Experiences of dementia in a foreign country: qualitative content analysis of interviews with people with dementia

Background: Dementia is a worldwide health concern of epidemic proportions. Research in the field of subjective experience of dementia suffers from a lack of diversity of their participants including immigrants. Different portraits of life with dementia could help us understand how people with dementia conceptualise their experiences of dementia and how they live. Our study aimed to explore the subjective experiences of living with dementia among Iranian immigrants in Sweden. Methods: Qualitative content analysis of interviews with fifteen people with dementia from Iranian immigrant backgrounds were conducted (8 females and 7 males). Results: Three themes and seven associated sub-themes were revealed. The themes included: Being a person with dementia means living with forgetfulness (personal sphere), living with forgetfulness in the private sphere means feeling incompetent but still loved, living with forgetfulness in the public sphere means feeling confident and secure but also isolated. Conclusions: Living with dementia for the participants meant living with forgetfulness. They experienced feeling incompetent but still loved within their families and feeling confident and secure but also isolated in the society. Educating people with dementia and their families about the course and process of dementia may help them understand the changes better and adjust their expectations. Our study can provide a basis for healthcare workers to understand the experiences of living with dementia from this specific perspective

The embodied experience of living with Parkinsons disease

People with Parkinsons disease (PD) face many continuous limitations in daily life because of their illness. To illuminate the lived experience of PD and to evaluate ways to give individuals who suffer from PD comprehensive opportunities to come to terms with the impact that the illness has on daily living, two intervention programs and one longitudinal study were carried out. The overall aims of this thesis were to investigate daily living conditions and the role of environmental and personal strategies for PD-afflicted persons and to illuminate lived illness experience as narrated by persons who suffer from PD - to gain understanding for meeting persons afflicted with PD. The first intervention study (I) was design as a five-week outpatient course with two weekly two-hour sessions; each session consisted of one hour of dialogue and one hour of physical performance. The next intervention (II, III) was carried out for three consecutive years as a week-long stay in a Swedish mounain area. One study (II) evaluated the effect of the intervention on PD-afflicted persons' mobility patterns, and the other study (III) described environmental influences on lived illness experience as narrated by these persons. In the longitudinal study (IV), a woman within the complicated stage of PD was interviewed continuously over a five-year period about her lived illness experiences. In study (I) questionnaires (SIP, UPDRS) and an optoelectronic instrument (PLM) were used to evaluate effects from the intervention. In study (II), the PLM was used to evaluate effects from the intervention on mobility patterns in the participants. In the first intervention, 43 persons with PD participated. The mean age was 75 and mean PD duration was 6 years (I). In the second intervention, 12 persons with PD participated, of which three participated three times and three persons participated two times; the mean age was 68 and mean PD duration was 8.5 years (II, III). When the longitudinal study started, the female participant was 72 and had received the PD diagnosis 15 years earlier (IV). Statistical methods (I, II) and phenomenological methods were used for data analysis (III, IV). In study I improvements in the participants psychosocial dysfunction, sleep patterns, and in daily activities lasted 12 weeks as did improved mobility patterns. In study II, results in mobility patterns showed immediate and long-lasting improvements in movement speed and integration of movements. Study III illuminated the importance of the environment for experiences of involvement, experiences of limitations, and trust in own abilities. Experiences during the intervention had long-lasting influence on daily living. Study IV illuminated the lived experience of the complicated stage of PD as a striving for involvement within experiences of changing habitual skillfulness that was influenced by environmental and emotional experiences. In creating new forms of expression, new worlds were discovered. These experiences changed the lived meaning of time and space

“I feel free”: Experiences of a dance intervention for adolescent girls with internalizing problems

Adolescent girls today suffer from internalizing problems such as somatic symptoms and mental health problems at higher rates compared to those of previous decades, and effective interventions are warranted. The aim of this study was to explore the experiences of participating in an 8-month dance intervention. This qualitative study was embedded in a randomized controlled trial of a dance intervention for adolescent girls with internalizing problems. A total of 112 girls aged 13–18 were included in the study. The dance intervention group comprised 59 girls, 24 of whom were strategically chosen to be interviewed. Data were analyzed using qualitative content analysis with an inductive approach. The experiences of the dance intervention resulted in five generic categories: (1) An Oasis from Stress, which represents the fundamental basis of the intervention; (2) Supportive Togetherness, the setting; (3) Enjoyment and Empowerment, the immediate effect; (4) Finding Acceptance and Trust in Own Ability, the outcome; and (5) Dance as Emotional Expression, the use of the intervention. One main category emerged, Finding Embodied Self-Trust That Opens New Doors, which emphasizes the increased trust in the self and the ability to approach life with a sense of freedom and openness. The central understanding of the adolescent girls’ experiences was that the dance intervention enriched and gave access to personal resources. With the non-judgmental atmosphere and supportive togetherness as a safe platform, the enjoyment and empowerment in dancing gave rise to acceptance, trust in ability, and emotional expression. Taken together, this increased self-trust and they discovered a new ability to “claim space.” Findings from this study may provide practical information on designing future interventions for adolescent girls with internalizing problems

