Select search scope: search across all journals or within the current journal
Free accessEditorialFirst published December, 2008pp. 3-3
Free accessResearch articleFirst published December, 2008pp. 4-8Autonomy has become an important focus within healthcare in Norway. The head nurse has a key strategic role and responsibility for the care of older people in nursing homes. With this in mind, it is important to focus on how the head nurse relates to the principles of autonomy in nursing home.
To describe how head nurses relate to the principles of autonomy in nursing homes, and their experiences of obstacles and solutions regarding autonomy in every day practice.
Data was obtained from interviews with twelve head nurses in six local and two private nursing homes in Norway and analyzed with content analyze.
Autonomy was described as the individuals' right to have influence on their own care. The resident's autonomy can be limited by factors related to the resident, staff, and the environment. The head nurse can improve the resident's autonomy by acquiring knowledge about the resident, influencing the staff's attitudes, expert knowledge and language.
Free accessResearch articleFirst published December, 2008pp. 9-13The aim of this study was to describe the formal care provided by the municipality and the staff's description of care-related needs among non-Nordic older immigrants compared to older Nordic-born persons in Sweden. A further aim was to describe the occurrence of informal care provided. Cross-sectional data were collected concerning 111 non-Nordic immigrants from the longitudinal study «Good Ageing in Skåne» (GAS). Comparisons were made between them and a group consisting of Nordic born older people (n=111) with the same age and gender distribution. The findings showed that the non-Nordic immigrants to a higher extent cohabited with children or partners, had family members employed as caregivers, received help with Instrumental Activities in Daily Living (IADL) and Personal Activities in Daily Living (PADL) from their family received more rehabilitation at home and more daytime home health care and were reported to have special care needs than the comparison group. Furthermore, the health care personnel had less knowledge about the non-Nordic immigrants, which in turn could mean that they do not receive the care they need.
Free accessResearch articleFirst published December, 2008pp. 14-18Studies have highlighted the significance of cancer patients' narrative work in order to cope and feel well and find meaning in life.
This article reports a study of whether and how cancer outpatients narrates, and how cancer care nurses contribute to the patients' narrative work during conversations taking place during planned first time consultations at out-patient clinics.
The study was qualitative phenomenological hermeneutic. The data material included recordings of eight patient — nurse meetings taking place as ordinary planned activities at out-patient clinics in Norway. Four female and four male patients, and eight female nurses participated. Transcribed recordings of conversations were content analysed, narrative sequences identified and analysed for how narratives developed and how narrating was encouraged and followed up by nurses.
Results gave insights into narrative contexts and how voices of nursing, medicine, and life world and relational or goal directed communication had implications for patient narrations.
The findings of this study of narrations in cancer outpatient — nurse conversations gave insights into nurses' meaning horizons and communication approaches with implications for practice. There is a need of more research providing insights into the effects of narrative meaning constructions for cancer patients.
Free accessResearch articleFirst published December, 2008pp. 19-23The current Norwegian national plan for mental health and other public documents emphasizes the need to include patient experiences and patient participation in treatment and organising psychiatric care. However, it is not clear whether this should apply to psychiatric research involving psychiatric inpatients, and Norwegian research that rely on the experiences of psychiatric inpatients seems scattered. There is a need to summarize this field, and the aim of the present analysis was to review Norwegian research based on psychiatric inpatients' experiences since 1970. A main finding is that during the 1970s the field was dominated by social scientists with fewer such studies in the 1980s while nursing scientists dominated the field since 2000. The relative absence of psychiatric inpatient's voices in psychiatric research may reflect a bio-medical approach to mental illnesses. A critical or relativist paradigm will on the other side nurture such research. Important aspects of the lives of psychiatric inpatients concern being locked up, experiencing organizational changes, and stigmatization as a psychiatric patient. Knowledge of these aspects may be gained only by asking patients themselves.
Free accessResearch articleFirst published December, 2008pp. 24-28Coronary Heart Disease is a major cause of death in women. Evidence shows that Cardiac Rehabilitation can reduce morbidity and mortality while improving mental well-being and promotes a return to social roles. Little is known, however, about women's experiences with Cardiac Rehabilitation.
To describe the experiences of women who participated, and those who did not participate in Cardiac Rehabilitation after myocardial infarction.
One year after discharge, six women treated for myocardial infarction took part in two focus group interviews. The interviews were tape-recorded verbatim, analysed and categorised using constant comparative analysis.
The mean age of the women was 72 years. They had an education level of 7th Grade, and were all retired. All CR participants had undergone Coronary Artery By-pass Graft surgery, unlike the non-participants. Analysis revealed experiences related to crises, preventing another coronary, gender roles and family life.
It seems that the women, who participated in Cardiac Rehabilitation, were able to eliminate their risk factors, including smoking, inactivity and unhealthy diet, in contrast to those who did not participate. The women in both groups had difficulties in accepting help. Therefore future Cardiac Rehabilitation programmes should challenge women's traditional role in the family.
Free accessResearch articleFirst published December, 2008pp. 29-33To test an intervention to improve physical health in patients with psychosis at risk for metabolic syndrome.
