14 research outputs found
Kvinners erfaringer med abortnemnder
Denne rapporten presenterer resultatene fra en amfunnsvitenskapelig studie om kvinners erfaringer med abortnemnder. Rapporten bygger pĂ„ 13 dybdeintervju med kvinner som hadde erfaring med Ă„ sĂžke om og gjennomleve andretrimesterabort innenfor et abortnemndsystem. Kvinnene hadde fĂ„tt sine abortbegjĂŠringer behandlet i nemnd ved Ă„tte ulike sykehus i hele landet. Studien undersĂžkte kvinnenes helhetlige prosess med Ă„ sĂžke andretrimesterabort innen rammene av et abortnemndsystem, opplevelser knyttet til selve mĂžtet med nemnden og kvinnenes erfaringer knyttet til nemndenes myndighet til Ă„ fatte beslutning om deres liv samtidig som de skal ivareta kvinnenes rett til informasjon og veiledning. Kvinnene fortalte sine historier fra de oppdaget svangerskapet til tiden etter at abortfĂždsel var overstĂ„tt. Analysen som presenteres i denne rapporten fokuserer pĂ„ temaene 1) Forventninger og forberedelser til nemndsmĂžtet, 2) Ă
mĂžte abortnemnden og 3) Tidsrammer og oppfĂžlging.
Studien viser at tiden fÞr selve nemndsmÞtet preges av varierende forkunnskaper og ulik og mangelfull informasjon til kvinnene om plikter og rettigheter ved nemndsbehandling. Muligheten for Ä fÄ avslag preget kvinnene i forkant av nemndsmÞtet, og gjorde kvinnenes beslutningsprosess vanskeligere. Videre viser studien at abortnemndene organiseres svÊrt ulikt fra sykehus til sykehus. Noen kvinner opplevde at nemnden ga rÄd og stÞtte utover det Ä avklare om aborten oppfylte lovens kriterier. Mens noen opplevde nemndsmÞtet som bÄde belastende og meningslÞst, opplevde andre det som en stÞtte. Metaforer som «eksamen» eller «avhÞr» ble brukt til Ä beskrive noen av kvinnenes mÞte med nemnden. Kvinner som hadde sÞkt om Ä fÄ avslutte et Þnsket svangerskap var frustrert over at partner ikke hadde plass som part i nemndsystemet. Tidsaspektet formet kvinnenes opplevelser med nemndsbehandling. For noen var det Ä vente pÄ nemnden en belastning. For andre gjorde lovens grenser for svangerskapets avslutning at vanskelige avgjÞrelser mÄtte tas pÄ kort tid. Kvinnene hadde et stort behov for stÞtte og oppfÞlging etter abortfÞdsel, og i dag er det ikke noe system som sikrer dette.
Abortnemndene utgjÞr bare én del av et stÞrre system som aktiveres nÄr en kvinne sÞker en andretrimesterabort. Kvinnenes erfaringer med abortnemndsystemet preges av skjevheten i makt mellom dem selv og nemnden. Denne skjevheten begrenser rommet for tvil og muligheten for en god og opplysende dialog. Noen kvinner opplever at mÞtet med nemnd gir dem stÞrre kontroll over egen situasjon. Slik det fungerer i dag favoriserer nemndsystemet ressurssterke kvinner og kan bidra til Ä ytterligere marginalisere sÄrbare kvinner.
Uklarhet og ulik praksis knyttet til abortnemndens oppgave utover det Ä fatte et vedtak om andretrimesterabort, skaper risiko for at viktig informasjon ikke formidles. Dette svekker kvinners rett til Ä ikke delta i nemndsmÞte samt hennes mulighet til Ä handle pÄ bakgrunn av riktig informasjon. Dagens system tar i liten grad hÞyde for at de fleste andrestrimesteraborter er avbrudd av Þnskede svangerskap. For kvinner som opplever dette virker abortnemdsystemet fremmedgjÞrende og lite forstÄelsesfullt. Dette kan gjÞre den vanskelige tiden etter en gjennomfÞrt abort ekstra krevende.
