bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of the Concept of Quality of Life
Authors: Qvarnstrøm Ulla , Haugen Margun
Published: March 2013

ABSTRACT. Nurses provide the constant human care that can make the difference between a life that is valuable to the last and a life that ends in humiliation, deprivation and suffering. Nurses, therefore, more than other health professionals, need a deep and reflective view of patients' value and quality of life. In this paper the concept of quality of life is analysed from a philosophical and scientific perspective. Quality of life in connection with treatment of a disease has its roots in the philosophical conception of the value of human life in general. Characteristics such as happiness, physical activity and interpersonal relations are what give life value and meaning. From the scientific viewpoint, it seems difficult to define the concept, given its multidimensional characteristics. However, the analysis indicates a growing interest among health‐professionals to develop scientific intersubjectivity of the concept in terms of measurable parameters.
Experience of Being Diabetic
Authors: Nyhlin Kerstin Ternulf , Lithner Folke , Norberg Astrid
Published: March 2013

ABSTRACT. In order to gain a deeper understanding of how to manage diabetes successfully, interviews with 20 well‐adapted insulin‐dependent diabetic patients, with long duration of the disease and with no vascular complications, were performed as a first step of a major long‐term study. The data were analysed qualitatively in line with “grounded theory”. The results are presented in five conceptual categories, as an account of the patients' experiences in dealing with diabetes: 1. Up to oneself. 2. Walking a fine line. 3. The days are numbered. 4. Not ill, but having a disease. 5. Being dependently independent. To maintain effective self‐management it is important for the patients to recognise and understand difficulties, and to get support. Disaccordance concerning e.g. the way patients are treated within the health care system may be depressing and confusing. Knowledge derived from well‐adapted diabetic patients might be of great value when caring for diabetic patients in general and in particular when taking care of newly diagnosed diabetic patients.
The Use of the Nurse Self Description Form in Sweden
Authors: Olsson Henny M. , Gullberg Mats T.
Published: March 2013

ABSTRACT. The Nurse Self Description Form (NSDF) is a self‐administered paper‐and‐pencil test and contains 19 items with which respondents mark own self‐valuation. The NSDF has previously been used in California (USA) to explore the relationship between sex‐role identity and description of self, and to study the perception of professional self among graduating nurses. A translation and adaptation of the instrument into Swedish conditions has been carried out. The applicability of the instrument has been tested with the aid of the result from a pilot study using the NSDF carried out in Sweden and the result from a study presented by Dagenais & Meleis in 1982. The comparison between the Swedish version of the instrument and its opposite number in California indicates that the substance of the Swedish NSDF is not influenced by the translation and adaptation into Swedish.
Interaction Between the Severely Demented Patient and His Caregiver during Feeding
Authors: Athlin Elsy , Norberg Astrid
Published: March 2013

ABSTRACT. A theoretical model for the assessment of interaction between the severely demented patient and his caregiver during feeding is suggested. It is based on literature of impairments in demented patients and interaction. The main concepts of the model are clarity of cues, sensitivity, interpretation, responsiveness and synchrony. The model stresses the fact that when the senile demented patient's communicative competence declines, the caregiver has to compensate for his disability.
Tedium Among Personnel Working with Geriatric Patients
Authors: Åström Sture , Norberg Astrid , Nilsson Mats , Winblad Bengt
Published: March 2013

ABSTRACT. The prevalence of tedium was assessed in 1136 caregivers at institutions for elderly patients in the health care district of Umeå, northern Sweden. The proportion of personnel at risk of developing tedium was higher in long‐term care than in general care and also higher among physicians and registered nurses than among enrolled nurses and nurses' aides. There was a lower proportion of respondents with positive attitudes towards demented patients in the group of respondents with experiences of tedium.
Nursing Education as an Instrument Towards Role Change
Authors: Olsson Henny M. , Gullberg Mats T.
Published: March 2013

ABSTRACT. Nursing education in Sweden aims at a development of and a change in the nursing profession, and the goals set comprise implicit thoughts of education as an instrument towards role change. Nurses trained according to reformed nursing education are the intended performers of changes in the professional role. The vital point here is whether these performers themselves consider education as an instrument towards role change. This paper deals with change in time of student nurses' and nurses' conceptions about nursing education as an instrument of change. Three studies have been carried out; initially, at the end of nursing education, and one year after graduation. We have found significant changes as to time in distribution of conceptions. The results indicate that the initially held conception describes a downward tendency at the end of training and an upward tendency after one year of work experience. This confirms the importance and necessity of role modelling, role repetition and interactions with a professional group. A successful role clarification is best achieved by being a registered nurse, where one can model, repeat, and interact.
Assessing the Need for Challenging Behaviour Services in an English Health District
Authors: Chung Man Cheung , Cumella Stuart , Bickerton Wai‐ling , Winchester Caroline
Published: March 2013