Referrals to Emergency Departments- The Processes and Factors That Influence Decision-Making among Community Nurses A. Kihlgren et al. Keywords

Abstract The aim of the study was to describe the basis on which municipal care registered nurses (RN) make decisions and their experiences when referring older persons from nursing homes to emergency departments (EDs). RNs in the community are to ensure that older adults receive good care quality in nursing home. This study used a descriptive design with a qualitative content analysis. The analysis of the data from the 13 interviews revealed one theme "Shared responsibilities in the best interests of the older person reduce feelings of insufficiency". The content was formulated, which revealed the RNs' feelings, reasoning and factors influencing them and their actions in the decision-making situation, before the patients were referred to an emergency department. Complex illnesses, non-adapted organizations, considerations about what was good and right in order to meet the older person's needs, taking account of her/his life-world, health, well-being and best interests were reported. Co-worker competencies and open dialogues in the "inner circle" were crucial for the nurses' confidence in the decision. Hesitation to refer was associated with previous negative reactions from ED professionals. The RN sometimes express that they lacked medical knowledge and were uncertain how to judge the acute illness or changes. Access to the "outer circle", i.e. physicians and hospital colleagues, was necessary to counteract feelings of insecurity about referrals. When difficult decisions have to be made, not only medical facts but also relationships are of importance. To strengthen the RNs' and staff members' competence by means of education seems to be important for avoiding unnecessary referrals. Guidelines and work routine need to be more transparent and referrals due to the lack of resources are not only wasteful but can worsen the older persons' health

Referrals to Emergency Departments: The Process and Factors That Influence Decision-Making among Community Nurses

The aim of the study was to describe the basis on which municipal care registered nurses (RN) make decisions and their experiences when referring older persons from nursing homes to emergency departments (EDs). RNs in the community are to ensure that older adults receive good care quality in nursing home. This study used a descriptive design with a qualitative content analysis. The analysis of the data from the 13 interviews revealed one theme “Shared responsibilities in the best interests of the older person reduce feelings of insufficiency”. The content was formulated, which revealed the RNs’ feelings, reasoning and factors influencing them and their actions in the decision-making situation, before the patients were referred to an emergency department. Complex illnesses, non-adapted organizations, considerations about what was good and right in order to meet the older person’s needs, taking account of her/his life-world, health, well-being and best interests were reported. Co-worker competencies and open dialogues in the “inner circle” were crucial for the nurses’ confidence in the decision. Hesitation to refer was associated with previous negative reactions from ED professionals. The RN sometimes express that they lacked medical knowledge and were uncertain how to judge the acute illness or changes. Access to the “outer circle”, i.e. physicians and hospital colleagues, was necessary to counteract feelings of insecurity about referrals. When difficult decisions have to be made, not only medical facts but also relationships are of importance. To strengthen the RNs’ and staff members’ competence by means of education seems to be important for avoiding unnecessary referrals. Guidelines and work routine need to be more transparent and referrals due to the lack of resources are not only wasteful but can worsen the older persons’ health.Article ID: 45320. The authors wish to express their gratitude to the Ministry of Health and Social Affairs and the Swedish Association of Local Authorities in Gävleborg for grants.</p

Referrals to Emergency Departments- The Processes and Factors That Influence Decision-Making among Community Nurses A. Kihlgren et al. Keywords

Abstract The aim of the study was to describe the basis on which municipal care registered nurses (RN) make decisions and their experiences when referring older persons from nursing homes to emergency departments (EDs). RNS&apos; in the community are to ensure that older adults receive good care quality in nursing home. This study used a descriptive design with a qualitative content analysis. The analysis of the data from the 13 interviews revealed one theme &quot;Shared responsibilities in the best interests of the older person reduce feelings of insufficiency&quot;. The content was formulated, which revealed the RNs&apos; feelings, reasoning and factors influencing them and their actions in the decision-making situation, before the patients were referred to an emergency department. Complex illnesses, non-adapted organizations, considerations about what was good and right in order to meet the older person&apos;s needs, taking account of her/his life-world, health, well-being and best interests were reported. Co-worker competencies and open dialogues in the &quot;inner circle&quot; were crucial for the nurses&apos; confidence in the decision. Hesitation to refer was associated with previous negative reactions from ED professionals. The RN sometimes express that they lacked medical knowledge and were uncertain how to judge the acute illness or changes. Access to the &quot;outer circle&quot;, i.e. physicians and hospital colleagues, was necessary to counteract feelings of insecurity about referrals. When difficult decisions have to be made, not only medical facts but also relationships are of importance. To strengthen the RNs&apos; and staff members&apos; competence by means of education seems to be important for avoiding unnecessary referrals. Guidelines and work routine need to be more transparent and referrals due to the lack of resources are not only wasteful but can worsen the older persons&apos; health