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  • 1. Nilsson, Sofia
    et al.
    Sjöberg, Misa
    Kallenberg, Kjell
    Örebro University, School of Health and Medical Sciences.
    Larsson, Gerry
    Moral stress in international humanitarian aid and rescue operations: a grounded theory study2011In: Ethics & behavior, ISSN 1050-8422, E-ISSN 1532-7019, Vol. 21, no 1, p. 49-68Article in journal (Refereed)
    Abstract [en]

    Humanitarian aid professionals frequently encounter situations in which one is conscious of the morally appropriate action but cannot take it because of institutional obstacles. Dilemmas like this are likely to result in a specific kind of stress reaction at the individual level, labeled as moral stress. In our study, 16 individuals working with international humanitarian aid and rescue operations participated in semistructured interviews, analyzed in accordance with a grounded theory approach. A theoretical model of ethical decision making from a moral stress perspective was developed. The practical implications of the study are discussed

  • 2.
    Svantesson, Mia
    et al.
    Örebro University, School of Health and Medical Sciences.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health and Medical Sciences.
    Thorsén, Håkan
    Örebro University, School of Health and Medical Sciences.
    Kallenberg, Kjell
    Ahlström, Gerd
    Hälsohögskolan i Jönköping.
    Interprofessional ethics rounds concerning dialysis patients: staff's ethical reflections before and after rounds2008In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, Vol. 34, no 5, p. 407-413Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate whether ethics rounds stimulated ethical reflection. METHODS: Philosopher-ethicist-led interprofessional team ethics rounds concerning dialysis patient care problems were applied at three Swedish hospitals. The philosophers were instructed to stimulate ethical reflection and promote mutual understanding between professions but not to offer solutions. Questionnaires directly before and after rounds were answered by 194 respondents. The analyses were primarily content analysis with Boyd's framework but were also statistical in nature. FINDINGS: Seventy-six per cent of the respondents reported a moderate to high rating regarding new insights on ethical problem identification, but the ethics rounds did not seem to stimulate the ethical reflection that the respondents had expected (p < 0.001). Dominant new insights did not seem to fit into traditional normative ethics but were instead interpreted as hermeneutic ethics. This was illustrated in the extended perspective on the patient and increased awareness of relations to other professions. Regarding insights into how to solve ethical problems, the request for further interprofessional dialogue dominated both before and after rounds. CONCLUSION: The findings show the need for interprofessional reflective ethical practice but a balance between ethical reflection and problem solving is suggested if known patients are discussed. Further research is needed to explore the most effective leadership for reflective ethical practice.

  • 3.
    Svantesson, Mia
    et al.
    Örebro University, School of Health and Medical Sciences.
    Löfmark, Rurik
    Thorsén, Håkan
    Kallenberg, Kjell
    Ahlström, Gerd
    Learning a way through ethical problems: Swedish nurses’ and doctors’ experiences from one model of ethics rounds2008In: Journal of Medical Ethics, ISSN 0306-6800, E-ISSN 1473-4257, Vol. 34, no 5, p. 399-406Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate one ethics rounds model by describing nurses' and doctors' experiences of the rounds.

    METHODS: Philosopher-ethicist-led interprofessional team ethics rounds concerning dialysis patient care problems were applied at three Swedish hospitals. The philosophers were instructed to promote mutual understanding and stimulate ethical reflection, without giving any recommendations or solutions. Interviews with seven doctors and 11 nurses were conducted regarding their experiences from the rounds, which were then analysed using content analysis. Findings: The goal of the rounds was partly fulfilled. Participants described both positive and negative experiences. Good rounds included stimulation to broadened thinking, a sense of connecting, strengthened confidence to act, insight into moral responsibility and emotional relief. Negative experiences were associated with a sense of unconcern and alienation, as well as frustration with the lack of solutions and a sense of resignation that change is not possible. The findings suggest that the ethics rounds above all met the need of a forum for crossing over professional boundaries. The philosophers seemed to play an important role in structuring and stimulating reasoned arguments. The nurses' expectation that solutions to the ethical problems would be sought despite explicit instructions to the contrary was conspicuous.

    CONCLUSION: When assisting healthcare professionals to learn a way through ethical problems in patient care, a balance should be found between ethical analyses, conflict resolution and problem solving. A model based on the findings is presented.

  • 4.
    Westius, Anders
    et al.
    Örebro University, School of Health and Medical Sciences.
    Andersson, Lars
    Ersta Sköndal university college, Stockholm, Sweden.
    Kallenberg, Kjell
    Örebro University, School of Health and Medical Sciences.
    View of life in persons with dementia2009In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 8, no 4, p. 481-499Article in journal (Refereed)
    Abstract [en]

    Objective: To study the view of life in dementia. The view of life of an individual is defined as a conception of reality, a central system of values and a basic emotional attitude.Method: Interviews with persons (N = 21) with mild to moderate dementia of the Alzheimer’s type. The interview data were interpreted with a phenomenological hermeneutical method.Results: Despite their cognitive deterioration it was possible to understand the view of life of the participants in the frame of their life story. Their view of life seemed to guide them towards selecting mainly emotionally powerful and value-oriented memories. No exceptional characteristics that could be traced to their dementia disease were found in the participants’ views of life. Conclusions: The view of life of the participants with mild to moderate dementia was vital for their life story and was not erased by dementia.Implications: In order to respect people with dementia as persons, caregivers should strive for gaining some knowledge of their view of life.

  • 5.
    Westius, Anders
    et al.
    Örebro University, School of Health and Medical Sciences.
    Kallenberg, Kjell
    Örebro University, School of Health and Medical Sciences.
    Norberg, Astrid
    Ersta Sköndal university college, Stockholm, Sweden.
    Views of life and sense of identity in people with Alzheimer's disease2010In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 30, no 7, p. 1257-1278Article in journal (Refereed)
    Abstract [en]

    Making it possible for people with Alzheimer's disease to retain a sense of identity during the process of the disease poses a great challenge to care-givers, professionals and family carers. The aim of this study is to elucidate the role of the view of life of people with Alzheimer's in framing their sense of identity. Is their view of life a vital aspect of their sense of identity? ‘View of life’ was interpreted as a vital aspect of sense of identity, understood as the individual's beliefs about their life history and about the attributes that characterised them. Twenty-one people with mild to moderate stages of Alzheimer's disease were interviewed about their life story. The narratives were interpreted using a phenomenological hermeneutic method. By telling their life story, the participants also narrated their view of life, i.e. their conception of reality, their central system of values and their basic emotional attitudes. By their own accounts, the origins of the narrators' central values and basic emotional attitudes were established in early life. They also expressed a sense of meaningfulness and continuity when looking back on their lives. The findings suggest that for a care-giver or confidant, having knowledge of a person with dementia's view of life is valuable when seeking to confirm that person's sense of identity.

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