Three groups of 4–10 patients took part in 14 educational gatherings led by a psychiatric nurse and a physical therapist at an outpatient clinic. Using an experimental action approach, participants identified individual goals and group sessions were designed to help attain their goals. The intervention was based on cognitive and behavioral change methodology and included also components of the Integrated Psychiatry treatment program. BMI, waist measurement and blood pressure were measured at baseline and at 6 and 18 month follow-up. Results: Patients identified improved diet, weight loss, and increased physical activity as prioritized goals. 14 patients completed the entire program and 8 of these (67%) had a lower BMI. A further reduction was seen in 5 persons at the 18 month follow-up but 6 others (43%) had increased BMI. In response to the open-ended evaluation questions, patients reported increased social contact and improved health awareness. Conclusion: An intervention with focus on behavioral change can lead to increased social interaction and greater knowledge of the importance of physical well-being. This can provide a foundation for continued motivational tutoring.
Free accessResearch articleFirst published December, 2008pp. 34-37The purpose of this study was to present the experiences of a group of midwife's while working on the coast of North-Norway during the Second World War. The midwifes' roles were unique and in many ways an institution in and of itself. They were viewed by the general population as having authority, and being strong and proud women who were experienced in their field of work. They often had to work alone in difficult situations such as assisting with childbirth and they were often called upon when people were ill or when accidents had taken place. This study was based on interviews with five midwifes aged 87–92 years. The data was analysed using the phenomenological — hermeneutical method. Both newly educated and experienced midwifes reported experiencing difficulties related to the subject of nursing. Difficulties the midwifes experienced included getting patients to the hospital or to the doctor and obtaining necessary equipment needed when assisting with the birth of a child. As a result the midwifes had to improvise. Because German soldiers were everywhere they were often scared both for their own and other people's well-being. They found it a challenge to deal with the trust the general population had given them.
Free accessResearch articleFirst published December, 2008pp. 38-41Preterm birth involves often long hospitalisation for the infant and its parents. Neonatal home care is an alternative to traditional care. Aim: To evaluate a neonatal home care program over a four year perspective at Lund University hospital in Sweden. Method: The evaluation consisted of descriptive statistics, a cost comparison with traditional hospital care and a description of parental experiences. Findings: Three hundred and ninety infants, who were physiologically stable, but in need of further special care, participated in the neonatal home care program during the years 2002–2005. On an average, each infant spent 17 days in the programme and received a mean of 4.6 home visits. When estimating the costs for traditional hospital care, neonatal home care was found to be less expensive. Interviews with ten parents revealed that at hospital parents felt vulnerable and incompetent in caring for their child. At home they felt comfortable and became gradually more confident. Conclusion: Neonatal home care with support of staff from the neonatal unit is feasible, less expensive, activates the family's own resources and normalises the family life.
Free accessResearch articleFirst published December, 2008pp. 42-45Practical nursing in a clinical setting is an important part of Nursing Education. My intention in this article is to focus on developing a model for learning nursing by discussing a patient situation in a group. The group consists of both students and nurses, except me as the teacher.
The theoretical framework of the model is built on the Social perspective on education and learning. Here is the relation between the group members, the activity in the group and the world important parts of developing this model. The relation was based on an I-you relationship, and the activity in the group was discussing the challenges in the daily work with a specific patient in the ward. The members of the group got the case described two days before the meeting. They all prepared for the meeting by reflecting how to act as a nurse in the different situations. The conversation in the group was based on the culture and on the nursing practice in that ward. By meeting each other in that group during the students practice, both the students and the nurses developed a better understanding for the daily work in the ward.
Free accessResearch articleFirst published December, 2008pp. 46-48Nursing in radiotherapy sections is strongly focused on the nursing assignment of giving the prescribed «solicitous and safe radiology treatment». Nursing acts related to this area are carefully documented in case reports, whereas ‘independent’ nursing acts and the care aspect of nursing are often absent from the documentation. The question is whether the paucity of documentation indicates a lack of independent nursing and care, or whether it merely takes place as a matter of course. To answer this question postcards and letters written by patients was analysed and interpreted.
The analysis and interpretation show that a large degree of independence and care is being displayed. Nurses engage in professional relationships with patients and their families and are capable of transforming radiotherapy sessions into positive experiences. This is connected to the nurse's manner which was described in subcategories such as «smiling» and «acknowledging the other as a person» and related to patients' experience of the nurse as being «highly competent».
Free accessResearch articleFirst published December, 2008pp. 49-51The purpose of this article is to show the application of Giorgi's descriptive phenomenological human scientific method. A brief description is used in order to provide an example of the human scientific process, from data collection to data analysis. First, the data collection is presented, using the phenomenon of frustration as an example. Some of the sufficient conditions for data gathering is also discussed in this section. Second, the data analysis is explicated. More specifically, the brief example of the phenomenon of frustration was taken through the four steps of Giorgi's human scientific method. The data analysis section accounts for the descriptive nature of the method as well as the critical attitude of the researcher. In addition, this section also points to the contrast between descriptive phenomenological human science and interpretative based qualitative methods. A brief description of the relation between constituents and structure closes this section. Overall, the implicit purpose of providing this article of the application of Giorgis's method, in the Swedish language, is to make his method more accessible to the graduate as well as to the undergraduate student in the Nordic countries.