Salutogenic nursing home care: Antonovsky’s salutogenic health theory as a guide to wellbeing

The nursing home (NH) population is characterized by a high symptom burden resulting from chronic illnesses and functional impairments that cannot be cured. Most long-term NH residents are in the last phase of life and in need of palliative care. Hence, health and wellbeing are important aims of salutogenic NH care, which includes more than the treatment of residents’ diseases and symptoms. Research shows that cognitively intact long-term NH residents with a high score on sense of coherence (SOC) experience better wellbeing. Therefore, NH care should be developed in a salutogenic direction, promoting residents’ health and wellbeing by identifying general and specific resistant resources and facilitating residents’ perceived SOC. Based on Antonovsky’s salutogenic health theory and focusing on SOC comprising comprehensibility, manageability and meaningfulness along with resistance resources, this article discusses how nurses can apply salutogenic knowledge as a guide to promote wellbeing among long-term NH residents.publishedVersio

Quality of life of women living with metastatic breast cancer and receiving palliative care: A systematic review

The quality of life (QoL) of women living with metastatic breast cancer and receiving palliative care needs more attention. We reviewed published studies (1992–2019) examining QoL of women receiving palliative care. The findings were interpreted according to the World Health Organization’s (WHO) definition of palliative care. Four themes emerged: (1) the impact of medical treatment on pain relief; (2) the need for psychosocial attention and support; (3) the necessity of an interdisciplinary approach; (4) ambiguous understanding of the term palliative care. A common understanding of the term palliative care and more research is needed to enhance the QoL of women living with metastatic breast cancer.publishedVersio

Living with chemotherapy-induced peripheral neuropathy

Attribution 4.0 International (CC BY 4.0)Background: The increasing number of cancer survivors means that many people are living with long-term effects after cancer treatment. Chemotherapy-induced peripheral neuropathy is a long-term effect that can impact on the life quality of those affected. Objective: The aim of the study was to gain greater insight into what it is like to live with chemotherapy-induced peripheral neuropathy. Method: The study has a qualitative design. We conducted semi-structured in-depth interviews with eight participants who all had symptoms of peripheral neuropathy more than a year after concluding chemotherapy treatment. The transcribed interviews were analysed using systematic text condensation. The findings of the study are discussed in the light of Antonovsky’s concept of ‘sense of coherence’. Results: The analysis led to the overall theme of ‘A changed life’. Two main categories emerged: ‘Bodily changes’ and ‘Learning to live with it’. The subcategories showed different aspects of these. Bodily changes affected activities of daily living and life-giving activities. The factors that had a bearing on how they learned to live with the changes included adaptations of various kinds to a new normal, their attitude towards the challenges they faced and an acceptance of side effects as the price they had to pay for surviving cancer. However, they also had expectations that life would be the same as before their cancer treatment. This made it more difficult to accept that their lives had changed. Conclusion: It is important that health personnel know about how long-term chemotherapy-induced peripheral neuropathy can impact on the daily lives of those who are affected. In order to help patients cope better with a changed way of life as a result of cancer treatment, health personnel should prepare them for the fact that life might not be the same as before.publishedVersio

Forståelse av kvantitativ helseforskning - en introduksjon og oversikt

Denne artikkelen gir en kort oversikt over ulike kvantitativ perspektiver, design, metoder og begreper som er relevant i helseforskning. Grunnleggende metodekunnskap er nødvendig både for å kunne forstå, vurdere nytten av og kunne anvende forskningsresultater i praksis

Forståelse av kvantitativ helseforskning – en introduksjon og oversikt

Denne artikkelen gir en kort oversikt over ulike kvantitativ perspektiver, design, metoder og begreper som er relevant i helseforskning. Grunnleggende metodekunnskap er nødvendig både for å kunne forstå, vurdere nytten av og kunne anvende forskningsresultater i praksis

”Course in Palliative Care for Children” 10 ECTS Master level

Rapporten finnes også på engels

Striving for a safe ground—A lifeworld approach of family members' experiences of the critical illness trajectory

