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  • 1.
    Ahlström, Gerd
    et al.
    Lund University.
    Nilsen, Per
    Linköping University.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Behm, Lina
    Lund University.
    Wallerstedt, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Persson, Magnus
    Lund University.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design: a study protocol2018In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 17, article id 52Article in journal (Refereed)
    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.

  • 2.
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    Att uppleva hopp2004In: Att vara och vårda äldre - man har ju sina krämpor. / [ed] Anna-Karin Edberg, Lund: Studentlitteratur , 2004Chapter in book (Other academic)
  • 3.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hopp2013In: Palliativ vård: begrepp & perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt och Cecilia Håkanson, Lund: Studentlitteratur AB, 2013, 1, p. 261-268Chapter in book (Other academic)
  • 4.
    Benzein, Eva
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hopp2012In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Lena Wiklund Gustin och Ingegerd Bergbom, Lund: Studentlitteratur AB, 2012, 1, p. 239-248Chapter in book (Other academic)
  • 5.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hälsostödjande familjesamtal2013In: Palliativ vård: begrepp & perspektiv i teori och praktik, Lund: Studentlitteratur AB, 2013, 1, p. 453-464Chapter in book (Other academic)
  • 6.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Nurses' perspective of hope in cancer care2013In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 49, p. S49-S49Article in journal (Other academic)
  • 7.
    Benzein, Eva
    Department of Nursing, Umeå University..
    Traces of hope1999Doctoral thesis, monograph (Other academic)
  • 8.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Berg, Agneta
    The level of and relation between hope, hopelessness and fatigue in patients and family members in palliative care2005In: Palliative medicine, Vol. 19 (3), p. 234-240Article in journal (Refereed)
  • 9.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Berg, Agneta
    The Swedish version of Herth Hope Index – an instrument for palliative care2003In: Scandinavian Journal of Caring Sciences, Vol. 17Article in journal (Other (popular science, discussion, etc.))
  • 10.
    Benzein, Eva
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Erlingsson, Christen
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hagberg, Margaretha
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Saveman, Britt-Inger
    Umeå University.
    Hälsostödjande familjesamtal2012In: Att möta familjer inom vård och omsorg / [ed] E. Benzein, M. Hagberg, B-I. Saveman, Lund: Studentlitteratur AB, 2012, p. 59-78Chapter in book (Other academic)
  • 11.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Hagberg, Margaretha
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Being appropriately unusual - a challenge for nurses in health promoting conversations with families2008In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 15, p. 106-115Article in journal (Refereed)
  • 12.
    Benzein, Eva
    et al.
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Hagberg, Margaretha
    University of Kalmar, eHealth Institute, School of Human Sciences, University of Kalmar,.
    Saveman, Britt-Inger
    Umeå Universitet.
    Familj och sociala relationer.2009In: Omvårdnadens grunder / [ed] Öhlén J. & Friberg F, Studentlitteratur, 2009, p. 65-84Chapter in book (Other academic)
  • 13.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Humanvetenskapliga Institutionen, högskolan i Kalmar
    Familjefokuserad omvårdnad – ett strategidokument.2009In: Högskolan i Kalmar, no Dnr 2009/675Article in journal (Other (popular science, discussion, etc.))
  • 14.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Johansson, Birgitta
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Families in home care – a resource or a burden? District nurses´ beliefs2004In: Journal of Clinical Nursing, Vol. 13, p. 867-875Article in journal (Refereed)
  • 15.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Johansson, Pauline
    University of Kalmar, School of Human Sciences.
    Utvärdering av PRIVO:s verksamhet: slutrapport 2004-05-202004Report (Other academic)
    Abstract [sv]

    I Sverige finns idag ett stort antal palliativa rådgivningsteam. En av deras huvudsakliga uppgifter är att genom råd, stöd och utbildning höja kompetensen hos de primära vårdgivarna avseende förhållningssätt och behandling inom palliativ vård. Med denna målsättning startade år 1998 det palliativa rådgivningsteamet i Västervik, Vimmerby och Oskarshamn (PRIVO), i form av ett projekt, som sedan permanentades.

    Syftet med denna rapport är att utvärdera PRIVO:s verksamhet, som en uppföljning av tidigare utvärdering år 2000. Datainsamlingen omfattar statistiska data, enkäter till primära vårdgivare inom landstingets öppen- och slutenvård, privat öppenvård samt kommuner. Intervjuer har genomförts med patienter och familjemedlemmar, samt PRIVO:s medlemmar.