Dagens helsesystem sikrer ikke god oppfÞlging til kvinnene som gjennomgÄr en andretrimesterabort. Tiden etter en gjennomfÞrt abortfÞdsel er den mest sÄrbare for kvinnene som har vÊrt gjennom abortnemndsystemet. Det er grunn til Ä stille spÞrsmÄl til ressursbruken knyttet til nemndsmÞtene i kontrast til fÄ ressurser til oppfÞlgingstjenester
Viewing the image? Ultrasound examination during abortion preparations, ethical challenges
During preparation for early abortion in Norway, an ultrasound examination is usually performed to determine gestation and viability. This article aims to provide a deeper understanding of womenâs and health care personnelâs (HCP) experiences with ultrasound viewing during abortion preparation in the first trimester. Qualitative in-depth interviews with women who had been prepared for early abortion and focus group interviews with HCP from gynaecological units were carried out. A hermeneutic-phenomenological analysis, inspired by van Manen, was chosen. Thirteen women who were pregnant and considering abortion in their first trimester and 20 HCP, namely, 19 registered nurses and one medical doctor, were recruited from gynaecological units at six hospitals. The study was approved by the ethics committee (2014/1276). The essential meaning structure of âautonomy under pressureâ consisted of two themes that expressed the different experiences of both the women and the HCP, namely, expectations versus precautions and choice versus protection. The women and HCP expressed different attitudes before the consultation that affected their experiences of the ultrasound examination. While the women had expectations of a clarification based on their choice to either see or not see the ultrasound image, HCP seemed to be more concerned with predetermined rules that they believed would protect the women. Consequently, the basis for dialogue was not optimal, and womenâs autonomy was under pressure. Health care personnel are ethically challenged during preabortion ultrasound examinations. Meeting the individual womanâs needs and respecting her autonomy during preparation for abortion requires sensitivity, involvement, and dialogue skills by health personnel. According to the womanâs desire to be informed about the possibility of viewing the image during the abortion preparations, a dialogue that is focused in this direction should arise before the examination
Viewing the image? Ultrasound examination during abortion preparations, ethical challenges
During preparation for early abortion in Norway, an ultrasound examination is usually performed to determine gestation and viability. This article aims to provide a deeper understanding of womenâs and health care personnelâs (HCP) experiences with ultrasound viewing during abortion preparation in the first trimester. Qualitative in-depth interviews with women who had been prepared for early abortion and focus group interviews with HCP from gynaecological units were carried out. A hermeneutic-phenomenological analysis, inspired by van Manen, was chosen. Thirteen women who were pregnant and considering abortion in their first trimester and 20 HCP, namely, 19 registered nurses and one medical doctor, were recruited from gynaecological units at six hospitals. The study was approved by the ethics committee (2014/1276). The essential meaning structure of âautonomy under pressureâ consisted of two themes that expressed the different experiences of both the women and the HCP, namely, expectations versus precautions and choice versus protection. The women and HCP expressed different attitudes before the consultation that affected their experiences of the ultrasound examination. While the women had expectations of a clarification based on their choice to either see or not see the ultrasound image, HCP seemed to be more concerned with predetermined rules that they believed would protect the women. Consequently, the basis for dialogue was not optimal, and womenâs autonomy was under pressure. Health care personnel are ethically challenged during preabortion ultrasound examinations. Meeting the individual womanâs needs and respecting her autonomy during preparation for abortion requires sensitivity, involvement, and dialogue skills by health personnel. According to the womanâs desire to be informed about the possibility of viewing the image during the abortion preparations, a dialogue that is focused in this direction should arise before the examination
Viewing the image? Ultrasound examination during abortion preparations, ethical challenges
During preparation for early abortion in Norway, an ultrasound examination is usually performed to determine gestation and viability. This article aims to provide a deeper understanding of womenâs and health care personnelâs (HCP) experiences with ultrasound viewing during abortion preparation in the first trimester. Qualitative in-depth interviews with women who had been prepared for early abortion and focus group interviews with HCP from gynaecological units were carried out. A hermeneutic-phenomenological analysis, inspired by van Manen, was chosen. Thirteen women who were pregnant and considering abortion in their first trimester and 20 HCP, namely, 19 registered nurses and one medical doctor, were recruited from gynaecological units at six hospitals. The study was approved by the ethics committee (2014/1276). The essential meaning structure of âautonomy under pressureâ consisted of two themes that expressed the different experiences of both the women and the HCP, namely, expectations versus precautions and choice versus protection. The women and HCP expressed different attitudes before the consultation that affected their experiences of the ultrasound examination. While the women had expectations of a clarification based on their choice to either see or not see the ultrasound image, HCP seemed to be more concerned with predetermined rules that they believed would protect the women. Consequently, the basis for dialogue was not optimal, and womenâs autonomy was under pressure. Health care personnel are ethically challenged during preabortion ultrasound examinations. Meeting the individual womanâs needs and respecting her autonomy during preparation for abortion requires sensitivity, involvement, and dialogue skills by health personnel. According to the womanâs desire to be informed about the possibility of viewing the image during the abortion preparations, a dialogue that is focused in this direction should arise before the examination.publishedVersio
From open to locked doors - From dependent to independent : Patient narratives of participation in their rehabilitation processes.
