Rendering the ungraspable graspable : the use of metaphors in Swedish palliative cancer care

Good communication is of utmost importance in all forms of cancer care and especially so in the palliative context. To render the ungraspable graspable, metaphors are frequently used drawing on their capacity to capture the intangible in terms of more familiar experiences. For instance, to die from cancer can be described as ’coming to the end of a life journey’ or ’losing a battle’. Metaphors are largely language and culture specific. Today’s increasingly multicultural societies require particular awareness in order to achieve dignified, individualized palliative cancer care. This project aims to strengthen the scientific foundation for the use of metaphors in Swedish palliative cancer care. A secondary aim is to compare the use of metaphors in Sweden and the UK in order to reveal differences and similarities. Textual data are collected froma) internet-based blogs, where patients write about their illness-related emotions and experiences while being in palliative care, and fromb) interviews with patients, family and health care professionals, where the focus is to investigate what it means to live a dignified life in palliative care.The two sets of data are analyzed using both qualitative and quantitative linguistic methods. First, the Pragglejaz procedure, a well-established linguistic method for metaphor identification, is used in order to manually identify metaphorical expressions in the material, develop analytic categories adapted to the Swedish language data and ensure inter-rater reliability. Second, the material is approached by means of corpus linguistic methods. The combination of research methods is inspired by the UK-based MELC project. The data are currently being processed and the first results will be presented at the conference. The project is funded by The Kamprad Family Foundation, Sweden

The experience of being a partner to a spinal cord injured person: A phenomenological-hermeneutic study

This qualitative focuses on the personal experiences of partners to a spinal cord injured person. Using a Ricoeurian phenomenological-hermeneutic approach, we analysed seven partners’ narratives 1 and 2 years after their partner's injury. The study revealed how the injury was experienced from the partners’ perspective through the aftermath. In the acute phase after the injury, partners also felt harmed, and support was needed in relation to their own daily activities, eating, resting, and managing distress. During the institutionalized rehabilitation, partners felt torn between supporting the injured partner and the demanding tasks of everyday life outside the institution. After discharge, partners struggled for the injured partner to regain a well-functioning everyday life and for reestablishing life as a couple. The partner struggled to manage the overwhelming amount of everyday tasks. Some sought to reestablish their usual functions outside the family, whereas others focused on establishing a new life together. The partners experienced much distress and appreciated the support they got, but felt that they were mainly left to manage the difficult process on their own

Behavioural Risk Factors in Mid-Life Associated with Successful Ageing, Disability, Dementia and Frailty in Later Life: A Rapid Systematic Review.

BACKGROUND: Smoking, alcohol consumption, poor diet and low levels of physical activity significantly contribute to the burden of illness in developed countries. Whilst the links between specific and multiple risk behaviours and individual chronic conditions are well documented, the impact of these behaviours in mid-life across a range of later life outcomes has yet to be comprehensively assessed. This review aimed to provide an overview of behavioural risk factors in mid-life that are associated with successful ageing and the primary prevention or delay of disability, dementia, frailty and non-communicable chronic conditions. METHODS: A literature search was conducted to identify cohort studies published in English since 2000 up to Dec 2014. Multivariate analyses and a minimum follow-up of five years were required for inclusion. Two reviewers screened titles, abstracts and papers independently. Studies were assessed for quality. Evidence was synthesised by mid-life behavioural risk for a range of late life outcomes. FINDINGS: This search located 10,338 individual references, of which 164 are included in this review. Follow-up data ranged from five years to 36 years. Outcomes include dementia, frailty, disability and cardiovascular disease. There is consistent evidence of beneficial associations between mid-life physical activity, healthy ageing and disease outcomes. Across all populations studied there is consistent evidence that mid-life smoking has a detrimental effect on health. Evidence specific to alcohol consumption was mixed. Limited, but supportive, evidence was available relating specifically to mid-life diet, leisure and social activities or health inequalities. CONCLUSIONS: There is consistent evidence of associations between mid-life behaviours and a range of late life outcomes. The promotion of physical activity, healthy diet and smoking cessation in all mid-life populations should be encouraged for successful ageing and the prevention of disability and chronic disease.This work was funded by the National Institute for Health and Care Excellence (NICE), invitation to tender reference DDER 42013, and supported by the National Institute for Health Research School for Public Health Research. The scope of the work was defined by NICE and the protocol was agreed with NICE prior to the start of work. The funders had no role in data analysis, preparation of the manuscript or decision to publish.This is the final version of the article. It first appeared from PLOS via http://dx.doi.org/10.1371/journal.pone.014440