    Enkäten, som skickades ut till 89 arbetslag, efterfrågar kommunikationsvägar, teamets tillgänglighet och service, genomförande och effekter av teamets insatser, samt synpunkter om förbättringar av teamets fortsatta verksamhet. Enkäten besvarades tillsammans i arbetslagen med så många yrkeskategorier som möjligt närvarande. Svar inkom från 71 arbetslag (80 %), vilket omfattar totalt 291 personer. Beräkningar har gjorts med dataprogrammet SPSS. Familjeintervjuerna var semistrukturerade och omfattade patienternas (n=8) och familjemedlemmarnas (n=12) upplevelser av den erhållna vården, samt PRIVO:s insatser. Intervjuerna med teamets medlemmar omfattade arbetssätt, kvalitetssäkring och målsättning, intern funktion, kompetensutveckling, marknadsföring, extern samverkan, utbildning samt dokumentation och informationsöverföring. Samtliga intervjuer bandades, skrevs ut ordagrant och analyserades genom att sortera och gruppera dess innehåll.

    Från och med september år 2003 arbetar samtliga teammedlemmar heltid; en läkare och tre sjuksköterskor. Utbildning till de primära vårdgivarna har omfattat 470 timmar och totalt inkluderat 3585 vårdpersonal under tiden 2001 - 2003. Antal personer och utbildningstillfällen har successivt minskat under perioden. Totalt gjordes 718 nyinskrivningar vid PRIVO under åren 2001 - 2003 och under samma period avled totalt 598 patienter. Av de med känd önskan att dö hemma var det 72% som faktiskt dog i hemmet. Antalet besök gjorda av teamets läkare och sjuksköterska tillsammans har ökat markant från 110 besök år 2001, till 275 besök år 2003. Ökningen består av flera besök på vårdavdelningar (från 45 till 117) och i eget boende (från 49 till 152), medan besöken i de särskilda boendena minskat från 16 till sex.

    Resultatet av enkäten påvisade en klar förbättring, avseende hur de primära vårdgivarna uppfattar PRIVO:s verksamhet, jämfört med utvärderingen år 2000. Den största förbättringen avser hur snabbt personalen får det stöd de efterfrågar och att PRIVO är lättillgängliga. De primära vårdgivarna anser att patienterna fått bättre vård och behandling sedan PRIVO kopplats in, främst när det gäller symtomlindring. En stor majoritet ansåg att teamet även i fortsättningen ska arbeta konsultativt, även om undantag kan göras i speciella situationer. Så gott som samtliga arbetslag ansåg att PRIVO ska fortsätta sin verksamhet och de efterfrågade fortsatt kontinuerlig utbildning. Enligt de primära vårdgivarna är det bästa sättet att utveckla den palliativa vården att höja kompetensnivån hos all personal med generella utbildningsinsatser och genom att utbilda palliativa ombud.

    Familjerna upplevde att vården i stort fungerade bra vad det gäller det fysiska omhändertagandet, men ansåg att det psykosociala och existentiella stödet var bristfälligt. PRIVO utgjorde en stor trygghet för familjerna då de var lättillgängliga och vården ansågs förbättrad efter att teamet kopplats in, framför allt vad det gäller smärtlindring. De patienter som hade en så kallad morfinpump, ansåg systemet som sårbart och upplevde otrygghet, då de primära vårdgivarna inte har kunskap om hur de ska skötas. Familjerna hade svårt att fullt ut förstå PRIVO:s roll och samverkan med andra vårdgivare. Familjemedlemmarna beskrev att de inte blev 'sedda', varken av vården i stort eller av PRIVO:s medlemmar, avseende deras välbefinnande och behov av stöd. Familjerna var i allmänhet osäkra på om de kunnat påverka den egna vården och de ansåg att de saknade information om sjukdomen och om tillgängliga resurser.

    PRIVO:s medlemmar gav uttryck för en stor arbetsbelastning och svårigheter att dra gränser för hur mycket de ska 'ta på sig'. Det konsultativa arbetssättet är visserligen mer inarbetat nu än vid utvärderingen år 2000, men inte ovillkorligt självklart för alla medlemmar i teamet. De olika geografiska förutsättningarna var, enligt teammedlemmarna, en orsak till att de inte arbetar helt lika. Samtliga trivdes med sitt arbete, som upplevdes intressant och utvecklande, men krävande. Samtliga ansåg att kompetensen hos de primära vårdgivarna ökat samtidigt som utbildningsbehovet aldrig sinar. Patienternas valfrihet av vårdnivå ansågs begränsad med anledning av för liten eller undanhållen information och otillräckliga resurser.

