lnu.sePublications
Change search
Refine search result
45678910 301 - 350 of 2140
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 301.
    Bremer, Anders
    University of Borås.
    Mötet med närstående2009In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud, Leif Svensson, Liber, 2009, 1, p. 150-161Chapter in book (Other academic)
  • 302.
    Bremer, Anders
    University of Borås, Sweden.
    Mötet med närstående2016In: Prehospital akutsjukvård, Stockholm: Liber, 2016, 2, p. 211-227Chapter in book (Other academic)
  • 303.
    Bremer, Anders
    University of Borås, Sweden.
    Nytta mot risker: etiska riktlinjer för HLR2014In: Akutsjukvård – den äldre patienten : Omvårdnad - flöden - kompetens: Stockholm 3-4 september 2014, 2014Conference paper (Other academic)
    Abstract [en]

    När en person drabbas av plötsligt hjärtstopp gör sjukvårdspersonal i regel allt för att få igång hjärtat igen. Ibland kan det dock vara mer etiskt försvarbart att avstå från HLR. Här får vi inblick i Svenska Läkaresällskapet, Svensk sjuk-sköterskeförening och Svenska HLR-rådets etiska riktlinjer, som stöd till sjukvårdspersonalens ställningstagande om HLR ska påbörjas eller inte och skälen som kan motivera ett ställningstagande att avstå.

  • 304.
    Bremer, Anders
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    När livet skakas om: patienters och närståendes erfarenheter av hjärtstopp utanför sjukhus2008Licentiate thesis, comprehensive summary (Other academic)
    Abstract [sv]

    I Europa vårdar ambulanspersonal årligen cirka 300 000 människor med hjärtstopp. Ungefär en av tio överlever. Tidigare forskning har inte i någon större utsträckning berört hur överlevande patienter och närstående mår efteråt eller vilka etiska aspekter och problem som möter ambulanspersonal i dessa situationer. Med hjälp av en reflekterande livsvärldsansats är syftet med denna licentiatavhandling att beskriva vad det innebär att överleva hjärtstopp utanför sjukhus respektive närvara vid en nära persons hjärtstopp. Med utgångspunkt i det empiriska resultatet är syftet att belysa och diskutera etiska aspekter och problem av betydelse för ambulanspersonals vårdande ur ett normativt perspektiv.

    Avhandlingens empiriska resultat visar hur ogripbart det är att drabbas av hjärtstopp och hur uppvaknandet ur medvetslösheten innebär vilsenhet och kontrollförlust genom den minneslucka som tillfogats. Att överleva innebär därför ett sökande efter sammanhang så att situationen kan ges mening och förklaring till tankar, känslor och upplevelser. Känslan av sammanhang nås via andra människors berättelser tillsammans med egna minnen. I det fortsatta livet finns existentiell rädsla och otrygghet där den egna identiteten och meningen i livet omvärderas i takt med en växande insikt om hur den egna kroppen påverkats av hjärtstoppet. Ibland upplevs kroppen som begränsad vilket skapar otrygghet och rädsla. I det fortsatta livet kan det finnas skuldkänslor för det inträffade likväl som att hjärtstoppet ses som en opåverkbar händelse. Men det finns även tacksamhet och glädje över välbefinnande och trygghet i ett förändrat liv där vardagliga sysslor ger tillvaron en viss stadga. Det passerade livshotet införlivas i ett liv där mänskliga relationer blivit än viktigare värden i ett gott liv.

    Närvaro vid en nära persons hjärtstopp omkullkastar känslan av kontroll. Allt upplevs overkligt, tiden tycks stanna upp och samtidigt är verkligheten extremt påtaglig. Förvåning övergår snabbt till ett kaos av tankar och känslor där panik, chock och fruktan griper tag. Verkligheten innebär ett överväldigande och ensamt ansvar där närstående känner sig otillräckliga. Väntan på professionell hjälp känns lång och det är en befriande känsla då ambulanspersonal anländer och övertar ansvaret. Samtidigt väcks hopp om att patienten ska överleva. För närstående är allt kaotiskt, ångestfyllt och omtumlande då de kastas mellan hopp och misströstan för att slutligen få ett overkligt och ogripbart besked om den nära personens överlevnad eller död. Livets grundvalar skakas om och uppmärksammar livets skörhet och att inget kan tas för givet. Efter händelsen finns obesvarade frågor och oro som riskerar att leda till ensamhet i sorg eller i en oro för den överlevandes framtid. Oavsett vilket, riskerar ensamheten att leda till uppoffring av egna och viktiga behov.

    I ett gott beslut balanseras etiska normer att rädda liv, rätten till värdig/god död, autonomiprincipen samt att göra gott och inte skada. Den övergripande normen vid hjärtstopp är att rädda liv. Att i det akuta skedet avgöra om patienten räddas till ett acceptabelt liv är svårt. Det empiriska resultatet ger dock stöd för att återupplivning bör göras vid behandlingsbara hjärtstopp samtidigt som resultatet visar hur svårt det är att dra en gräns för vad ett acceptabelt liv är. Undantagsvis är det goda beslutet att avstå från eller avbryta återupplivning, exempelvis vid förekomst av ett giltigt förhandsdirektiv. En värdig/god död är då det primära. Ett utökat etiskt ansvar för ambulanssjuksköterskor kan vara att de ges beslutsrätt för avbrytande av återupplivning. Ett annat ansvar handlar om möjligheten att främja ett gott liv för överlevande genom att efteråt bidra med kunskap som kan skapa förlorade sammanhang. Ansvaret för närstående kan innebära att meningslös återupplivning inte görs ”för deras skull” utan att deras behov möts på bättre sätt.

    Download full text (pdf)
    Licentiate Thesis (Full Text)
  • 305.
    Bremer, Anders
    University of Borås, Sweden.
    Specialistsjuksköterska med inriktning mot ambulanssjukvård2014In: Att bli specialistsjuksköterska eller barnmorska: utbildningar för framtiden, Studentlitteratur AB, 2014, p. 19-46Chapter in book (Other academic)
    Abstract [en]

    Behovet av specialistutbildade sjuksköterskor ökar. I den här boken presenteras tolv utbildningar som leder till en examen som specialistsjuksköterska eller barnmorska. Vidare ger boken en inblick i vad de olika yrkena innebär. Boken presenterar arbetsplatser och karriärvägar och ger också konkreta exempel på vad specialistsjuksköterskor eller barnmorskor kan komma att möta en vanlig dag på jobbet. Därutöver presenteras Högskoleverkets examensmål för respektive inriktning samt länkar till fastställda kompetensbeskrivningar. Kapitlet "Specialistsjuksköterska med inriktning mot ambulanssjukvård" beskriver professionen, utbildningen och utmaningar inför framtiden.

  • 306.
    Bremer, Anders
    University of Borås, Sweden.
    Vid existensens gräns: Etiskt vårdande och professionellt ansvar vid hjärtstopp utanför sjukhus2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: To describe and interpret patients’, family members’ and ambulance personnel’s experiences with regard to survival, attendance, and caring at cardiac arrests and deaths, and to analyze ethical conflicts that arise in relation to families and how the personnel’s ethical competence can affect caring and the ability to handle ethical problems.

