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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.
    Alftberg, Åsa
    et al.
    Malmö University.
    Ahlström, Gerd
    Lund University.
    Nilsen, Per
    Linköping University.
    Behm, Lina
    Lund 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.
    Wallerstedt, Birgitta
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Rasmussen, Birgit H.
    Lund University;Region Skåne.
    Conversations about Death and Dying with Older People: An Ethnographic Study in Nursing Homes2018In: Healthcare, E-ISSN 2227-9032, Vol. 6, no 2, article id 63Article in journal (Refereed)
    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.

  • 3.
    Blomqvist, Marjut
    et al.
    Halmstad University, Sweden.
    Ivarsson, Andreas
    Halmstad University, Sweden.
    Carlsson, Ing-Marie
    Halmstad University, Sweden.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Jormfeldt, Henrika
    Halmstad University, Sweden.
    Health Effects of an Individualized Lifestyle Intervention for People with Psychotic Disorders in Psychiatric Outpatient Services: A Two Year Follow-up2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673Article in journal (Refereed)
    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.

  • 4.
    Blomqvist, Marjut
    et al.
    Halmstad University.
    Ivarsson, Andreas
    Halmstad University.
    Carlsson, Ing-Marie
    Halmstad University.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Jormfeldt, Henrika
    Halmstad University.
    Health risks among people with severe mental illness in psychiatric outpatient settings2018In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 39, no 7, p. 585-591Article in journal (Refereed)
    Abstract [en]

    Life expectancy is greatly reduced in patients with schizophrenia, and cardiovascular diseases are a leading cause of mortality. The aim of this cross-sectional study was to investigate the prevalence of overweight, obesity, and cardiovascular disease (CVD) risk and to investigate the relationships between self-rated health, sense of coherence, CVD risk, and body mass index (BMI) among people with severe mental illness (SMI) in psychiatric outpatient settings. Nearly 50% of the participants were exposed to moderate/high risk of CVD and over 50% were obese. The results showed no statistically relationships between the subjective and objective measures (Bayes factor <1) of health. The integration of physical health into clinical psychiatric nursing practice is vital.

  • 5.
    Blomqvist, Marjut
    et al.
    Halmstad University.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Ing-Marie
    Halmstad University.
    Jormfeldt, Henrika
    Halmstad University.
    Enabling healthy living: Experiences of people with severe mental illness in psychiatric outpatient services2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 1, p. 236-246Article in journal (Refereed)
    Abstract [en]

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

  • 6.
    Brolin, Rosita
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Brunt, David
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Rask, Mikael
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Syrén, Susanne
    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.
    Mastering everyday life in ordinary housing for people with psychiatric disabilities2016In: The Grounded Theory Review, ISSN 1556-1542, E-ISSN 1556-1550, Vol. 15, no 1, p. 10-25Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to develop a classic grounded theory about people who have psychiatric disabilities and live in ordinary housing with housing support. Interviews and observations during the interviews were analyzed, and secondary analyses of data from previous studies were performed. The impossible mission in everyday life emerged as the main concern and mastering everyday life as the pattern of behavior through which they deal with this concern. Mastering everyday life can be seen as a process, which involves identifying, organizing, tackling, challenging and boosting. Before the process is started, avoiding is used to deal with the main concern. The community support worker, providing housing support, constitutes an important facilitator during the process, and the continuity of housing support is a prerequisite for the process to succeed. If the process mastering everyday life is interrupted by, for example, changes in housing support, the strategy of avoiding is used.

  • 7.
    Brolin, Rosita
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Brunt, David
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Rask, Mikael
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Syrén, Susanne
    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.
    Striving for meaning: Life in supported housing for people with psychiatric disabilities2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 31249Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to develop a grounded theory about people with psychiatric disabilities, living in supported housing. Interviews as well as observations during the interviews were analyzed together with secondary analyses of quantitative and qualitative material from previous studies. Being deprived of self-determination emerged as the main concern for residents in supported housing and striving for meaning emerged as the pattern of behavior through which this group resolves their main concern. Striving for meaning involves living in the present, striving for self-determination, strengthening self-esteem, emotional processing and resting from the present. The strategies facilitate each other and are used singly, together simultaneously, or alternately. If they are successful, a meaning in the present is perceived. If all the strategies fail repeatedly, escaping from the present is used in order to deal with being deprived of self-determination. The implications of the findings suggest prioritizing a reduction of the institutional nature of the social and physical environment, and to support the residents' self-determination.

  • 8.
    Brolin, Rosita
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Syrén, Susanne
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Rask, Mikael
    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.
    Brunt, David
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Residents' perceptions of the most positive and negative aspects of the housing situation for people with psychiatric disabilities2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 603-611Article in journal (Refereed)
    Abstract [en]

    The major aim of the present study was to explore what people with psychiatric disabilities, living in two different types of housing, consider to be the best and the worst in their housing situation. A secondary aim was to explore to what extent additional questions to a questionnaire with a free-response format can provide complementary information to the previous knowledge in the field. The content analysis revealed that the physical attributes were of great significance for the residents in ordinary housing, while both psychosocial aspects and physical attributes were important for those living in supported housing. When providing good housing solutions for people with psychiatric disabilities, attention needs to be given to these aspects by politicians, policymakers as well as by nursing staff.

