Biomedical subjects

A Norberg

Publications and source records attributed to A Norberg.

At least 55 records · Page 3Linked to original sources

PubMed1999

The meaning of suicidal psychiatric in-patients' experiences of being cared for by mental health nurses.

Twenty-one psychiatric in-patients who had thought about, expressed the wish or even attempted to commit suicide narrated their experiences of receiving care from mental health nurses. The interview texts were transcribed and interpreted using a phenomenological-hermeneutic method, inspired by Ricoeur's philosophy. Two main themes with subthemes were found: Confirming: attending to patients' basic needs; seeing patient; having time for patient; being with patient; listening to patient without prejudice; being open to patient; accepting patient's feelings; communicating hope to patient; and Lack of confirming: overlooking patient's basic needs; not seeing patient; not having time for patient; leaving patient to herself or himself; listening to patient with prejudice; not being open to patient; denying patient her or his feelings; communicating hopelessness to patient. These findings were interpreted in the light of Hegel's philosophy of mutual recognition and confirmation. When relating episodes of good or bad nursing care suicidal patients emphasized their need for confirmation during their interaction with nurses when in hospital after suicide attempts.

Adult↗

PubMed1999

Nurses' and physicians' narratives about long-term non-malignant pain among men.

The aim of this study was to illuminate the meaning of skilled nurses' and physicians' lived experiences in their encounters with men suffering from long-term, non-malignant pain of at least 6 months duration. Seventeen nurses and four physicians participated in the study. A phenomenological-hermeneutic method was used. In the analysis three themes, 'needing to be manly', 'struggling for relief from pain' and 'needing human support' emerged. The phenomenon 'confirmation' was especially important in all three themes. This study indicates that confirmation of the theme 'needing to be manly' means that nurses' and physicians' must have such a relationship with these men that they really feel respected. Confirmation of the theme 'struggling for relief from pain' means that the care givers must convince these men that they really believe each unique individual's narratives. Confirmation of the theme 'needing human support' means that nurses and physicians have to behave in such a way that these men are convinced that the caregivers really care about them. When the men felt confirmation they dared to disclose their pain experiences more honestly. This is a preliminary prerequisite for nurses' and physicians' potential to help these men.

Adult↗

PubMed1999

Women's perceptions of phenomena they label premenstrual tension: normal experiences reflecting ordinary behaviour.

Remarkably little empirical knowledge exists about premenstrual tension (PMT), a construct that has been studied intensively during the last 30 years. Practically nothing is known about the perceptions women have about PMT. The purpose of this study is to describe the perceptions healthy women have about PMT. Seventeen women, who had 4 years earlier participated in a concurrent diary study assessing the prevalence of PMT, were interviewed. The interviews were analysed by means of a qualitative content analysis. Four main categories describing the women's perceptions were formed: (1) individual experiences of phenomena referred to as PMT; (2) phenomena referred to as PMT reflect ordinary experiences in healthy women; (3) biopsychosocial explaining of phenomena referred to as PMT; (4) internal and external resources used to manage the variability of phenomena referred to as PMT. The content of these categories reflects the participants' perceptions of PMT as the common, normal and very variable experiences which women handle by the use of management strategies commonly used in contemporary society to deal with life in general. Experiences of women differ with respect to what they experience and the timing and persistence of those experiences. This the participants explain from a biopsychosocial perspective. It is suggested that women have adapted a medical term, PMT, to describe what they consider normal female phenomena.

Adaptation, Psychological↗

PubMed1999

Attitudes of registered nurses towards patients with severe dementia.

Meeting the needs and wishes of people with severe dementia is difficult and demanding for carers, and a number of approaches can be used in encounters with dementia sufferers. The aim of this study was to explore how registered nurses in a northern Norwegian county thought about approaching people with severe dementia. A patient case was used as a vignette, followed by a questionnaire with 13 sets of statements, each set containing two alternative approaches (one reality orientation approach and one personhood focused approach). In 12 out of the 13 sets of statements the reality orientation alternative was usually chosen, but responses to the statement regarding the meaning of confusion tended more towards the personhood focused approach. RNs with more than the basic education and staff nurses working in a team nursing system, chose the personhood focused approach significantly more often than RNs with no post-basic education and nurses working in a primary nursing system. The article discusses how reflection on daily experiences can improve one's ability to reflect on one's own experiences and encourage a personhood focused approach. Working in a team means gaining opportunities to reflect together with coworkers, while working in a primary nursing care system might afford fewer such opportunities.