    Method: The three interview studies were guided by a reflective lifeworld approach grounded in phenomenology and analyzed by searching for the essence of the phenomenon in two studies and by attaining a main interpretation in one study. In the fourth study, the general approach was supplemented by “reflective equilibrium” that guided the ethical analysis.

    Results: The survivors are striving towards a good life by means of efforts to reach meaning and coherence, facing existential fear and insecurity as well as gratitude and the joy of life. Family members lose everyday control through feelings of unreality, inadequacy and overwhelming responsibility. Ambulance personnel’s care mediates hope and despair until the announcement of survival or death. After the event, family members risk involuntary loneliness and anxiety about the future. For the ambulance personnel, caring for families involves a need for mobility in decision making, forcing the personnel to balance their own perceptions, feelings and reactions against interpretative reasoning. To base decision making on emotional reactions creates the risk of erroneous conclusions and a care relationship with elements of dishonesty, misdirected benevolence and false hopes. Identification with family members can promote recognition of and response to their existential needs, but also frustrate meeting family members emotions’ and handling one’s own vulnerability and inadequacy. It was found that futile cardiopulmonary resuscitation, administered to patients for the benefit of family members, is not an acceptable moral practice, due both to norms of not deliberately treating persons as mere means and to norms of taking care of families.

    Conclusions: Ethical conflicts exist when it comes to conveying realistic hope, relief from guilt, participation, responsibility for decision making, and fairness in the professional role. Ambulance personnel need support to enhance ethical caring competence and to deal with personal discomfort, as well as clear guidelines on family support.

    Download full text (pdf)
    fulltext
  • 307.
    Bremer, Anders
    University of Borås, Sweden.
    Vilka möjligheter finns att använda register för uppföljning?2013In: Skandinaviskt utbildningsmöte – Vård efter hjärtstopp: Prognosbedömning, uppföljning och rehabilitering. 30-31 maj, 2013. Skånes Unversitetssjukhus, Lund, Sverige, 2013Conference paper (Other academic)
    Abstract [en]

    Svenska Hjärt-lungräddningsregistret innehåller sedan länge beskrivande data med kontinuerliga variabler som ålder och tidsfördröjningar till påbörjande av behandling. Det innehåller också kategoriska variabler om defibrillerbar rytm, hjärtstoppets inträffande i hemmet, kardiell etiologi etc. Cerebral funktion registreras med CPC-score. Sedan 1 maj 2013 kompletterades registret med patientskattningar och mätningar av kvalitativa livskvalitetsvariabler. Den hälsorelaterade livskvaliteten kommer framledes att bedömas med det generiska instrumentet Euro Quality Life Scale (EQ-5D-5L) som mäter rörlighet, egenvård, vardagsaktiviteter, smärta-obehag och ängslan-depression. Dessutom används EQ-VAS för skattning av upplevd hälsa. Ängslan, oro och depression kommer mer detaljerat att bedömas med The Hospital Anxiety and Depression Scale (HADS). Utöver detta inhämtas data om kognitiv funktion och sysselsättning, totalt sju frågor med fasta svarsalternativ. Denna uppföljning av livskvaliteten hos överlevande efter hjärtstopp är en intensifiering av det rutinmässiga omhändertagandet av patientgruppen. Men framför allt innebär detta initiala och systematiska inhämtande av kvalitativa data från patienterna själva en möjlighet att tidigt upptäcka hur de mår och de behov av uppföljande vård och stöd som kan finnas. Genom registrets datainsamling ges även anhöriga en möjlighet att diskutera problem relaterade till den överlevandes situation. Med den utökade datainsamlingen kommer ny och viktig kunskap om patientgruppens cerebrala funktion och hälsorelaterade livskvalitet att genereras över tid, till gagn för patienter och anhöriga.

  • 308.
    Bremer, Anders
    University of Borås, Sweden.
    Vilken livskvalitet har patienter efter hjärtstopp?2013In: XV Svenska Kardiovaskulära Vårmötet: Svenska Hjärtförbundet. Göteborg 2013-04-17, 2013Conference paper (Other academic)
  • 309.
    Bremer, Anders
    Svenska läkaresällskapet.
    Vårdpersonal i ’dokusåpor’: är det etiskt försvarbart?2014In: Medicinska Riksstämman, Stockholm, 2014, 2014Conference paper (Other academic)
    Abstract [en]

    Att som vårdpersonal medverka i s.k. dokusåpor är förknippat med en rad etiska problem. Kan dessa problem lösas på ett etiskt försvarbart sätt, dvs. så att patienters och närståendes rätt till värdighet, integritet och autonomi säkerställs? Slutsatsen är att detta inte är möjligt. Risken att tillfoga skada är större än den potentiella nyttan.

  • 310.
    Bremer, Anders
    et al.
    University of Borås, Sweden.
    Axelsson, Åsa B.
    University of Gothenburg, Sweden.
    Vårdvetenskaplig analys: erfarenheter vid prehospitala hjärtstopp2016In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud, Lars Lundberg, Stockholm: Liber, 2016, 2, p. 345-349Chapter in book (Other academic)
  • 311.
    Bremer, Anders
    et al.
    University of Borås, Sweden.
    Creutz, Tobias
    Region of Västra Götaland, Sweden.
    Pettersson Georgii, Johan
    Region of Västra Götaland, Sweden.
    Family members’ experiences of care provided by ambulance staff in out-of-hospital cardiac arrest situations2015In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, no 1 suppl, article id 268Article in journal (Refereed)
    Abstract [en]

    Purpose: Approximately 10 000 people in Sweden suffer from sudden cardiac arrest outside the hospital each year. Cardiopulmonary resuscitation (CPR) is started in about half of the cases. Treatment of patients with cardiac arrest in a pre-hospital context is complex and focus is placed first and foremost on the patient because of the acute and life-threatening condition. For relatives, it is a traumatic and upsetting experience to be present when a family member suffers from cardiac arrest. The purpose of this study was therefore to describe family members experiences of an out-of-hospital cardiac arrest (OHCA) situation and how the ambulance staff cared for them.

    Methods: This pilot study had a qualitative design, based on six individual interviews with family members who were present when the patient suffered OHCA. The interviews were conducted with an initial open-ended question and follow-up questions based on the responses. The data were analysed by qualitative content analysis with an inductive approach. The analysis generated subcategories, which were clustered into seven main categories.

    Results: The result describes the informants’ situation management, responsibility handover and their hope and hopelessness in the situation. The result also describes the staff’s care of family members by the categories closeness and distance, confirmation and exclusion, caring relationship and answered and unanswered questions. Family members described the OHCA situation as traumatic with feelings of panic, uncertainty, unreality, but also calm and rationality. Contentedness and gratitude for the ambulance staffs caring approach emerged. However, family members sometimes were not allowed to decide if they wanted to witness the resuscitation attempts or not, and a lack of information led to unnecessary frustration.