AIMS AND OBJECTIVES: The present study aimed to explore patients' experiences of participating in their rehabilitation process in the context of specialised rehabilitation in Norway. BACKGROUND: The rights of patients to participate in their care and treatment is an ideology that underlines newer international and Norwegian public documents. However, there is a gap between policy statements and clinical practice, and a discrepancy between patients' and professionals' statements about patient participation in rehabilitation. DESIGN: A qualitative approach with a narrative design. METHODS: Eleven patients were individually interviewed to tell their stories about the rehabilitation processes. We utilised narrative analysis with a three-dimensional space narrative structure including temporality, sociality and spatiality. This study followed the COREQ checklist. RESULTS: The analysis identified two throughout plots: 'person-centred culture' and 'time', and three plots which constructed how the patients participate in change through the rehabilitation process: (a) dependent-'open doors'; (b) motivation from within; and (c) independence-'locked doors'. CONCLUSIONS: Patient participation in rehabilitation was dependent on person-centred cultures in the unit and on different aspects of time. The dialogue and the power balance between the patients and the health personnel changed as the rehabilitation progressed. Motivation for rehabilitation had to come from within patients. The paternalistic ideology did not seem to dominate the specialised rehabilitation unit in the present study. RELEVANCE TO CLINICAL PRACTICE: This study gives new insight into how patients participate in change in the rehabilitation process. This can be valuable for healthcare professionals and governments. Insight into how the lack of person-centred focus can harm the rehabilitation process, and a deeper understanding of the meaning of time in the rehabilitation process is essential. These results may provide a stimulus for discussions on how patients might participate in their rehabilitation process
Beyond autonomy and care: Experiences of ambivalent abortion seekers
Background While being prepared for abortions, some women experience decisional ambivalence during their encounters with health personnel at the hospital. Womenâs experiences with these encounters have rarely been examined. Objective The objective of this study was to explore ambivalent abortion-seeking womenâs experiences of their encounters with health personnel. Research design The data were collected in individual interviews and analysed with dialogical narrative analyses. Participants and research context Thirteen women (aged 18-36 years), who were uncertain of whether to terminate their pregnancies during the first trimester, were interviewed before and after they made their decisions. The participants were recruited at six Norwegian outpatient clinics. Ethical considerations Approval was granted by the Regional Committee for Medical and Health Research Ethics. Findings The ambivalent pregnant women sought to make autonomous decisions while simultaneously involving their closest confidants and health personnel in the process. The following three types of narratives of womenâs experiences with encounters with health personnel were identified: the respected women, the identified women and the abandoned women. Discussion The findings are discussed in terms of the ambivalent pregnant womanâs autonomous responsibility in considering an abortion and how her autonomy can be enabled or impaired during encounters with health personnel. Conclusion and implication Although the women considered themselves autonomous and responsible for their final decisions, they wished health personnel were involved in their situations. The health personnel contributed by enabling or disabling the possibility of decision-making in accordance with the womenâs values. The findings indicate that health personnel who care for women considering abortions must be trained in dialogical competence
Women's experiences when unsure about whether or not to have an abortion in the first trimester
Abortion during the first trimester is legal in most Western countries. However, deciding to terminate a pregnancy is a challenging process, and some women arrive at the abortion clinic still not absolutely certain. We explored the experiences of 13 pregnant Norwegian women struggling to finalize their decision, interviewing them before and after their decision. Verification of the pregnancy meant a new reality for the women. They started to consider their readiness, describing the experience as a lonely journey during which their values were challenged. A feeling of existential loneliness dominated the decision-making process and the implementation