    Utvärderingen visar att de flesta rekommendationer från föregående utvärderingstillfälle är mer eller mindre uppfyllda. PRIVO utför ett mycket gott arbete och är uppskattade av patienter, familjemedlemmar och primära vårdgivare, oavsett vårdverksamhet. För framtida verksamhet är det dock viktigt att PRIVO skapar enighet i teamet om deras roll och arbetssätt och gör detta tydligt, så att adekvat information kan ges framför allt till familjerna. Idag kan flera av teamets medlemmar nås utanför dagtid/vardagar, vilket å ena sidan är till gagn för primära vårdgivare och familjer,men som å andra sidan måste ifrågasätts. En orsak till den ökade tillgängligheten är att primära vårdgivare och familjer inte klarar av de så kallade morfinpumparna, om något 'krånglar'. Det är stor risk att teamet hamnar i en negativ spiral; ju mer tillgängliga teamet är, desto mer krav på ytterligare tillgänglighet kommer att krävas av primära vårdgivare, patienter och deras familjemedlemmar. Det kan till och med ifrågasättas om avancerad teknisk utrustning ska användas så länge de primära vårdgivarna inte har den kunskap som behövs för att kunna sköta den. Ett sätt att förhindra den negativa spiralen är att teamet intensifierar utbildningen för primära vårdgivare i medicinsk teknik, så att sårbarheten i vården minskas när PRIVO:s medlemmar ej är tillgängliga. Det är uppenbart att teamet behöver prioritera kunskaper avseende psykosociala och existentiella frågor samt uppmärksamma familjemedlemmars behov för att kunna genomföra steg två i utbildningspaketet till de primära vårdgivarna. Teamets kvalitetssäkring måste systematiskt utvecklas och PRIVO:s dokumentation bli mer fokuserad, tillgänglig och användarvänlig.

    Med dessa åtgärder kan PRIVO:s fortsatta verksamhet vara till stor gagn för både primära vårdgivare, patienter och familjemedlemmar.

  • 16.
    Benzein, Eva
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, Vårdhögskolan i Växjö.
    Johansson, Pauline
    Växjö University, Faculty of Humanities and Social Sciences, Vårdhögskolan i Växjö.
    Saveman, Britt-Inger
    Växjö University, Faculty of Humanities and Social Sciences, Vårdhögskolan i Växjö.
    The significance of families in nursing care2005In: 7th International Family Nursing Conference: Opening Spaces: Inviting Dialogue in Family Nursing, 2005Conference paper (Refereed)
    Abstract [en]

    Objective: The aim of thé study was to investigate Swedish nurses1 attitudes to thé significance of families in nursing care. Method: An instrument (FAMBO), based on a research literature review, was developed by thé researchers. The instrument consists of 60 items about nurses' attitudes to thé significance of families in nursing care, i.e. for thé patients, thé family members and for thé nurses. The items include nurses' thoughts, feelings and actions in relation to, for example, engagement, communication, information and family resources. During May 2004, thé questionnaire was posted to 1000 nurses randomly sampled from The Swedish Association of Health Professionals' list of members, excluding administrators, teachers and retired nurses. After two reminders, we received 709 instruments, of which 50 were unanswered. The response rate was 66% (n = 659). The analysis, descriptive and analytic statistics, has just begun (Nov, 2004). The study is a co-operation between Kalmar University and The Swedish Association of Health Professionals. Results: At thé conférence, nurses' attitudes to thé significance of families in nursing care will be presented, for example, in relation to âge, organizational form and in relation to nurses' areas of work. Conclusion: The resuit of this study will be a part of thé foundation for further development of family nursing in Sweden.

  • 17.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Johansson, Pauline
    University of Kalmar, School of Human Sciences.
    Årestedt, Kristofer
    University of Kalmar, School of Human Sciences.
    Berg, Agneta
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Families' Importance in Nursing Care: Nurses' Attitudes An Instrument Development2008In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 14, no 1, p. 97-114Article in journal (Refereed)
  • 18.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Johansson, Pauline
    University of Kalmar, School of Human Sciences.
    Årestedt, Kristofer
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Nurses' Attitudes About the Importance of Families in Nursing Care: A Survey of Swedish Nurses2008In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 14, no 2, p. 162-180Article in journal (Refereed)
  • 19.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Norberg, Astrid
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Hope - Future imagined reality. The meaning of hope as described by a group of healthy Pentecostalists1998In: Journal of Advanced Nursing, Vol. 28(5), p. 1063-1070Article in journal (Refereed)
  • 20.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Norberg, Astrid
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Limitations of The Sense of Coherence Scale in a Swedish Pentecostal Population1997In: Scandinavian Journal of Caring Sciences, Vol. 11, p. 139-144Article in journal (Refereed)
  • 21.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Norberg, Astrid
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    The meaning of the lived experience of hope in patients with cancer in palliative home care2001In: Palliative Medicine, Vol. 15, p. 117-126Article in journal (Refereed)
  • 22.
    Benzein, Eva
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Olin, Cecilia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Persson, Carina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    ‘You put it all together’: families' evaluation of participating in family health conversations2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 1, p. 136-144Article in journal (Refereed)
    Abstract [en]

    Aims and objectives

    To evaluate the Family Health Conversations from the perspective of families living with chronic illness.