    Conclusions: Family members often have a need to talk to someone about their experiences of the OHCA situation, express their views on the care that was provided and receive feedback afterwards. Further research on family members’ situation at OHCAs is of great importance for the development of ambulance staff’s skills in caring approaches.

  • 312.
    Bremer, Anders
    et al.
    University of Borås, Sweden.
    Dahlberg, Karin
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Sandman, Lars
    University of Borås, Sweden.
    Balancing Between Closeness and Distance: Emergency medical services personnel’s experiences of caring for families at out-of-hospital cardiac arrests and deaths2012In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 27, no 1, p. 42-52Article in journal (Refereed)
    Abstract [en]

    Introduction: Out-of-hospital cardiac arrest (OHCA) is a lethal health problem thataffects between 236,000 and 325,000 people in the United States each year. As resuscitationattempts are unsuccessful in 70-98% of OHCA cases, Emergency Medical Services(EMS) personnel often face the needs of bereaved family members.Problem: Decisions to continue or terminate resuscitation at OHCA are influenced byfactors other than patient clinical characteristics, such as EMS personnel’s knowledge,attitudes, and beliefs regarding family emotional preparedness. However, there is littleresearch exploring how EMS personnel care for bereaved family members, or how theyare affected by family dynamics and the emotional contexts. The aim of this study is toanalyze EMS personnel’s experiences of caring for families when patients suffer cardiacarrest and sudden death.Methods: The study is based on a hermeneutic lifeworld approach. Qualitative interviewswere conducted with 10 EMS personnel from an EMS agency in southern Sweden.Results: The EMS personnel interviewed felt responsible for both patient care and familycare, and sometimes failed to prioritize these responsibilities as a result of their ownperceptions, feelings and reactions. Moving from patient care to family care implied amovement from well-structured guidance to a situational response, where the personnelwere forced to balance between interpretive reasoning and a more direct emotionalresponse, at their own discretion. With such affective responses in decision-making, thepersonnel risked erroneous conclusions and care relationships with elements of dishonesty,misguided benevolence and false hopes. The ability to recognize and respond to people’sexistential questions and needs was essential. It was dependent on the EMS personnel’sbalance between closeness and distance, and on their courage in facing the emotionalexpressions of the families, as well as the personnel’s own vulnerability. The presence offamily members placed great demands on mobility (moving from patient care to familycare) in the decision-making process, invoking a need for ethical competence.Conclusion: Ethical caring competence is needed in the care of bereaved family membersto avoid additional suffering. Opportunities to reflect on these situations within a frameworkof care ethics, continuous moral education, and clinical ethics training are needed.Support in dealing with personal discomfort and clear guidelines on family support couldbenefit EMS personnel.Bremer A, Dahlberg K, Sandman

  • 313.
    Bremer, Anders
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. University of Borås.
    Dahlberg, Karin
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Sandman, Lars
    University of Borås.
    Experiencing Out-of-Hospital Cardiac Arrest: Significant Others’ Lifeworld Perspective2009In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 19, no 10, p. 1407-1420Article in journal (Refereed)
    Abstract [en]

    When patients suffer out-of-hospital cardiac arrests (OHCA), significant others find themselves with no choice about being there. Afterwards they are often left with unanswered questions about the life-threatening circumstances, or the patient’s death, the emergency treatment and future needs. When it is unclear how the care, and the event itself will affect significant others’ well being, prehospital emergency personnel face ethical decisions. This study describes the experiences of significant others present at OHCA, focusing on ethical aspects and values. Using a lifeworld phenomenological approach, seven significant others were interviewed. The essence of the phenomenon of OHCA can be stated as: Unreality in the reality; Overwhelming responsibility; Inadequacy and limitation; Hope and hopelessness; Ethical considerations; Insecurity about the future; Trembling of life. These study findings show how significant others’ sense of unreality, inadequacy, and overwhelming responsibility at OHCA can threaten values deemed important for a good life.

     

  • 314.
    Bremer, Anders
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. University of Borås, Sweden.
    Dahlberg, Karin
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Sandman, Lars
    University of Borås, Sweden.
    To Survive Out-of-Hospital Cardiac Arrest: A Search for Meaning and Coherence2009In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 19, no 3, p. 323-338Article in journal (Refereed)
    Abstract [en]

    The primary responsibility of prehospital emergency personnel at out-of-hospital cardiac arrests (OHCA) is to provide lifesaving care. Ethical considerations, decisions, and actions should be based in the patient’s beliefs about health and well-being. In this article, we describe patients’ experiences of surviving OHCA. By using a phenomenological approach, we focus on how OHCA influences patients’ well-being over time. Nine survivors were interviewed. Out-of-hospital cardiac arrest is described as a sudden and elusive threat, an awakening in perplexity, and the memory gap as a loss of coherence. Survival means a search for coherence with distressing and joyful understanding, as well as existential insecurity exposed by feelings of vulnerability. Well-being is found through a sense of coherence and meaning in life. The study findings show survivors’ emotional needs and a potential for prehospital emergency personnel to support them as they try to make sense of what has happened to them.

     

  • 315.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Dahné, Tova
    Linköping University.
    Stureson, Lovisa
    Linköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council.
    Thylén, Ingela
    Linköping University.
    Lived experiences of surviving in-hospital cardiac arrest2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, p. e122-e122Article in journal (Refereed)
  • 316.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Dahné, Tova
    Uppsala University, Sweden;Linköping University, Sweden.
    Stureson, Lovisa
    Linköping University, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Thylén, Ingela
    Linköping University, Sweden.
    Lived experiences of surviving in‐hospital cardiac arrest2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 1, p. 156-164Article in journal (Refereed)
    Abstract [en]

    Background

    Out‐of‐hospital cardiac arrest survivors suffer from psychological distress and cognitive impairments. They experience existential insecurity and vulnerability and are striving to return to a life in which well‐being and the meaning of life have partly changed. However, research highlighting the experiences of in‐hospital cardiac arrest survivors is lacking. This means that evidence for postresuscitation care has largely been extrapolated from studies on out‐of‐hospital cardiac arrest survivors, without considering potential group differences. Studies investigating survivors’ experiences of an in‐hospital cardiac arrest are therefore needed.

    Aim

    To illuminate meanings of people's lived experiences of surviving an in‐hospital cardiac arrest.

    Design

    An explorative, phenomenological hermeneutic method to illuminate meanings of lived experiences.

    Method

    Participants were identified through the Swedish national register of cardiopulmonary resuscitation and recruited from two hospitals. A purposive sample of eight participants, 53–99 years old, who survived an in‐hospital cardiac arrest 1–3 years earlier, was interviewed.

    Findings

    The survivors were striving to live in everyday life and striving for security. The struggle to reach a new identity meant an existence between restlessness and a peace of mind, searching for emotional well‐being and bodily abilities. The search for existential wholeness meant a quest for understanding and explanation of the fragmented cardiac arrest event and its existential consequences. The transition from hospital to home meant a transition from care and protection to uncertainty and vulnerability with feelings of abandonment, which called for a search for security and belonging, away from isolation and loneliness.

