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  • 1.
    Alverbratt, Catrin
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för vårdvetenskap på avancerad nivå.
    Berlin, Johan
    Högskolan Väst, Institutionen för individ och samhälle, Avd för socialpedagogik och sociologi.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Kauffeldt, Anders
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Carlström, Eric
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    A New Working Method in Psychiatric Care: the impact of implementation2016Ingår i: International Journal of Public Administration, ISSN 0190-0692, E-ISSN 1532-4265, Vol. 40, nr 3, s. 295-304Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.

  • 2.
    Alverbratt, Catrin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur.
    Carlström, Eric
    Sahlgrenska Akademin, Göteborgs universitet.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur. Umeå universitet.
    Kauffeldt, Anders
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur.
    Berlin, Johan
    Högskolan Väst, Institutionen för individ och samhälle.
    The process of implementing a new working method - a project towards change in a Swedish psychiatric clinic2014Ingår i: Journal of Hospital Administration, ISSN 1927-6990, E-ISSN 1927-7008, Vol. 3, nr 6, s. 174-189Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The implementation of evidence-based methods in hospital settings is difficult and complex. The aim of the present study was to highlight the implementation process concerning a new working method, i.e. a new assessment tool, based on the International Classification of Functioning Disability and Health (ICF), among psychiatric nursing staff on five participating wards at a Swedish county hospital. Descriptive, qualitative data were collected through focus group interviews pre- and post-implementation. Data were analysed using directed content analysis, guided by Normalization Process Theory (NPT). The results revealed that just one of the five participating wards met the criteria for a successful implementation process. The results confirm previous studies showing the difficulty of implementation. Although participants agreed with the intention of the model, they were reluctant to apply it in practice. The implementation process seemed to be influenced by factors such as: time pressure; heavy workload; stress; lack of routines in using the tool; lack of nursing staff; as well as cultural characteristics and resistance to change.

  • 3.
    Antonsson, H
    et al.
    Umeå University, Department of Nursing.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Lundström, M
    Umeå University, Department of Nursing.
    Graneheim, U H
    Umeå University, Department of Nursing.
    Skilled interaction among professional carers in special accommodations for adult people with learning disabilities.2013Ingår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, nr 7, s. 576-583Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Communicative difficulties affect interactions between people with learning disabilities and their carers. Despite such difficulties, however, some carers seem to interact successfully with people who have limited ability to communicate verbally and exhibit challenging behaviour. This study aims to illuminate skilled interaction among carers working in special accommodations for people with learning disabilities. Interactions between 16 caregivers and 11 residents with learning disabilities were recorded on video. Verbal and non-verbal interaction skills among the carers were identified. Four caring situations with people with learning disabilities were chosen to illuminate skilled interaction. The transcribed text was subjected to qualitative content analysis and core stories were created. The results show that skilled interaction between the carers and the people with learning disabilities is based upon being confirming, sharing daily life experience, giving time and space, and using congruent and distinct language. In this paper we present examples that offer concrete suggestions of how to promote successful interaction and create meaning in the shared day-to-day life in special accommodations for people with learning disabilities.

  • 4.
    Antonsson, Helena
    et al.
    University of Umeå , Department of Nursing , Umeå , Sweden.
    Hällgren Graneheim, Ulla
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Umeå , Department of Nursing , Umeå , Sweden.
    Isaksson, Ulf
    University of Umeå , Department of Nursing , Umeå , Sweden.
    Åström, Sture
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. University of Umeå , Department of Nursing , Umeå , Sweden.
    Lundström, Mats O
    University of Umeå , Department of Nursing , Umeå , Swede.
    Evaluation of a Web-Based Training Program for Professional Carers Working With People With Learning Disabilities and Challenging Behavior: A Pilot Study with SSED-Design.2016Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, nr 10, s. 734-743Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The interaction between people with intellectual disabilities and professional carers is often influenced by communicative difficulties contributing challenging behaviours. The aims of this study were to evaluate to a web-based training program aimed at improving carers' abilities to interact with people with learning disabilities who exhibit challenging behaviours and to explore carers' experiences of participating in such a program. A single-subject experimental design and mixed methods were used to integrate qualitative and quantitative data. Triangulation of questionnaires, interviews with carers, and assessments of one woman's behaviour was performed. The participants were professional carers aged 20 to 55 years. The web-based training program increased carers' abilities to handle challenging behaviours and decreased challenging behaviours in daily care. The program improved the opportunities to offer training to carers who work in community-based accommodations with limited time to receive training.