    Methodological design and justification

    This study has a descriptive qualitative design using semi-structured evaluative family interviews and conventional content analysis.

    Ethical issues and approval

    The study was approved by a Regional Ethical Review Board.

    Research methods

    Family Health Conversations were used as an intervention with 14 families living with chronic illness. The outcome measures consisted of evaluative family interviews.

    Results

    Families' experiences of the conversations embraced their structure and the interactions with the conversation leaders. All families were satisfied with the conversations, pointing to the importance of having them early in the illness process. The opportunity to talk with someone outside the family was strongly emphasised as promoting well-being. The experienced significance of the conversations was captured in four categories: creating a whole picture, that is, being given the opportunity to listen to other family members' experiences and fill in potential memory gaps; making the situation manageable, that is, receiving support from other participants in order to handle problems and gain control; facilitating healing, that is, being able to tell their story about what had previously been ‘the unspeakable’; and strengthened family cohesion, that is, increased understanding for each other's experiences, thus bringing family members closer together.

    Study limitations

    Most families were partners, which could possibly limit transferability of the findings to families constituted by couples.

    Conclusions

    Family Health Conversations should be offered as a part of standard care shortly after diagnosis and at various transitions in life.

  • 23.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Rosen, Annika
    Palliativt rådgivningsteam inom den sammanhållna hälos- och sjukvården i norr - en utvärderingsrapport.2000Report (Other academic)
  • 24.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    2nd Nordic family Nursing Conference in Kalmar, Sweden - A brief report2006In: Journal of Family Nursing, Vol. 12, no 4, p. 344-345Article in journal (Refereed)
  • 25.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Att vara närstående till person som drabbats av ohälsa2004In: Närståendes behov / [ed] Gertrud Östlinder, Stockholm: Svensk Sjuksköterskeförening , 2004Chapter in book (Other academic)
  • 26.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Family members of persons afflicted by ill health2004Report (Other academic)
  • 27.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Health-promoting conversations about hope and suffering with couples in palliative care2008In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 14, no 9, p. 439-445Article in journal (Refereed)
  • 28.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Hope within cancer patients undergoing palliative care: A systematic literature review2000In: Recent Advances and Research Updates in medicine, Vol. 1(1), p. 89-96Article in journal (Refereed)
  • 29.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Nurses´ perception of hope in patients with cancer: A palliative care perspective1998In: Cancer Nursing, Vol. 21(1), p. 10-16Article in journal (Refereed)
  • 30.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    One step towards the understanding of hope: A concept analysis1998In: International Journal of Nursing Studies, Vol. 35, p. 322-329Article in journal (Refereed)
  • 31.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Rehab 300 - samverkan i vården. Slutrapport1999Report (Other academic)
  • 32.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Rehab 300 - spirapärm. Delrapport.1997Report (Other academic)
  • 33.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Reviews the videotape ‘How to do a 15 minute (or less) family interview’, produced by Lorraine M. Wright and Maureen Leahey2000In: Journal of Family Nursing, Vol. 6(4), p. 405-407Article in journal (Refereed)
  • 34.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Samverkan ivårdkedjan. Utvärdering.1997Report (Other academic)
  • 35.
    Benzein, Eva
    et al.
    University of Kalmar, School of Human Sciences.
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    The meaning of hope in healty, nonreligious Swedes2000In: Western Journal of Nursing Research, Vol. 22(3), p. 303-319Article in journal (Refereed)
  • 36.
    Bergdahl, Elisabeth
    et al.
    Enheten för forskning om palliativ vård, Ersta Sköndal Högskola.
    Benzein, Eva
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Ternestedt, Britt-Marie
    Enheten för forskning om palliativ vård, Ersta Sköndal Högskola.
    Andershed, Birgitta
    Enheten för forskning om palliativ vård, Ersta Sköndal Högskola.
    Development of nurses´ abilities to reflect on how to create good caring relationships with patients in palliative care: an action research approach2011In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 18, no 2, p. 111-122Article in journal (Refereed)
    Abstract [en]

    In this paper we present an action research process aimed at enhancing nurses’ abilities to reflect on how to create good caring relationships with patients in advanced home care. Another aim was to examine the usefulness of an emerging theory, derived from results from a previous study. The request for this project to take place came from an advanced home care unit which had received complaints concerning patients in the palliative phase. The action performed was clinical supervision, structured around abilities that nurses need in order to create good caring relationships. During the action research process 42 narratives were analysed by the participating group. Three different data collections were carried out and analysed with qualitative content analysis in a triangulation procedure. The emerging theory was found to be useful and was also refined. The nurses reported that they felt strengthened and had developed their ability to reflect over good caring relationships. Some changes to practice were carried out by the participating nurses. The result also indicates that action research can be helpful in examining the usefulness of an emerging theory.