    Conclusion

    Surviving an in‐hospital cardiac arrest can be further understood by means of the concept of hospital‐to‐home transition. Following hospital discharge, patients felt vulnerable and abandoned when pending between denial and acceptance of the ‘new’ life. Hence, the healthcare system should play a significant role when it comes to facilitate cardiac arrest survivors’ security during hospital‐to‐home transition.

  • 317.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Holmberg, Mats
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Ambulance nurse students’ experiences of ethical problems in patient-relationships2019In: Presented at the 3rd NCCS/EACS Conference: "Sustainable Caring for Health and Wellbeing", Vaasa, Finland, October 1-3, 2019, 2019Conference paper (Refereed)
    Abstract [en]

    Background: Ambulance nurse education in Sweden is a one-year master’s degree program for registered nurses leading to a postgraduate diploma in specialist nursing. Ambulance nurses face unpredictable and ethically challenging situations with multi-dimensional suffering, requiring the ability to provide medical care and simultaneously creating a trustful relationship. Students undergoing their specialist education face the same challenges. 

    Aim: The aim was to describe ambulance nurse students’ (ANS) experiences of ethical problems in patient relationships during clinical studies. 

    Method: Written exams (n=69) in ANS’ clinical placements studies were collected between 2014-2016 in three courses. In the exam the ANS were asked to describe and problematize a self-experienced ethical problem in the care relationship with a specific patient. The thematic analysis commenced with being familiarized with the text as a whole before condensation and coding. The exams were read and re-read several times. After coding followed further analysis, re-analysis and validation in several linear and circular steps to finally compile sub-themes and themes. 

    Results: Ethical problems emerged as six themes; 1) Insecurity in considering patient autonomy, 2) Conflicting assessments of the patients best, 3) Inadequate access to patient narratives, 4) Absence of trustful relationships, 5) Disturbance of patient focus and 6) Limited possibility to provide proper care. 

    Conclusions and implications: The result emphasizes ethical problem within patient-relationships in the ambulance care as multifaceted and strongly connected to patient’s autonomy. Outgoing from the results an intervention project regarding older patients’ autonomy in ambulance care started in January 2019.

  • 318.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Holmberg, Mats
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Ambulance nurse students’ experiences of ethical problems in patient-relationships2019In: Presented at the 3rd NCCS/EACS Conference: "Sustainable Caring for Health and Wellbeing", Vaasa, Finland, October 1-3, 2019, 2019Conference paper (Refereed)
    Abstract [en]

    Background: Ambulance nurse education in Sweden is a one-year master’s degree program for registered nurses leading to a postgraduate diploma in specialist nursing. Ambulance nurses face unpredictable and ethically challenging situations with multi-dimensional suffering, requiring the ability to provide medical care and simultaneously creating a trustful relationship. Students undergoing their specialist education face the same challenges.

    Aim: The aim was to describe ambulance nurse students’ (ANS) experiences of ethical problems in patient relationships during clinical studies.

    Method: Written exams (n=69) in ANS’ clinical placements studies were collected between 2014- 2016 in three courses. In the exam the ANS were asked to describe and problematize a selfexperienced ethical problem in the care relationship with a specific patient. The thematic analysis commenced with being familiarized with the text as a whole before condensation and coding. The exams were read and re-read several times. After coding followed further analysis, re-analysis and validation in several linear and circular steps to finally compile sub-themes and themes.

    Results: Ethical problems emerged as six themes; 1) Insecurity in considering patient autonomy, 2) Conflicting assessments of the patients best, 3) Inadequate access to patient narratives, 4) Absence of trustful relationships, 5) Disturbance of patient focus and 6) Limited possibility to provide proper care.

    Conclusions and implications: The result emphasizes ethical problem within patient-relationships in the ambulance care as multifaceted and strongly connected to patient’s autonomy. Outgoing from the results an intervention project regarding older patients’ autonomy in ambulance care started in January 2019.

  • 319.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Borås, Sweden.
    Holmberg, Mats
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Uppsala University, Sweden; Region Sörmland, Sweden.
    Ethical conflicts in patient relationships: experiences of ambulance nursing students2020In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, p. 1-14Article in journal (Refereed)
    Abstract [en]

    Background: Working as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship. This entails a need to be clinically trained in order to identify ethical conflicts.

    Aim: To describe ethical conflicts in patient relationships as experienced by ambulance nursing students during clinical studies.

    Research design: An exploratory and interpretative design was used to inductively analyse textual data from examinations in clinical placement courses.

    Participants: The 69 participants attended a 1-year educational programme for ambulance nurses at a Swedish university.

    Ethical consideration: The research was conducted in accordance with the Declaration of Helsinki. Participants gave voluntary informed consent for this study.

    Findings: The students encountered ethical conflicts in patient relationships when they had inadequate access to the patient’s narrative. Doubts regarding patient autonomy were due to uncertainty regarding the patient’s decision-making ability, which forced students to handle patient autonomy. Conflicting assessments of the patient’s best interest added to the conflicts and also meant a disruption in patient focus. The absence of trustful relationships reinforced the ethical conflicts, together with an inadequacy in meeting different needs, which limited the possibility of providing proper care.

    Discussion: Contextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest. Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation.

    Conclusion: The essence of the patient relationship is a struggle to preserve autonomy while focusing on the patient’s best interest. Hence, there is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, particularly in situations that affect the patient’s decision-making ability.

  • 320.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital, Sweden;University of Borås, Sweden.
    Kowalczyk, Emma
    Helsingborg County Hospital, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital, Sweden.
    Wireklint Sundström, Birgitta
    University of Borås, Sweden.
    Emergency Medical Services physicians’ perceptions of ambulance nurses’ responsibility for referring patients to primary care and self-care - a Swedish national survey2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no Suppl 1, p. A6-A6Article in journal (Refereed)
    Abstract [en]

    Background: Based on guidelines developed by EMS physicians, registered nurses in the Swedish ambulance services sometimes by-pass the emergency department and refer non-urgent patients to primary care and self-care. However, these referrals are associated with problems that may jeopardize patient safety and patient participation.

    Aim: To identify the EMS physicians’ perceptions of ambulance nurses’ responsibilities and prerequisites to refer patients to primary care and self-care.

    Methods: A national survey of all EMS physicians (n=51) using study specific questions with close-ended and open response options, analysed with descriptive statistics and thematic analysis.

    Results: The response rate was 78% (n=40). The majority of the physicians (95%) perceived that nurses should be able to refer patients to primary care and self-care. One fourth (25%) perceived specialist nurses in ambulance care as the most appropriate professionals. The majority of the physicians (65%) perceived that referral to primary care maintain patient safety, whereas fewer (50%) assessed the referral as safe for the patient. All perceived that feedback should be given to nurses when the referral was incorrect. The majority perceived it important to extend the nurses’ authority to refer to primary care (63%) and self-care (55%).

