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  • 1. Ahlström, Gerd
    et al.
    Lindvall, B.
    Wenneberg, Stig
    Örebro University, Department of Nursing and Caring Sciences.
    Gunnarsson, Lars-Gunnar
    Örebro University, Department of Clinical Medicine.
    A comprehensive rehabilitation programme tailored to the needs of adults with muscular dystrophy2006In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, no 2, p. 132-141Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess if activities of daily living (ADL), coping and quality of life could be improved in adults with muscular dystrophy through a comprehensive rehabilitation programme. DESIGN: Quasi-experimental, controlled clinical study comparing patients with similar age and disease aspects. SETTING: Two different counties in Sweden, being either study or control setting. SUBJECTS: The study group comprised 37 adults (21 women, 16 men; mean age 50 years), while the control group comprised 39 people (25 women, 14 men; mean age 46 years). INTERVENTIONS: Four rehabilitation sessions tailored to different medical, physical and psychosocial needs of the patients, comprising a total of 10 days over a period of 18 months. MAIN MEASURES: ADL, the Mental Adjustment to Cancer Scale measuring coping strategies, the Sickness Impact Profile measuring health-related quality of life, the Hospital Anxiety and Depression Scale, and the Psychosocial Well-being Questionnaire. RESULTS: No significant differences were found between groups with regard to the outcome measures. There was increased dependence on others in ADL after 18 months in both groups, but it was more pronounced in the control group. Furthermore, a clear trend was observed in the data with regard to coping patterns, the control group using more coping strategies such as 'Helplessness/hopelessness' (P= 0.057), 'Anxious preoccupation' (P = 0.085) and 'Fatalistic' (P= 0.073) when being compared to the study group. CONCLUSIONS: No apparent effects on ADL were found from the rehabilitation programme, although there was a tendency of reduction of maladaptive coping patterns in the study group. This initial study may provide the rationale and basis for a randomized controlled trial.

  • 2. Johansson, Ingrid
    et al.
    Hildingh, Cathrine
    Wenneberg, Stig
    Örebro University, Department of Nursing and Caring Sciences.
    Fridlund, Bengt
    Ahlström, Gerd
    Theoretical model of coping among relatives of patients in intensive care units: a simultaneous concept analysis2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, no 5, p. 463-471Article in journal (Refereed)
    Abstract [en]

    This paper reports the development of a theoretical model of relatives' coping approaches during the patient's intensive care unit stay and subsequent recovery at home by performing an analysis of concepts generated from two empirically grounded, theoretical studies in this area. BACKGROUND: When supporting relatives of intensive care unit patients, it is important that nurses have access to evidence-based knowledge of relatives' coping approaches during the period of illness and recovery. METHOD: Simultaneous concept analysis was used to refine and combine multiple coping concepts into a theoretical model of coping. The concepts were generated in two previous empirical studies of relatives' coping approaches during mechanically ventilated patients' intensive care unit stays and recovery at home. FINDINGS: The theoretical model was developed in 2004-2005 and illustrates the effectiveness of different coping approaches in relation to each other and to social support. Definitions summarizing each coping approach and containing the knowledge gained through the simultaneous concept analysis method were also formulated. CONCLUSION: This middle-range theory of relatives' coping approaches may make a valuable contribution to international intensive care unit nursing practice, especially as it is based on empirical studies and may therefore serve as a basis for the development of future clinical guidelines. However, the theoretical model needs to be empirically validated before it can be used.

  • 3. Tang, Ping Fen
    et al.
    Johansson, Camilla
    Wadensten, Barbro
    Wenneberg, Stig
    Örebro University, Department of Nursing and Caring Sciences.
    Ahlström, Gerd
    Chinese nurses' ethical concerns in a neurological ward2007In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 14, no 6, p. 810-824Article in journal (Refereed)
    Abstract [en]

    Our aim was to describe Chinese nurses' experiences of workplace distress and ethical dilemmas on a neurological ward. Qualitative interviews were performed with 20 nurses. On using latent content analysis, themes emerged in four content areas: ethical dilemmas, workplace distress, quality of nursing and managing distress. The ethical dilemmas were: ( 1) conflicting views on optimal treatment and nursing; ( 2) treatment choice meeting with financial constraints; and ( 3) misalignment of nursing responsibilities, competence and available resources. The patients' relatives lacked respect for the nurses' skills. Other dilemmas could be traced to the transition from a planned to a market economy, resulting in an excessive workload and treatment withdrawal for financial reasons. Lack of resources was perceived as an obstacle to proper patient care in addition to hospital organization, decreasing the quality of nursing, and increasing moral and workplace distress. The nurses managed mainly by striving for competence, which gave them hope for the future.

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