Aged↗

PubMed1999

Towards recovery: living in a home-like setting after the move from a hospital ward.

Six clients with a diagnosis of schizophrenia were interviewed about their experiences of their lives in a home-like setting, their key care provider and the care received. Their narratives of lived experiences in care were interpreted as living a process of health in the midst of severe mental illness, involving: 'becoming more', 'being disabled', 'comforting/conforming relationship', 'discomforting/unconfirming relationship' and 'caring about the caring relationship'. Fatigue and lack of strength influenced the lives of most clients considerably, and the stories were about problems and conflicts. Nevertheless, the clients seemed really to struggle to make communal life work, and there were experiences of increased competence and better self-confidence in most of the stories. On the whole care was described as good, and the process of health seemed to be supported by experiences of comfort and being confirmed in the client-care provider relationship.

Activities of Daily Living↗

PubMed1999

Unwillingness to be violated: carers' experiences of caring for a person acting in a disturbing manner. An interview study.

Carers working in psychiatric care are sometimes exposed to insane, unpredictable and violent actions. In rare cases a patient appears to be resistant to all forms of pharmacological treatment. Fifteen carers (four registered nurses, 11 enrolled nurses) on a psychiatric ward in Sweden were interviewed about their experiences when caring for a person who acted in a disturbing manner. Narrative interviews were conducted and interpreted using a method inspired by Ricoeur. Four themes were formulated which describe the carers' uncertainty about the future, their inability to interpret the patient's disturbing behaviour and their own overall feeling of meaninglessness. The carers were of the opinion that the patient had the power and ruled the ward, which led to them feeling they were subjugated victims. The interviews also revealed the carers' recognition of forbidden feelings and actions and unknown negative sides. These results were interpreted and reflected on in the light of an ethical framework in order to achieve a deeper understanding of the text. This paper shows that an ethical perspective is important when searching for the meaning of caring for patients acting in a disturbing manner. The study raises the question: 'Is it possible to establish good when evil has dominion?'.

Attitude of Health Personnel↗

PubMed1999

Transforming desolation into consolation: the meaning of being in situations of ethical difficulty in intensive care.

The purpose of this phenomenological-hermeneutic study was to illuminate the meaning of being in ethically difficult care situations. The participants were 20 enrolled nurses employed in six intensive care units in Sweden. The results reveal a complex human process manifested in relation to one's inner self and the other person, which transforms desolation into consolation through becoming present to the suffering other when perceiving fragility rather than tragedy. The main point of significance here is for all health professionals to create an ethical work environment and strive for praxis that fosters 'at-homeness', which renders us free to transform desolation into consolation. Consolation is of significance in ethics because it makes us available and helps us to fulfil the demands of life, while desolation makes us unavailable to others.

Adult↗

PubMed1999

Struggling for dignity: the meaning of women's experiences of living with fibromyalgia.

Fibromyalgia (FM) is a common chronic pain syndrome with an obscure etiology, which mostly afflicts middle-aged women. In this study, 14 women with FM were interviewed about the meaning of living with the illness. A phenomenological-hermeneutic method was used to analyze and interpret the interview texts. The findings show that being a woman with FM means living a life greatly influenced by the illness in various ways. The women's experiences of living with FM were presented in three major interlaced themes: loss of freedom, threat to integrity, and a struggle to achieve relief and understanding. This study highlights the importance of meeting people suffering in illness with respect for their human dignity. The care of women with FM must empower the women to bring to bear their own resources so that they can manage to live with the illness.

Activities of Daily Living↗

PubMed1999

Crisis phenomena after stroke reflected in an existential perspective.

The study gains a deeper understanding of crisis phenomena emerging after stroke and focuses on these phenomena viewed in an existential perspective. Ten stroke victims narrated their experiences of their new life situation in open-ended interviews, conducted during the first few months after discharge. The participants were analyzed using a phenomenological-hermeneutic approach. This analysis disclosed an extremely distressing situation related to the individuals' struggle to manage in various dimensions of life. The phenomena were intertwined in a complex way and the critical interpretation involved a transcendence to the existential dimension of life. The situation was metaphorically depicted as "a struggle in the darkness" in a "boundary situation," where the issues ultimately touched on life and death, fate and future, meaning and meaninglessness. The study indicates the significance of existential issues pervading the seemingly concrete struggle to manage life after stroke.