    Conclusion: There is no consensus among the EMS physicians regarding responsibilities and conditions for nurses’ referral of patients. Registered nurses with basic education are expected to be able to refer, while there is varying opinion regarding requirements of specialist trained ambulance nurses to refer patients. Professional experience as a nurse is perceived more important than formal education.

  • 321.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. University of Borås, Sweden.
    Sandman, Lars
    University of Borås, Sweden.
    Futile cardiopulmonary resuscitation for the benefit of others: An ethical analysis2011In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 18, no 4, p. 495-504Article in journal (Refereed)
    Abstract [en]

    It has been reported as an ethical problem within prehospital emergency care that ambulance professionals administer physiologically futile cardiopulmonary resuscitation (CPR) to patients having suffered cardiac arrest to benefit significant others. At the same time it is argued that, under certain circumstances, this is an acceptable moral practice by signalling that everything possible has been done, and enabling the grief of significant others to be properly addressed. Even more general moral reasons have been used to morally legitimize the use of futile CPR: That significant others are a type of patient with medical or care needs that should be addressed, that the interest of significant others should be weighed into what to do and given an equal standing together with patient interests, and that significant others could be benefited by care professionals unless it goes against the explicit wants of the patient. In this article we explore these arguments and argue that the support for providing physiologically futile CPR in the prehospital context fails. Instead, the strategy of ambulance professionals in the case of a sudden death should be to focus on the relevant care needs of the significant others and provide support, arrange for a peaceful environment and administer acute grief counselling at the scene, which might call for a developed competency within this field.

  • 322.
    Bremer, Anders
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Wireklint Sundström, Birgitta
    University of Borås, Sweden.
    Vårdrum – ett vårdande rum2019In: Akut omhändertagande av trauma: på skadeplats och akutmottagning / [ed] Carina Elmqvist & Sofia Almerud Österberg, Lund: Studentlitteratur AB, 2019, 2, p. 23-49Chapter in book (Other academic)
  • 323.
    Bremer, Anders
    et al.
    University of Borås, Sweden.
    Wireklint Sundström, Birgitta
    University of Borås, Sweden.
    Vårdrum: ett vårdande rum2014In: Akut omhändertagande av trauma: på skadeplats och akutmottagning / [ed] Carina Elmqvist, Sofia Almerud Österberg, Liber, 2014, p. 23-53Chapter in book (Other academic)
    Abstract [en]

    Syftet med detta kapitel är att bidra med fördjupad förståelse av begreppet vårdrum och samtidigt presentera en vårdvetenskaplig ram. I detta kapitel beskrivs skadeplatsens oordnade miljö och skiftande villkor, kännetecken och utmaningar som finns för ambulanspersonal att planera för och upprätta vårdrum för patienter som utsatts för trauma, i samverkan med räddningstjänst och polis. Därefter beskrivs villkor för patienternas och de närståendes vårdrum på akutmottagningen. I kapitlet ges exempel på hur vårdande rum kan främjas och upprättas samt hur vårdrummet kan upplevas av de närvarande, vilket gestaltas utifrån forskning och erfarenheter som gjorts av vårdare, patienter och närstående. Kapitlet bygger främst på vårdvetenskaplig forskning.

  • 324.
    Broberg, Anna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hesselgård, Lotten
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    När psykiatri möter somatik: En intervjustudie om sjuksköterskors upplevelser av vården vid samsjuklighet inom psykiatrisk heldygnsvård2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: As patients with mental illness have an increased risk of developing somatic conditions, somatic nursing in psychiatric inpatient care also increases. The somatic care is not so good for these people. This places increased demands of knowledge on registered nurses in psychiatric inpatient care, to bee able to meet somatic conditions and co-morbidity. Objective: Describe nurses' experiences and perceptions regarding the care of patients with psychiatric and somatic complicity in psychiatric full-day care.

    Method: A qualitative interview study with semi-structured interviews and questions from an interview guide which interviews and registered nurses who are actively working in psychiatric inpatient care. Collected material has been analyzed through qualitative content analysis of manifest character.

    Results: The analysis resulted in three categories, where each category consisted of three subcategories describing the informants' experiences. The three categories with subcategories are: 1) To care for patients with psychiatric and somatic complicities; Overall view, lack of resources, emotions, 2) The importance of knowledge; Lack of knowledge, need for knowledge, responsibility to acquire new knowledge  and3) The collaboration between psychiatric and somatic care departments; Expectations, the divided care, the importance of cooperating.

    Conclusion: The registered nurses experience the somatic nursing as challenging. The biggest challenge is the shortage of resources, that knowledge about diseases is limited and to carry out medical technical tasks. The nursing is also seen as challenging as an ignorance and incomprehension about each other's departments that constitutes a difficulty to co-operation. However, there is basically good cooperation, in the situations they need to consult and get help from each other's expertise.

    Clinical implications: The hope is that the study's results will give an increased understanding of how the nurses experience caring for somatic disease conditions in a psychiatric inpatient department.

    Download full text (pdf)
    Broberg Hesselgard
  • 325.
    Broder, Stina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Johansson, Maria
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Den yngre kvinnans upplevelser av att leva med bröstcancer: En kvalitativ litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Bröstcancer är kvinnans vanligaste cancerdiagnos och varje år insjuknar ca. 470 kvinnor under 40 års ålder i Sverige. För behandling av bröstcancer finns kirurgi-, strål-, cytostatika- och hormonbehandling som alternativ. Dessa behandlingar och sjukdomen i sig påverkar individuellt kvinnan och kan skapa ett lidande och en sårbarhet. För att uppmärksamma kvinnors upplevelser är det som allmänsjuksköterska viktigt att ha ett öppet och följsamt bemötande.

    Syfte: Syftet med studien var att beskriva den yngre kvinnans upplevelser av att leva med bröstcancer i åldern 18–45 år.

    Metod: En kvalitativ litteraturstudie med induktiv ansats. Tio vetenskapliga artiklar analyserades med hjälp av en manifest innehållsanalys enligt Lundman och Granheim.

    Resultat: Fem kategorier framkom; en rädsla över oviss framtid, kroppsliga förändringar av behandling, en förändrad fertilitet, betydelsen av närstående relationer samt vårdpersonalens inflytande.

    Slutsatser: Det är inte alltid själva diagnosen bröstcancer som skapar det största lidandet utan det kan grundas i biverkningar från behandling t.ex. håravfall, infertilitet eller bristande stöd från vårdpersonal. Vårdpersonalen har en betydande roll, genom att erbjuda information och stöd skapas en känsla av trygghet och ökad livskvalité hos kvinnan.

    Download full text (pdf)
    fulltext
  • 326.
    Brolin, Rosita
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    "Jag kan öppna fönstret när jag vill": Boendesituationen för personer med psykisk funktionsnedsättning2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: The overall aim of this thesis was to explore and develop knowledge about the housing situation for people with psychiatric disabilities, based on the residents' perspectives.

