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Biomedical subjects

A Norberg

Publications and source records attributed to A Norberg.

At least 109 records · Page 6Linked to original sources
PubMed1995

Breast cancer patients' experiences of nursing care with the focus on emotional support: the implementation of a nursing intervention.

Nursing care with the focus on emotional support, aimed at improving breast cancer patients' adjustment to everyday life, was implemented. The women were offered the opportunity to talk about illness-related thoughts and reactions, as well as to express feelings of anxiety, fear and anguish with a nurse who listened, consoled and answered questions. The organizational changes included extensive co-operation between the surgical ward and primary health care, shorter waiting times, and changed routines around information about the diagnosis. A total of 26 Swedish women, aged 35-69, with newly diagnosed breast cancer, described their experiences of the disease and nursing care in a semi-structured interview 6 months after the primary treatment. Data were coded by open coding; themes and categories were formulated. Findings showed that emotional support, as well as organizational changes of care, led to feelings of safety and security. Most of the women could plan for the future despite a demanding situation. The study indicates that the nursing intervention may improve women's sense of control, and also that further changes in care are needed to meet their psychosocial needs, such as adequate information about medical treatment and more 'confirming' relationships.

Adult↗
PubMed1995

Gender differences in moral reasoning among physicians, registered nurses and enrolled nurses engaged in geriatric and surgical care.

Physicians, registered nurses (RNs) and enrolled nurses (ENs) engaged in geriatric (n = 49) and surgical (n = 59) care at a large hospital in Sweden gave 180 accounts of morally difficult care episodes. In total, the ENs (n = 40) gave 78, the RNs (n = 38) 55 and the physicians (n = 30) 47 accounts; there were 83 from geriatric care and 97 from surgical care. Forty-nine participants were male, and 59 were female; there were no differences in gender in the form and content of the moral reasoning disclosed in either morally difficult care episodes or in the complete interviews when coded as mainly narrative or propositional, or as showing a care or a justice orientation. The ENs showed a care orientation, while RNs and physicians, to an equal degree, showed both a justice and a care orientation. The ENs also used narrative reasoning more often than RNs and physicians. No differences were seen between the two health care specialties.

Ethical Analysis↗
PubMed1995

Patients', relatives', and nurses' experience of stroke in northern Vietnam.

Transcriptions were made of interviews held in Vietnam with five nurses, five people affected by stroke (aged 28-60), and with one relative each. Their stories were analysed as texts by means of a phenomenological hermeneutic method. The role of the nurses in Vietnam appeared to differ from that usually ascribed to nurses in Western institutionalized care. In the former a relative was expected to carry out basic care during the acute stage and to assist socioeconomically thereafter. The interviewees spoke of family bonds in the past, present, and future tenses when narrating their experiences of stroke as nurses, patients, and relatives. This was interpreted as an indication of a consciousness of an essential relatedness. Nurses were aware of playing a temporary and secondary role mainly as assistants: firstly to the doctor by carrying out orders and reporting, secondly to the stroke patient and his or her family by carrying out advanced nursing procedures and giving support. The advantages and disadvantages of involving the family in nursing care can be revealed by obtaining views from a different culture, which can provide a contrast against which constructive criticism of the Western nursing tradition can be made.

Adult↗
PubMed1995

Dimensions and progression in the interaction between bilingual/monolingual caregivers and bilingual demented immigrants: analysis of video-recorded morning care sessions in institutions coded by means of the Erikson theory of "eight stages of man".

Seven demented Finnish immigrants were video-recorded during morning care together with bilingual and monolingual Swedish-speaking caregivers. A phenomenological-hermeneutic analysis of the video-recordings inspired by Ricoeur's philosophy was performed. The structural analysis was made by means of the Erikson theory of "eight stages of man." A statistical analysis was done in order to study dimensions and progression of interaction and compare the communication seen in relation to how caregivers supported the patients' integrity.

Adolescent↗
PubMed1995

The experience of being at home throughout the life span. Investigation of persons aged from 2 to 102.

One hundred and fifty persons aged two to 102 narrated their experiences related to the phenomenon "being at home." Several common interdependent and interrelated aspects of the experience of being at home were identified throughout the life span. These aspects are believed to entail cognitive, emotional, and conative dimensions of the experience: safety, rootedness, harmony, joy, privacy, togetherness, recognition, order, control, possession, nourishment, initiative, power, freedom. The sense of being related was found to be a common condition of the experience of being at home, i.e., related to significant others, significant things, significant places, significant activities, oneself, and transcendence. In the process of maintaining the experience of being at home throughout life the phenomena "being given a home," "creating a home," "sharing a home," and "offering a home" were integral parts. A progression in the experience of being at home throughout the life span was identified.

Activities of Daily Living↗
PubMed1995

Meeting cancer patients. Interviews with Swedish district nurses.

