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  • 1.
    Bergh, Anne-Louise
    et al.
    University of Borås.
    Friberg, Febe
    University of Stavanger.
    Persson, Eva
    Lund University.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Perpetuating ‘New Public Management’ at the expense of nurses’ patient education: a discourse analysis2015In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 22, no 3, p. 190-201Article in journal (Refereed)
    Abstract [en]

    This study aimed to explore the conditions for nurses’ daily patient education work by focusing on managers’ way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could ‘see’ neither their role as a supporter of the patient education provided by nurses, nor their role in the development of nurses’ pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses’ provision of patient education. The organisational discourse was an umbrella term for ‘things’ such as cost-effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses’ patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice.

  • 2.
    Dahlborg Lyckhage, Elisabeth
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Pennbrant, Sandra
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Boman, Åse
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    "The Emperor's new clothes": discourse analysis on how the patient is constructed in the new Swedish Patient Act.2017In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 24, no 2, article id e12162Article in journal (Refereed)
    Abstract [en]

    The Swedish welfare debate increasingly focuses on market liberal notions and its healthcare perspective aims for more patient-centered care. This article examines the new Swedish Patient Act describing and analyzing how the patient is constructed in government documents. This study takes a Foucauldian discourse analysis approach following Willig's analysis guide. The act contains an entitlement discourse for patients and a requirement discourse for healthcare personnel. These two discourses are governed by a values-based healthcare discourse. Neo-liberal ideology, in the form of New Public Management discourse, focusing on the value of efficiency and competition, is given a hegemonic position as laws and regulations are used to strengthen it. The new Swedish Patient Act seems to further strengthen this development. The Act underlines the increased entitlement for patients, but it is not legally binding as it offers patients only indirect entitlement to influence and control their care. To safeguard the patient's entitlement under the Patient Act, healthcare personnel should be made aware of the contents of the Act, so that they can contribute to the creation of systems and working methods that facilitate respect of the Act's provisions in daily healthcare work.

  • 3.
    Fex, Angelika
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Flensner, Gullvi
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health, Faculty of Health Sciences .
    Söderhamn, Olle
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Living with an adult family member using advanced medical technology at home2011In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 18, no 4, p. 336-347Article in journal (Other academic)
    Abstract [en]

    Living with an adult family member using advanced medical technology at home An increased number of chronically ill adults perform self-care while using different sorts of advanced medical technology at home. This hermeneutical study aimed to gain a deeper understanding of the meaning of living with an adult family member using advanced medical technology at home. Eleven next of kin to adults performing self-care at home, either using long-term oxygen from a cylinder or ventilator, or performing peritoneal or haemodialysis, were interviewed. The qualitative interviews were analysed using a Gadamerian methodology. The main interpretation explained the meaning as rhythmical patterns of connectedness versus separation, and of sorrow versus reconciliation. Dependence on others was shown in the need for support from healthcare professionals and significant others. In conclusion, next of kin took considerable responsibility for dependent-care. All next of kin were positive to the idea of bringing the technology home, even though their own needs receded into the background, while focusing on the best for the patient. The results were discussed in relation to dependent-care and transition, which may have an influence on the self-care of next of kin and patients. The study revealed a need for further nursing attention to next of kin in this context. 

  • 4.
    Karlsson, Veronika
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Anesthesia and Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden. (Äldre och långvariga hälsoproblem, Older Adults and Long-Term Health Problems).
    Lindahl, Berit
    Department of Intensive Care Unit, SkaS, Skaraborgssjukhus Skövde, Skövde.
    Bergbom, Ingegerd
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden..
    Patients' statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study2012In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 19, no 3, p. 247-258Article in journal (Refereed)
    Abstract [en]

    Patients' statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study Prospective studies using video-recordings of patients during mechanical ventilator treatment (MVT) while conscious have not previously been published. The aim was to describe patients' statements, communication and facial expressions during a video-recorded interview while undergoing MVT. Content analysis and hermeneutics inspired by the philosophy of Gadamer were used. The patients experienced almost constant difficulties in breathing and lost their voice. The most common types of communication techniques patients used were nodding or shaking the head. Their expressions were interpreted as stiffened facial expression, tense body position and feelings of sadness and sorrow. Nursing care for patients' conscious during MVT is challenging as it creates new demands regarding the content of the care provided. In caring for patients undergoing MVT while conscious, establishing a caring relationship, making patients feel safe and helping them to communicate seem to be most important for alleviating discomfort and instilling hope.

  • 5.
    Tengelin, Ellinor
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Dahlborg Lyckhage, Elisabeth
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Discourses with potential to disrupt traditional nursing education: Nursing teachers’ talk about norm-critical competence2017In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 24, no 1, article id UNSP e12166Article in journal (Refereed)
    Abstract [en]

    This paper describes the discourses underlying nursing teachers’ talk about their own norm-critical competence. Norm criticism is an approach that promotes awareness and criticism of the norms and power structures that exert an excluding effect in society in general and in the healthcare encounter in particular. Given the unequal relationships that can exist in healthcare, for example relationships shaped by racism, sexism and classism, a norm-critical approach to nursing education would help illuminate these matters. The studied empirical material consisted of focus group interviews. Nursing teachers discussed their norm-critical competence based on the university course "Norm-Aware Caring" in which they had recently participated. Through a critical discourse analysis, three discourses were identified in their talk, all of which had the potential to disrupt traditional, normative nursing education. However, in all three discourses there was an underlying discourse of normality, clearly positioning the teachers as exemplifying the "normal." The binary constructed between normality and otherness contradicts a basic tenet of the norm-critical approach and may hamper the development of genuine norm-critical competence in nursing education. © 2016 John Wiley & Sons Ltd.

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