    Methods: Three studies are based on a new Swedish questionnaire (SHPD) containing preconceived questions (Studies I-II) and two open-ended questions (Study III), while two studies are theory-generating (Studies IV-V). I - the psychometric properties of SHPD (ICC, descriptive statistics, factor analysis); II - the degree and predictors of housing satisfaction (descriptive statistics, logistical regression analysis); III - the best and worst in housing situation (qualitative content analysis); IV-V - Classic grounded theories about people with psychiatric disabilities, living in supported housing (IV) and in ordinary housing with housing support (V).

    Results: The results show good psychometric properties for SHPD, a generally high degree of housing satisfaction, and reveal security, privacy and choice as important predictors for satisfaction. Life in supported housing is shown to be characterized by constant togetherness, limited self-determination and violated integrity. Being deprived of self-determination emerged as the main concern for residents, who handle this through striving for meaning. Life in ordinary housing with housing support is shown to be characterized by independence, self-determination, loneliness, and sometimes lack of support. The impossible mission in everyday life emerged as the main concern for residents, who deal with this concern through mastering everyday life. The housing support staff are important facilitators in the process of mastering everyday life, and the continuity of housing support is a prerequisite for the process to succeed.

    Conclusions: The thesis contributes knowledge about the housing situation for people with psychiatric disabilities. The thesis raises awareness of a need for changes in housing support services towards housing forms and support that strengthen the residents' integrity and autonomy. The individuals' experiences need to be considered in planning and performance of housing support services, and security, privacy, choice, social support and continuity in housing support need to be prioritized.

    Download full text (pdf)
    Rosita Brolin, Doctoral Thesis (Kappa)
    Download (jpg)
    Front page
  • 327.
    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.
    "Jag kan öppna fönstret när jag vill": Boendesituationen för personer med psykisk funktionsnedsättning - ur de boendes perspektiv2017Report (Other (popular science, discussion, etc.))
    Download full text (pdf)
    fulltext
  • 328.
    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.

    Download full text (pdf)
    fulltext
  • 329.
    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.

    Download full text (pdf)
    fulltext
  • 330.
    Brolin, Rosita
    et al.
    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.
    Baigi, Amir
    University of Gothenburg, Sweden.
    Brunt, David
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Satisfaction with housing and housing support for people with psychiatric disabilities2015In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 36, no 1, p. 21-28Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the degree of satisfaction with housing and housing support for people with psychiatric disabilities in Sweden. A total of 370 residents, in supported housing and in ordinary housing with housing support, completed a new questionnaire and reported a high degree of overall satisfaction, but many of them wanted to move somewhere else. Differences were found between the two different types of housing concerning satisfaction with housing support, social life and available choices. Security and privacy, as well as other's influence on the choice of residential area and dwelling proved to be important predictors for satisfaction.

  • 331.
    Brolin, Rosita
    et al.
    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.
    Brunt, David
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Validity and reliability of a Swedish questionnaire for assessing satisfaction with housing and housing support for persons with psychiatric disabilities2013In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 10, p. 731-738Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the reliability and validity of a questionnaire for studying satisfaction with housing and housing support for people with psychiatric disabilities. Most items were gathered from English language questionnaires. These were translated and adapted to a Swedish context and items concerning housing support were added. Two studies were conducted. The first, a test-retest reliability analysis, was performed in a pilot study with 53 participants; in the second study, which had 370 participants, a five factor solution with good internal consistency emerged. Further development of the questionnaire is discussed.

  • 332.
    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.

  • 333.
    Broman, Liv
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Jonsson, Hilda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Djurterapins inverkan på äldres hälsa: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund Risken för psykisk och fysisk ohälsa ökar med stigande ålder. Åldrandet medför ofta nedsatt fysisk, psykisk och social förmåga, förändrad identitet och en minskad umgängeskrets vilket är bidragande orsaker till ohälsa. Flera olika djurarter har varit trogna följeslagare till människan genom alla tider. Forskare har använt sig av djurterapi som behandlingsmetod för patienter inom olika vårdkontexter.

    Syfte Syftet var att beskriva djurterapins betydelse för äldres hälsa inom äldreomsorgen.

    Metod En litteraturstudie genomfördes där tio vetenskapliga artiklar användes. Åtta kvantitativa och två kvalitativa vilka söktes fram via databaserna CINAHL, PubMed och PsycINFO. Dataanalysen genomfördes enligt Kristensson (2014).

    Resultat Analysprocessen resulterade i fyra kategorier. Den första kategorin var beteendeförändring då det visat sig att djurterapi har positiv inverkan på exempelvis minskad trötthet, nedstämdhet och förvirring. Den andra kategorin var social funktion. Då många äldre beskrev djuren som en vän, bidrog djuren till en minskad känsla av ensamhet. Den tredje kategorin var meningsfullhet då djuren fick de äldre att känna sig meningsfulla. Den fjärde och sista kategorin var minnen då djur bidrog till att gamla minnen kom tillbaka.

    Slutsatser Djur skulle kunna vara en del i de äldres dagliga aktiviteter inom äldreomsorgen och på så vis förebygga ohälsa.

    Download full text (pdf)
    fulltext
  • 334.
    Bronge Oscarsson, Malin
    et al.
    University of Kalmar, School of Human Sciences.
    Axelsson, Martina
    University of Kalmar, School of Human Sciences.
    Att leva med schizofreni – upplevelser av livssituationen2008Independent thesis Basic level (degree of Bachelor), 15 poäng / 22,5 hpStudent thesis
    Abstract [sv]

    Att drabbas av schizofreni påverkar hela personens livssituation. Schizofrenin medför funktionsnedsättningar som gör det svårt att ta tillvara på de vardagliga resurserna. Syftet med denna litteraturstudie var att beskriva hur personer med schizofreni upplever sin livssituation. Metoden som användes var en litteraturstudie. Sökningarna gjordes i Cinahl, Psycinfo och Elin@Kalmar. Åtta vetenskapliga artiklar har kvalitetsgranskats och analyserats vilket resulterades i fyra kategorier av upplevelser: upplevelser av ohälsa, upplevelser av relationer, upplevelser av sysselsättning och oro inför framtiden. Dessa upplevelser påverkade livssituationen i flera olika avseenden. Denna litteraturstudie är av betydelse för vårdpersonal eller anhöriga till en person med schizofreni för att förstå dennes livssituation och på så sätt bemöta dem på ett tillfredställande sätt.

    Download full text (pdf)
    FULLTEXT01
  • 335.
    Brorsson, Emil
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Takvam, Camilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Inte bara barn: En kvalitativ självbiografistudie om vuxna personers upplevelser av att leva med ADHD2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: ADHD står för Attention Deficit Hyperactivity Disorder och är en neuropsykiatrisk funktionsnedsättning. Genom åren har ADHD varit huvudsakligen förknippat med barn. Det är först på senare år som ADHD har blivit en erkänd funktionsnedsättning även hos vuxna. Uppskattningsvis lever 2,5 % av den vuxna befolkningen i Sverige med ADHD.