  • 37.
    Bergdahl, Elisabeth
    et al.
    Erstaköndal Högskola.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Ersta Sköndal Univ Coll, Dept Palliat Care Res, Stockholm, Sweden.
    Ternestedt, Britt-Marie
    Ersta Sköndal Högskola.
    Elmberger, Eva
    Ersta Sköndal Högskola.
    Andershed, Birgitta
    Ersta Sköndal Högskola.
    Co-creating possibilities for patients in palliative care to reach vital goals: a multiple case study of home-care nursing encounters2013In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 20, no 4, p. 341-351Article in journal (Refereed)
    Abstract [en]

    Co-creating possibilities for patients in palliative care to reach vital goals – a multiple case study of home-care nursing encountersThe patient’s home is a common setting for palliative care. This means that we need to understand current palliative care philosophyand how its goals can be realized in home-care nursing encounters (HCNEs) between the nurse, patient and patient’srelatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been areliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliativecare. The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation buildingphase. The results show that planned palliative HCNEs can be described as a process of co-creating possibilities for thepatient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However,in some HCNEs, co-creation did not occur: Wishes and needs were discouraged or made impossible and vital goals werenot reached for the patients or their relatives. Further research is needed to understand why. The co-creative process presentedin this article can be seen as a concretization of the palliative care ideal of working with a person-centered approach.

  • 38.
    Bylund, Ami
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Persson, Carina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Creating a New Sense of We-ness: Family Functioning in Relation to Gastric Bypass Surgery2013In: BARIATRIC SURGICAL PRACTICE AND PATIENT CARE, ISSN 2168-023X, Vol. 8, no 4, p. 152-160Article in journal (Refereed)
    Abstract [en]

    Background: Gastric bypass surgery (GBP) is the most common treatment for morbid obesity (body mass index 35). To date, the person with obesity has been the main focus in bariatric nursing and research, although the person coexists within their family. Aim: The aim of this study was to describe family functioning in relation to GBP. Methods: Open ended questions were used. Nine families were interviewed on two occasions within 2 weeks 3 months after surgery. The interviews were transcribed and analyzed according to a hermeneutic method. Main Findings: An ongoing process of alterations related to family functioning was identified. Before, GBP families experienced distance and disengagement. Immediately after GBP, there were changes within relationships. Families experienced a period of difficulty, in interactions, while adapting to the lifestyle changes and altered positions. After 3 months, families experienced enhanced closeness in inter-relations within the family and increased social interactions as a whole family with friends and relatives. Conclusions: To better support families and enhance family functioning, bariatric nursing care needs to shift focus from an individual to a family perspective. Further studies are needed to gain a longitudinal perspective and improve understanding of family functioning after GBP.

  • 39.
    Bylund, Ami
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet;Ersta Hospital.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Stabilizing family life after gastric bypass surgery2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1, article id 1325674Article in journal (Refereed)
    Abstract [en]

    Weight-loss surgery requires lifelong lifestyle modifications for the maintenance of weight loss and health effects, and can affect both the individual and family. Earlier research indicates that the quality of social relationships has positive and negative influences on wellbeing and health. There is little research on family-life after a member has undergone gastric bypass (GBP) against obesity. Thus, this study aimed to develop a classic grounded theory about families with a member treated with GBP against obesity. The study design used classic grounded theory and included data from 16 interviews. Families’ shared a main concern of unexpected changes after GBP, resulting in the theory Stabilizing family life, explained as a social process to decrease uncertainty and find stability and well-being in family interactions. The social process develops differently which entail families: attaining unity, returning to old patterns, or disconnecting to find stability, depending on the discrepancy in expectations and knowledge. This is affected by the overall life situation, life-stage and relationship quality. The theory highlights unexpected change as a potential challenge for the family, as well as how they resolve this. Hence, the theory can be applied in care strategies for families. Identification of families needing support to stabilize family life after GBP requires further research.

