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Biomedical subjects

A C Ek

Publications and source records attributed to A C Ek.

At least 37 records · Page 2Linked to original sources
PubMed1996

Ritualized practices among caregivers at meals in geriatric care.

The aim of this study was to examine the procedures of the caregivers in their daily work with meals in geriatric care, emphasizing ritualized practices, praxis and norms. An ethnographic approach was used. Registered nurses, enrolled nurses and nurse's assistants observed in the study responded to a questionnaire and, finally, were interviewed. The findings indicated that the meals mainly took the form of ritualized practices, and praxis depended on the ability and needs of the patients as well as on the working conditions. The guiding norms identified were 'to provide a home-like situation with fellowship for training purposes', 'to ensure each patient gets what he/she needs/wants by means of a fair method of serving', and 'to keep things in order and to be responsible'. These norms were transferred from the traditional family in the society, giving the caregivers the role of the parent when training patients. The enrolled nurses, responsible for the meal performance, strove to keep the eating milieu in order, and the meal as a whole was performed as a ritual. Its static form made it difficult to individualize the meal in accordance with the different needs of the patients.

Adult↗
PubMed1996

Interrater variability and validity in subjective nutritional assessment of elderly patients.

The subjective Global Assessment technique was evaluated with regard to its reliability and validity in a Swedish elderly population. Ninety patients, 70 years of age or older, and newly admitted to the geriatric clinic, participated in the study. The nutritional state was assessed subjectively by two independent observers using the Subjective Global Assessment form, and objectively, using a combination of anthropometry and serum-protein analysis. The subjectively assessed malnutrition rate was about 20% higher than that assessed objectively. The agreement level between the two observers was 77.8%, Kappa 0.56 (< 0.001), and the levels between the subjective and objective assessments were 57.8% (Kappa = 0.17) and 73.3% (Kappa = 0.46), respectively. The experienced observer identified 85.2% of those who were defined as malnourished using the objective criteria and the less experienced observer, 66.6%. Furthermore, a regression analysis indicated weight index as the main significant objective factor influencing the subjective assessment. The subjective technique could be regarded as reliable from a clinical and preventive perspective since the agreement between the two rates was just under 80%. It seems also to be valid since the subnormalities in the selected criteria showed a similar pattern. The necessity of being well trained in order to manage nutritional status assessment, for both clinical and research purposes, is obvious.

Aged↗
PubMed1996

[Expectations and satisfaction of patients in home care--a qualitative study].

The purpose of this study was to illuminate the following questions, What do the district nurses think about the expectations of the patients during a home-visit? Which are the expectations of the patients concerning the home-visit done by a district nurse? The district nurses in a primary health care-centre and the patients that received home nursing in the primary health care district constituted the population. Ten nurses and twenty patients participated in the study. The method was qualitative with a hermeneutical approach. The tape-recorded interviews were transcribed verbatim to constitute the empirical material for analysis and interpretation. The theoretical starting point was the concept of patient satisfaction. In the analysis and interpretation the following dimensions appeared; knowledge--professionalism, art of care--patient-district nurse relationship, participation and responsibility, continuity and availability. The result shows that the patients' expectations of the district nurses were extensively met and that they were satisfied with the home nursing care. The patients expected to meet a skilled district nurse who was kind, able to listen and reassuring. The district nurses think that the patients expect to meet a skilled person whose judgements are correct, who listens, shows respect and keeps her appointments.

Adult↗
PubMed1995

Breast self-examination among Swedish women: a survey of frequency, knowledge, and attitudes.

Breast cancer is a common cause of death among women. The aim of this study was to determine whether women carry out regular breast self-examination (BSE), and to describe their knowledge of, and attitudes towards, breast cancer. Questionnaires were mailed to 200 randomly selected women who had not undergone breast cancer surgery. The response rate was 81%. The respondents were divided in three groups: those who practiced BSE regularly, those who practiced BSE occasionally, and those who did not practice BSE. The results show that only 10% of the sample practice BSE. Neither age, educational background, nor occupation, nor having knowledge of breast disease and medical outcome was associated with BSE practice. Nor did having a close relative or friend with breast cancer affect the practice of BSE.

Adult↗
PubMed1994

The meal situation in geriatric care--intentions and experiences.

Meals in geriatric institutions are often served in a dining room. The elderly patients--endowed with their socialized table manners and diet habits--who enter this milieu are affected by diseases and handicaps, reducing their ability to eat. In the present study individual patients' meals in geriatric care institutions were studied with respect both to nursing staffs' intentions and assessments of patients, as well as to those patients' experiences and the amount of influence they expected to have. The research approach was ethnographic. Eighteen newly admitted, mentally orientated patients and their primary enrolled nurses were allocated. The results indicated that the idea of both the nurses and the elderly patients was to reach a meal situation that was as natural and independent as possible. Compared with the elderly patients, the nursing staff had broader standards for acceptable table manners, and carried out collective dining of all 18. The elderly patients strove to behave in accordance with their standards and suffered because of their own limited eating competence and the experience of other patients' problems. The elderly patients avoided expressing their needs, and some enrolled nurses thought they were prying if they asked questions about such issues. These different, culturally dependent, perceptions resulted in care that was not congruent with the needs of the elderly patients.

Activities of Daily Living↗
PubMed1994

Feeding dependence and nutritional status after acute stroke.

BACKGROUND AND PURPOSE: We assessed the nutritional status of patients with acute stroke and evaluated it in relation to the patients' dependence on assistance with feeding. METHODS: Fifty patients aged 70 years or older, admitted from their homes, were included. Weight index, triceps skinfold thickness, arm muscle circumference, serum proteins, delayed hypersensitivity, body composition measured by bioelectric impedance, and functional condition were determined on admission and 2 and 9 weeks after admission. Food and fluid consumption were also recorded. RESULTS: On admission, four patients were regarded as protein-energy malnourished. Those who required assistance with feeding after admission (n = 18, 36%) had lower serum albumin (P < .05), lower body cell mass (P < .01), and were more anergic than the independent patients (P < .01) on admission. The mean food consumption was 72% of the food served without significant difference between dependent and independent patients. Nine weeks after the onset of stroke symptoms, the patients who were dependent on assisted feeding showed a decrease in body cell mass. The loss of body cell mass was related to their activity and feeding dependence. CONCLUSIONS: Low serum albumin and anergy commonly occur in elderly patients with acute stroke, and they occur more prevalently among those with a severely impaired functional condition. During the recovery period, the patients use body fat to compensate for energy needs, and immobility leads to loss of body cell mass.

Activities of Daily Living↗
PubMed1993

Long-term care patients and their dietary intake related to eating ability and nutritional needs: nursing staff interventions.

Meals combine human beings' nutritional requirements with cultural needs. The aim of this paper was to evaluate how individual patients' meals were planned, carried out and followed up by nursing staff related to nutritional requirements and ability to eat in the ward. Eighteen newly admitted long-term care patients hospitalized for more than 3 weeks were observed for up to 6 weeks. The patients' conditions were examined using interviews, observations, recorded data and analyses for nutritional assessment. Fourteen patients experienced difficulties related to motor dysfunctions in the upper extremities, mouth and pharynx in handling food. Six of those were prescribed feeding aids or nutritional supplement. Biochemistry was not used as a basis for these interventions and four at risk of malnutrition on admittance were missed. Thus, this study exposed defective nursing assessment strategies. However, eating dependency was prevented and nutritional status tended to recover among those where interventions were made.

Activities of Daily Living↗
PubMed1993

The care and handling of peripheral intravenous cannulae on 60 surgery and internal medicine patients: an observation study.

The purpose of this study was to analyse the actual routines surrounding the use of peripheral cannulae and the occurrence of complications. Thirty surgery patients and 30 internal medicine patients were observed daily at a medium-sized hospital. The patients were followed from the time the cannula was inserted until after withdrawal and until both the insertion site and the vein were free from pain. The results showed that most of the cannulae were placed on the upper side of the hand and sizes most frequently used were 1.0 and 1.2 mm. The fixation was unsatisfactory in 23 cases already after the second day. Twenty-three cannulae were removed after 24 hours. Thirty-seven (62%) patients were stated to have thrombophlebitis phlebitis in different degrees. Only seven cannulae fulfilled the criteria for good cannula care and handling. The frequency of complication was especially high when fructose-glucose, antibiotics or anticoagulants were given. There was no documentation in the patient record, according to current laws in Sweden. The complications observed were redness, swelling, haematoma, subcutaneous swelling and suppurating infection. The study showed that the longer the cannula had been in situ, the greater were the complications (very distinct after 24 hours). The care and handling was unsatisfactory to very unsatisfactory in 52% of the cases. Complications can last for a very long time. In this research, pain was noted up to 5 months after the cannulae were removed.

Adult↗
PubMed1993

Quality of life of adults with acute leukaemia.

The cause of acute leukaemia is unknown. Untreated, the disease is generally fatal after a few months. The therapeutic regimen is chemotherapy, and sometimes also bone marrow transplantation, and the aim is to cure the patient. Not only does the person live under pressure from a life-threatening disease with all the physiological complications that therapy can result in, the therapeutic regimen also involves a great psychological effect. The concept of quality of life (QOL) is individual for each person, as is his/her experience of the value of the contents of life. The principal aim of the study was to describe what QOL means to adults with acute leukaemia, not to describe the degree of QOL. The second aim was to give the concept of QOL a theoretical and empirical significance relevant to nursing care. Eight adults with diagnosed acute leukaemia detected in adulthood have been interviewed about their quality of life. The concept was given one superior dimension in all the interviews; positive attitude to life. Below the superior dimension were two further dimensions; interpersonal relationships and autonomy. Different qualities were given below these dimensions, viz. security, support, respect, information and conversation.

Acute Disease↗
PubMed1992

Effects of dietary supplement on functional condition and clinical outcome measured with a modified Norton scale.

Elderly long-term care patients (n = 501) were randomly allocated to receive dietary supplementation (400 kcal/day) in addition to a normal hospital diet, or normal hospital diet only, for 26 weeks. The patients' functional condition was assessed by a modified Norton scale comprising mental condition, activity, mobility, food intake, fluid intake, incontinence and general physical state. Nutritional status was assessed by anthropometry, serum protein analysis and delayed hypersensitivity skin tests. Improvements during the first 8 weeks were seen in activity and general physical condition in the supplemented group, and in mobility and general physical condition in the control group. After 8 weeks the supplemented group showed a significantly higher level of activity (p < 0.05) compared to the control group. We conclude that in long-term geriatric care nutritional supplements help to maintain and improve the patients function.

Journal Article↗
PubMed1992

Living with fibromyalgia. Consequences for everyday life.

The influence of chronic pain on daily life was studied in 58 patients (55 women and three men) with fibromyalgia. The mean age was 45 +/- 11 (SD) years. A mail questionnaire including a 2-day diary was used for data collection. Information was gathered on social background, employment status, symptoms, physical training habits, patients' experience of general health, physical condition, and difficulties in performing motor tasks. The patient reported every half hour in the activity diary the degree of pain and fatigue, whether the activities were difficult to perform, and whether the patient considered them to be enjoyable, valuable, and meaningful. Fifty-five percent of the group had gainful employment. Most were working shorter hours and with changed work tasks. Motor tasks, such as carrying, holding, and running were more difficult to perform than before the onset of the symptoms, and half of the group reported most of their activities as strenuous to perform. Thirty-nine persons (67%) reported no, or very short, pain-free periods during the 2 days. In conclusion, symptoms influenced daily life considerably, and almost all patients reported changes in habits and routines as a consequence of fibromyalgia. An assessment of the patient's total life situation gives valuable information for understanding the patients' ability to handle everyday life.

Activities of Daily Living↗
PubMed1992

The relevance of sleep, circadian rhythm and lifestyle as related to a holistic theory of health.

This paper highlights the relation between health, lifestyle, sleep and circadian rhythm in disease, using a holistic theory of health, for subjects with, for example, coronary heart disease, nursed in intensive care or post-operative ward following coronary arterial by-pass surgery. The paper will also illuminate the World Health Organization's health targets nine and 13-17, adopted by the Member States of the European Region, about the relevance of lifestyle and its influence on the subject's health values for patients with coronary heart disease. Sleep is affected by a person's own will, repertoire and circumstance, both internal and external. It plays a meaningful part in maintaining good health. Disturbance of sleep leads to change in circadian rhythm and is an early symptom of psychophysiological and social ill health, independent of disease. It influences a person's values, actions and ability to adjust. Disturbance of sleep over longer periods leads to disease. Patients who have undergone, for example, coronary arterial by-pass surgery are expected to change their lifestyle. It is therefore important that the nurse can define the subject's sleep patterns and circadian rhythm.

Adaptation, Psychological↗
PubMed1992

The condition of the oral mucosa in institutionalized elderly patients before and after using a mucin-containing saliva substitute.

The purpose of this investigation was to evaluate whether the condition of the oral mucous membrane and the mouth comfort of the elderly could improve using a mucin-containing saliva substitute. In total, 52 patients were examined before and after a 60-day treatment period, with mucin-containing saliva substitute given three times a day before meals. The patients were examined with regard to weight, oral mucosa condition, the duration of meals, eating and swallowing. Before the treatment period the prevalence of stomatitis was 90.4% and oral candidosis was 80.8% compared to 15.4% and 5.8% respectively after the treatment period. The pH increased significantly. Artificial mucin-containing saliva substitute seems to be an adequate treatment of stomatitis and oral candidosis in elderly patients.

Aged↗
PubMed1991

The development and healing of pressure sores related to the nutritional state.

The aims of the study were to investigate the relationship between nutritional state and the development of pressure sores and to test the hypothesis that supplementary nutritional support might prevent pressure sore development and improve healing. Newly admitted long-term care patients hospitalised for more than 3 weeks were included and randomised into an experimental and a control group. The nutritional state was evaluated using serum protein analyses, anthropometry and the delayed hypersensitivity skin test. Further, the patients' condition was assessed weekly using a modified Norton scale. The experimental group received extra nutritional support. Significantly more patients with protein-energy malnutrition had, or developed, pressure sores. Regression analyses indicated albumin, mobility, activity and food intake as predictors for pressure sores. Patients who received extra nutritional support tended to develop fewer pressure sores and to heal existing pressure sores to a greater extent than the control group, although this did not reach statistical significance.

Journal Article↗
PubMed1991

Demographical, sociomedical and physical characteristics in relation to malnutrition in geriatric patients.

The purpose of this study was to describe and compare demographical, sociomedical and physical characteristics between protein-energy malnourished and non-malnourished geriatric patients on admission. According to the International Statistical Classification of Diseases, 104 malnourished patients were age-, gender- and diagnosis-matched with 104 non-malnourished patients. Data were collected from patients' medical records. The patient's condition was assessed by a modified Norton scale on admission. No differences were seen in marital status, type of dwelling, previous need for help service, residence before admission, and dependence on assistance with ADL function. The malnourished patients had a greater consumption of diuretics (47%; P less than 0.05) and a lower consumption of analgesics (29%; P less than 0.05) than the non-malnourished patients (33% and 42% respectively). In the malnourished group, impaired conditions in activity (83%; P less than 0.05), and general physical condition (78%; P less than 0.01) were observed compared to the non-malnourished group (69% and 60% respectively). The malnourished patients had less sufficient food intake (41% vs 21%; P less than 0.01) and fluid intake (25% vs 10%; P less than 0.01) than non-malnourished patients. This study indicates that demographical characteristics and primary ADL-functions are of minor importance for the development of protein-energy malnutrition in geriatric patients. Observation of the patients' physical condition and drug consumption seemed more important on admission.

Activities of Daily Living↗