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Nässén, Kristina
Publications (10 of 14) Show all publications
Xiarchi, L., Nässén, K., Palmér, L., Cowdell, F. & Lindberg, E. (2024). Unveiling the dynamics of older person care: a qualitative exploration of the intersection between formal and Informal Caregiving from the perspectives of registered nurses in Greece. BMC Health Services Research, 24, Article ID 966.
Open this publication in new window or tab >>Unveiling the dynamics of older person care: a qualitative exploration of the intersection between formal and Informal Caregiving from the perspectives of registered nurses in Greece
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2024 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, article id 966Article in journal (Refereed) Published
Abstract [en]

In the evolving landscape of older person care, the imperative to explore holistic approaches persists, especially in regions with distinct societal norms around informal caregiving. The deeply ingrained tradition of familial caregiving, often led by female family members, has historically compensated for healthcare system gaps in less integrated systems. Hence, societal expectations may affect registered nurses’ experiences and impact the quality of care for older persons. This study aims to describe the meaning of caring for older persons in care settings in Greece. Ten in-depth interviews with registered nurses in older person care settings underwent qualitative thematic analysis. Four themes emerged from the analysis: (i) Living and bonding with older people as a basis for caring, (ii) Caring as a double-faced fulfillment, (iii) A sense of insufficiency in the caring relationship, and (iv) The encounter of existential issues creating loneliness. This research provides insights into the meaning of caring for older persons, highlighting the experiences of the closest professional caregivers of older individuals. A specific capture of the entanglement of cultural norms, societal expectations, and their impact on professional caregivers’ experiences may contribute to quality care provision in systems rooted in familial caregiving traditions. 

Keywords
Holistic care, Nursing, Family caregiving, Older person care, Qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-32512 (URN)10.1186/s12913-024-11401-5 (DOI)001295910500002 ()2-s2.0-85201710483 (Scopus ID)
Available from: 2024-09-06 Created: 2024-09-06 Last updated: 2024-11-26Bibliographically approved
Mathiesen, K. L., Lindberg, E., Nässén, K., Cowdell, F. & Palmér, L. (2023). “A becoming in the meeting”: the interpretations of competence in home care from the perspectives of older people and registered nurses – a meta-ethnography. International Journal of Qualitative Studies on Health and Well-being, 18, Article ID 2262170.
Open this publication in new window or tab >>“A becoming in the meeting”: the interpretations of competence in home care from the perspectives of older people and registered nurses – a meta-ethnography
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2023 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, article id 2262170Article in journal (Refereed) Published
Abstract [en]

Aim

The aim of this meta-ethnography was to identify and synthesize qualitative studies focusing on older people’s and registered nurses’ interpretations of competence in home care. 

Methods

The meta-ethnography followed the six phases developed by Noblit and Hare (1988). 

Results

In Phase 6, the translation process of the included studies, three themes were identified: i) temporality—the feeling of being of value; ii) dignity—a person, not just a patient; and iii) mutuality of being—togetherness. A synthesis was developed, and the phrase “a becoming in the meeting” emerged. 

Conclusion

The sense of becoming includes progress, which means becoming something other than before in relation with others and refers to what constitutes the meeting between the older person and the registered nurse working in home care. Competence originates from becoming in the meeting, and registered nurses should therefore value what they do and hold on to this aspect of caring competence that centres on a caring relationship. It is important for registered nurses working in home care to be able to cultivate a caring relationship.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Competence, care, caring, relationship, dignity, home care, meta-ethnography, older people, registered nurses, temporality, togetherness
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30983 (URN)10.1080/17482631.2023.2262170 (DOI)001073146400001 ()2-s2.0-85173465701 (Scopus ID)
Funder
EU, Horizon 2020, 813,928
Note

INNOVATEDIGNITY The European Union’s Horizon 2020 Research and Innovation Programme (MSCA-ITN-2018 under grant agreement number 813,928)

Available from: 2023-12-12 Created: 2023-12-12 Last updated: 2024-02-01Bibliographically approved
Xiarchi, L., Palmér, L., Nässén, K., Cowdell, F. & Lindberg, E. (2023). Balancing between familiarity and professionalism in caring for older persons: A phenomenological study from the perspective of nursing students. Nurse Education in Practice, 71, Article ID 103695.
Open this publication in new window or tab >>Balancing between familiarity and professionalism in caring for older persons: A phenomenological study from the perspective of nursing students
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2023 (English)In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 71, article id 103695Article in journal (Refereed) Published
Abstract [en]