    Syfte: Syftet med studien var att belysa upplevelserna av att som vuxen leva med ADHD

    Metod: Studien var en kvalitativ självbiografistudie. En induktiv ansats har använts och analysen utfördes genom en manifest innehållsanalys.

    Resultat: Analysen gav fyra kategorier och fem underkategorier. Resultatet visade att livet med ADHD innebar svårigheter i vardagen, att vara full av känslor samt att omgivningens stöd var av betydelse. Vidare visade resultatet att hälsa kunde upplevas trots ADHD.

    Slutsats: Att som vuxen leva med ADHD innebär svårigheter i vardagen sammankopplade till de huvudsymtom som funktionsnedsättningen ger. Det innebär vidare känslor av att vara annorlunda och missförstådd samt att uppleva svårigheter med pendlande humör. Med stöd från omgivningen samt ökad begriplighet och hanterbarhet kan känslan av hälsa och välbefinnande öka. Då varje persons upplevelser är individuella är det viktigt att som sjuksköterskan se till den personliga livsvärlden för att kunna stärka individens hälsoprocesser.

    Download full text (pdf)
    Inte bara barn
  • 336.
    Bruce, Elisabeth
    et al.
    Umeå University.
    Dorell, Åsa
    Umeå University.
    Lindh, Viveca
    Umeå University.
    Erlingsson, Christen
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Lindkvist, Marie
    Umeå University.
    Sundin, Karin
    Umeå University.
    Translation and Testing of the Swedish Version of Iceland-Family Perceived Support Questionnaire With Parents of Children With Congenital Heart Defects2016In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 22, no 3, p. 298-320Article in journal (Refereed)
    Abstract [en]

    There is a need for a suitable instrument for the Swedish context that could measure family members’ perceptions of cognitive and emotional support received from nurses. The purpose of this study was to translate and test the psychometric properties of the Swedish version of the Iceland-Family Perceived Support Questionnaire (ICE-FPSQ) and, further, to report perceptions of support from nurses by family members of children with congenital heart defects (CHDs). A sample of 97 parents of children with CHD, living in Sweden, completed the Swedish translation of ICE-FPSQ. The Swedish version of ICE-FPSQ was found to be reliable and valid in this context. Parents scored perceived family support provided by nurses working in pediatric outpatient clinics as low, which suggests that nurses in these outpatient contexts in Sweden offered family nursing only sparingly.

  • 337.
    Brunt, David
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Boende2005In: Att leva med psykiska funktionshinder / [ed] David Brunt, Lars Hansson, Lund: Studentlitteratur , 2005, p. 85-102Chapter in book (Other academic)
  • 338.
    Brunt, David
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Boende2014In: Att leva med psykisk funktionsnedsättning: livssituation och effektiva vård- och stödinsats / [ed] David Brunt och Lars Hansson, Lund: Studentlitteratur AB, 2014, 2, p. 99-116Chapter in book (Other academic)
  • 339.
    Brunt, David
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Socialt nätverk2005In: Att leva med psykiska funktionshinder - livssituation och effektiva vård- och stöd insatser / [ed] David Brunt, Lars Hansson, Lund: Studentlitteratur , 2005, p. 157-172Chapter in book (Other academic)
  • 340.
    Brunt, David
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Socialt nätverk2014In: Att leva med psykisk funktionsnedsättning: livssituation och effektiva vård- och stödinsatser / [ed] David Brunt och Lars Hansson, Lund: Studentlitteratur AB, 2014, 2, p. 171-188Chapter in book (Other academic)
  • 341.
    Brunt, David
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    The ward atmosphere of single-sex wards in a maximum-security forensic psychiatric hospital in Sweden2008In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 29, no 3, p. 221-241Article in journal (Refereed)
    Abstract [en]

    This exploratory study aims to investigate the ward atmosphere of single-sex wards in a forensic psychiatric context in the light of Moos’ conceptualization of the treatment setting.

    The wards for female patients bore similarities to Relationship-Oriented and Insight-Oriented programmes and had a generally positive ward atmosphere. On the other hand the wards for male patients did not resemble any treatment programme and had a more mixed diagnosis profile than those for female patients. Comparisons of the two types of wards are made and implications of the findings in terms of the overriding principle of normalization are discussed.

  • 342.
    Brunt, David
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Äldres psykiska hälsa2010In: Omsorg och mångfald / [ed] Stina Johansson, Malmö: Gleerups Utbildning AB, 2010, p. 26-43Chapter in book (Other academic)
  • 343.
    Brunt, David
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hansson, Lars
    Att leva med psykiska funktionsshinder: livssituation och effektive vård- och stödinsatser2005Collection (editor) (Other academic)
  • 344.
    Brunt, David
    et al.
    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.
    Resident and staff perceptions of the content of their relationship in supported housing facilities for people with psychiatric disabilities2018In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 11, p. 673-681, article id 179322Article in journal (Refereed)
    Abstract [en]

    Background: The work of staff in supported housing facilities for people with psychiatric disabilities has most often been studied from the perspective of one of the two groups but not from both. The staff in these facilities generally come from differing professions, reflecting either the beliefs of the medical or social models of psychiatric care. 

    Aim: The aim of the present study was thus to investigate the perceptions of residents and staff of the frequency and the importance of verbal and social interactions in supported housing facilities for people with psychiatric disabilities and to compare these perceptions. A further aim was to investigate whether differences in education background and other sociodemographic factors are reflected in the staff perceptions of these interactions.

    Methods: One hundred and eleven residents living in supported housing facilities in Sweden and 223 staff completed the Verbal and Social Interaction Supported Housing questionnaire. 

    Results: The results revealed significant differences between the perceptions of the residents and staff on all six categories of interactions, where the staff rated the frequency and importance higher than the residents, but also some similarities in terms of the relative order of the frequency of the categories of interactions. Both the residents and staff perceived that “To build a relationship with a supportive quality” as the most frequently occurring and most important category. The mean levels of importance for all the categories were higher than for the frequency according to both groups. No differences were found between the staff with a medical or social educational background. Similarly, no differences were found in staff perceptions between those with short experience and those with long experience. 

    Conclusion: This study is the first survey of its kind and the results indicate the need for reducing the gap between the staff intentions and the residents’ preferences, which could form the basis for in-house training activities. 

  • 345.
    Brunt, David
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Rask, Mikael
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Ward Atmosphere – the Scarlet Pimpernel of psychiatric settings?2007In: Issues in Mental Health Nursing, Vol. 28, no 6, p. 639-656Article in journal (Refereed)
    Abstract [en]

    Patients and staff in a forensic psychiatric setting were requested to name three distinguishing characteristics of the ward atmosphere. The manifest content analysis of the responses revealed the following categories: interpersonal relations and pre-conditions for interpersonal relations, organization, staff, treatment, daily activities, physical environment and feeling good and secure. The patients appeared to have a peripheral role as contributors to the ward atmosphere in the views of the respondents. The easily administered single question format provided valuable information about that intangible element of psychiatric settings – the ward atmosphere.