Interactions between family members and staff in intensive care units-An observation and interview study.

Background: Research about interactions between family members and staff are sparse, although family members’ needs and experiences in intensive care units are well researched areas. Aim: The aim was to describe and interpret interactions between family members and staff in intensive care units. Methods: Interviews (n=24) with family members and repeated observations of interactions of family members and staff in intensive care units were performed and analysed together by means of content analysis. Results: The initial interactions between staff and family members had a substantial effect on family members and influenced their further interactions with the staff. Two kinds of interactions were revealed; mutual understanding and mutual misunderstanding. Family members, who understood the explicit information and the implicit messages were open in communication with the staff, adjusted well to the system, were acknowledged by the staff and sometimes consoled. Family members, who had difficulties understanding information and implicit messages drew back from communication with staff, did not adjust to the system and were sometimes insulted by the staff. Conclusions: Unambiguous information from the staff is important for developing interactions of mutual understanding. The results may be a starting point for intensive care unit staff to reflect on how all family members are initially met and further informed and treated. Further research of family members’ experiences of interactions with staff in a longitudinal perspective and the influence of critical illness on families are needed

Well-being, mental health and the psychosocial work-environment in municipal eldercare post covid-19

Pandemin som utlöstes av covid-19 har påverkat den psykosociala arbetsmiljön och välmående för medarbetare och personal vid särskilda boenden för äldre i Sverige. Det finns flera faktorer som kan relateras till det ökade antalet personer som upplever mental ohälsa i samband med den psykosociala arbetsmiljön, såsom arbetsbelastning, stress på arbetet, brist på återhämtning, oro och rädsla för att smittas eller för att föra smitta vidare till anhöriga och andra boende. Syftet med uppsatsen är att uppnå ökad förståelse för medarbetare inom särskilda boenden och deras upplevelse av den nuvarande psykosociala arbetsmiljön jämfört med perioden före och under pandemins utbrott. Studien använder uppsatta hypoteser och jämför samband mellan mentalt välmående och psykosocial arbetsmiljö utifrån självbestämmandeteorin. En kvantitativ forskningsansats har använts och undersökningen har skett via en digital enkät till en population av medarbetare inom särskilt boende i en västsvensk kommun. Svaren från den digitala undersökningen jämfördes med en tidigare enkät som utförts vid Sahlgrenska Universitetssjukhuset, och resultatet stödjer inte hypoteserna om en förbättring i den psykosociala arbetsmiljön efter covid-19 pandemin. Tvärtom tycks andelen negativa svar ha ökat även om det inte bör jämföras rakt av. För ytterligare kunskap i området krävs fler och framtida studier.The pandemic of covid-19 has affected the psychosocial work environment and well-being for workers and staff of elderly care homes across the country of Sweden. There are a various number of factors that can be related to the increased number of workers experiencing mental health problems due to changes in the psychosocial work environment such as workload, jobstrain, stress, worry or fear of being infected by the virus either spreading it to patients or family members. The purpose of this thesis is to achieve an increased understanding about eldercare in the form of home care staff and their experiences of the present psychosocial work environment compared with the peak of covid-19. The study uses assumptions in the form of hypotheses and explores connections between mental well-being and psychosocial work environment by the theory of self-determination. A quantitative research approach was used, and the study was carried out in the form of a digital survey by email to a population of workers. The data provided by the home care staff was compared to a previous survey at the University Hospital of Sahlgrenska, and the result does not support the hypothesis that the psychosocial work environment has improved as the pandemic restrictions lessen. On the contrary, the comparison between the two surveys shows that the experienced psychosocial work environment has further decreased in score, even if a straight comparison is questionable. Further research is necessary to achieve more knowledge in the subject

Family Health Conversations: How Do They Support Health?