  • 5.
    Holm, Anne Lise
    et al.
    Buskerud & Vestfold University College, The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway.
    Lyberg, Anne
    Buskerud & Vestfold University College, The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway.
    Berggren, Ingela
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Severinson, Elisabeth
    Buskerud & Vestfold University College, The Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Kongsberg, Norway.
    Social Capital and Depressive Ill-Health: An Evaluative Approach to the Implementation of the Chronic Care Model (CCM)2014Ingår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, nr 10, s. 683-694Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Social capital has been described as a person's sense of belonging as a result of the number and type of relationships she/he has, in which trust and reciprocity are especially important. Aim: To illuminate older persons' experiences of social capital and depressive ill-health after implementation of the CCM. Methods: Data were collected from nine participants resident in two districts of Norway by means of individual in-depth interviews. A qualitative hermeneutic analysis was performed. Results: Two overall themes, desire for a guardian and a wish for independence despite being dependent, and two themes emerging from the analysis. The first theme—searching for protection was based on three sub-themes overwhelmed by the emotional pain of other people, a sense of exclusion and worries about the future, while the second theme—the need for a relationship with trustworthy persons comprised two sub-themes, namely, emotional pain was not understood and powerlessness to change the situation. The result of this study highlights the need for greater understanding on the part of healthcare professionals of how older persons manage their social relationships. Healthcare professionals require more knowledge about how negative self-beliefs held by older persons suffering from emotional pain, which can lead to reduced ability to trust other people. Another consequence is that fear of being dependent on other people can result in unwillingness to admit the need for help. Conclusion: This study highlights the lack of social capital in older persons who suffer from depressive ill-health. The implementation of the CCM does not appear to improve the situation. Older persons need to be more aware of their social needs and productive interactions in order to protect themselves and obtain support from their social network.

  • 6.
    Holm, Anne Lise
    et al.
    Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, Kongsberg.
    Lyberg, Anne
    Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, Kongsberg.
    Berggren, Ingela
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå. Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, Kongsberg.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Severinsson, Elisabeth
    Centre for Women’s, Family and Child Health, Faculty of Health Sciences, Buskerud and Vestfold University College, Kongsberg.
    Going around in a Circle: A Norwegian Study of Suicidal Experiences in Old Age2014Ingår i: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, artikel-id 734635Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Depression has repeatedly been found to be a risk factor for completed suicide, particularly when coupled with a pervasive sense of hopelessness. The aim of this study was to evaluate depressed older persons’ suicidal experiences. Data were collected by means of individual in-depth interviews with nine informants living in two districts of Norway. A hermeneutic analysis was performed. Onemain theme: Going around in a circle and two themes: being alone without meaning in life and struggling to achieve reconciliation emerged from the analysis. An important implication for mental healthcare practice is the need to develop a person’s ability to shape and take control of her/his life. The healthcare organisation must be committed to a plan that sets out strategies enabling suicidal individuals to avoid the negative experience of meaninglessness. It was concluded that suicidal depressed elderly persons need helpto escape from their desperate situation. More research is urgently required in order to prevent suicide in depressed elderly persons whose emotional pain is unbearable.

  • 7.
    Hällgren Graneheim, Ulla
    et al.
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Åström, Sture
    Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.
    Until Death Do Us Part: Adult Relatives' Experiences of Everyday Life Close to Persons with Mental Ill-Health2016Ingår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, nr 8, s. 602-608Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study illuminates adult relatives' experiences of everyday life close to a person with mental ill-health. The study was based on nine diaries and four narrative interviews with relatives of people with mental ill-health. Data were subjected to qualitative content analysis. The participants experienced everyday life as a constant fight, for better and for worse, with psychiatric care. They were fighting for the mentally ill person's right to care; sometimes they felt resigned, but yet they had a confidence in the care. Their mission in life was to sacrifice themselves, meaning that they felt indispensable and became lonely and socially isolated. They considered their mission to last until death set them apart because they were keeping a family secret, and had great worries about the future. We conclude that relatives experience a two-folded stigma in living close to a person with mental ill-health and in becoming lonely and socially isolated.