The aim of the present study was to assess the health care needs for people with learning difficulties who display challenging behaviour in a newly established health district. Ninety‐eight clients were studied, using Disability Assessment Schedule (DAS), Aberrant Behaviour Checklist (ABC) and The Psychopathology Inventory for Mentally Retarded Adults (PIMRA). The results showed that a large proportion of them were mobile, continent and able to feed themselves. Almost half had no problems in communication but less than half were sociable. On the whole, they did not have adequate skills. A large proportion of them did not present severe challenging behaviour and did not suffer from psychiatric illnesses, apart from inappropriate adjustment disorder. Correlation coefficients showed that there were relationships between challenging behaviours and some of clients' disabilities and inappropriate adjustment disorder.
The Perception of Aggression
Authors: Jansen Gerard , Dassen Theo , Moorer Peter
Published: March 2013

Several academic and clinical disciplines are involved in clarifying the concept of aggression by formulating operational and descriptive definitions. In the present paper the validity of the definitions of aggression, reported by nurses in an earlier qualitative study, is examined, using a survey approach among nurses of five general psychiatric hospitals in the Netherlands. Three dimensions of aggression were found; aggression as a normal, adaptive reaction, aggression as a violent reaction and aggression as a functional reaction. These findings match the results of the qualitative study. It was investigated whether there was a relation between personal and environmental characteristics of the nurses and the way they perceive aggression. The gender of the respondents, the setting in which they were working, the degree to which they used constraint measures and whether patients were voluntarily admitted or not, were related to the perception of aggression. The study points out that different instruments are needed to measure the prevalence or incidence of aggression and to diagnose or to intervene on aggression in clinical practice.
Elderly People's Daily Activities and Need for Mobility Support
Authors: Lilja Margareta , Borell Lena
Published: March 2013

The aim of the present study is to describe elderly people's performance of some daily activities in relation to their need for mobility support in their living environment. Two groups of individuals, over the age of 65 and living in an old urban area with access to elevators in their housing, were compared, as regards mobility, shopping, hobbies and social contacts. The first group (n = 284) comprised persons who needed assistance from another person in using the elevator. The subjects in the second group (n = 325) were able to manage the elevator independently. The subjects in the first group experienced more problems in carrying out the activities than those in the second group. Weekly shopping was the only action in which the findings demonstrated no main differences between the groups. Throughout all the activities of daily living (ADL), and in both groups, there were persons who were rated as having the capacity to perform the activities, but did not do so and did not want to do so. The elderly, especially in the first group, wanted to engage in more activities than they were judged to have the capacity for and/or the environmental support to do. The implications of the result for the assessment of the homes of the elderly in relation to their environment are discussed.
A Philosophy of Care for a Neonatal Intensive Care Unit
Authors: Nyqvist Kerstin Hedberg , Karlsson Kerstin Hjelm
Published: March 2013

Crisis reactions, a stressful environment, infant care practices, and nurse behavior may cause difficulties in entering the natural parental role for parents of infants who are admitted to a neonatal intensive care unit (NICU). In connection with discussions in the Uppsala NICU on what constitutes good care, a philosophy of care, based on Callista Roy's adaptation model, was formulated for the purpose of providing developmentally supportive, family‐centered care, and for defining good care and the professional nurse role. The philosophy describes the infant's needs and environment. Caring activities focus on support of the infant's and his parent's roles and self‐concept in their progress towards independence from professional assistance. The philosophy is an essential component in the introductory program which integrates newly recruited personnel from different disciplines into the unit. It is presented as a suggestion of how a model‐based philosophy of care can be formulated by operationalization of the theoretical concepts of a nursing model.
Walking Around in Circles—The Life Situation of Patients with Asthma‐like Symptoms but Negative Asthma Tests
Authors: Ringsberg Karin C. , Segesten Kerstin , Åkerlind Ingemar
Published: March 2013

In‐depth interviews were conducted with fourteen women with asthma‐like symptoms but negative asthma tests. In collecting and analysing data the method of grounded theory was used. A core category emerged, Walking around in circles, and three main categories, Subjective Hyperreactivity, Social Limitations and Non Confirmation which elucidated the life situation and psychosocial processes involved in having the breathing disorder. The findings were characterised by numerous self‐reinforcing vicious circles. The symptoms were especially associated with subjective hyperreactivity with strong sensitivity to odours, impaired ability to perform physical activities and mental stress, which in turn impose social limitations. These restrictions arouse feelings of social isolation and distress, which implies mental stress and thereby increased attention and sensitivity to adverse stimuli. The fact that the medical experts cannot offer diagnosis and treatment engenders feelings of confusion, non‐confirmation and thereby anxiety which further aggravate the vicious circles described. Most informants considered that they had few coping strategies. Some stated that they had changed their strategies from being passive, taking no responsibility, to become more active, not caring about the reactions of others and taking the risk of being ill, favouring social contacts and thus minimising the impact of the disorder.
Fathers' Experience of Childbirth and its Relation to Crying in His Infant
Authors: Wikander Birgitta , Theorell Töres
Published: March 2013