  • 40.
    Bylund, Ami
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Thorell, Anders
    Danderyd Hospital (KI DS).
    Persson, Carina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Associations between family functioning, weight loss, sex and Health-Related Quality of Life outcomes two years after gastric bypass surgeryManuscript (preprint) (Other academic)
  • 41.
    Bylund, Ami
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet;Ersta Hospital.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Thorell, Anders
    Karolinska Institutet;Ersta Hospital.
    Persson, Carina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Assessment of family functioning: evaluation of the General Functioning Scale in a Swedish Bariatric Sample2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 3, p. 614-622Article in journal (Refereed)
    Abstract [en]

    BackgroundThe General Functioning Scale (GFS) was developed to assess self-perceived overall family functioning. The scale has satisfactory psychometric properties, is internationally recognised and has been used in different contexts. However, no validated Swedish version is available. Healthy family functioning can support patients and help them adhere to treatment regimens. Moreover, it maintains the physical and emotional health and that of the family as a unit. Yet, there is limited information regarding family functioning postgastric bypass surgery. Thus, it is important to use validated instruments to understand family functioning in bariatric contexts. AimTo evaluate aspects of reliability and validity in GFS in a Swedish bariatric sample, focusing on factor structure. MethodThe Swedish version of the GFS (S-GFS) was administered on two occasions to 163 participants who had undergone gastric bypass surgery 6-8 weeks prior to testing. Internal consistency, temporal stability and construct validity were assessed. ResultsData were positively skewed. The S-GFS showed good internal consistency (ordinal = 0.92) with a sufficient overall mean interitem correlation (0.500) and adequate temporal stability (intraclass correlation coefficient = 0.833). After modifying response alternatives, confirmatory factor analysis indicated acceptable fit for a one-factor model. ConclusionThe scale is a promising tool for assessing family functioning in bariatric settings. The S-GFS showed satisfactory reliability - consistent with prior research - and acceptable validity in the study sample. This study contributes to the limited research on the scale's validity. However, the S-GFS needs to be evaluated in different cultural and clinical contexts, focusing on various aspects of validity and responsiveness (sensitivity to detect significant change over time) in different samples.

  • 42.
    Dalteg, T.
    et al.
    Jönköping university.
    Sandberg, J. S. Jonas
    Jönköping university.
    Malm, D. M. Dan
    Jönköping university.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S41-S41Article in journal (Other academic)
  • 43.
    Dalteg, Tomas
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Jönköping University.
    Benzein, Eva
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Fridlund, Bengt
    Jönköping University.
    Malm, Dan
    Jönköping University.
    Cardiac Disease and its Consequences on the Partner Relationship: A Systematic Review2011In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 10, no 3, p. 140-149Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Cardiac disease is a chronic illness that has extensive impact on patients and their partners. No previous review has been made on how the partner relationship is affected following cardiac disease. The review limited itself to the main cardiac disease of myocardial ischemia, arrhythmia and heart failure. AIM: The aim of this review was to identify how the partner relationship is affected following cardiac disease after hospital discharge.

    METHOD: CINAHL, PubMed and PsycINFO were searched from 1999 to 2009. Quality assessment of included articles was made using the Joanna Briggs Institute Reviewers' Manual. A total of 20 articles were included.

    RESULTS: Five themes identified how the partner relationship is affected following cardiac disease, namely: overprotection, communication deficiency, sexual concerns, changes in domestic roles, and adjustment to illness. Patients reported feeling overprotected by their spouses which occasionally served as a fertile ground for arguments or conflicts. Most couples experienced some implications concerning their sexual life following cardiac disease, though in various degrees. Both patients and partners seemed to experience communication deficiency concerning emotions within their relationship following the event. Most couples experienced a shift in roles and responsibilities within their partner relationship. Even though most couples experienced great distress following being afflicted with cardiac disease they reported that the disease had brought them closer together.

    CONCLUSION: The review found that though couples found the cardiac event distressful they conformed and adjusted their relationship to the new situation.

  • 44.
    Dalteg, Tomas
    et al.
    Jönköping University.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandgren, Anna
    Jönköping University.
    Fridlund, Bengt
    Jönköping University.
    Malm, Dan
    Jönköping University.
    Managing uncertainty in couples living with atrial fibrillation2014In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 29, no 3, p. E1-E10Article in journal (Refereed)
    Abstract [en]

    Background: Living with a chronic disease such as atrial fibrillation (AF) not only affects the patient but also has implications for the partner. There is a lack of research on couples living with AF and, in particular, how they experience and deal with the disease.

    Objective: The aim of this study was to explore couples’ main concerns when one of the spouses is afflicted with AF and how they continually handle it within their partner relationship.

    Methods: Classical grounded theory was used throughout the study for data collection and analysis. Interviews were conducted with 12 couples (patient and partner together). There were follow-up interviews with 2 patients and 2 partners separately.