Beyond autonomy and care: Experiences of ambivalent abortion seekers
Background While being prepared for abortions, some women experience decisional ambivalence during their encounters with health personnel at the hospital. Womenâs experiences with these encounters have rarely been examined. Objective The objective of this study was to explore ambivalent abortion-seeking womenâs experiences of their encounters with health personnel. Research design The data were collected in individual interviews and analysed with dialogical narrative analyses. Participants and research context Thirteen women (aged 18-36 years), who were uncertain of whether to terminate their pregnancies during the first trimester, were interviewed before and after they made their decisions. The participants were recruited at six Norwegian outpatient clinics. Ethical considerations Approval was granted by the Regional Committee for Medical and Health Research Ethics. Findings The ambivalent pregnant women sought to make autonomous decisions while simultaneously involving their closest confidants and health personnel in the process. The following three types of narratives of womenâs experiences with encounters with health personnel were identified: the respected women, the identified women and the abandoned women. Discussion The findings are discussed in terms of the ambivalent pregnant womanâs autonomous responsibility in considering an abortion and how her autonomy can be enabled or impaired during encounters with health personnel. Conclusion and implication Although the women considered themselves autonomous and responsible for their final decisions, they wished health personnel were involved in their situations. The health personnel contributed by enabling or disabling the possibility of decision-making in accordance with the womenâs values. The findings indicate that health personnel who care for women considering abortions must be trained in dialogical competence
Women's experiences when unsure about whether or not to have an abortion in the first trimester
Abortion during the first trimester is legal in most Western countries. However, deciding to terminate a pregnancy is a challenging process, and some women arrive at the abortion clinic still not absolutely certain. We explored the experiences of 13 pregnant Norwegian women struggling to finalize their decision, interviewing them before and after their decision. Verification of the pregnancy meant a new reality for the women. They started to consider their readiness, describing the experience as a lonely journey during which their values were challenged. A feeling of existential loneliness dominated the decision-making process and the implementation
Beyond autonomy and care: Experiences of ambivalent abortion seekers
Background While being prepared for abortions, some women experience decisional ambivalence during their encounters with health personnel at the hospital. Womenâs experiences with these encounters have rarely been examined. Objective The objective of this study was to explore ambivalent abortion-seeking womenâs experiences of their encounters with health personnel. Research design The data were collected in individual interviews and analysed with dialogical narrative analyses. Participants and research context Thirteen women (aged 18-36 years), who were uncertain of whether to terminate their pregnancies during the first trimester, were interviewed before and after they made their decisions. The participants were recruited at six Norwegian outpatient clinics. Ethical considerations Approval was granted by the Regional Committee for Medical and Health Research Ethics. Findings The ambivalent pregnant women sought to make autonomous decisions while simultaneously involving their closest confidants and health personnel in the process. The following three types of narratives of womenâs experiences with encounters with health personnel were identified: the respected women, the identified women and the abandoned women. Discussion The findings are discussed in terms of the ambivalent pregnant womanâs autonomous responsibility in considering an abortion and how her autonomy can be enabled or impaired during encounters with health personnel. Conclusion and implication Although the women considered themselves autonomous and responsible for their final decisions, they wished health personnel were involved in their situations. The health personnel contributed by enabling or disabling the possibility of decision-making in accordance with the womenâs values. The findings indicate that health personnel who care for women considering abortions must be trained in dialogical competence