  • 9.
    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.

  • 10.
    Bylund-Grenklo, Tove
    et al.
    University of Gävle, Sweden;Karolinska institutet, Sweden.
    Werkander Harstäde, Carina
    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.
    Benzein, Eva
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Östlund, Ulrika
    Uppsala university, Sweden;Örebro university, Sweden.
    Dignity in life and care: the perspectives of Swedish patients in a palliative care context.2019In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 25, no 4, p. 193-201Article in journal (Refereed)
    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.

  • 11.
    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
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    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 Care2018In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 20, no 4, p. 392-399Article in journal (Refereed)
    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.

  • 12.
    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)
  • 13.
    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.

  • 14.
    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.

  • 15.
    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.

  • 16.
    Grimheden, Sofia
    et al.
    Region Kronoberg.
    Lindqvist, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bylund Grenklo, Tove
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    An obligation to care for seriously ill children in their homes: a qualitative study of community nurses' perceptions2017In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 37, no 4, p. 201-208Article in journal (Refereed)
    Abstract [en]

    When children are seriously ill, being able to be cared for at home with the family is valuable, but community nurses are often not trained to care for children. The aim of this study was therefore to describe community nurses´perceptions of caring for serioulsy ill children at home. A content analysis was conducted of 11 semi-structed interviews with nurses. One theme, obligation to care, was found, followed by three categories: making an impact, feeling confident, and emotional processing. In conclusion, we found collaboration with paediatric staff in the hospital is important for community nurses in order to gain confidence, which would optimise care at home for seriously ill children and their families.

  • 17.
    Gustafsson, Anna W.
    et al.
    Lund University, Sweden.
    Hommerberg, Charlotte
    Linnaeus University, Faculty of Arts and Humanities, Department of Languages.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Coping by metaphors: The versatile function of metaphors in blogs about living with advanced cancer2019In: Medical Humanities, ISSN 1468-215X, E-ISSN 1473-4265Article in journal (Refereed)
    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.

  • 18.
    Henoch, Ingela
    et al.
    University of Gothenburg, Sweden.
    Carlander, Ida
    Ersta Sköndal Bräcke University College, Sweden;Ersta Hospital Sweden;Karolinska Institutet, Sweden.
    Holm, Maja
    Ersta Sköndal Bräcke University College, Sweden;Ersta Hospital, Sweden;Karolinska Institutet, Sweden.
    James, Inger
    Örebro university, Sweden.
    Sarenmalm, Elisabeth Kenne
    Ersta Sköndal Bräcke University College, Sweden;Ersta Hospital, Sweden;Skaraborg Hospital, Sweden.
    Hagelin, Carina Lundh
    Karolinska Institutet, Sweden;Sophiahemmet University, Sweden;Stockholm Sjukhem, Sweden.
    Lind, Susanne
    Ersta Sköndal Bräcke University College, Sweden;Ersta Hospital, Sweden;Karolinska Institutet, Sweden.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping University, Sweden.
    Ohlen, Joakim
    University of Gothenburg, Sweden;Ersta Sköndal Bräcke University College, Sweden;Ersta Hospital, Sweden.
    Palliative Care Research - A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 20122016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 1, p. 5-25Article, review/survey (Refereed)
    Abstract [en]

    BackgroundIn 2007, a literature review was undertaken of palliative care research from Sweden during the 1970s-2006, paving the way for a follow-up study to explore the recent developments. The aim was to systematically examine palliative care research from Sweden between 2007 and 2012, with special attention to methods, designs and research foci. MethodsA literature review was undertaken. The databases Academic search elite, Age line, Ahmed, Cinahl, PsychInfo, PubMed, Scopus, Soc abstracts, Web of science and Libris were reviewed for Swedish palliative care research studies published from 2007 to 2012, applying the search criteria palliative care OR palliative medicine OR end-of-life care OR terminal care OR hospice care OR dying OR death'. ResultsA total of 263 papers met the inclusion criteria, indicating an increased volume of research compared to the 133 articles identified in the previous review. Common study foci were symptom assessment and management, experiences of illness and care planning. Targeting non-cancer-specific populations and utilisation of population-based register studies were identified as new features. There was continued domination of cross-sectional, qualitative and mono-disciplinary studies, not including ethnic minority groups, nonverbally communicable people or children <18years of age. ConclusionsThe trend is that Swedish palliative care research has expanded in volume from 2007 to 2012 compared to during the 1970s to 2006, with increasing participation of non-cancer-specific populations. A domination of qualitative approaches and small, cross-sectional studies with few interventions is still characteristic. Still more strategies are needed to expand the knowledge development of palliative care to respond to demographical, epidemiological, therapeutic and healthcare structure changes.

  • 19.
    Hjelmfors, A-L
    et al.
    Linköping University.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Stromberg, A. S.
    Linköping University.
    Martensson, J. M.
    Jönköping University.
    Jaarsma, T. J.
    Linköping University.
    Friedrichsen, M. F.
    Linköping University.
    Patient perspectives of prognosis communication2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S65-S66Article in journal (Other academic)
  • 20.
    Hjelmfors, A-L
    et al.
    Linköping University.
    Strömberg, A. S.
    Linköping University.
    Friedrichsen, M. F.
    Linköping University.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Mårtensson, J. M.
    Jönköping University.
    Jaarsma, T. J.
    Linköping University.
    Using co-design to develop an intervention to improve communication about the heart failure trajectory and end-of-life care2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, p. 23-23Article in journal (Other academic)
  • 21.
    Hjelmfors, Lisa
    et al.
    Linköping University.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Strömberg, Anna
    Linköping University.
    Mårtensson, Jan
    Jönköping University.
    Jaarsma, Tiny
    Linköping University.
    Friedrichsen, Maria
    Linköping University.
    “I was told that I would not die from heart failure”: patient perceptions of prognosis communication2018In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 41, p. 41-45Article in journal (Refereed)
    Abstract [en]

    Aim and objectives

    To describe patients’ experiences of communication about their heart failure prognosis and explore how these experiences affected their preferences for future communication about the prognosis.

    Background

    Professionals need to discuss about the heart failure prognosis with patients in order to improve their understanding of their illness and address palliative care needs.

    Methods

    An inductive and exploratory design was used. A total of 24 patients (75% men, 52–87 years of age) in New York Heart Association class I-III from primary outpatient care participated in focus group-, or individual semi-structured interviews. Thematic analysis was used to identify and interpret patterns in the data.

    Findings

    Two overarching themes, “The message sent” and “Hoping for the best or preparing for the worst”, each with three sub-themes, were discovered during the thematic analysis. Many patients described that professionals had not provided them with any prognosis information at all. Other patients described professional information about prognosis that was given in an either very optimistic or very negative way. However, patients also described situations where professionals had given information in a way that they thought was perfect for them to handle, and in accordance with their preferences.

    Conclusion

    This study shows that patients have different experiences and preferences for communication about prognosis and uses different approaches in order to cope living with a chronic illness such as heart failure.

  • 22.
    Hjelmfors, Lisa
    et al.
    Linköping University.
    Strömberg, Anna
    Linköping University.
    Friedrichsen, Maria
    Linköping University.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Mårtensson, Jan
    Jönköping University.
    Jaarsma, Tiny
    Linköping University.
    Using co-design to develop an intervention to improve communication about the heart failure trajectory and end-of-life care2018In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 17, article id 85Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this paper was to describe the development of an intervention that is developed to improve communication about the heart failure (HF) trajectory and end-of-life care. We also present data that provides a first insight in specific areas of feasibility of the intervention. Methods: Co-design was used and patients, family members and health care professionals were constructive participants in the design process of the intervention. Feasibility of the intervention was tested in two areas; acceptability and limited efficacy. Results: Two communication tools were designed and evaluated; 1) a Question Prompt List (QPL) for patients and family members and 2) a communication course for professionals which was web -based with one face-to-face training day with simulation. Data on feasibility was collected with questionnaires that were developed for this study, from the 13 participants who completed the course (all nurses). They reported improved knowledge, confidence and skills to discuss the HF trajectory and end-of-life care. The QPL was evaluated to be a useful tool in communication with patients and family members. Conclusions: In a co-design process, future users identified the need for a QPL and a communication course. These communication tools can be used as a dual intervention to improve communication about the HF trajectory and end-of-life care. The QPL can help patients and families to ask questions about the HF trajectory and end-of-life care. The communication course can prepare the professionals to be knowledgeable, confident and skilled to discuss the questions in the QPL. Before the tools are ready for implementation in clinical practice, further studies testing the feasibility of the intervention are needed, including also patients and their families.

  • 23.
    Hommerberg, Charlotte
    Linnaeus University, Faculty of Arts and Humanities, Department of Languages.
    Wallberg Gustafsson, Anna (Contributor)
    Lund University.
    Sandgren, Anna (Contributor)
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hur vi talar om cancer2017Other (Other (popular science, discussion, etc.))
  • 24.
    Hommerberg, Charlotte
    et al.
    Linnaeus University, Faculty of Arts and Humanities, Department of Languages.
    Gustafsson, Anna W.
    Lund 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.
    Metaforer i palliativ cancervård2016In: Palliativ vård: tidskriften för palliativ vård i Sverige, ISSN 2001-841X, no 4, p. 36-37Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Metaforer är våra språkliga ”redskap” när vi talar om okända eller känsliga ämnen. Att reflektera över hur dessa används kan ge vårdpersonal ökad förståelse för hur patienter och närstående ser på och hanterar sin situation.

  • 25.
    Hommerberg, Charlotte
    et al.
    Linnaeus University, Faculty of Arts and Humanities, Department of Languages.
    Gustafsson, Anna W.
    Lund 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.
    Semino, Elena
    Lancaster University.
    Koller, Veronika
    Lancaster University.
    Rendering the ungraspable graspable: the use of metaphors in Swedish palliative cancer care2016In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 30, no 6, p. NP364-NP364Article in journal (Other academic)
    Abstract [en]

    Good communication is of utmost importance in all forms of cancer care and especially so in the palliative context. To render the ungraspable graspable, metaphors are frequently used drawing on their capacity to capture the intangible in terms of more familiar experiences. For instance, to die from cancer can be described as ’coming to the end of a life journey’ or ’losing a battle’. Metaphors are largely language and culture specific. Today’s increasingly multicultural societies require particular awareness in order to achieve dignified, individualized palliative cancer care. This project aims to strengthen the scientific foundation for the use of metaphors in Swedish palliative cancer care. A secondary aim is to compare the use of metaphors in Sweden and the UK in order to reveal differences and similarities. Textual data are collected from

    1. a) internet-based blogs, where patients write about their illness-related emotions and experiences while being in palliative care, and from

    2. b) interviews with patients, family and health care professionals, where the focus is to investigate what it means to live a dignified life in palliative care.

    The two sets of data are analyzed using both qualitative and quantitative linguistic methods. First, the Pragglejaz procedure, a well-established linguistic method for metaphor identification, is used in order to manually identify metaphorical expressions in the material, develop analytic categories adapted to the Swedish language data and ensure inter-rater reliability. Second, the material is approached by means of corpus linguistic methods. The combination of research methods is inspired by the UK-based MELC project. The data are currently being processed and the first results will be presented at the conference. The project is funded by The Kamprad Family Foundation, Sweden.

  • 26.
    Lindmark, Ulrika
    et al.
    Jönköping University, Sweden.
    Bülow, Pia H.
    Jönköping University, Sweden;University of the Free State, South Africa.
    Mårtensson, Jan
    Jönköping University, Sweden.
    Rönning, Helén
    Jönköping University, Sweden.
    Broström, Anders (Contributor)
    Jönköping University, Sweden.
    Fransson, Eleonor I. (Contributor)
    Jönköping University, Sweden.
    Fridlund, Bengt (Contributor)
    Jönköping University, Sweden.
    Gunnarsson, Nina (Contributor)
    Jönköping University, Sweden.
    Henricsson, Maria (Contributor)
    Jönköping University, Sweden.
    Kjellström, Sofia (Contributor)
    Jönköping University, Sweden.
    Sandgren, Anna (Contributor)
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review2019In: Nursing Open, E-ISSN 2054-1058, p. 1-12Article in journal (Refereed)
    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.

  • 27.
    Malm, Dan
    et al.
    Jönköping university.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Jönköping university.
    Regaining normalcy in relatives of patients with pacemaker2014In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, no 3, p. 139-149Article in journal (Refereed)
    Abstract [en]

    Patients with chronic diseases, such as those with pacemakers, have shown that they have a worsened well-being, which means an increased interest in investigating how relatives of patients with pacemakers experience their situations and how the disease affects their life situations. The aim of this study was to explore the main concerns for the relatives of patients with a pacemaker and how they resolve these issues. A classic grounded theory was used throughout the study for data collection and analysis. Interviews were conducted with ten participants. Striving for normalcy emerged as the main concern for relatives of patients with a pacemaker and was handled through a process of regaining normalcy where the relatives strive to find a way to live as normal as possible. Regaining normalcy is done through developing trustdwindling and finally life stabilizing, in which they are either holding back or new normalizing. Distinguishing signs are constantly done during the process to quickly notice possible symptoms of the patient. Increased knowledge and understanding of how the relatives of patients with a pacemaker regain normalcy can be used as a guide in order to support and inform the patient as well as their relatives in conjunction with implantation occasions but also in connection with recurring and lifelong follow-up occasions.

  • 28.
    Moellerberg, Marie-Louise
    et al.
    Skåne University Hospital, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Swahnberg, Katarina
    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.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    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 study2019In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030XArticle in journal (Refereed)
    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.

  • 29.
    Munck, Berit
    et al.
    Jönköping University, Sweden.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    The impact of medical technology on sense of security in the palliative home care setting2017In: British Journal of Community Nursing, ISSN 1462-4753, E-ISSN 2052-2215, Vol. 22, no 3, p. 130-135Article in journal (Refereed)
    Abstract [en]

    The increase in the use of medical devices in palliative home care requires that patients and next-of-kin feel secure. Therefore, the aim was to describe medical technology's impact on the sense of security for patients, next-of-kin and district nurses. Deductive content analysis was conducted on data from three previous studies, using the theoretical framework 'palliative home care as a secure base'. The use of medical technology was shown to have an impact on the sense of security for all involved. A sense of control was promoted by trust in staff and their competence in managing the technology, which was linked to continuity. Inner peace and being in comfort implied effective symptom relief facilitated by pain pumps and being relieved of responsibility. Health care professionals need to have practical knowledge about medical technology, but at the same time have an awareness of how to create and maintain a sense of security.

  • 30.
    Munck, Berit
    et al.
    Hälsohögskolan, Jönköping.
    Sandgren, Anna
    Hälsohögskolan, Jönköping .
    Fridlund, Bengt
    Hälsohögskolan, Jönköping.
    Mårtensson, Jan
    Hälsohögskolan, Jönköping.
    Next-of-kin’s conceptions of medical technology in palliative homecare2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 13/14, p. 1868-1877Article in journal (Refereed)
    Abstract [en]

    Aims and objectives.  Describe next-of-kin’s conceptions of medical technology in palliative homecare.

    Background.  Next-of-kin to palliative patients are in an exposed position with increasing responsibility. The more involved they are in the care, the greater caregiver burden they describe. Medical technology has become increasingly common in palliative homecare, and previous research suggests that the devices transform the homes to a hospital ward, thus shifting responsibility from the personnel to the next-of-kin.

    Design.  An explorative descriptive design with a phenomenographic approach was chosen to describe qualitatively different conceptions of the phenomenon medical technology.

    Method.  Interviews with 15 next-of-kin to patients in palliative homecare were analysed in a seven-step process where 10 conceptions emerged in five description categories.

    Results.  Medical technology in palliative homecare required next-of-kin’s responsibility in monitoring or providing practical help. It also implied uncertainty among the next-of-kin because of worries about its safety or because of an improper handling. The technology trespassed on daily life because it restricted and affected the private sphere. Medical technology enabled comfort as it implied security and was a prerequisite for the patient to be cared for at home. It also required an adjustment to comprehend and manage the medical technology.

    Conclusions.  Medical technology resulted in an increased caregiver burden and uncertainty among the next-of-kin. Although it meant restrictions and affected their social life, they had great confidence in its possibilities.

    Relevance to clinical practice.  It is important to limit the amount of personnel and materials in the home to avoid trespassing on the family’s daily life. Medical personnel also have to be sensitive to what next-of-kin have the strength to do and not use them as informal caregivers.

  • 31.
    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 analysis2012In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 14, no 3, p. 191-198Article in journal (Refereed)
    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.

  • 32.
    Möllerberg, Marie-Louise
    et al.
    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.
    Lithman, T.
    Lund University.
    Noreen, D.
    Lund University.
    Olsson, H.
    Lund University Hospital.
    Sjovall, K.
    Lund University Hospital.
    The effects of cancer diagnosis on the health of the patient's partner: A population-based register study of cancer in Sweden2015In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 51, p. S250-S51Article in journal (Other academic)
  • 33.
    Möllerberg, Marie-Louise
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Skåne University Hospital.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lithman, T.
    Lund University.
    Noreen, D.
    Lund University.
    Olsson, H.
    Skåne University Hospital;Lund University.
    Sjövall, K.
    Skåne University Hospital;Lund University.
    The effects of a cancer diagnosis on the health of a patient's partner: a population-based registry study of cancer in Sweden2016In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 25, no 5, p. 744-752Article in journal (Refereed)
    Abstract [en]

    The aim of this population-based registry study was to explore how cancer influences the health of partners, by examining the onset of new diagnoses for partners, health care use and health care costs among partners living with patients with cancer. The sample consisted of partners of patients with cancer (N = 10 353) and partners of age- and sex-matched controls who did not have cancer (N = 74 592). Diagnoses, health care use and health care costs were studied for a continuous period starting 1 year before the date of cancer diagnosis and continued for 3 years. One year after cancer diagnosis, partners of patients with cancer had significantly more mood disorders, reactions to severe stress and ischaemic heart disease than they exhibited in the year before the diagnosis. Among partners of patients with cancer, the type of cancer was associated with the extent and form of increased health care use and costs; both health care use and costs increased among partners of patients with liver cancer, lung cancer, colon cancer and miscellaneous other cancers. The risk of poorer health varied according to the type of cancer diagnosed, and appeared related to the severity and prognosis of that diagnosis.

  • 34.
    Möllerberg, Marie-Louise
    et al.
    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.
    Swahnberg, Katarina
    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.
    Familial interaction patterns during the palliative phase of a family member living with cancer2017In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 72, p. S162-S162Article in journal (Other academic)
  • 35.
    Möllerberg, Marie-Louise
    et al.
    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.
    Swahnberg, Katarina
    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.
    Familial Interaction Patterns During the Palliative Phase of a Family Member Living With Cancer2017In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 19, no 1, p. 67-74Article in journal (Refereed)
    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.

  • 36.
    Oliva, Delmy
    et al.
    Ryhov County Hospital, Jönköping.
    Sandgren, Anna
    Jönköping university.
    Nilsson, Mats
    Jönköping County Council.
    Lewin, Freddi
    Ryhov County Hospital, Jönköping.
    Variations in self-reported nausea, vomiting and well-being during the first 10 days postchemotherapy in women with breast cancer2014In: Clinical Journal of Oncology Nursing, ISSN 1092-1095, E-ISSN 1538-067X, Vol. 18, no 2, p. E32-E36Article in journal (Refereed)
    Abstract [en]

    Women with breast cancer undergoing chemotherapy experience nausea and vomiting, both common symptoms affecting quality of life. The aim of the current study was to describe how nausea, vomiting, and well-being vary during the first 10 days after chemotherapy in women with breast cancer. A pilot study with a repeated-measurements design was conducted at a Swedish county hospital where 39 women with breast cancer treated with adjuvant chemotherapy were observed. A structured 10-day diary was used for data collection. Of the 39 women in the study, 33 experienced nausea and 6 also experienced vomiting after chemotherapy. Changes in well-being as a result of nausea or vomiting during any part of the day, as well as distress for other reasons, were reported. Well-being also varied among the individuals. The pattern of change in experienced levels of well-being was not homogeneous, nor did it move in any certain direction. The results of this study show that an individualized treatment approach is required to better meet individual women’s needs.

  • 37.
    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
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Apostolo, Joao
    Nursing Sch Coimbra, Portugal.
    Burnout in Palliative Care Settings Compared With Other Settings: A Systematic Review2017In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 19, no 5, p. 442-451Article in journal (Refereed)
    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.

  • 38.
    Parola, Vitor
    et al.
    University of Porto, Portugal.
    Coelho, Adriana
    University of Porto, Portugal.
    Cardoso, Daniela
    University of Porto, Portugal.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Apóstolo, João
    University of Porto, Portugal.
    Prevalence of burnout in health professionals working in palliative care: a systematic review2017In: The JBI Database of Systematic Reviews and Implementation Reports, E-ISSN 2202-4433, Vol. 15, no 7, p. 1905-1933Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: More than ever, the current increasing need for palliative care leads to health professionals providing this type of care which further leads to multiple challenges, and stressful and demanding situations. The multiple challenges of working in palliative care put health professionals working in this context at the risk of burnout.

    OBJECTIVES: To examine the evidence on the prevalence of burnout among health professionals working in palliative care.

    INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review included studies that encompass qualified health professionals working in palliative care, caring for patients 18 years of age or older.

    CONDITION: The current review considered studies reporting on the point prevalence of burnout, measured by a burnout scale, such as, but not limited to, the Maslach Burnout Inventory, Burnout Measure and Copenhagen Burnout Inventory.

    CONTEXT: The current review considered studies conducted in the context of specialist palliative care, more specifically, palliative care units, specialized palliative home care or hospices.

    TYPES OF STUDIES: The current review considered observational study designs, including prospective and retrospective cohort, case-control and cross-sectional studies.

    SEARCH STRATEGY: An initial search of MEDLINE (via PubMed) and CINAHL was undertaken, followed by a second search for published and unpublished studies since 1975 in major healthcare-related electronic databases. Studies written in English, Spanish and Portuguese were included.

    METHODOLOGICAL QUALITY: Two independent reviewers assessed the methodological quality of studies using the standardized critical appraisal instrument from the Joanna Briggs Institute. No studies were excluded from the review based on the methodological appraisal.

    DATA EXTRACTION: Data were extracted using a data extraction table, taking into account the review questions.

    DATA SYNTHESIS: Significant differences were found between condition measures, thus we were unable to perform a meta-analysis.

    RESULTS: Eight cross-sectional studies met the inclusion criteria, with a total of 1406 health professionals. The sample was limited to nurses, physicians and social workers. None of the included articles presented data about other health professionals. Seven of the included studies assessed the prevalence of burnout using the same instrument - the Maslach Burnout Inventory. Data revealed a prevalence of burnout of 17.3% among health professionals. Personal Accomplishment was the sub-scale from the Maslach Burnout Inventory that had the highest prevalence (19.5%). Nurses had higher levels of Emotional Exhaustion (19.5%) and Depersonalization (8.2%), and physicians had lower levels of Personal Accomplishment (41.2%). The prevalence of burnout was, however, higher in social workers (27%). The palliative care context with the highest prevalence of burnout was home care (19.6%).

    CONCLUSION: The current systematic review contributes to a body of empirical knowledge that can facilitate the professional development of palliative care teams by highlighting the prevalence of burnout in health professionals, which staff category is the most affected (social workers), and which palliative care context has the highest prevalence (home care).

  • 39.
    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
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    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 Experiences2018In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 20, no 2, p. 180-186Article in journal (Refereed)
    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.

  • 40.
    Persson, Helene Avik
    et al.
    Lund University.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Furst, Carl-Johan
    Lund University;Region Skåne.
    Ahlström, Gerd
    Lund University.
    Behm, Lina
    Lund University.
    Early and late signs that precede dying among older persons in nursing homes: the multidisciplinary team's perspective2018In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, article id 134Article in journal (Refereed)
    Abstract [en]

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

  • 41.
    Reigada, Carla
    et al.
    Univ Navarra, Spain;Inst Hlth Res Navarra IdiSNA, Spain.
    Martin-Utrilla, Salvador
    Catholic Univ Valencia San Vicente Martir, Spain;Valencia Inst Oncol, Palliat Care Unit, Spain.
    Perez-Ros, Pilar
    Catholic Univ Valencia San Vicente Martir, Spain.
    Centeno, Carlos
    Univ Navarra, Spain;Inst Hlth Res Navarra IdiSNA, Spain;Clin Univ Navarra, Spain.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Gomez-Baceiredo, Beatriz
    Univ Navarra, Sch Commun, Spain.
    Understanding illnesses through a film festival: An observational study2019In: Heliyon, E-ISSN 2405-8440, Vol. 5, no 8, p. 1-8, article id e02196Article in journal (Refereed)
    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.

  • 42.
    Sandgren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Complexities in Palliative Cancer Care: Can Grounded Theories be Useful to Increase Awareness?2017In: The Grounded Theory Review, ISSN 1556-1542, E-ISSN 1556-1550, Vol. 16, no 1, p. 75-78Article in journal (Refereed)
    Abstract [en]

    This paper includes first a summary of a grounded theory "Living on hold", which was one of four different grounded theories in my dissertation (Sandgren, 2010). The theory is then explained in relation to the other grounded theories to give an example of how different grounded theories can be integrated, which leads to an increased awareness of what is going on in a research area.

  • 43.
    Sandgren, Anna
    Hälsohögskolan, Jönköping.
    Deciphering unwritten rules2012In: The Grounded Theory Review, ISSN 1556-1542, E-ISSN 1556-1550, Vol. 11, no 2Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to develop a classic grounded theory of patients, relatives and nurses in palliative cancer care. Data from three earlier studies conducted in palliative care were analyzed. “Deciphering unwritten rules” emerged as the pattern of behavior through which patients, relatives and nurses are dealing with the uncertainty of how to act and behave in palliative cancer care. Deciphering means finding out what the rules mean and trying to interpret them and this can be done consciously or unnoticed. Deciphering unwritten rules involves the strategies figuring out, deliberating, maneuvering and evaluating. This theory demonstrates the complexities of palliative care and the importance of knowledge, counseling and resources for all involved.

  • 44.
    Sandgren, Anna
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Deciphering Unwritten Rules: Patients, relatives and nurses in palliative cancer care2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis focuses on palliative cancer care in acute care hospitals and home care settings. The overall aim was to generate a grounded theory explaining the latent patterns of behavior of patients, relatives and nurses. The thesis includes one population-based study with cross-sectional design and four classic grounded theory studies.

    Study I was conducted in two acute care hospitals. In this 5-year follow-up study, the proportion of hospitalized palliative cancer patients had decreased. The patients were older with more symptoms and care needs per patient. In both years, the most common symptoms were pain and deterioration and the most common cancer sites were prostate and colorectal. The results showed that associations between symptoms, care needs and cancer site were mostly weak.

    In study II, striving for emotional survival emerged as the pattern of behavior through which nurses in acute care hospitals deal with their main concern, the risk of being emotionally overloaded. Striving for emotional survival involves emotional shielding, emotional processing and emotional postponing.

    In study III, doing good care emerged as the pattern of behavior through which nurses in home care deal with their main concern, their desire to give good care. Doing good care involves three different caring behaviors: anticipatory caring, momentary caring and stagnated caring.    

    In study IV, living on hold emerged as the pattern of behavior through which patients and relatives deal with their main concern, being put on hold. Living on hold involves three modes: fighting, adjusting and surrendering.

    The overall theory, deciphering unwritten rules, explains how patients, relatives and nurses are dealing with the uncertainty of how to act and behave.   Deciphering unwritten rules involves figuring out, deliberating, maneuvering and evaluating.

    In conclusion, this thesis demonstrates the complexities of palliative cancer care and the importance of knowledge, resources and counseling. Patients should be cared for at the right care level according to their care needs and the care focus should be on treating symptoms irrespective of the diagnosis. The palliative care approach therefore needs to be implemented in all caring contexts with dying people.

  • 45.
    Sandgren, Anna
    Hälsohögskolan, Jönköping.
    Grounded Theory2012In: Vetenskaplig teori och metod: Från idé till examination inom omvårdnad / [ed] Maria Henricson, Lund: Studentlitteratur AB, 2012, p. 407-425Chapter in book (Other academic)
  • 46.
    Sandgren, Anna
    Jönköping university.
    Grounded Theory2014In: Videnskabelig teori og metode: fra idé till eksamination / [ed] Maria Henricson, Köbenhavn: Munksgaard Forlag, 2014Chapter in book (Other academic)
  • 47.
    Sandgren, Anna
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Region Kronoberg, Sweden.
    Fridlund, Bengt
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Jönköping university, Sweden.
    Nyberg, Per
    Lund university, Sweden.
    Strang, Peter
    Stockholms Sjukhems FoUU, Sweden;Karolinska Institutet.
    Petersson, Kerstin
    Region Kronoberg, Sweden.
    Thulesius, Hans
    Region Kronoberg, Sweden.
    Symptoms, care needs and diagnosis in palliative cancer patients in acute care hospitals: A 5-year follow-up survey2010In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 49, no 4, p. 460-466(7)Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Palliative cancer care in acute hospitals is scarcely studied. We therefore described and compared symptoms, care needs and types of cancer sites in 2002 compared to 2007 and analysed the relationships between these factors. METHODS: The study was population-based with a cross-sectional design and was carried out in medical, surgical and oncology wards in two acute care hospitals with no advanced palliative home care service. In 2002, 82 one-day-inventories were done (1 352 patients) compared to 142 one-day-inventories in 2007 (2 972 patients). Symptoms, care needs and cancer site were registered according to a questionnaire. Multiple logistic regression models were used to analyse associations between symptoms, care needs and cancer site. RESULTS: The proportion of palliative cancer patients had decreased during a five year period (14% vs. 11%, p<0.01). The patients were older in 2007 (74 vs. 70 years, p<0.001) and had more symptoms and care needs per patient (2.6 vs. 1.6, p<0.001). The most common symptoms were pain and deterioration and the most common cancer sites were prostate and colorectal cancer in both samples. Associations between symptoms, care needs and cancer site were mostly weak. Deterioration was associated with colorectal cancer, whereas pain was not associated with any specific cancer site. In haematological malignancies there was a high occurrence of infections and a high need of blood transfusions and infusions. Stomach/oesophagus cancers were significantly associated with nausea, nutritional problems and need of infusions while unknown primary malignancies were associated with abdominal surgery and infusions. DISCUSSION: Although we do not know all the causes for hospitalization, this study indicates that more focus should be on the symptoms instead of the specific cancer diagnosis. The findings also indicate that many palliative cancer patients' problems would be suitable for advanced palliative home care instead of acute hospital care.