OBJECTIVE: To illuminate district nurses' experiences in the home care of cancer patients. DESIGN: A qualitative approach. SETTING: Primary health care in the south-east of Sweden. PARTICIPANTS: 39 district nurses employed in the eastern part of the county council area. MAIN OUTCOME MEASURE: Interpretation of tape recorded interviews concerning positive and negative experiences of caring for cancer patients. FINDINGS: In the meeting with cancer patients nurses reported some satisfaction, but mainly dissatisfaction and strong feelings of mental strain. Situations identified as especially trying were connected with dressing of ulcerous cancer wounds, managing physical pain, being too close to the patient, not being allowed to communicate openly, not being allowed to help, and patient's trust in alternative medicine. Positive experiences were described when nurses were accepted as helpers. District nurses felt like cowards, and also experienced meaninglessness, uncertainty, shame, irresolution, and insufficiency in the trying situations. The overall emotional tone in the interviews was, however, positive. The deep human contacts were described as a source of both strain and enrichment. CONCLUSION: It seems important to develop support systems to provide district nurses with an opportunity to discuss and handle emotions evoked in the care, thereby improving their possibilities of caring for terminally ill cancer patients.

Adult↗
PubMed1995

Stories about becoming a hospice nurse. Reasons, expectations, hopes and concerns.

Two months after the opening of Sweden's first purpose-built free-standing hospice, 19 nurses were asked to narrate their reasons, expectations, hopes, and concerns about their future work as hospice nurses. The stories were analyzed using a phenomenological-hermeneutic approach inspired by the philosophy of Ricoeur. The tension between endurance and enjoyment seems to be the essential feature of the nurses' stories. The nurses who were experienced in terminal care hope and expect to enjoy being hospice nurses, provided they are able to give good terminal care, that is, nursing care that is experienced as being meaningful. Those nurses who are inexperienced in terminal care hope and expect that they will be able to give and to grow as people and to develop as professionals, but do not yet know what to make of their experiences. Possible implications of the nurses' reasons, expectations, hopes, and concerns are discussed, and an understanding of the tension between endurance and enjoyment of being a hospice nurse is presented.

Adult↗
PubMed1994

A porcine gut polypeptide identical to the pancreatic hormone PP (pancreatic polypeptide).

A peptide hormone has been isolated from porcine intestine. Its primary structure was found to consist of 36 amino acid residues in a sequence identical to that of the porcine pancreatic polypeptide, previously not isolated from intestines or a tissue other than pancreas. The gut polypeptide significantly suppresses glucose-induced insulin secretion in vitro. Using an immunohistochemical technique, we also identified cells in the porcine gastrointestinal tract that were immunoreactive with pancreatic polypeptide. The immunoreactivity disappeared after absorption with the isolated gut polypeptide or synthetic human pancreatic polypeptide.

Animals↗
PubMed1994

Metabolic control, food intake and mood during the menstrual cycle in patients with insulin-dependent diabetes.

The impact of menstruation on metabolic control was studied among 20 insulin-dependent diabetics (IDDM) and 20 healthy controls during two menstrual cycles. No systematic fluctuation in glycated protein, blood glucose levels, food intake, intake of mono- and disaccharides, body weight, or mood could be seen during different weeks in the menstrual cycle. A tendency towards menstruation-related variations in the number of insulin reactions and amount of extra injected insulin was observed in the patient group. Levels of glycated protein were significantly (P < 0.05) higher during the premenstruational than during the postmenstruational week, although the difference was small in absolute terms. A poorer mood during the premenstruation weeks (indicating premenstruation syndrome) was associated with a high number of hypoglycemic events (P < 0.01) and frequent changes in insulin doses (P < 0.01). Thus, taken as a group diabetic women do not experience great changes in food intake or metabolic control during the menstrual cycle. This does not exclude the possibility that a small proportion of women have major menstruation related difficulties in controlling their diabetes.

Activities of Daily Living↗
PubMed1994

A descriptive study of childbirth education provided by midwives in Sweden.

OBJECTIVE: to describe the content, modes of working and reaction/interaction of childbirth education provided by midwives in Sweden. DESIGN: qualitative, using non-participant observation to collect the data. Grounded theory approach was used. SETTING: antenatal classes provided in the community in Sweden. PARTICIPANTS: twelve midwives with varying lengths of experience in teaching antenatal classes, and the prospective parents who attended these classes. MEASUREMENTS AND FINDINGS: three perspectives on the content and three modes of working were found. Combinations of the differing perspectives and working modes provided differing interactions within the classes. KEY CONCLUSIONS: the confirming/mixed model resulted in dialogue in the classes. It was assumed that this model would contribute to an increased understanding of the coming experience of giving birth. IMPLICATIONS FOR PRACTICE: the findings provide midwives with a basis for reflection on their experiences as leaders in the childbirth preparation part of education for parenthood.

Curriculum↗
PubMed1994

Preconditions for communication in the care of bilingual demented persons.

This study describes how demented immigrants' communicative performance together with caregivers who speak/do not speak these people's native language relates to the demented persons' cognitive, linguistic, and neuropsychological abilities. The study was carried out among demented persons who were born in Finland and had immigrated to Sweden. Their life history, linguistic history and linguistic behavior, and communication in standardized situations were assessed. neuropsychological and medical examinations were performed for diagnostic reasons. The results show that many of these Finnish immigrants had difficulties communicating with their Swedish-speaking caregivers, while their communication with a Finnish-speaking caregiver was adequate. The frequent misunderstanding of a person's message often leads to a one-way communication, in which the caregiver commands and interrupts the demented person. The demented Finnish immigrants functioned on a level of manifest competence that seemed far below their level of latent competence. It seems reasonable that the presence of Finnish-speaking caregivers is an environmental change that would markedly enhance the demented Finnish immigrants' performance and quality of life and also reduce the costs for their care.

Aged↗
PubMed1994

Registered nurses' and physicians' reflections on their narratives about ethically difficult care episodes.

Thirteen registered nurses and eight physicians in medical and oncological care reflected on their previous narratives about ethically difficult care situations. Although the interviewees had narrated different kinds of stories there were more similarities than differences in their reflections. Common themes were: meeting death, balancing between being open to one's own and others' reactions and being sheltered, handling advanced medical technology and grasping care as a whole. The two groups, however, disclosed different cognitive styles and types of rationality. The nurses referred to their personal experience of giving care and also receiving care very much within a praxis perspective, while physicians referred to science and proven experience within a poiesis perspective.

Adult↗
PubMed1994

Emotional experiences, empathy and burnout among staff caring for demented patients at a collective living unit and a nursing home.

Experiences of empathy and burnout were compared among staff caring for demented patients, at a collective living unit (n = 10) and a nursing home (n = 10) in the middle of Sweden. In both milieus, the staff showed great confidence in their own caring ability and disclosed a deep care and concern for their patients. All staff had the requisite attributes of empathy, and none had burnout scores indicating risk of burnout. The staff of the collective living unit gave exclusively positive descriptions of their patients, but expressed an emotional exhaustion and a feeling of being overutilized. The staff of the nursing home gave positive and negative descriptions of their patients, and experienced physical exhaustion and a feeling of being only partly utilized. The study indicates that exhaustion in staff may be related both to overwhelming experiences connected with being close to demented patients, and to feelings of guilt for not being closely related to their patients.

Adult↗
PubMed1994

Ethical reasoning concerning the feeding of severely demented patients: an international perspective.

Structured interviews were held with 149 registered nurses in seven countries in America, Asia, Australia and Europe concerning the feeding of severely demented patients who do not accept food. The most common reasons for nurses being willing to change their decision to feed or not to feed were an order from the medical head, a request from the patient's husband and/or the staff meeting. There was a connection between the willingness to feed and the ranking of ethical principles. Nurses who were most prone to feed the patient most often gave a high rank to the ethical principle of sanctity of life, while those who primarily chose not to feed the patient gave a high rank to the ethical principle of autonomy. All nurses stressed the ethical principle of beneficence.

Adult↗
PubMed1994

Intuition: two caregivers' descriptions of how they provide severely demented patients with loving care.

To understand how caregivers reason when faced with patients in late states of dementia, two recognized expert caregivers were interviewed about their experiences of caring for severely demented patients. Combined in the precontext were hermeneutic, psychodynamic, and existentialist perspectives with regard to theories of human development and care ethics. Ethical reasoning, exemplified by tender descriptions of relatedness to patients, indicated that expert caregivers use sound knowledge combined with imagination, empathy, and intuition, to reach a total grasp of the situation, where the patient is regarded as a person with worth, dignity, and integrity.

Adaptation, Psychological↗
PubMed1994

Integrity promoting care of demented patients: patterns of interaction during morning care.

Video-recorded morning care sessions (n = 49) of demented nursing home patients (n = 5), were analyzed before, as well as after, training of the staff in integrity promoting care. A phenomenological-hermeneutic analysis was performed based on the Erikson theory of "eight stages of man" and musical notations were used for the analysis of courses of events. The analysis revealed five main patterns of interaction; positive, negative, intermediate, negative/intermediate turned into positive by the patient, and negative/intermediate turned into positive by the caregiver. Before the training, negative and intermediate patterns dominated (58%), while positive patterns dominated (84%) after the training. The positive patterns of interaction were characterized by the caregiver communicating with the patient as a competent partner, showing humanity, respect and support. The activity was carried out in intimacy. This led to the patient displaying more and more ability.

Baths↗
PubMed1994

Eating a meal increases the clearance of ethanol given by intravenous infusion.

We studied the effect of eating a meal on the rate of ethanol elimination (clearance) from the blood after giving 0.4 g/kg by intravenous infusion to six female and six male volunteers. Half of the subjects had eaten breakfast whereas the other half had fasted overnight. After the first infusion of alcohol, those who had fasted ate lunch, and all the volunteers received a second infusion with the same dose of ethanol. The blood ethanol concentration was measured repeatedly for up to 180-240 min after the start of each experiment. Intake of food (lunch or breakfast) increased the clearance of ethanol by about 60% (P < 0.001). Alcohol intoxication was less pronounced at the end of the ethanol infusions preceded by eating a meal (P < 0.01). Gender had no significant effect on the rate of ethanol elimination. We conclude that eating a meal increases the rate of ethanol elimination even when alcohol is given by intravenous infusion.

Adult↗