Family Caregivers' Experiences in Nursing Homes: Narratives on Human Dignity and Uneasiness

This qualitative study focused on dignity in nursing homes from the perspective of family caregivers. Dignity is a complex concept and central to nursing. Dignity in nursing homes is a challenge, according to research. Family caregivers are frequently involved in their family members’ daily experiences at the nursing home. Twenty-eight family caregivers were included in this Scandinavian cross-country, descriptive, and explorative study. A phenomenological-hermeneutic approach was used to understand the meaning of the narrated text. The interpretations revealed two main themes: “One should treat others as one would like others to treat oneself” and “Uneasiness due to indignity.” Dignity was maintained in experiences of respect, confidence, security, and charity. Uneasiness occurred when indignity arose. Although family caregivers may be taciturn, their voices are important in nursing homes. Further investigation of family caregivers’ experiences in the context of nursing homes is warranted

Maintaining dignity in vulnerability : A qualitative study of the residents' perspective on dignity in nursing homes

Author's accepted version (post-print)

Dignity and existential concerns among nursing homes residents from the perspective of their relatives

Aims and objectives: The aim of this cross-country Scandinavian study was to explore how residents in nursing homes experience that their dignity is promoted and attended to. This is one part of the Scandinavian project in which we interviewed residents, relatives and staff members. Background: The main subject concerns the dignity of residents of nursing homes for older people. This article brings forward results from interviews of relatives on how they experience that the dignity is met, promoted and attended to for their next of kin. Design: The study was qualitative with a hermeneutic approach. Methods: Qualitative research interviews of 28 relatives of residents at six participating nursing homes in Scandinavia. The results derive from analysis of the interviews using Kvale’s three levels of interpretation; self-understanding, common sense and a theoretical understanding. Results: The following themes emerged, from the perspective of the relatives, concerning what was deemed important to the resident according his existential needs and concerns: a). To have a comfortable, homely and practical room. b). To have close contact with family, friends and with the staff. c). To have aesthetic needs and concerns attended to. d). To have ethical needs and intrinsic values attended to. e). To have cultural and spiritual needs and concerns attended to. Conclusion: The results provide more substance to the theme and are all important in terms of the residents’ feeling of worthiness and dignity. In general it seemed that the relatives experienced a positive encounter with the staff, but it was also mentioned that staff members were not confronted about episodes that were undignified and disgraceful. This could be a sign or expression that they were worried that negative responses or complaints could lead to a kind of reprisal against the resident and to indignit

The significance of meaningful and enjoyable activities for nursing home resident’s experiences of dignity.

Author's accepted version (post-print).This is the peer reviewed version of the following article: Slettebø, Å., Sæteren, B., Caspari, S., Lohne, V., Rehnsfeldt, A.W., Heggestad, A.K.T., ... Nåden, D. (2016). The significance of meaningful and enjoyable activities for nursing home resident’s experiences of dignity. Scandinavian Journal of Caring Sciences, which has been published in final form at http://dx.doi.org/10.1111/scs.12386

Musikkterapeut på en sykehusavdeling for barn : helsefremmende arbeid for både pasient og miljø