    Results: Couples living with AF experience uncertainty as a common main concern. This uncertainty was fundamentally rooted in not knowing the cause of AF and apprehension about AF episodes. Couples managed this uncertainty by either explicitly sharing concerns related to AF or through implicitly sharing their concerns. Explicit sharing incorporated strategies of mutual collaboration and finding resemblance, whereas implicit sharing incorporated strategies of keeping distance and tacit understanding. Time since diagnosis and time being symptom-free were factors influencing afflicted couples’ shifting between implicit and explicit sharing.

    Conclusions: Atrial fibrillation affects the partner relationship by bringing uncertainty into couples’ daily lives. Even though this study shares similarities with previous studies on couples living with chronic disease, it contributes to the existing knowledge by presenting a set of strategies used by couples in managing uncertainty when living with AF.

  • 45.
    Dalteg, Tomas
    et al.
    Jönköping University.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Malm, Dan
    Jönköping University;County Hospital Ryhov.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Associations of Emotional Distress and Perceived Health in Persons With Atrial Fibrillation and Their Partners Using the Actor–Partner Interdependence Model2016In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 22, no 3, p. 368-391Article in journal (Refereed)
    Abstract [en]

    Individual behavior affects and is affected by other people. The aim of this study was to examine if emotional distress in patients with atrial fibrillation (AF) and their spouses was associated with their own and their partner’s perceived health. Participants included 91 dyads of patients and their spouses. Emotional distress was measured using the Hospital Anxiety and Depression Scale and perceived health was measured with the Short Form 36 Health Survey. The Actor–Partner Interdependence Model was used for dyad-level analyses of associations, using structural equation modeling. Higher levels of anxiety and depression were associated with lower levels of perceived health in patients and spouses. Higher levels of depression in patients were associated with lower levels of vitality in spouses and vice versa. As AF patients and their spouses influence each other, health-care interventions should consider the dyad to address dyadic dynamics. This may benefit the health of the individual patient and of the couple.

  • 46.
    Dalteg, Tomas
    et al.
    Jönköping University.
    Sandberg, Jonas
    Jönköping University.
    Malm, Dan
    Jönköping University;County Hospital Ryhov.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 21-22, p. 3699-3709Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. To explore illness beliefs in couples where one spouse has atrial fibrillation.& para;& para;Background. Beliefs are the lenses through which we view the world, guiding our behaviour and constructing our lives. Couples evolve an ecology of beliefs from their interaction whereby their actions and choices arise from their beliefs. Atrial fibrillation is a common cardiac arrhythmia that has implications for both patients and partners. A couple's illness beliefs play an important role in convalescence and illness management, and no previous studies have explored illness beliefs in couples living with atrial fibrillation.& para;& para;Design. A qualitative hermeneutic design.& para;& para;Methods. Data collection constituted in-depth interviews with nine couples (patient and partner together). Hermeneutic philosophy as described by Gadamer was used to interpret and to understand illness beliefs in couples living with atrial fibrillation.& para;& para;Results. The findings revealed both core illness beliefs and secondary illness beliefs. From the core illness belief 'The heart is a representation of life', two secondary illness beliefs were derived: atrial fibrillation is a threat to life and atrial fibrillation can and must be explained. From the core illness belief 'Change is an integral part of life', two secondary illness beliefs were derived: atrial fibrillation is a disruption in our lives and atrial fibrillation will not interfere with our lives. Finally, from the core illness belief 'Adaptation is fundamental in life', two secondary illness beliefs were derived: atrial fibrillation entails adjustment in daily life and atrial fibrillation entails confidence in and adherence to professional care.& para;& para;Conclusion. Couples' interaction has developed mutual illness beliefs regarding atrial fibrillation that guide them in their daily lives and influence their decisions. The adoption of a family-centred perspective in cardiovascular care settings is warranted.

  • 47.
    Edback, Maria Palmetun
    et al.
    University Hospital Örebro ; Örebro University ; Örebro County Council.
    Lindberg, Magnus
    University Hospital Örebro ; Örebro University.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Örebro University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University ; Ersta Sköndal University College ; Ersta Hospital.
    Social support: an important factor for quality of life in women with hirsutism2014In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 12, article id 183Article in journal (Refereed)
    Abstract [en]

    Background: Women with hirsutism have reported imparied health and health-related quality of life (HRQoL). Social support is a factor that might increase HRQoL in chronic diseases, but little is known about this association among women with hirsutism. Aim: The aim of the study was to describe social support and explore its association with HRQoL among women with hirsutism. A further aim was to compare HRQoL in women with hirsutism with a Swedish normal population. Methods: A questionnaire including socio-demographic questions, Short-Form Health Survey (SF-36), the Multidimensional Scale of Perceived Social Support (MSPSS), and a self-estimation of hairiness using the Ferriman-Gallway scale (F-G scale) was answered by 127 women with hirsutism. Results: Multiple regression analyses showed significant associations between social support and all health dimensions in the SF-36, also after the model was adjusted for age, hairiness and body mass index. Compared to the normal Swedish population, women with hirsutism reported significantly lower HRQoL in all dimensions of the SF-36 (p < 0.01). Conclusions: There is a significant positive association between social support and HRQoL, demonstrating its importance for the ability to adapt to problems associated with hirsutism. As women with hirsutism reported poorer HRQoL compared to the normal population, social support may be a factor to consider in clinical practice.