Aged↗

PubMed1999

Changes in quality of life after rehabilitation for patients with progressive neurological disorders.

The aim was to study whether patients with progressive neurological disorders experienced a changed quality of life at the end of a rehabilitation period and 3-4 months after their return home. Forty-one and 37 patients respectively filled in a self-administered questionnaire Quality of Life: Status and Change (QLsc). There was a significant difference between the two occasions for responses regarding the items 'My bodily health has become', 'My well-being has become' and 'I am able to maintain a good pace and lead an active life'. The alternatives 'rather good' to 'much better' were chosen more often at the end of the rehabilitation period than after 3-4 months. There were also differences between respondents who had been to the rehabilitation centre for the first time and those who had recurrent visits, regarding the items: 'My bodily health has become', 'My well-being has become' and 'My whole life is'. The alternative neither/nor was rated fairly evenly on both response occasions. The study probably indicates that the recurrent rehabilitation periods at the centre have an effect. When the respondents respond to items with a global focus, they seem to indicate experiences of a higher QOL.

Adult↗

PubMed1998

Nurses' reflections about dementia care, the patients, the care and themselves in their daily caregiving.

In this study the aim was, through interviews, to disclose 13 nurses' personal knowledge about the patients, themselves, and care provision, using a phenomenological-hermeneutic analysing method. Caring for people with severe dementia meant an intertwined life world emanating from making and doing together and the delicate interpretative work that the care provision required. The intertwined life world consisted of the interaction between the nurses' and the patients' separate lives, their common life and the environment, culminating in mutual dependency. Making together signifies the relationship being based on the nurses' knowledge and skills as nurses i.e., the task they had to perform. Doing together signifies the relationship being based on the oneness of the nurses and the patients with severe dementia as ordinary human beings. The delicate interpretation process required, to adapt care to the individual patient, was based on knowledge about the patient's personality, life history and disease progression in combination with the nurses' interpretation of the current situation. The nurses searched for meaning and that, in turn, meant that the patient's inner world was determined by the nurses and thus the patient was seen as being in their hands. It seems important to further understand the human aspects of both the nurse and the patient and to examine this dynamic, ongoing, vulnerable interpretation process, critically, in order to achieve high quality nursing care for the patients with severe dementia, and an experience of well-being in nurses everyday working lives.

Adult↗

PubMed1998

Self-reported quality of life for patients with progressive neurological diseases.

Progressive neurological diseases influence the life situation of patients either totally or partially. Such patients' own ratings of their life situation and well-being were made using a health-related quality of life HRQoL instrument called Quality of Life: status and change (QLsc). In general the interviewees rated their life domains in terms of positive response alternatives and no subgroups were found, e.g. with the same diagnoses, periods of sickness or age. The results suggest that the interviewees' experience of quality of life (QoL) is subjective and individual. The interviewees who had been to the rehabilitation centre several times rated their quality of life, in terms of positive response alternatives for the items covering overall experiences of bodily health, well-being and their whole life as well as for items in the social domain, to a greater extent than those who were visiting it for the first time.

Activities of Daily Living↗

PubMed1998

Nurses' narratives about using coercion in psychiatric care.

To illuminate nurses' experience of using coercion against psychiatric patients, a phenomenological hermeneutic study was conducted with seven registered nurses and seven enrolled mental nurses. The findings revealed that these nurses desired to be seen by themselves, their co-workers and patients as doing good, being good and providing good care but they experienced the use of coercion as not good. This conflict made it difficult for these nurses to question the use of coercion and consider alternative solutions. The theory of change by Watzlawick et al. (1974) served as a theoretical framework for the interpretation of all interviews regarded as one text. In order to explore alternatives to the use of coercion in psychiatric care, nurses need assistance to step outside the traditional way of regarding coercion in psychiatric care and seek to create new solutions.

Adult↗

PubMed1998

Hope: future imagined reality. The meaning of hope as described by a group of healthy Pentecostalists.