I året 2010 kunne vi feire 15 års jubileum for et kontinuerlig musikkterapeutisk nærvær ved Barneklinikken ved Oslo universitessykehus – Rikshospitalet. Denne artikkelen beskriver musikkterapeutenes arbeidsoppgaver på sykehuset; enkelte av disse er primært knyttet til å redusere uønskede symptomer som smerter og angst for den enkelte pasient (noe vi vil gi eksempler på), men meget mer av musikkterapeutens arbeid handler om å fremme mestring, gode opplevelser og om å bidra til å skape et terapeutisk miljø. Et fellestrekk ved både de problem- og de ressursorienterte tilnærmingene, er at målet er å fremme helse, og dette gjelder om man arbeider med enkeltpasienter, med familier, grupper eller ulike sider av sykehusmiljøet.1 ”To promote health” er også et sentralt element i en meget anvendt definisjon av musikkterapi (Bruscia 1998:20) der ”health” defineres som ”[…] the process of becoming one’s fullest potential for individual and ecological wholeness” (ibid.:84) og der ”ecological wholeness” videre forklares som ”[…] usually conceived as consisting of society, culture, and environment […]” (ibid.: 87). Med et slikt utgangspunkt blir det meningsløst å snakke om å forholde seg til pasienten ”alene” på samme måte som ”musikken” ikke kan isoleres fra ulike kontekstuelle faktorer som alltid vil være tilstede. Et særskilt fokus på miljøfaktorer i musikkterapien har, siden slutten av 1990-årene, resultert i ulike fremstillinger og teoretiske innfallsvinkler (Bruscia 1998; Aasgaard 1998, 1999a, 2004; Ansdell 2002; Stige 2003, 2006; Ansdell og Pavlicevic (red.) 2004). - - Oppsummering: Helse på mange nivåer: I denne artikkelen har vi forsøkt å vise hvordan musikkterapien kan være av betydning på mange nivåer på én gang. ”Musikken” kan både få den enkelte til å glemme eller fokusere bort fra smerter og angstfylte situasjoner samtidig som den fremmer kommunikasjon, samhandling og positive identiteter. Det er i tillegg få bivirkninger knyttet til denne ”medisinen”. For veldig mange mennesker er musikkaktiviteter knyttet til det gode liv, enten ”deres musikk” primært handler om å lytte eller konsumere musikk eller om å synge eller spille instrumenter. Med tanke på det at musikk hører inn i manges normalsfære, blir det avgjørende at barn kan ha en alvorlig sykdom samtidig som de beholder eller utvikler aspekter av helse i livene sine. Praksiseksemplene i denne artikkelen forteller om syke barn som fremfører sosiale roller som viser deres ressurser og mestringsevne. Det å musisere og å kunne glede seg over musikk, kan være ett viktig helseelement; og slik kan musikkterapeuten arbeide salutogenetisk (med å utvikle helse) selv i miljøer der hvor patogenese (det som skaper sykdom) og det å behandle sykdom må vektlegges sterkt. I klinikken erfares og forstås musikkterapeutens virksomhet stadig fra ulike vinkler. Noen ganger kan kanskje det vi gjør være terapi, sosialt arbeide, underholdning og kunst – på én gang. Dette kan også være en av grunnene til at flere barneavdelinger ønsker at deler av musikkterapeutens praksis skal knyttes, ikke kun til direkte pasientarbeid, men til selve institusjonsmiljøet: En musisk tilstedeværelse som synliggjør barneklinikkens egen ønskede identitet som helseforetak og som fungerer som en humanistisk markør i en ellers høyteknologisk, effektorientert og spesialisert sykehushverdag

The Norwegian version of the scale to assess the therapeutic relationship (N-STAR) in community mental health care: Development and pilot study

Background/Aims: Psychotherapy research has continually placed emphasis on the role of the therapeutic relationship. The current provision of mental health care, however, is often carried out in a variety of contexts and involves a range of health professionals. Measures for assessing the therapeutic relationship provided in community settings by multidisciplinary mental health teams is therefore required. The aim of this study was to describe the development of the Norwegian version of the Scale To Assess the therapeutic Relationship (N‑STAR) and to examine its reliability. Methods: A pilot study was conducted with clients with mental health issues (n=29) and mental health practitioners (n=29). Participants were recruited from a Norwegian community mental health setting and asked to complete the N‑STAR. Data were analysed using T‑tests, Cronbach’s alpha, the Pearson correlation coefficient (r) and the intraclass correlation coefficient (ICC). Results: The internal consistency of the N‑STAR total scale was good, whereas the subscales showed acceptable to questionable internal consistencies. There was a significant association between the total scores of clients and therapists (r = 0.42, p = 0.02), and the consistency in agreement between the clients’ and the therapists’ scores was good (ICC= 0.57, p = 0.02). Conclusion: The N‑STAR total scale showed promising results in terms of its internal consistency and level of client‑therapist agreement. Further research is needed to evaluate N-STAR measurement properties in larger samples in order to establish this method as a way of assessing and monitoring the therapeutic relationship in community mental health settings in Norwa

The Norwegian version of the scale to assess the therapeutic relationship (N-STAR) in community mental health care: Development and pilot study

Background/Aims: Psychotherapy research has continually placed emphasis on the role of the therapeutic relationship. The current provision of mental health care, however, is often carried out in a variety of contexts and involves a range of health professionals. Measures for assessing the therapeutic relationship provided in community settings by multidisciplinary mental health teams is therefore required. The aim of this study was to describe the development of the Norwegian version of the Scale To Assess the therapeutic Relationship (N‑STAR) and to examine its reliability. Methods: A pilot study was conducted with clients with mental health issues (n=29) and mental health practitioners (n=29). Participants were recruited from a Norwegian community mental health setting and asked to complete the N‑STAR. Data were analysed using T‑tests, Cronbach’s alpha, the Pearson correlation coefficient (r) and the intraclass correlation coefficient (ICC). Results: The internal consistency of the N‑STAR total scale was good, whereas the subscales showed acceptable to questionable internal consistencies. There was a significant association between the total scores of clients and therapists (r = 0.42, p = 0.02), and the consistency in agreement between the clients’ and the therapists’ scores was good (ICC= 0.57, p = 0.02). Conclusion: The N‑STAR total scale showed promising results in terms of its internal consistency and level of client‑therapist agreement. Further research is needed to evaluate N-STAR measurement properties in larger samples in order to establish this method as a way of assessing and monitoring the therapeutic relationship in community mental health settings in Norwa