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Aims and Objectives: To explore the experiences of family members after they have lived through a close one's illness trajectory starting with critical illness and intensive care treatment, throughout hospitalisation and after their return home, and describe what was important and challenging for them during this time. Background: Being family during and after critical illness and intensive care treatment may be traumatic and challenging. An in-depth understanding of family members’ lifeworld throughout a close one's illness trajectory is needed. Design: A qualitative design with a phenomenological approach. Methods: We held ten interviews with eleven next of kin, nine of which were individual and one with a parent couple. The interviews lasted 90 minutes, on average, and were transcribed verbatim. Giorgi's phenomenological method guided the analysis. Results: The overall structure was ‘striving for a safe ground for themselves and their close one’, which was dependent on the three constituents of ‘in need of care’, ‘to take on responsibility’ and ‘to create new understanding’. Throughout the illness trajectory, the family members required care to increase their feelings of safety in the context of their close one being unsafe. They described taking on responsibility for their close one—a responsibility that increased after hospital discharge—as demanding new knowledge which they were often unable to obtain. Conclusions: Families of critically ill patients need to be seen on their own behalf. Moreover, when taking on responsibility for their close one, they regularly need more knowledge than they get. There seems to be an absence of a support system for families with caring responsibilities after their relatives are discharged from hospitals. Relevance to Clinical Practice: This study shows the importance of family carers being considered in their own right, as well as their individual needs throughout a close one's illness trajectory. There seems to be a gap in the knowledge of what family members require when their close one is discharged. Indeed, a better support system is essential for families following a hospital discharge.publishedVersio

Understanding the course of critical illness through a lifeworld approach

An increasing number of individuals receive and survive intensive care treatment; however, several individuals experience problems afterward, which may threaten recovery. Grounded in a lifeworld approach, the aim of this study was to explore and describe what intensive care patients experience as limiting and strengthening throughout their illness trajectories. Ten former intensive care patients were interviewed three to eight months after hospital discharge. Using Giorgi’s phenomenological analysis, a general structure of gaining strength through a caring interaction with others was revealed. The structure consisted of three constituents: feeling safe through a caring presence, being seen and met as a unique person, and being supported to restore capacity. Being met with a humanistic approach and individualized care appeared to be important, and the findings are discussed within the framework of lifeworld-led care. To facilitate improved aftercare of the critically ill, more tailored support throughout the illness trajectory is needed.publishedVersio

“Finding oneself after critical illness”: voices from the remission society

Under embargo until: 2021-10-07The number of people who survive critical illness is increasing. In parallel, a growing body of literature reveals a broad range of side-effects following intensive care treatment. Today, more attention is needed to improve the quality of survival. Based on nine individual stories of illness experiences given by participants in two focus groups and one individual interview, this paper elaborates how former critically ill patients craft and recraft their personal stories throughout their illness trajectory. The analysis was conducted from a phenomenological perspective and led to the meaning structure; a quest to find oneself after critical illness. In this structure, illness represented a breakdown of the participants’ lives, forcing them to develop a new understanding of themselves. Despite acute illness, they felt safe in hospital. Coming home, however, meant a constant balancing between health and illness, and being either in or out of control. To gain a deeper understanding of the participants’ narratives of survival, the meaning structure was developed from a phenomenological life world perspective, Heidegger’s concept of homelikeness and Arthur Frank’s typologies of illness narratives. In conclusion listening to and acknowledging the patients’ lived experiences of critical illness may support the patient efforts to establish the newly defined self and hence be vital for recovery. Phenomenology is one approach facilitating care tailored to the patients’ lived experience of critical illness and its aftermaths.acceptedVersio

The effect of transitions intervention to ensure patient safety and satisfaction when transferred from hospital to home health care-A systematic review

Aim The aim of this systematic review is to describe and evaluate the effectiveness of transition interventions to safeguard patient safety and satisfaction during patients' transition from hospital to home health care. Design Systematic review. Data Sources MEDLINE, Ovid Nursing Database, PsycINFO, EMBASE, CINAHL, Clinical Trials and SveMed+ was systematic searched in January 2019 and September 2020 to identify peer-reviewed papers. No language, geographical or publication date restrictions. Review Methods Cochrane Handbook for Systematic Reviews of Interventions was used. Data analysis focused on aggregated data and a descriptive synthesis. Risk of bias was rated using Cochrane risk-of-bias tool. Results In total, 10,524 references were identified in the literature search, twenty-six articles were included. The interventions were divided into three main groups: (i). systematic patient education pre-discharge; (ii). establishment of contact with the local healthcare services pre-discharge and (iii). follow-up initiated by nurses from the hospital at home post-discharge. The studies either used one intervention or combined two or three interventions. We considered the intervention to improve patient safety or satisfaction when they reported statistically significant results. Only four interventions increased both patient safety and satisfaction, seven interventions increased patient safety and thirteen increased patient satisfaction. Interventions that appear to be quite similar, with the same duration, measured different effects on patients' satisfaction and safety. Interventions that ensured patient safety did not necessarily facilitate patient satisfaction and vice versa. Conclusion Interventions can improve patient safety and satisfaction during transfer. However, interventions that improve patient safety or satisfaction do not always match. Impact This review suggests that transition interventions can improve patients' safety and satisfaction. However, to compare the impact of future interventions is it important to use standardized measurement tools of satisfaction. There is a need to try out tailored interventions, where interventions are customized to the needs of each patient.publishedVersio