As part of a research project exploring ways through which we can understand the crying infant and its family, this study focuses on the experiences of fathers during labour and delivery of their infant. In a previous part of the project it was shown that fathers' negative experiences during the childbirth were correlated with the amount of crying in the infant during the first months after birth. The aim of the present study was to explore and interpret the experiences that fathers reported in an interview when the infant was between six months and one year of age. A hundred and nine fathers were interviewed. The interviews, which took place in the families' homes and with both parents present, were carried out in dialogue form with open‐ended questions. The results reveal that complications during the delivery were significantly correlated with the amount of crying in the infant. Feelings of helplessness, of guilt and that staff behaviour had been negative were more common in the group of fathers who experienced the delivery as a negative event. ‘Locus of control’ seems to be the most relevant concept.
Well‐being and Functional Ability in Uraemic Patients Before and After Having Started Dialysis Treatment
Authors: Klang Birgitta , Clyne Naomi
Published: March 2013

In this study perceived well‐being and functioning in 28 uraemic patients (14 women and 14 men, mean age 54 years) were measured in the predialysis stage during conservative renal therapy and 3–9 months after having started maintenance dialysis treatment. The patients had participated in a patient education programme in the predialysis stage. Disease‐specific symptoms, perceived health (Health Index), functional (SIP) and emotional (STAI) status were analysed. The results showed that there were no significant differences in the patients' correction of uraemia, frequency of symptoms or anxiety prior to and after having started dialysis. After having started dialysis treatment, fatigue, lack of energy and functional disability in work increased while disability in recreation and pastime decreased. Standard bicarbonate correlated significantly to the symptoms of leg cramps and itching. Serum albumin correlated significantly to eating dysfunction in the SIP. There was a large variation within the group with regard to their self‐rated disturbances. Some patients reported a relatively intact quality of life, some reported a moderate influence, and some a severe decrease in quality of life irrespective of whether they were in the predialysis state or on maintenance haemodialysis or CAPD. In conclusion, dialysis treatment resulted in increased fatigue and lack of energy, while disease‐specific symptoms, functional disability and anxiety did not increase during the first months on dialysis. The symptoms of itching and leg cramps correlated significantly with level of metabolic acidosis, and eating disability correlated with serum albumin levels, indicating that biochemical variables should be combined with patient assessment of health and well‐being in order to optimize treatment and care. Moreover, the wide range of scores in all the research variables indicates that assessment of quality of life can be helpful in allocating support to those patients in need of it.
The Appearance and Disappearance of Cognitive Impairment in Elderly Patients During Treatment for Hip Fracture
Authors: Strömberg Lars , Lindgren Urban , Nordin Conny , Öhlén Gunnar , Svensson Olle
Published: March 2013

We studied the natural course of cognitive state in 256 consecutive hip fracture patients who were admitted from an independent living situation. We employed a treatment programme that focused on preventing postoperative cognitive impairment. Cognitive function was assessed with the SPSMQ screening test. The incidence of postoperative cognitive impairment among those lucid on admission was 13%, which generally was reversed before discharge. Thirty‐seven percent were cognitively impaired on admission; of those, 51% reached normal test scores while in hospital. Those who recovered within the first week had as good a prognosis during the first year as those who remained lucid throughout the hospital stay. Cognitive impairment was associated with an increased complication rate, e.g. a three‐fold increase of early fracture displacement and a four‐fold increase of wound infection. This increased risk was present even in patients with mild/moderate cognitive impairment and could not entirely be explained by age. Our results suggest that it is possible to decrease postoperative cognitive impairment by routine monitoring of cognitive status, a high level of continuity and a reorientation programme. The routine assessment of the cognitive function is recommended in geriatric patients who are admitted for surgery.
Quantitative Research on Therapeutic Touch
Authors: Spence Jeanette E. , Olson Melodie A.
Published: March 2013

Quantitative research on Therapeutic Touch (TT), published in refereed nursing journals from 1985 to 1995, is reviewed. Therapeutic Touch is defined by Dolores Krieger, the founder of this nursing intervention. The authors of this Integrative Review examine what is known and not known to date in order to facilitate appropriate application of this modality in practice, and to offer recommendations for future research. Critical characteristics of eleven quantitative studies are identified and analyzed. These characteristics include: author/year/journal/title; study purpose (hypotheses); background/literature review/conceptual citations; sample selection method; study design/random assignment; independent variable/length of treatment/control and confounders; dependent variables/measurements; outcomes; study limitations; and implications for future research. After reviewing the studies, it is concluded that there is evidence to support the practice of Therapeutic Touch for the reduction of pain or anxiety. There is clearly a lack of congruity between the research statement, conceptual framework, operational definition of TT and the findings. This incongruity is discussed and incorporated in the recommendations for future research including outcome, theory‐generating and theory‐testing research.
Nurses' Attitudes to Attempted Suicide Patients
Authors: Samuelsson Mats , Sunbring Ylva , Winell Ingalill , Åsberg Marie
Published: March 2013

The purpose of this study was to investigate the attitudes towards attempted suicide patients among registered nurses involved in the somatic care of such patients, and to compare them with those of psychiatric nurses. The attitudes were measured on a newly constructed scale, the Understanding of Suicide Attempt Patients Scale (USP‐Scale), and three brief clinical vignettes with the answer format of a visual analogue scale (VAS). The nurses working within the psychiatric services were more understanding and more willing to nurse suicide attempt patients than nurses in somatic disciplines. Among all the nurses, older personnel were more favourably disposed than the younger, and more frequent contact with suicide‐prone patients was related to more positive attitudes. The perceived need for further training in suicidology was significantly stronger among the nurses in the general hospitals. This suggests that their ‘negative attitudes’ may to some extent be a result of lack of knowledge and uncertainty rather than a hostile attitude. The nurse has a responsibility to create a positive climate in the patient's encounter with the health services. Knowledge and understanding are needed to enable the nurse to provide professional care for a difficult and challenging patient group.
A Concept Analysis of Energy
Authors: Lerdal Anners
Published: March 2013

Energy is an essential concept in nursing which seems to be a key concept in the daily life of three individuals with chronic illness. Much has been done within the natural sciences to investigate and explain the concept, but studies on the meaning of energy and how it is experienced are difficult to find. A review of the existing literature reflects that energy has been an important term for nursing theorists, both in empirical studies and in nursing theories. In this study the principles of the hybrid model developed by Schwartz‐Barcot & Kim of concept development were used to examine: (a) how the concept has been outlined in the literature within different disciplines, (b) how energy is experienced in the daily lives of three individuals with chronic illness, and finally, (c) the existing literature compared and contrasted with the empirical findings. The experience of having energy was very important for all three individuals. Energy was a familiar term which each individual linked most directly with his or her feeling states and the ability to perform daily activities. It demanded attention every day. Energy was defined as the individual's potential to perform physical and mental activity. The study indicates that this concept has potential for theory development and for clinical practice.
Physical Restraints in Geriatric Care
Authors: Karlsson Stig , Bucht Gösta , Sandman P. O.
Published: March 2013

The aim of the present study was to investigate the use of physical restraints in institutional elder care and staff knowledge about and attitudes toward the use of these restraints. Poor knowledge and negative attitudes toward the use of restraints were found among staff. Significant differences between various staff categories were found concerning knowledge about the use of restraints; nurse aids had the lowest and physicians the highest scores on the knowledge test. Nurse aids demonstrated the least negative attitudes (were most prone to use restraints) and physicians the most negative. Furthermore, there was a significant relation between attitudes and knowledge, i.e. staff with poor knowledge also demonstrated the least negative attitudes toward the use of restraints. Despite these negative attitudes among staff, we found a large proportion of restrained patients in the institutions investigated. Twenty‐nine percent of the patients at the investigated clinics were physically restrained. The most common reason given was that restraints were used to prevent falls. No documentation of the observed use of restraints was found in any of the restrained patients' hospital records.
Perioperative Nurses' Encounter with Value Conflicts
Authors: von Post Iréne
Published: March 2013

The aim of the study was to gain a better insight into perioperative nurses' experience in a value conflict that has arisen in the perioperative caring environment and how they deal with it. In order to obtain as full and objective a picture as possible the critical incident technique was chosen. Perioperative nurses were asked to write down stories about value conflicts which they have experienced in the perioperative caring environment. When interpreting the textual content of the stories the aim has been to understand the meaning of nurses' experiences and how the nurses act in a value conflict situation. A value conflict is something that nurses have become part of against their own will. They are prevented from giving the good care they want to give, they are in conflict with themselves and have a bad conscience, and they feel guilt and shame for not having prevented the value conflict. The nurse who is involved in a value conflict aims, for the sake of the patient, to be a professional caring nurse. The nurse chooses to be the patient's neighbour, the one who suffers along with the patient and represents the patient's cry for help.
Physical and Psychosocial Work‐related Risk Factors Associated with Musculoskeletal Symptoms among Home Care Personnel
Authors: Brulin Christine , Gerdle Björn , Granlund Brittmarie , Höög Jonas , Knutson Anders , Sundelin Gunnevi
Published: March 2013

The aim of this cross‐sectional study was to investigate physical and psychosocial aspects of the work environment, sociodemographic data and certain lifestyle factors, and the relationship between these variables and complaints in the shoulder/neck and low back area among female home care personnel. A questionnaire was completed by 361 randomly selected women. Multiple logistic regression analyses were conducted to evaluate the importance of several exposure factors for complaints in the shoulder/neck and low back areas. The results of this study clearly indicate that ‘standing in forward‐bent and twisted postures’ can be viewed as a risk factor for shoulder/neck pain. A combination of this physical exposure and ‘no possibility of influencing the planning of work’ gave an increase in odds ratio, indicating an interaction between these two exposure indices. However, this interaction was not found for low back pain. ‘Standing in forward‐bent and twisted postures’, ‘standing in awkward positions’ and whether the subject had children staying at home were significantly correlated to complaints about the low back. In fact, the latter factor decreased the risk of having complaints. The results indicated that certain physical and psychosocial work risk factors could influence shoulder/neck and low back pain.
Postoperative Energy Intake in Patients after Colorectal Cancer Surgery
Authors: Ulander Kerstin , Jeppsson Bengt , Grahn Gertrud
Published: March 2013

In a prospective noninterventional study of 75 consecutive patients (mean age 71 ± 12 years) undergoing surgery for colorectal cancer, standard postoperative energy intake was evaluated. Seventeen patients expended 40%–60% of estimated basal energy during hospitalization, 33 patients 60%–80%, 22 patients 80%–100% and three patients 100%–125%. Weight loss was observed in 67 patients (mean loss 4.7 ± 4.4%) during hospitalization. Men had a significantly higher mean total calorie deficit (p < 0.001), and mean weight loss percentage (p < 0.01), compared to women. Preoperative nutritional status, nutrition‐associated complications and length of hospital stay did not change the nutritional support and intake. Correlation analyses resulted in significant associations between gender and total calorie deficit (rs = 0.41, p < 0.01), postoperative weight loss and total calorie deficit (rs = −0.32, p<0.01), and between postoperative weight loss and length of stay (rs = 0.27, p < 0.05). We concluded that the patients' energy intake was insufficient compared to estimated basal energy expenditure. These results suggest a need for individualized nutritional care, based on each patient's energy needs and on registration of daily calorie intake, all with the aim of increasing energy intake postoperatively in standard hospital care.
Autonomy in the Rehabilitation of Stroke Patients in Nursing Homes. A Concept Analysis
Authors: Proot Ireen M. , Crebolder Harry F. J. M. , Abu‐Saad Huda Huijer , Ter Meulen Ruud H. J.
Published: March 2013

This article presents a concept analysis of autonomy in relation to the rehabilitation of stroke patients. Analysis of the results of a literature survey provided three important concepts of autonomy in the field of biomedical ethics: self‐governance, self‐realization and actual autonomy. These concepts are compared with concepts from caring sciences and summarized in a table. The results indicate the importance of the social environment (formal and informal caregivers) for the restoration of autonomy. Because of the patient's condition and context, a social concept of autonomy makes more sense in the rehabilitation of stroke patients in nursing homes than does an individual concept. The concept analysis sheds light on the fact that the majority of studies regarding patient autonomy are primarily based on theoretical reflections, not on empirical studies. More research is warranted to gather information on how patients themselves consider and appreciate autonomy during rehabilitation, to explore the views of stroke patients' formal and informal caregivers and to investigate whether a social concept of autonomy is suitable for all phases of rehabilitation. Concerning the practice of rehabilitation, no definite conclusion can be given as yet.
Pupils' Experiences of the Annual Health Dialogue with the School Health Nurse
Authors: Borup Ina K.
Published: March 2013

This study describes and analyses the health dialogue on the basis of the pupils' experience and the association with background factors such as age, sex, geographical areas, family and social class. The theoretical framework is based on empowerment and health promotion, and on Kolb's theory of experiential learning. The study, conducted in 1991, is the Danish contribution to the WHO collaborative study ‘Health Behaviour in School Children’. A nationwide random sample of pupils aged 11, 13 and 15 (n = 1860) answered a standardized questionnaire about perceived health, health behaviour, social situation and the health dialogue with the school health nurse. Among the pupils, 68% had participated in the annual health dialogue at the time of the survey (three quarters of the way through the school year). The youngest pupils, and the girls, often participated in groups and reported the greatest number of topics discussed. The health dialogue most frequently comprised 11–20 topics. Most topics discussed were related to health promotion, 31%–60% were related to prevention of illness and symptoms and the rest were related to psychosocial issues. Girls more often reported discussing personal relationships and boys more often discussed action‐related topics. Pupils from lower social classes more frequently reported topics related to prevention of illness and symptoms and psychosocial issues. The discussions are the first step in a learning process as a Concrete Experience (CE).
Use of Care by Home‐dwelling Stroke Patients during Three Years following Hospital Discharge
Authors: Hermans Eric , Anten Hubert W. M. , Diederiks Joseph P. M. , Philipsen Hans
Published: March 2013

Of 82 stroke survivors who had been discharged from hospital, 49 were still living at home after a three‐year period. Thirty‐three of these patients formed the population of the present study of the use of care at home. Sixty‐one percent had received professional care and 88% had received family care. Although their overall functional status indicated only mild handicaps, after three years patients still reported a large number of disabilities and problems. The average weekly amount of family care was 37 h, and many family carers experienced a high burden of care and had emotional problems coping with the patients' disabilities. Concerning factors related to the use of care, in spite of the relatively small number of study patients, some interesting hypotheses can be advanced.
Coping Strategies and Quality of Life among Patients on Hemodialysis and Continuous Ambulatory Peritoneal Dialysis
Authors: Lindqvist Ragny , Carlsson Marianne , Sjödén Per‐Olow
Published: March 2013

A consecutive series of hemodialysis (HD) patients (n = 30) was included in a descriptive‐comparative design. The aim was to study coping strategies and quality of life compared to a group of patients on continuous ambulatory peritoneal dialysis (CAPD). Coping was measured on the Jalowiec Coping Scale. Quality of life was measured by the Swedish Health‐Related Quality of Life Survey (SWED‐QUAL). An optimistic coping style was the most widely adopted by men and women in both groups, and this style was also considered to be the most effective in terms of dealing with stressful treatment aspects. The HD sample used more evasive coping strategies than the CAPD sample. Compared to a sample from the general population, HD patients had lower values on all SWED‐QUAL subscales. Further, the CAPD women scored lower on general health than did the HD women. Significant gender differences were found in that men in both samples regarded themselves as better able to cope with physical aspects of the illness. Women in both samples scored lower on general health. It seems important to identify patients who use emotive, evasive and palliative coping techniques extensively, because they seem to be less effective at handling their illnesses.
Patients' Fears in Coronary Arteriography
Authors: Heikkilä Johanna , Paunonen Marita , Laippala Pekka , Virtanen Vesa
Published: March 2013

This study was concerned with the objects of fear and the intensity of fears related to coronary arteriography (CA) in 378 patients scheduled for coronary arteriography at a university hospital. Intensity of fear was measured on a 10‐point Likert‐type scale which listed 26 objects of fear. The patients were asked to assess the intensity of their fears both before and after CA. The results showed that the intensity of fear varied depending upon the object of fear. The highest intensity was recorded for fear of coronary artery bypass surgery. A significant increase was found in fear of lying flat in bed after CA and fear of not receiving social support. Fears of uncertainty about the illness, the CA procedure, results of CA, pain, coronary artery bypass surgery and coronary angioplasty decreased significantly after CA. Significant associations were found between objects of fear and patient demographics. It is concluded that patients' fears should be assessed individually both before and after CA. Special attention should be paid to the fears of women, patients under 45 years, upper and lower level employees and the unemployed.
Senses of Responsibility
Authors: Bellner Anna‐Lena
Published: March 2013

The aim of this paper was to delineate different senses of responsibility in the therapeutic relationship between occupational and physical therapists and their patients, in the context of ongoing professionalization. To assist the analysis of the therapists' responsibilities, Ozar's guild and interactive relationship models were employed. The questions with regard to each model asked how the model might be used in order to describe the therapists' professional development in general, and specifically their professional responsibilities. Based on earlier findings, the professional development of the therapy groups has developed in line with both the guild and interactive models, i.e. some therapists have adopted the former and others the latter. Whether therapists in general, in recent years, have shifted their paradigm, and consequently also their choice of relationship model, is a question that necessitates further research. However, based on the results from the analysis here, it seems relevant to propose that therapists, with a renewed sense of urgency, should use Ozar's models as tools for reflection on the development of their professional responsibilities in the therapist‐patient relationship, in the frame of a rehabilitation paradigm.
Quality of Life among the Elderly
Authors: Holmén Karin , Ericsson Kjerstin , Winblad Bengt
Published: March 2013

Cognitively impaired and intact elderly subjects from a longitudinal project were interviewed in a follow‐up study about their present state of mood and how often they experienced loneliness. In all, 315 subjects were involved in the study. The dropout rate was high, about 50%, due to death and to the fact that some elderly persons—especially those with slightly impaired cognitive function—declined to participate. The present state of mood was measured by the Geriatric Depression Scale and loneliness was assessed by the question, ‘Do you experience loneliness often, sometimes, seldom or never?’ Most subjects (4 out of 5), above all those who were cognitively intact, reported basic satisfaction with their lives. The greatest difference in response between the two cognitive groups was found in the question about having an empty life. Loneliness and sad mood prevailed especially among subjects with cognitive difficulties. In summary, experiencing loneliness had a negative influence on the state of mood in both cognitive groups, particularly among persons with cognitive impairment.
Focus on Occupational Therapists' Paradigms
Authors: Björklund Anita
Published: March 2013

The primary aim of this study was to identify and characterize the perceptions of seven experienced occupational therapists' about their profession, in particular with respect to a ‘world view’ and a ‘field of action view’. The secondary aim was to determine whether there were similarities among the respondents' personal paradigms that could constitute a potential, local ideology for the group. The study has an explorative design based on Törnebohm's theory of paradigms. Qualitative data were collected on three occasions during the autumn of 1996, using audio‐and video‐taped, thematic discussions, involving focus groups. The data were analysed qualitatively within the two paradigm components, ‘world view’ and ‘field of action view’. The results show several unifying factors, and dissimilarities were limited to specifications within these unifying factors, with respect to the respondents' notions. The unifying factors could be described as a potential, local ideology for the group.
Validity of the Body Awareness Scale‐Health (BAS‐H)
Authors: Gyllensten Amanda Lundvik , Ekdahl Charlotte , Hansson Lars
Published: March 2013

Quality of movement assessment using the Body Awareness Scale‐Health (BAS‐H) was validated against the following self‐rating tests: Nottingham Health Profile (NHP); Arthritis Self‐Efficacy Scale (ASES); Psychological General Well‐Being (PGWB); Sense of Coherence (SoC); Sivic Psychosomatism test (SPS); Symptom Check List 90‐R (SCL 90‐R); and Visual Analogue Scale for pain intensity (VAS‐pain). In total, 75 persons were included, divided into three groups: psychiatric outpatients (n = 25), chronic pain patients (n = 25) and healthy controls (n = 25). The highest significant correlations were obtained between the BAS‐H total index and the sub‐indices of grounding/stability to the centre line, centering/breathing and flow on the one hand, and the NHP, the ASES, and the PGWB on the other, with r ranging from 0.36 to 0.73. Multiple regression analysis revealed the NHP to explain 50% and ASES a further 5% of the variance in the BAS‐H total index. Significant differences for both the BAS‐H total index and the sub‐indices were obtained between the two patient groups and the healthy controls. It is concluded that the construct validity of the BAS‐H was found to be in accordance with theoretical expectations.
Occupational Case Analysis Interview and Rating Scale
Authors: Lai Jin‐Shei , Haglund Lena , Kielhofner Gary
Published: March 2013

The Occupational Case Analysis Interview and Rating Scale (OCAIRS) was developed based on the Model of Human Occupation with the intention of assessing patients' occupational adaptation. Several studies examining the quality of this instrument have been completed; however, none have discussed the internal validity of the instrument or the appropriateness of the rating scale. The purpose of this study is to validate the internal validity of the OCAIRS and to test the quality of the rating scale. The results indicate that the OCAIRS is a valid measure of occupational adaptation. Each item was shown to have its own rating scale structure, however, all items together still shared the same five‐point rating scale.
Suffering from Care as Expressed in the Narratives of Former Patients in Somatic Wards
Authors: Sundin Karin , Axelsson Karin , Jansson Lilian , Norberg Astrid
Published: March 2013

To illuminate patients' experiences of suffering from care, ten former patients in somatic wards narrated a desirable care episode (n = 39) and an undesirable care episode (n = 51). The interviews were analysed using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. Four themes were found:having a good rest, suffering through, searching for autonomy and being cared for by attentive and committed staff. The findings were interpreted in light of Eriksson's description of suffering, which describes three kinds of suffering: ‘suffering of life’, ‘suffering of illness' and ‘suffering of caring’. Although not mentioned explicitly, it was evident that cases of suffering from care were indicated in the patients' narratives. The themes were related to the patients' states of health, their experience of the care situation and their descriptions of themselves, and could be understood as related to the acts of the ‘drama of suffering’ described by Eriksson. The study highlights the need for the patient to find a co‐actor in the drama of suffering in order to prevent suffering from care, i.e. prevent hindrance to the patient in her/his struggle against the ‘suffering of illness' and the ‘suffering of life’. The patients must be seen as the directors of their own dramas of suffering.
Coping with Fibromyalgia
Authors: Hallberg Lillemor R.‐M. , Carlsson Sven G.
Published: March 2013

This study aims to describe, from the perspective of patients with fibromyalgia themselves, their experiences of having to live with chronic pain and how they manage their situation. The sample consists of 22 female patients (22–60 years). Open‐ended in‐depth interviews were analysed by a method directed by the tradition of Grounded Theory. Three descriptive categories were grounded in the data, labelled subjective pain language, diversified pain coping, and pain communication. These descriptive categories formed the higher‐order, or core, concept preoccupied with pain. Having to live with chronic pain seems to include that the sufferer becomes self‐centred and preoccupied with the pain: the pain is mostly present and affects every aspect of life, leading to a continuous awareness of and coping with the pain. Pain tends to interrupt normal life, demands attention and is difficult to disengage from. Although coping should not be evaluated in terms of good and bad, passivity, escape behaviours, and resignation/catastrophizing, which dominated in the present study sample, might affect social and psychological functioning negatively. Patients with fibromyalgia might benefit from psychological support in coping with their pain and from reinforcement of healthy behaviours.
Context and Methodological Decontextualization in Nursing Research with Examples from Phenomenography
Authors: Friberg Febe , Dahlberg Karin , Petersson Maria Nyström , Öhlén Joakim
Published: March 2013

In both human science and nursing research the concept of context is important. However, context can be understood in different ways. The aim of this article is to elucidate, discuss and problematize context, decontextualization and recontextualization in some health care‐related phenomenographical studies. A further aim is to problematize the concept of context in a wider perspective of human science, in order to gain a better understanding of phenomenographical research related to nursing care. Our analysis indicates that the complex phenomena which characterize nursing research demand a broad contextual understanding. Both the local or immediate context and the global or mediated context must be considered, as they are dialectically related. This includes the informants' experiences of the phenomenon of interest as well as the socio‐cultural discourse. A balance between openness and pliability to the phenomenon is suggested. Reflection is considered an important tool in this process. Within phenomenography, the interest is directed towards conceptions of certain aspects of the world. Thus, context in a wider sense is given a subordinate role. Accordingly, phenomenography is considered to have limited applicability in nursing research when complex phenomena are to be studied.
Relatives of Stroke Patients—Their Experiences and Needs in Hospital
Authors: van der Smagt‐Duijnstee Miebet , Hamers Jan P. H. , Abu‐Saad Huda Huijer
Published: March 2013

This study explores the experiences and needs of relatives of hospitalized stroke patients. In semi‐structured interviews, 17 relatives of stroke patients were asked about their experiences during the hospitalization period. The interviews were analysed by thematic content analysis. The findings indicate that the experiences of the relatives change during the hospitalization period, and that they are influenced by four factors: the individual character of the relatives, the position of the patient, the people in the relatives' social environment and the hospital situation. Four categories of needs were also found: the need for information, communication, support and accessibility.
Assessment by Nurses of Mood, General Behaviour and Functional Ability in Patients with Dementia Receiving Nursing Home Care
Authors: Edberg Anna‐Karin
Published: March 2013

The aim of this study was to investigate the reliability of the Patient Mood Assessment Scale (PMAS), the General Behaviour Assessment Scale (GBAS) and the Gottfries Bråne Steen scale and to investigate mood, general behaviour, degree of dementia and symptoms for patients with dementia living permanently in nursing home care (n = 75). Interviews were conducted with the contact nurses, focussing on their view of the patients during the preceding week, based on the above‐mentioned assessment scales. In 29 cases a second interview was conducted with another nurse in order to investigate the inter‐rater reliability. The inter‐rater reliability was high for items associated with ADL and intellectual functions, but low for items associated with emotional aspects. The nurses' difficulties in assessing the patients' emotional state could arise because these matters are not regularly discussed among the staff or could reflect the nurse's inner state rather than that of the patient. The varying understanding that the nurses had of the patients raises the question of whether the care provided is based on the nurses' opinions rather than on the patients' needs. There is a need for continuous and reflective discussions in the staff group, focusing on the patients' physical as well as emotional needs.
Oral Health Care—A Low Priority in Nursing
Authors: Wårdh Inger , Hallberg Lillemor R.‐M. , Berggren Ulf , Andersson Lars , Sörensen Stefan
Published: March 2013

In this study we examined how nursing home staff experienced assisting patients with oral health care. The results of a previous questionnaire indicated that oral health care is a low priority in nursing. The 22 in‐depth interviews administered in this study showed that the quality of the oral health care received by the patients depended on several factors. It was found that often there were no specific routines for assisting oral health care in the nursing homes and that other activities were given higher priority. Assisting oral health care was described as passing a barrier, where the main problem was to gain access to the oral cavity. It was concluded that nursing staff working with geriatric patients need to be better educated in oral health care and should be seen by themselves and others as part of a team, where oral health care is clearly defined and included among other daily nursing activities.
Job Innovation for Direct Caregivers in the Care of Persons with Mental Retardation
Authors: Boumans Nicolle P. G. , van den Berg Andre A.
Published: March 2013

Professionals in different branches of the health care sector increasingly advocate a more flexible, individually‐tailored type of care. To fit in with this trend, the Job Innovation Model was developed in The Netherlands. This model involves the systematic introduction of a system of personal caregiving. The purpose of the present study, using a pre‐test—post‐test quasi‐experimental design, was to evaluate the effects of the implementation of the Job Innovation Model on the work and work perception of direct caregivers in the care of persons with mental retardation. Caregivers in the experimental group were found to have adopted the principles of the Job Innovation Model to a greater extent than their colleagues in the control group, and as a result, the experimental group started to work more methodically and perceived greater clarity in their work. In addition, a trend was observed towards greater job satisfaction among caregivers as a result of the introduction of the new model. No changes were found concerning burnout.