  • 48.
    Sandgren, Anna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Strang, P.
    Karolinska Institutet;Stockholms Sjukhems FoUU.
    Palliative care needs in hospitalized cancer patients: a 5-year follow-up study2018In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 26, no 1, p. 181-186Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to describe and compare diagnoses, symptoms, and care needs in palliative cancer patients in two medium-sized hospitals in a county council with no specialized palliative care available 24/7; to analyze the relationships between diagnosis and symptoms/care needs; and to compare results and trends from two datasets (from 2007 and 2012). The study was population-based with a cross-sectional design and was conducted at two acute care hospitals. We performed 142 one-day inventories (n = 2972) in 2007 and 139 in 2012 (n = 2843) to register symptoms, care needs, and diagnosis based on a questionnaire. Multiple logistic regression models were used in the analysis. During 2007 and 2012 combined, 10% (n = 589) of hospitalized patients were assessed as having cancer in a palliative phase. Prostate (12%) and colorectal (12%) cancers were most common. Pain (42%) and deterioration (42%) were the most prevalent symptoms and were associated with pancreas cancer in our regression models (p = 0.003 and p = 0.019, respectively). Other cancers had different associations: hematologic malignancies were associated with infections and blood transfusions (p < 0.001), breast cancer with pleurocentesis (p = 0.002), and stomach/esophagus cancer with nausea (p < 0.001). Nausea was more common in women than in men (p < 0.01). The mean number of symptoms/care needs was 2.9; patients with stomach/esophagus cancer had the highest number of symptoms/care needs (3.5). Acute care hospitals still play an important role for patients requiring palliative care. Symptoms and care needs were not strongly associated with specific diagnoses. Therefore, symptoms, rather than the specific cancer diagnoses, should be the focus of care.

  • 49.
    Sandgren, Anna
    et al.
    Kronoberg County, Research Center, Sweden.
    Thulesius, Hans
    Kronoberg County, Research Center, Sweden.
    Fridlund, Bengt
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Petersson, Kerstin
    Lund university, Sweden;Kronoberg County, Research Center, Sweden.
    Striving for emotional survival in palliative cancer nursing2006In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 16, no 1, p. 79-96Article in journal (Refereed)
    Abstract [en]

    In this grounded theory study, the authors analyze interviews and participant observation data related to palliative cancer nursing in hospitals. Striving for Emotional Survival emerged as the pattern of behavior through which nurses deal with their main concern, the risk of being emotionally overloaded by their work. It involved three main strategies: Emotional Shielding through Professional Shielding or Cold Shielding; Emotional Processing through Chatting, Confirmation Seeking, Self-Reflecting, or Ruminating; and Emotional Postponing through Storing or Stashing. Emotional Competence is a property of Striving for Emotional Survival that explains more or less adequate ways of dealing with emotional overload. The theory Striving for Emotional Survival can be useful in the nurses' daily work and provides a comprehensive framework for understanding how nurses deal with emotional difficulties. The authors suggest that health care organizations encourage self-care, prioritize time to talk, and offer counseling to nursing staff with emotionally difficult working conditions.

  • 50. Sandgren, Anna
    et al.
    Thulesius, Hans
    Petersson, Kerstin
    Fridlund, Bengt
    Anticipatory Caring2008In: The Grounded Theory Review, ISSN 1556-1542, Vol. 7, no 3Article in journal (Refereed)
    Abstract [en]

    Today, more and more people die in own homes and nursinghomes, which fundamentally affects community nursing. The aimof this study was to develop a grounded theory of palliative homenursing care and we analyzed interviews and data related to thebehavior of community nurses caring for palliative cancerpatients. Doing Good Care emerged as the pattern of behaviorthrough which nurses deal with their main concern, their desireto do good care. The theory Doing Good Care involves threecaring behaviors; anticipatory caringmomentary caring andstagnated caring. In anticipatory caring, which is the optimalcaring behavior, nurses are doing their best or even better thannecessary, in momentary caring nurses are doing bestmomentarily and in stagnated caring nurses are doing good butfrom the perspective of what is expected of them. When nursesfail in doing good, they experience a feeling of letting the patientdown, which can lead to frustration and feelings of powerlessness.Depending on the circumstances, nurses can hover between thethree different caring behaviors. We suggest that healthcareproviders increase the status of palliative care and facilitate fornurses to give anticipatory care by providing adequate resourcesand recognition.

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