  • 8.
    Isaksson, Ulf
    et al.
    Umeå University, Department of Nursing.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Graneheim, Ulla H.
    Umeå University, Department of Nursing.
    Being flexible and tuning in: Professional caregivers’ reflections on management of violent behaviour in nursing homes2013Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 8, nr 4, s. 290-298Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives: This qualitative, descriptive study aimed to illuminate professional caregivers’ reflections on managing residents’ violent behaviour in nursing homes. Background: Violence towards caregivers in the care of older people is a challenge attracting increasing attention in nursing research. However, studies that focus on the approaches caregivers in nursing homes resort to and how they manage everyday care situations involving threats and violent situations are relatively few. Methods: The study was based on 41 interviews in which the caregivers reflected on their own courses of action in violent situations. The interviews were subjected to qualitative content analysis. Results: This study showed that caregivers were flexible and in tune with the resident by averting and defusing threatening and violent situations. The caregivers tried to give care in line with the residents’ condition, control their own spontaneous reactions and interpret the residents’ reactions as communicative signs indicating how they should interact with the resident in the situation. As a last resort, when previous approaches had been unsuccessful, the caregivers took a firm stand, confronted the resident and the violent behaviour more directly, but with respect and with the residents’ best interests in mind. Conclusions: These findings illuminate how caregivers successfully can manage threatening and violent behavior in nursing homes by being flexible and tuning in with the resident but also by taking a firm stand with the residents’ best interests in mind. To be flexible and in tune with residents, it is important to know the residents’ personal histories. This may mean involving stakeholders, such as family members and friends, in the care of residents with violent behaviour. Implications for practice: We believe that it is important to involve stakeholders in the care of threatening and violent residents in nursing homes as it is important to get information on the residents’ personal history. However, there are risks when interpreting residents’ behaviour in light of their personal histories as relatives experiences may be subjective and the information may give the caregivers preconceived ideas about the resident. © 2012 Blackwell Publishing Ltd.

  • 9.
    Johansson, Catrin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Kauffeldt, Anders
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Carlström, Eric D.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Daily Life Dialogue Assessment in Psychiatric Care—Face Validity and Inter-Rater Reliability of a Tool Based on the International Classification of Functioning, Disability and Health2013Ingår i: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 27, nr 6, s. 306-311Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article describes the development of an assessment tool based on the International Classification of Functioning Disability and Health (ICF) adapted to a psychiatric nursing context where both the patient and the nurse assess the patient's ability to participate in various spheres of life. The aim was to test psychometric properties, focusing on face validity and inter-rater reliability. Three Swedish expert groups participated. Analysis of inter-rater reliability was conducted through simulated patient cases. The results of an unweighted kappa value of 0.38, a linear weighted kappa value of 0.65 and a quadratic weighted kappa value of 0.73 were considered as acceptable when using simulated patient cases.

  • 10.
    Johansson, Catrin
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Kauffeldt, Anders
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Helldin, Lars
    The NU Health Care, Department of Psychiatry, SE-461 85 Trollhättan.
    Carlström, Eric D.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Culture as a predictor of resistance to change: A study of competing values in a psychiatric nursing context.2014Ingår i: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 114, nr 2-3, s. 156-162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It is well known that a conservative organizational culture can hinder the implementation of new organizational models. Prior to introducing something new it is important to identify the culture within the organization. This paper sets out to detect the feasibility of reform in a psychiatric clinic in a Swedish hospital prior to implementation of a new working method - a structured tool based on the International Classification of Functioning Disability and Health. A survey consisting of two instruments - an organizational values questionnaire (OVQ) and a resistance to change scale (RTC) - was distributed to registered and assistant nurses at the clinic. The association between the organizational subcultures and resistance to change was investigated with regression analysis. The results revealed that the dominating cultures in the outpatient centers and hospital wards were characterized by human relation properties such as flexibility, cohesion, belongingness, and trust. The mean resistance to change was low, but the subscale of cognitive rigidity was dominant, reflecting a tendency to avoid alternative ideas and perspectives. An instrument like the one employed in the study could be a useful tool for diagnosing the likelihood of extensive and costly interventions.