A holistic health care approach involves body, mind and spirit. Religiosity, spirituality and hope, as a part of the spiritual dimension, are often linked to various health-related outcomes such as physical health, spiritual well-being and experienced meaning in life. A person's outlook on life and the experience of hope are essential issues in all health care. The purpose of this paper is to describe the meaning of hope as expressed by a group of healthy adult Pentecostalists (n = 15). Using narratives, the ultimate hope was described as life after death, the future imagined reality, promised by God. Hope was strengthened by reading the Bible and saying prayers, through experienced meetings with God and shared values. Hope was quite stable but sometimes God was experienced as being at a distance, which resulted in a sense of alienation. Hope unconnected to Christian belief was of no significant importance to the interviewees.

Adult↗

PubMed1998

Episodes of lucidity in people with severe dementia as narrated by formal carers.

Twenty formal carers employed in three nursing homes narrated 92 episodes of lucidity (ELs) in people with severe dementia. Sixty-two episodes concerned speech, nine concerned actions and 21 episodes concerned both speech and actions. Most ELs were said to occur spontaneously when the patients were acting closely together with a carer who did not make demands on them and regarded them as valuable human beings whose behaviour was a meaningful expression of their experiences. The narrations showed characteristics that indicated trustworthiness and the episodes described in three separate nursing homes were very similar and resembled descriptions given in previous research reports as well as in relatives' reports. Further research seems necessary and the assumption that severe dementia implies the destruction of the self or personhood must be questioned.

Adult↗

PubMed1998

From optimism to pessimism. A case study of a psychiatric patient.

This article focuses on the results of a single case study which illuminates an understanding of phases in nursing care for a patient in a psychiatric setting in Sweden. The focus of this study is a 50-year-old man who showed progressive deterioration from increased motor activity to oral, sexual, destructive and aggressive actions. Data collection using five methods occurred during a 21-month period. Results of the content analysis processes identified four distinct but non-discrete phases of the patient's complex condition. Medical and nursing care was categorized in three approaches: optimistic, strategic and resigned. The results raise the question of whether there is action that is without any meaning as an expression of the patient's wishes, thoughts and feelings. It seems clear that the patient in this study felt really angry and in despair. However, during moments of lucidity, he also indicated that he felt this was not an authentic expression of his 'real' self. His experience was that of a splintered world.

Aggression↗

PubMed1998

The meaning of caring for patients on a long-term psychiatric ward as narrated by formal care providers.

Seventeen care providers were interviewed about their caring experiences on a hospital psychiatric ward. The interviews focused on the meaning of their work, including the care they provide and the nature of the patient as a person. The study was guided by a phenomenological hermeneutic perspective inspired by Ricoeur (1976). The analysis focused on context and form. Three themes illuminate the meaning of care provided. These themes are as follows; being in the midst of human storage, moving towards a human care of relations, and struggling with 'the old' and 'the new'. Experiencing work as being in the midst of a human storage reflects the historical and human situation of warehousing psychiatric patients. The care providers are experiencing a shift in their view of the patient and the meaning of their work, towards a more human care of relations. For these care providers, there is a struggle between the past, the present and the future. This struggle between 'the old' and 'the new' conveys a struggle between doing as a nurse, which dominates the past, and relating, which is, or needs to be, the current and future focus in psychiatric care. The shift in view distinguished itself by the care providers viewing the patient as being vulnerable and having problems with relations. The results have been interpreted and discussed in the light of a previously published interview study with the patients, carried out at the same time on the same ward. Attending to ingrained attitudes of the past and their influence on new approaches to care is essential to understanding not only changes in ways of doing nursing tasks, but also ways of relating.

Adult↗

PubMed1998

Living with breast cancer: care givers' perceptions in a surgical ward.

Caring for women with breast cancer has potential for increasing care giver distress and anxiety. Knowledge of the threats implicit in the disease and treatment as well as overidentification with the patient form the basis for this outcome. In order to describe perceptions of breast cancer as an illness, semistructured interviews were carried out with 37 care givers at a surgical department. The interviews were tape-recorded and transcribed verbatim. An analysis was then carried out of the stories told by the care givers about breast cancer as an illness. The results indicated that breast cancer as an illness gave rise to predominantly negative and dark associations among the care givers. Their experiences of caring for women in critical stages of the illness over many years appear to have had a negative influence on them. Death itself, and even more so the process leading to the end, were very tangible in their stories. The article concludes that care givers on a surgical ward have a fragmented picture of the patients and need to be given opportunities to follow the total care process. Those care givers who were able to follow the women's stages of illness throughout more often had a positive picture.

Adult↗