  • 346.
    Brunt, David
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Schroder, Agneta
    Örebro University, Sweden;Norwegian Univ Sci & Technol NTNU, Norway.
    Lundqvist, Lars-Olov
    Örebro University, Sweden.
    Rask, Mikael
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Residents' Perceptions of Quality in Supported Housing for People with Psychiatric Disabilities2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 8, p. 697-705Article in journal (Refereed)
    Abstract [en]

    The residents' perspective of the quality of housing support for people with psychiatric disabilities living in congregate supported housing has been studied and a comparison has been made with the findings from those from a previous study in ordinary housing with outreach support. One-hundred and seventy-eight residents from 27 supported housing facilities in eight Swedish municipalities completed the Quality of Psychiatric Care-Housing (QPC-H) instrument. The highest quality ratings were found for: Secluded Environment, Encounter and Support, while Participation, Housing Specific and Secure Environment were rated at lower levels. Despite relatively high ratings, a majority of items did not attain the 80% cutoff point deemed as defining satisfactory quality of service. The residents in ordinary housing with outreach support rated higher levels for the majority of the QPC-H dimensions in comparison with those in supported housing. A conclusion is that the quality of care in supported housing facilities has a number of deficiencies that need to be addressed. Supported housing is generally rated as having a lower quality of care than in ordinary housing with outreach support. Suggestions for the content of staff training are made based on the results.

  • 347.
    Brüggemann, A. Jelmer
    et al.
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Patients’ silence towards the healthcare system after ethical transgressions by staff: associations with patient characteristics in a cross-sectional study among Swedish female patients2012In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, no 6Article in journal (Refereed)
    Abstract [en]

    Objectives: To identify which patient characteristics are associated with silence towards the healthcare system after experiences of abusive or ethically wrongful transgressive behaviour by healthcare staff.

    Design: Cross-sectional questionnaire study using the Transgressions of Ethical Principles in Health Care Questionnaire.

    Setting: A women's clinic in the south of Sweden.

    Participants: Selection criteria were: consecutive female patients coming for an outpatient appointment, ≥18-year-old, with the ability to speak and understand the Swedish language, and a known address.

    Questionnaires were answered by 534 women (60%) who had visited the clinic, of which 293 were included in the present study sample.

    Primary outcome measure: How many times the respondent remained silent towards the healthcare system relative to the number of times the respondent spoke up.

    Results: Associations were found between patients’ silence towards the healthcare system and young age as well as lower self-rated knowledge of patient rights. Both variables showed independent effects on patients’ silence in a multivariate model. No associations were found with social status, country of birth, health or other abuse.

    Conclusions: The results offer opportunities for designing interventions to stimulate patients to speak up and open up the clinical climate, for which the responsibility lies in the hands of staff; but more research is needed.

  • 348.
    Brüggemann, A. Jelmer
    et al.
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    What contributes to abuse in health care?: A grounded theory of female patients’ stories2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 3, p. 404-412Article in journal (Refereed)
    Abstract [en]

    Background

    In Sweden, 20% of female patients have reported lifetime experiences of abuse in any health care setting. Corresponding prevalence among male patients is estimated to be 8%. Many patients report that they currently suffer from these experiences. Few empirical studies have been conducted to understand what contributes to the occurrence of abuse in health care.

    Objectives

    To understand what factors contribute to female patients’ experiences of abuse in health care.

    Design

    Constructivist grounded theory approach.

    Settings

    Women's clinic at a county hospital in the south of Sweden.

    Participants

    Twelve female patients who all had reported experiences of abuse in health care in an earlier questionnaire study.

    Methods

    In-depth interviews.

    Results

    The analysis resulted in the core category, the patient loses power struggles, building on four categories: the patient's vulnerability, the patient's competence, staff's use of domination techniques, and structural limitations. Participants described how their sensitivity and dependency could make them vulnerable to staff's domination techniques. The participants’ claim for power and the protection of their autonomy, through their competence as patients, could catalyze power struggles.

    Conclusions

    Central to the participants’ stories was that their experiences of abuse in health care were preceded by lost power struggles, mainly through staff's use of domination techniques. For staff it could be important to become aware of the existence and consequences of such domination techniques. The results indicate a need for a clinical climate in which patients are allowed to use their competence.

  • 349.
    Brüggemann, Adrianus Jelmer
    et al.
    Linköpings universitet.
    Wijma, Barbro
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Abuse in health care: a concept analysis2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 1, p. 123-132Article in journal (Refereed)
    Abstract [en]

    Aims and objectives:  To analyse the concept of abuse in health care. This analysis also covers how abuse in health care is different from the related concepts of medical error, patient satisfaction and personal identity threat.

    Background:  Abuse in health care is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated.

    Design:  Concept analysis as developed by Walker and Avant.

    Method:  The databases Cumulative Index to Nursing and Allied Health Literature, Medline, and Google Scholar were used to obtain articles published between 1997 and 2009. A total of eleven articles are referred to on abuse in health care, four on medical error, six on patient satisfaction and three on personal identity threat.

    Results:  Abuse in health care is defined by patients’ subjective experiences of encounters with the health care system, characterized by devoid of care, where patients suffer and feel they lose their value as human beings. The events are most often unintended. We also found differences with the aforementioned related concepts: medical error does not share the patients’ perspective, and patient satisfaction does not offer room for patients’ abusive experiences. The concept of personal identity threat shares all attributes with abuse in health care, but it lacks an antecedent that signifies the social structures underlying the phenomenon.

    Conclusions:  Abuse in health care covers a phenomenon that has severe consequences but is invisible if seen from a medical error or patient satisfaction perspective.

  • 350.
    Brüggemann, Jelmer
    et al.
    Linköping University.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Hälsouniversitetet, Linköping.
    Staff silence about abuse in health care: an exploratory study at a Swedish women’s clinic2014In: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 9, no 2-3, p. 71-76Article in journal (Refereed)
    Abstract [en]

    Background It has been well documented that patients can feel abused in health care and that many patients suffer from these experiences. Insight lacks into contributing factors behind such events. Silence surrounding the abuse has been suggested as a possible mechanism. The present study explores silence surrounding the abuse as a possible contributing factor. We have explored whether this silence is connected with the staff’s hierarchical position and with the staff’s own experiences as patients abused in health care.

    Methods During January 2008, a paper questionnaire was sent to all staff members at a Swedish women’s clinic. The questionnaire included questions on sociodemography and profession and multiple questions about abuse in health care. After univariate testing, a binary logistic regression model including variables concerning profession and staff’s own experiences of abuse was built.

    Results Our data show that in contrast to midwives and gynaecologists, auxiliary nurses seldom report hearing about cases of abuse in health care. Staff who themselves experienced abuse in health care as patients, so-called wounded healers, were more likely to have heard about abuse in health care during the last 12 months.

    Conclusions This study suggests that a form of silence reigns over events of abuse in health care that is not randomly distributed over staff. Professional hierarchies and staff’s own experiences of abuse as patients could be considered in the design of interventions to break the silence surrounding patients’ experiences of abuse in health care.

45678910 301 - 350 of 2140
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf