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Söderman, A., Östlund, U., Werkander Harstäde, C. & Blomberg, K. (2020). Dignity-conserving care for persons with palliative care needs - identifying outcomes studied in research: An integrative review.. Palliative & Supportive Care, 1-19
Open this publication in new window or tab >>Dignity-conserving care for persons with palliative care needs - identifying outcomes studied in research: An integrative review.
2020 (English)In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, p. 1-19Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVES: With people living longer, palliative care may be required for lengthier periods of time. This puts demands on healthcare organizations to provide optimal palliative care. Maintaining dignity is central for any person's health and quality of life, but especially for a person with palliative care needs. Dignity-conserving care needs to be evaluated to increase knowledge about outcomes and how to assess these. The purpose of this integrative review was to identify outcomes studied within dignity-conserving care and how these have been operationalized.

METHODS: An integrative review was conducted in 26 quantitative or mixed-method studies and study protocols. Thematic synthesis with an abductive approach was used for analysis.

RESULTS: Seven themes of studied outcomes were identified, as well as four cluster themes: themes related to Illness-Related Concerns, themes related to the Dignity-Conserving Repertoire, themes related to the Social Dignity Inventory, and themes regarding Overarching Dignity Issues. Most outcomes studied dealt with Illness-Related Concerns within the themes of "Performance, symptoms and emotional concerns" and "End-of-life and existential aspects". Themes linked to the Social Dignity Inventory had the lowest number of outcomes studied. Outcomes regarding overarching dignity issues such as "Dignity-related distress" and "Quality of life" were common. However, the results lacked concrete communication outcomes.

SIGNIFICANCE OF RESULTS: The results will underpin future research in which dignity-conserving care is implemented and evaluated, and contribute to the provision of evidence-based palliative care. A greater focus on outcomes within cluster themes related to the Dignity-Conserving Repertoire and the Social Dignity Inventory is needed, as is more focus on communication outcomes.

Place, publisher, year, edition, pages
Cambridge University Press, 2020
Keywords
Dignity-conserving care, Human dignity, Outcome assessment, Palliative care, Review
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-80481 (URN)10.1017/S1478951520000139 (DOI)32131926 (PubMedID)
Available from: 2020-03-09 Created: 2020-03-09 Last updated: 2020-03-09Bibliographically approved
Odencrants, S., Blomberg, K. & Wallin, A.-M. (2020). "The meal is an activity involving at least two people": Experiences of meals by older persons in need of elderly care. Nursing Open, 7(1), 265-273
Open this publication in new window or tab >>"The meal is an activity involving at least two people": Experiences of meals by older persons in need of elderly care
2020 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 7, no 1, p. 265-273Article in journal (Refereed) Published
Abstract [en]

Aim: A shift of focus on older persons' nutrition has occurred, from focusing on nutrition status to focusing on the whole meal. There is lack of studies on how older persons experience meals. Knowledge is needed to enhance a meal with dignity and pleasure, but also to prevent deterioration in nutrition. The aim was to describe meals from the perspective of older persons in need of elderly care.

Design: A descriptive qualitative study.

Method: Semi-structured interviews (N = 18) were conducted and analysed using thematic analyses.

Result: Three themes were identified: The meal is an activity which involves at least two persons, The meal relates to habits and traditions and The meal seldom gives possibilities to make individual choices. It was obvious that older persons who live in nursing homes miss the opportunity to decide what to eat, when to eat and with whom to eat. Attention must be paid to listening to older persons to enhance mealtime with dignity and autonomy.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2020
Keywords
experiences, interviews, meal, meal situation, older persons, qualitative study
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-77802 (URN)10.1002/nop2.387 (DOI)000492972400001 ()31871710 (PubMedID)2-s2.0-85074726887 (Scopus ID)
Available from: 2019-11-09 Created: 2019-11-09 Last updated: 2020-01-13Bibliographically approved
Blomberg, K., Eriksson, M., Böö, R. & Grönlund, Å. (2019). Coping with narcolepsy after Pandemrix®vaccination using a Facebook forum. In: : . Paper presented at 6th Nordic Narcolepsy Symposium, Uppsala, Sweden, 7-8 februari, 2019.
Open this publication in new window or tab >>Coping with narcolepsy after Pandemrix®vaccination using a Facebook forum
2019 (English)Conference paper, Oral presentation only (Other academic)
Keywords
Narcolepsy, Social Media
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:oru:diva-72362 (URN)
Conference
6th Nordic Narcolepsy Symposium, Uppsala, Sweden, 7-8 februari, 2019
Projects
LISAN
Available from: 2019-02-09 Created: 2019-02-09 Last updated: 2019-02-11Bibliographically approved
Tavemark, S., Hermansson, L. & Blomberg, K. (2019). Enabling activity in palliative care: focus groups among occupational therapists. BMC Palliative Care, 18(1), Article ID 17.
Open this publication in new window or tab >>Enabling activity in palliative care: focus groups among occupational therapists
2019 (English)In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 18, no 1, article id 17Article in journal (Refereed) Published
Abstract [en]

Background: Activity participation may support clients in palliative care to maintain dignity and quality of life. Literature and policy documents state that occupational therapists should be part of the team in palliative care, but give limited guidance on how interventions should be employed. Thus, the aim was to describe occupational therapists’ experiences of enabling activity for seriously ill and dying clients.

Methods: In a descriptive, qualitative study, three focus groups with occupational therapists (n = 14) were conducted. The data were analysed using qualitative content analysis.

Results: The findings showed that occupational therapists were enabling activity in clients in palliative care whilst considering the client’s individual preferences. Motivation was seen to facilitate activity, while environmental restrictions act as barriers. The occupational therapists wanted to bring activities physically closer to the clients and felt a need for more client contact to enable activity.

Conclusions: Occupational therapists’ interventions in palliative care includes prioritizing and planning activities according to clients’ preferences and capacities. The individual nature of these activities makes it impossible to create standardised protocol for interventions, but the study results can be used to describe occupational therapists’ strategies and to guide their work, especially unexperienced occupational therapists in palliative care.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Activities of daily living, leisure activities, client participation, quality of life, qualitative research
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:oru:diva-71694 (URN)10.1186/s12904-019-0394-9 (DOI)000458150200001 ()30732615 (PubMedID)2-s2.0-85061266778 (Scopus ID)
Note

Funding Agency:

University Health Care Research Center, Region Örebro County, Örebro, Sweden

Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2019-06-18Bibliographically approved
Stenninger, E., Blomberg, K., Eriksson, M. & Brorson, L.-O. (2019). Epilepsi: 50 års uppföljning. In: : . Paper presented at Barnveckan 2019, Örebro, Sweden, 1-4 April, 2019.
Open this publication in new window or tab >>Epilepsi: 50 års uppföljning
2019 (Swedish)Conference paper, Oral presentation only (Other academic)
Keywords
Epilepsi, Uppföljning
National Category
Nursing Neurology
Research subject
Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-73486 (URN)
Conference
Barnveckan 2019, Örebro, Sweden, 1-4 April, 2019
Available from: 2019-04-03 Created: 2019-04-03 Last updated: 2019-04-09Bibliographically approved
Sundler, A. J., Blomberg, K., Bisholt, B., Eklund, A., Windahl, J. & Larsson, M. (2019). Experiences of supervision during clinical education among specialised nursing students in Sweden: A cross-sectional study. Nurse Education Today, 79, 20-24, Article ID S0260-6917(19)30697-5.
Open this publication in new window or tab >>Experiences of supervision during clinical education among specialised nursing students in Sweden: A cross-sectional study
Show others...
2019 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 79, p. 20-24, article id S0260-6917(19)30697-5Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The importance of the clinical learning environment in nurse education has gained increasing attention over the last decades. However, there is a lack of research on the learning environment, its significance and meaning in specialist nurse education.

OBJECTIVE: The objectives of the study were to investigate specialised nursing students' experiences of supervision during clinical practice and to compare students who were satisfied with the supervision with those who were dissatisfied with respect to a) organisation of supervision and number of preceptors, as well as time allocated by preceptors for b) supervision, c) reflection, d) discussion of intended learning outcomes, and e) assessments of students' performance by preceptors.

DESIGN: This study used a cross-sectional design.

SAMPLE AND SETTINGS: A convenience sample of specialised nursing students was derived from five Swedish universities in the years 2016 and 2017.

METHODS: Data were collected using a questionnaire. Statistical analyses and a qualitative conventional content analysis were performed.

RESULTS: While almost all specialised nursing students reported that there had been time for discussion on their performance assessment, almost half of the students reported not getting time for supervision, or time for reflections and discussions on intended learning outcomes with the preceptor. Students reporting having time allocated for supervision by preceptors were found to be more satisfied with supervision. It was described as important that the preceptor(s) acknowledged the students previous work experiences. Even though being a registered nurse, reflections and feedback were described as valuable for the students learning. Several preceptors were described as positive allowing a broader picture and different views regarding working as a specialist nurse.

CONCLUSIONS: This study indicates that supervision, in terms of discussions and reflections, of specialised nursing students is significant for learning experiences and satisfaction during clinical placement.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Clinical practice, Community health care, Graduate nursing education, Learning, Preceptorship, Primary health care, Specialist nurse education, Supervision
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-74534 (URN)10.1016/j.nedt.2019.05.009 (DOI)000473377700004 ()31085423 (PubMedID)2-s2.0-85065447098 (Scopus ID)
Available from: 2019-06-02 Created: 2019-06-02 Last updated: 2019-08-08Bibliographically approved
Brorson, L.-O., Eriksson, M., Blomberg, K. & Stenninger, E. (2019). Fifty years' follow-up of childhood epilepsy: Medical outcome, morbidity, and medication. Epilepsia, 60(3), 381-392
Open this publication in new window or tab >>Fifty years' follow-up of childhood epilepsy: Medical outcome, morbidity, and medication
2019 (English)In: Epilepsia, ISSN 0013-9580, E-ISSN 1528-1167, Vol. 60, no 3, p. 381-392Article in journal (Refereed) Published
Abstract [en]

Objective: To describe the long‐term prognosis of childhood epilepsy, with special emphasis on seizure remission, relapse, medication, associated neurologic impairment, mortality rate, and cause of death.

Methods: A prospective longitudinal study on a population‐based total cohort of 195 children with epileptic seizures in 1962‐1964. Data were collected from medical records and a questionnaire.

Results: Follow‐up data from 94% of the initial cohort showed the best long‐term prognosis for seizure freedom for children with no intellectual or neurologic impairment. These children had later seizure onset, shorter total duration of epilepsy, and were more often medication free. Only a few of them had isolated relapses. Generalized, rather than focal, epilepsy was associated with fewer relapses and less ongoing medication. The “true incidence” group, with onsets during the inclusion period of 1962‐1964, had the best long‐term prognosis for seizure freedom, with 90% seizure‐free after 50 years. Although only 10% of this group had ongoing seizures at follow‐up, 22% still used anticonvulsive medication, often with old drugs, that is, phenobarbital or phenytoin, as one of the anticonvulsive drugs. The standardized mortality ratio (SMR) was 2.61 for the whole group, with no difference between those with or without other neurodeficits. Those who died young either had neurologic impairment or died from epilepsy‐related conditions; later deaths often followed non–epilepsy‐related conditions. No one in the incidence group died of SUDEP (sudden unexpected death in epilepsy).

Significance: This 50‐year, long‐term follow‐up of a cohort of persons with childhood epilepsy in general demonstrates a better outcome for seizure freedom compared to our follow‐up after 12 years and to previous reports. We also report a low incidence of seizure relapses. Remission of seizures does not automatically lead to termination of medication. The mortality rate associated with SUDEP was lower than previously reported.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2019
Keywords
cause of death, long-term follow-up, medication, mortality, relapse, seizures
National Category
Nursing Neurology
Research subject
Medicine; Caring Sciences w. Medical Focus
Identifiers
urn:nbn:se:oru:diva-71610 (URN)10.1111/epi.14643 (DOI)000460315700004 ()30663037 (PubMedID)2-s2.0-85060353799 (Scopus ID)
Note

Funding Agencies:

OÖrebro University Faculty of Medicine and Health  

Research Committee at Region Örebro County  

Föreningen Margaretahemmet, Sweden 

Available from: 2019-01-21 Created: 2019-01-21 Last updated: 2019-06-18Bibliographically approved
Blomberg, K., Brorson, L.-O., Stenninger, E. & Eriksson, M. (2019). Fifty-year follow-up of childhood epilepsy: Social, psychometric, and occupational outcome. Epilepsy & Behavior, 96, 224-228
Open this publication in new window or tab >>Fifty-year follow-up of childhood epilepsy: Social, psychometric, and occupational outcome
2019 (English)In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 96, p. 224-228Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The objective of this study was to explore and describe the experience of a childhood diagnosis of epilepsy and its consequences for the experiences of daily life over a span of 50 years.

METHODS: A descriptive mixed method design was chosen. Data were collected through a survey returned by 86 persons (59% response rate) who had received diagnoses of epilepsy as children. The survey contained questions about education, vocation, family status, and included the 14-item Hospital Anxiety and Depression Scale (HAD). Additionally, interviews (n = 11) were conducted and analyzed by interpretative description.

RESULTS: Few persons reported that the childhood diagnosis of epilepsy had affected their choice of education, work, or leisure activities. However, 20% reported that the diagnosis had caused problems in school or at work and had restricted their activities of daily living. Sixty-six percent of the participants were married, and 68% had children; of those, 12 (20%) reported that one or more of the children had also had seizures. Almost all reported no anxiety (82%) and no depression (90%). The results of the interviews revealed a balancing act between 'Controlling and managing the situation' and 'Not being restricted by the condition'.

SIGNIFICANCE: This long-term follow-up over a 50-year life-span of persons who received childhood diagnoses of epilepsy suggests that the consequences for education, work, and leisure activities were few. Most of the participants had developed strategies to manage their situation.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Life-situation, Long-term follow-up, Seizures, Epilepsy, Child, Life-span
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-74623 (URN)10.1016/j.yebeh.2019.01.034 (DOI)000472472900033 ()31176891 (PubMedID)2-s2.0-85066789610 (Scopus ID)
Note

Funding Agencies:

Faculty of Medicine and Health, Örebro University  

Föreningen Margaretahemmet, Sweden 

Available from: 2019-06-07 Created: 2019-06-07 Last updated: 2019-08-09Bibliographically approved
Östlund, U., Blomberg, K., Söderman, A. & Werkander Harstäde, C. (2019). How to conserve dignity in palliative care: suggestions from older patients, significant others, and healthcare professionals in Swedish municipal care. BMC Palliative Care, 18(1), Article ID 10.
Open this publication in new window or tab >>How to conserve dignity in palliative care: suggestions from older patients, significant others, and healthcare professionals in Swedish municipal care
2019 (English)In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 18, no 1, article id 10Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: An essential aspect of palliative care nursing is to conserve the dignity of the patient. A Dignity Care Intervention (DCI) has been developed in Scotland to facilitate this role for nurses. The DCI is now being adapted to a Swedish context (DCI-SWE) and a central step is to identify culturally relevant, dignity-conserving care actions. These care actions will be incorporated into the DCI-SWE. Therefore, the aim of this study was to suggest care actions for conserving dignity in palliative care from the perspectives of the patients, significant others (SOs), and health care professionals (HPs) in municipality care in Sweden.

METHODS: This study used a descriptive design with a qualitative approach. Data from 20 participants were collected through semi-structured individual interviews with patients (n = 3), SOs (n = 4), two focus groups with nurses (n = 9) and one focus group with physicians (n = 4) in two Swedish municipalities. These data were deductively analysed using qualitative content analysis with the Chochinov model of dignity as framework.

RESULTS: With the Chochinov model of dignity as a framework, care actions based on suggestions from the participants were identified and presented under three themes: Illness related concerns, Dignity conserving repertoire, and Social dignity inventory. The study found both specific concrete care actions and more general approaches. Such general approaches were found to be relevant for several dignity related issues as all-embracing attitudes and behaviours. However, these general approaches could also be relevant as specific care actions to conserve dignity in relation to certain issues. Care actions were also found to be linked to each other, showing the importance of a holistic perspective in conserving dignity.

CONCLUSIONS: As part of the adaption of the DCI from a Scottish to a Swedish context, this study added relevant care actions for collaborative planning of individualised care in mutual dialogues between nurses and those they care for. The adapted intervention, DCI-SWE, has the potential to help the nurses in providing palliative care of evidence-based quality.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Care actions, Community nursing, DCI-SWE, Dignity, Dignity care intervention, End of life care, Palliative care, Person centred, Sweden
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-71849 (URN)10.1186/s12904-019-0393-x (DOI)000457121700002 ()30678669 (PubMedID)2-s2.0-85060556337 (Scopus ID)
Funder
The Kamprad Family Foundation, 20152002
Note

Funding Agencies:

Ulrika Crones Foundation from the Swedish Society of Nursing 

Faculty of Medicine and Health, Örebro University 

Available from: 2019-02-12 Created: 2019-02-12 Last updated: 2019-03-26Bibliographically approved
Runngren, E., Eriksson, M. & Blomberg, K. (2019). School nurse’s experiences of offering HPV vaccination to young girls in a Swedish vaccination program. In: : . Paper presented at School Nurses International Conference (SNI), Stockholm, Sweden, 22-26 July, 2019.
Open this publication in new window or tab >>School nurse’s experiences of offering HPV vaccination to young girls in a Swedish vaccination program
2019 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

Background: In the Swedish school health system, girls 10-12 years old are vaccinated for Human Papillomavirus (HPV) with a vaccination coverage of 80%, which is less than other vaccinations in the national child vaccination program according to The Public Health Agency of Sweden. The aim of this study was to describe school nurse’s experience of offering HPV vaccination to girls, age 10-12 years old.

Methods: Focus group interviews (n=4) with school nurses (n=17) working in rural and urban areas. The analysis was based on Elo & Kyngäs content analysis.

Results: The school nurses had different strategies, abilities and presumptions when offering HPV vaccination. There were various ways to inform parents and girls  about HPV and HPV vaccination, but commonly they use information from the school health systems guidelines. It was found that school nurses experienced that there was a lack of knowledge about HPV among both school nurses, parents, girls. One of the problems that the school nurses had was to get the written consent from the parent. Without the written consent, the vaccination will not be performed.

Conclusions: The school nurse's vaccination assignment is complex. There are several factors that are important before the vaccination itself can be carried out.  How it is performed differs between the school nurses depending on strategy, ability and presumption. The results indicate that an increased knowledge and support in the daily work with HPV vaccination is needed in order to increase the HPV vaccination coverage in the long term.

 

Keywords
HPV vaccination
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-75555 (URN)
Conference
School Nurses International Conference (SNI), Stockholm, Sweden, 22-26 July, 2019
Available from: 2019-08-05 Created: 2019-08-05 Last updated: 2019-08-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-9209-5179

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