  • 48.
    Ekback, Maria
    et al.
    University Hospital Örebro ; Örebro University.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lindberg, Magnus
    University Hospital Örebro ; Örebro University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University ; Ersta Sköndal University College ; Ersta hospital.
    The Swedish version of the multidimensional scale of perceived social support (MSPSS): a psychometric evaluation study in women with hirsutism and nursing students2013In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 11, article id 168Article in journal (Refereed)
    Abstract [en]

    Background: The Multidimensional Scale of Perceived Social Support (MSPSS) is a short instrument, developed to assess perceived social support. The original English version has been widely used. The original scale has demonstrated satisfactory psychometric properties in different settings, but no validated Swedish version has been available. The aim was therefore to translate, adapt and psychometrically evaluate the Multidimensional Scale of Perceived Social Support for use in a Swedish context. Method: In total 281 participants accepted to join the study, a main sample of 127 women with hirsutism and a reference sample of 154 nursing students. The MSPSS was translated and culturally adapted according to the rigorous official process approved by WHO. The psychometric evaluation included item analysis, evaluation of factor structure, known-group validity, internal consistency and reproducibility. Results: The original three-factor structure was reproduced in the main sample of women with hirsutism. An equivalent factor structure was demonstrated in a cross-validation, based on the reference sample of nursing students. Known-group validity was supported and internal consistency was good for all scales (alpha = 0.91-0.95). The test-retest showed acceptable to very good reproducibility for the items (kappa(w) = 0.58-0.85) and the scales (ICC = 0.89-0.92; CCC = 0.89-0.92). Conclusion: The Swedish version of the MSPSS is a multidimensional scale with sound psychometric properties in the present study sample. The simple and short format makes it a useful tool for measuring perceived social support.

  • 49.
    Ekbäck, Maria
    et al.
    Örebro universitet.
    Wijma, Klas
    Linköpings universitet.
    Benzein, Eva
    University of Kalmar, School of Human Sciences.
    It is always on my mind: Women’s experiences of their body when living with hirsutism2009In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 30, no 5, p. 358-372Article in journal (Refereed)
    Abstract [en]

    Many women suffer from excessive hair growth, often in combination with polycystic ovarian syndrome (PCOS). It is unclear how hirsutism influences such women's experiences of their bodies. Our aim is to describe and interpret women's experiences of their bodies when living with hirsutism. Interviews were conducted with 10 women with hirsutism. We used a qualitative latent content analysis. Four closely intertwined themes were disclosed: the body was experienced as a yoke, a freak, a disgrace, and as a prison. Hirsutism deeply affects women's experiences of their bodies in a negative way.

  • 50. Henriksson, A.
    et al.
    Andershed, B.
    Benzein, Eva
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Adaptation and psychometric evaluation of the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale in a sample of Swedish family members of patients with life-threatening illness2012In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 26, no 7, p. 930-938Article in journal (Refereed)
    Abstract [en]

    Background: Family members often take on many caring responsibilities, with complex issues and challenges to consider. Feelings of preparedness, competence and reward are identified as concepts that may protect caregiver wellbeing and decrease negative outcomes related to caregiving. Aim: This study aimed to translate, adapt and psychometrically evaluate the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale in Swedish family members of patients with life threatening illness. Design: Correlational. Setting/participants: The study took place in four settings including advanced palliative care. The scales were tested in a sample of 125 family members of persons with life-threatening illness. All three scales were tested in relation to distribution of item and scale scores, missing data patterns, dimensionality, convergent validity and reliability. Results: The results in this study indicate that the Swedish versions of The Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale are valid, reliable and user-friendly scales. Confirmatory factor analysis showed that the scales were unidimensional and all demonstrated Cronbach's alpha values of ≥0.9. Conclusions: As a result of this study it is anticipated that the Preparedness for Caregiving Scale, Caregiver Competence Scale and Rewards of Caregiving Scale could provide a basis for collaborative research between different countries and make international studies more comparable and generalizable despite differences in language and culture. © 2011 The Author(s).

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