Research shows that living with illness can be a distressing experience for the family and may result in suffering and reduced health. To meet families’ needs, family systems intervention models are developed and employed in clinical contexts. For successful refinement and implementation it is important to understand how these models work. The aim of this study was therefore to describe the dialogue process and possible working mechanisms of one systems nursing intervention model, the Family Health Conversation model. A descriptive evaluation design was applied and 15 transcribed conversations with five families were analyzed within a hermeneutic tradition. Two types of interrelated dialogue events were identified: narrating and exploring. There was a flow between these events, a movement that was generated by the interaction between the participants. Our theoretically grounded interpretation showed that narrating, listening, and reconsidering in interaction may be understood as supporting family health by offering the families the opportunity to constitute self-identity and identity within the family, increasing the families’ understanding of multiple ways of being and acting, to see new possibilities and to develop meaning and hope. Results from this study may hopefully contribute to the successful implementation of family systems interventions in education and clinical praxis

Well-being, mental health and the psychosocial work-environment in municipal eldercare post covid-19

Pandemin som utlöstes av covid-19 har påverkat den psykosociala arbetsmiljön och välmående för medarbetare och personal vid särskilda boenden för äldre i Sverige. Det finns flera faktorer som kan relateras till det ökade antalet personer som upplever mental ohälsa i samband med den psykosociala arbetsmiljön, såsom arbetsbelastning, stress på arbetet, brist på återhämtning, oro och rädsla för att smittas eller för att föra smitta vidare till anhöriga och andra boende. Syftet med uppsatsen är att uppnå ökad förståelse för medarbetare inom särskilda boenden och deras upplevelse av den nuvarande psykosociala arbetsmiljön jämfört med perioden före och under pandemins utbrott. Studien använder uppsatta hypoteser och jämför samband mellan mentalt välmående och psykosocial arbetsmiljö utifrån självbestämmandeteorin. En kvantitativ forskningsansats har använts och undersökningen har skett via en digital enkät till en population av medarbetare inom särskilt boende i en västsvensk kommun. Svaren från den digitala undersökningen jämfördes med en tidigare enkät som utförts vid Sahlgrenska Universitetssjukhuset, och resultatet stödjer inte hypoteserna om en förbättring i den psykosociala arbetsmiljön efter covid-19 pandemin. Tvärtom tycks andelen negativa svar ha ökat även om det inte bör jämföras rakt av. För ytterligare kunskap i området krävs fler och framtida studier.The pandemic of covid-19 has affected the psychosocial work environment and well-being for workers and staff of elderly care homes across the country of Sweden. There are a various number of factors that can be related to the increased number of workers experiencing mental health problems due to changes in the psychosocial work environment such as workload, jobstrain, stress, worry or fear of being infected by the virus either spreading it to patients or family members. The purpose of this thesis is to achieve an increased understanding about eldercare in the form of home care staff and their experiences of the present psychosocial work environment compared with the peak of covid-19. The study uses assumptions in the form of hypotheses and explores connections between mental well-being and psychosocial work environment by the theory of self-determination. A quantitative research approach was used, and the study was carried out in the form of a digital survey by email to a population of workers. The data provided by the home care staff was compared to a previous survey at the University Hospital of Sahlgrenska, and the result does not support the hypothesis that the psychosocial work environment has improved as the pandemic restrictions lessen. On the contrary, the comparison between the two surveys shows that the experienced psychosocial work environment has further decreased in score, even if a straight comparison is questionable. Further research is necessary to achieve more knowledge in the subject