Sandgren, Anna
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Fernandes, Olga
    Univ Porto, Portugal.
    Kolcaba, Katharine
    Univ Akron, USA.
    Apostolo, Joao
    Nursing Sch Coimbra, Portugal;Portugal Ctr Evidence Based Practice, Portugal;Hlth Sci Res Unit, Portugal.
    The Effects of Guided Imagery on Comfort in Palliative Care2018Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 20, nr 4, s. 392-399Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Guided imagery (GI) is a nonpharmacological intervention that is increasingly implemented in different clinical contexts. However, there have been no studies on the effect of GI on the comfort of inpatients of palliative care (PC) units. Therefore, the aim of this study was to evaluate the effects of GI on the comfort of patients in PC. A 1-group, pretest-posttest, pre-experimental design was used to measure differences in heart rate, respiratory rate, pain, and comfort in patients (n = 26) before and after a 2-session GI program. The intervention featuring GI increased comfort, measured by an Abbreviated Holistic Comfort Scale and the visual analog comfort scale (P < .001), and decreased heart rate (P < .001), respiratory rate (P < .001), and pain, as measured by the (numerical) visual analog pain scale (P < .001). This study demonstrates that the use of an intervention featuring GI increases the comfort of oncology patients admitted to a PC unit. The use of GI by nurses is inexpensive, straightforward to implement, and readily available and may result in the provision of comfort care.

  • 2.
    Munck, Berit
    et al.
    Hälsohögskolan, Jönköping.
    Sandgren, Anna
    Hälsohögskolan, Jönköping .
    Fridlund, Bengt
    Hälsohögskolan, Jönköping.
    Mårtensson, Jan
    Hälsohögskolan, Jönköping.
    Patients’ understanding of medical technology in palliative home care; a qualitative analysis2012Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 14, nr 3, s. 191-198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Healthcare reforms and reductions in the number of hospital beds are leading to an increasing amount of medical technology moving from hospitals into home care, affecting the daily lives of patients. The aim of this study was therefore to describe the ways patients understand medical technology in palliative home care. With use of a phenomenographic approach, 15 patients with medical technology were interviewed, and data were analyzed in a 7-step process. Three ways of understanding the phenomenon emerged: a masterful patient, an adjustable patient, and a restricted patient. Masterful patients took control over the medical technology and were mostly independent of assistance from personnel. Adjustable patients accepted and adapted their lives to the medical technology and were satisfied with assistance from the personnel. Restricted patients were reminded daily of the medical technology and dependent on assistance from personnel. Depending on the patients' health conditions, the support from the personnel, and the impact of medical technology, a transfer between the different ways of understanding occurred with a simultaneous movement between independence and dependence. The patient exhibited various ways of understanding, although one way of understanding was more dominant.

  • 3.
    Möllerberg, Marie-Louise
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Sandgren, Anna
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Swahnberg, Katarina
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Benzein, Eva
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Familial Interaction Patterns During the Palliative Phase of a Family Member Living With Cancer2017Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 19, nr 1, s. 67-74Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to illuminate aspects of familial interactions when 1 member is in the palliative phase of his/her cancer course. An individual cancer diagnosis influences the entire family, often requiring daily life changes for all members. Current research has examined individual family member perspectives; family system nursing studies are warranted. Narrative family interviews were conducted on 13 families living with cancer. The interviews were transcribed and analyzed according to a hermeneutic method. Analyses revealed the following: Family interaction patterns were adjusted in response to changes in family life, which encompassed 3 different, but interrelated, patterns: (1) power dynamics in the family, (2) the "secret game" in the family, and (3) multifaceted closeness and distance in the family. It is crucial to adopt a family perspective during palliative care to meet each unique family's needs. Health care facilitators should be aware of the complex dynamics and challenges that these families encounter. This will help obtain a greater understanding of factors underlying effective palliative care.

  • 4.
    Parola, Vitor
    et al.
    Univ Porto, Portugal;Nursing Sch Coimbra, Portugal.
    Coelho, Adriana
    Univ Porto, Portugal;Nursing Sch Coimbra, Portugal.
    Cardoso, Daniela
    Nursing Sch Coimbra, Portugal.
    Sandgren, Anna
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Apostolo, Joao
    Nursing Sch Coimbra, Portugal.
    Burnout in Palliative Care Settings Compared With Other Settings: A Systematic Review2017Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 19, nr 5, s. 442-451Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A systematic review, using the guideline of the Joanna Briggs Institute, was conducted to explore the effect of working in palliative care settings, compared with other settings, on burnout among health care professionals. Multiple databases were searched-CINAHL, PubMed, Scopus, and SciELOV-as well as gray literature for studies published since 1975 that compared health professionals caring for patients older than 18 years in specialized palliative care settings (palliative care units, home care, or hospices) with health professionals working in other settings. Of the 539 studies retrieved, 7 cross-sectional studies were included in this review. Of these, six were conducted with nurses, and six used the Maslach Burnout Inventory. Working in palliative care (palliative care unit or hospices) was associated with lower levels of emotional exhaustion and depersonalization, as well as higher levels of personal accomplishment, compared with working in other settings. Evidence indicates that burnout levels seem to be lower among professionals working in palliative care compared with professionals working in other settings. Further research is needed to explore the strategies used by nurses working in palliative care that help them deal with burnout and to apply these same strategies to professionals working in other settings.

  • 5.
    Parola, Vitor
    et al.
    Univ Porto, Portugal;Portugal Ctr Evidence Based Practice, Portugal.
    Coelho, Adriana
    Univ Porto, Portugal;Portugal Ctr Evidence Based Practice, Portugal.
    Sandgren, Anna
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Fernandes, Olga
    Nursing Sch Porto, Portugal;Univ Porto, Portugal.
    Apostolo, Joao
    Nursing Sch Coimbra, Portugal.
    Caring in Palliative Care: A Phenomenological Study of Nurses' Lived Experiences2018Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 20, nr 2, s. 180-186Artikel i tidskrift (Refereegranskat)
    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.

  • 6.
    Werkander Harstäde, Carina
    et al.
    Karolinska Institute.
    Andershed, Birgitta
    Good palliative care: how and where?: the patients’ opinions2004Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 6, nr 1, s. 27-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to describe what patients with cancer who are in the final stage of life consider to be good palliative end-of-life care and where they think such care should be carried out. Nine patients receiving palliative end-of-life care were interviewed and the material was analyzed using Grounded Theory. Three main categories (and 7 subcategories) emerged during the analysis: safety, participation, and trust. They were conceptualized metaphorically as a wheel that rolls along smoothly as long as the care is good and all 3 categories are present. The concepts of safety, participation, and trust were interwoven with the patients’ beliefs about where this care should be carried out. The majority said that they wanted to be cared for in the hospital.

  • 7.
    Werkander Harstäde, Carina
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Andershed, Birgitta
    Roxberg, Åsa
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Brunt, David
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Feelings of guilt: Experiences of next-of-kin in end-of-life care2013Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 15, nr 1, s. 33-40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to gain a greater understanding of the experiences of guilt of the next-of-kin in end-of-life care. Seventeen next-of-kin who had lost a loved one were interviewed with a focus on possible experiences of guilt. A Gadamerian-based hermeneutic approach to interpret these experiences was used. The interpretation showed that next-of-kin’s experiences of guilt emanated from a situation where the next-of-kin had a moral view on what was the right thing to do, it could also originate from a wish to do the best possible for the dying person out of love for this person. The situation could also involve both these aspects.  The way in which the situation was handled, could, if the next-of-kin felt that s/he did not fulfill her/his commitments, omitted or neglected the dying person or was the cause of something, lead to experiences of guilt. The situation of being next-of-kin in end-of-life care is complex and demanding, something that health professionals are and should be aware of. Acknowledgement of experiences of guilt can help the next-of-kin in their adaptation to the end-of-life situation as a whole and maybe also give useful tools to support next-of-kin through bereavement.

  • 8.
    Werkander Harstäde, Carina
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Roxberg, Åsa
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Mälardalen University.
    Brunt, David
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Andershed, Birgitta
    Ersta Sköndal University College.
    Next of Kin's Experiences of Shame in End-of-Life Care2014Ingår i: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 16, nr 2, s. 86-92Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to gain a greater understanding of the experiences of shame of next of kin in end-of-life care. Seventeen next of kin who had lost a family member were interviewed. A method inspired by Gadamer's hermeneutic approach was used to interpret possible experiences of shame and to discuss these interpretations. The result showed that next of kin's experiences of shame are linked to their perception of the remaining time and are guided by views on morality and what is right and wrong. Shame can occur when the next of kin are involved and actually cause harm to the family member as well as in situations that are beyond their control. Shame can also involve actions that have nothing to do with what they have actually done but is instead a shame that is placed on them by others, for example, health professionals or relatives. Shame is interpreted as experiences of ignominy, humiliation, and disgrace. Second-order shame is also found. It is important that health professionals are aware of these experiences of unhealthy shame when they meet and support next of kin in end-of-life care.

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