  • 11.
    Kauffeldt, Anders
    et al.
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    "Formuleringarna blev professionella": upplevelser av omvårdnadsplanering med stöd av ICF ipsykiatrisk vård2012Rapport (Refereegranskat)
  • 12.
    Norberg, Monika
    et al.
    Umeå University, Department of Nursing.
    Magnusson, Eva
    Umeå University, Department of Psychology.
    Egberg Thyme, Karin
    Sankt Lukas Psykoterapimottagning, Umeå, Sweden .
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå. Umeå University, Department of Nursing.
    Lindh, Jack
    Umeå University, Department of Radiation Sciences.
    Öster, Inger
    Umeå University, Department of Nursing.
    Breast Cancer Survivorship: Intersecting Gendered Discourses in a 5-Year Follow-Up Study2015Ingår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 36, nr 5, s. 617-633Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this article the authors present a follow-up study of women's interview narratives about life 5 to 7 years after a breast cancer operation. The women had taken part in a study during the 6-month postoperation period. Art therapy contributed to well-being, including strengthening personal boundaries. In the new study, interview analysis informed by critical discursive psychology indicated three problematic discourses that the women still struggled with several years after the operation: the female survivor, the “good woman,” and individual responsibility. We concluded that many women with a history of breast cancer need support several years after their medical treatment is finished.

  • 13.
    Öster, Inger
    et al.
    Umeå University, Department of Nursing.
    Tavelin, Björn
    Umeå University, Department of Radiation Sciences.
    Egberg Thyme, Karin
    Department of Clinical Sciences, Division of Psychiatry, Umeå University.
    Magnusson, Eva
    Umeå University, Department of Clinical Sciences, Division of Psychiatry.
    Isaksson, Ulf
    Umeå University, Department of Nursing.
    Lindh, Jack
    Umeå University, Department of Radiation Sciences.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Art therapy during radiotherapy: A five-year follow-up study with women diagnosed with breast cancer2014Ingår i: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 41, nr 1, s. 36-40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Follow-up studies on art therapy are lacking. In a randomised art therapy intervention study from 2001 to 2004 with women with breast cancer, results showed that patients benefitted from participating in art therapy for up to four months after the intervention. The aim of this study was to describe the coping resources and quality of life amongst women treated for breast cancer five to seven years after participating in individual art therapy during radiotherapy as compared to a control group. In 2009, thirty-seven women, 18 from the intervention group and 19 from the control group, answered questionnaires about their coping resources and quality of life. The results showed no significant difference between the groups regarding their coping resources or quality of life, except for an unexpected significantly lower score in the domain ’Social relations’ in the study group as compared to baseline, at the time of the follow up. However, our study from 2001 to 2004 supports various positive effects of art therapy within six months of participation as compared to a control group. Consequently, attending art therapy during the treatment period for breast cancer can be of great importance to support health, coping and quality of life in a short-term perspective. © 2013 Elsevier Ltd.

  • 14.
    Økland Lier, Haldis
    et al.
    Haugesund Hospital, Section of Mental Health Research, Helse Fonna HF, Haugesund, Norway.
    Åström, Sture
    Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.
    Rørtveit, Kristine
    Stavanger University Hospital, Psychiatric Nursing, Stavanger District Psychiatric Centre, Stavanger, Norway.
    Patients’ daily life experiences five years after gastric bypass surgery – a qualitative study2016Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 3-4, s. 322-331Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim and objective The objective was to explore and describe patients’ daily life experiences five years after gastric bypass surgery. Background Bariatric surgery markedly decreases body weight. Previous studies describe positive consequences, as well as physical, social and emotional challenges during the first few years after surgery. An understanding of how patients adjust to and cope with postsurgical changes in the long term is crucial to help them obtain a successful outcome after bariatric surgery. Method A qualitative method was employed. In-depth interviews with 10 men and women were conducted five years after bariatric surgery in a Norwegian hospital. Results One overarching theme – a multitude of daily life changes following bariatric surgery – was developed based on three main themes: relational aspects related to weight loss, the new body and changes in self-esteem. Six sub-themes are described. Conclusion Those who undergo gastric bypass surgery experience enormous changes in their daily lives. Their social lives, their relationship to their body and their self-esteem may be altered by the weight loss. Relevance to clinical practice The results of this study suggest directions for patient education, health staff education and peer education. A patient education programme focusing on changes in daily life experiences when undergoing gastric bypass surgery is suggested due to the changes experienced by the patients involved in this study.

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