Aim: To describe the meaning of caring for older persons based on the experiences of nursing students in Greece. Background: The present study is conducted based on a caring science perspective derived from a holistic viewpoint of human beings, aiming to support the well-being of older persons. In Greece, informal caregivers play an important role in caring for older people; however, as the population ages, the need for registered nurses specialising in caring for older people is also increasing. Previous research in other countries has reported a relative lack of interest in this field, which is a threat to the quality of care. To ensure an adequate number of new-generation nurses caring for older people, nursing students’ perceptions of the phenomenon of caring for older persons should be well understood and explored in a context where the number of long-term care beds and residential care facilities are low and where informal caregiving is common. Design: Based on Descriptive Phenomenology, in line with the Reflective Lifeworld Research (RLR) approach. Methods: A total of 12 nursing students at a university in Greece underwent in-depth lifeworld interviews online during June and July 2021 and March 2022; Interviews were transcribed verbatim and were analysed according to the principles of RLR that approaches the phenomena with openness and constant reflection. The participants were students in their fourth or fifth year of nursing education; they had previous experience in older person care and were not acquainted with the authors. Results: The results show the essential structure of the meaning of caring for older persons, where otherness consists of intertwined demanding and rewarding elements. The essence is further conveyed by three constituents: otherness of the older person: witnessing someone's vulnerability; trustful caring: struggling with normative structures; and closeness and distance: balancing between familiarity and professionalism. Conclusion: To ensure quality of care for older persons in the future, an understanding of how nursing students describe their experiences of caring for older persons during education is important. Balancing between familiarity and professionalism highlights the need for further reflection on professionalism and dignity and identifying the norms and values helps to highlight particularities of the context and national healthcare system. Curricula focusing on cultivating students’ preunderstanding, regarding caring for older persons are required to promote a higher quality of care in the future. Caring science can contribute to a focus on a holistic perspective in caring for older people. Tweetable abstract: There is an ever-increasing need for educated nurses in the field of caring for older people. With the lack of interest in this field of nursing, the overall quality of care is impacted. This study describes the meaning of caring for older persons based on the experiences of nursing students in the Greek health care system. 

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Education, Greece, Health care, Informal caregivers, Nurses, Nursing care, Nursing students, Older adults, Qualitative research methods, aged, article, care behavior, caregiver, clinical article, female, genetic transcription, health care system, human, human dignity, human experiment, interview, intimacy, long term care, male, nurse, nursing education, nursing student, perception, phenomenology, professionalism, qualitative research, registered nurse, residential care, vulnerability, wellbeing
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30251 (URN)10.1016/j.nepr.2023.103695 (DOI)001037472500001 ()2-s2.0-85164317659 (Scopus ID)
Available from: 2023-08-15 Created: 2023-08-15 Last updated: 2024-11-26Bibliographically approved
Tauzer, J., Cowdell, F. & Nässén, K. (2023). From ethical approval to an ethics of care: Considerations for the inclusion of older adults in ethnographic research from the perspective of a ‘humanisation of care framework’. Journal of Aging Studies, 66, Article ID 101162.
Open this publication in new window or tab >>From ethical approval to an ethics of care: Considerations for the inclusion of older adults in ethnographic research from the perspective of a ‘humanisation of care framework’
2023 (English)In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 66, article id 101162Article in journal (Refereed) Published
Abstract [en]

A deeper understanding of care demands the methodological finesse of qualitative research: we must observe, listen, and witness to expose what matters to care recipients. In this paper, we – a team of three: one early-career researcher and two supervisors – reflect on our experiences of designing and then seeking ethics approval for ethnographic research on care for older adults, many of whom demonstrate a lack of capacity to consent to research. Viewing experiences of well-being and dignity as embedded within interpersonal negotiations, this study privileges care home residents' daily life, looking to stories and observations of daily life to reveal the complexities of well-being in the care home setting. This paper emphasizes the importance of using qualitative research methods to gain a deeper understanding of care practices, particularly in the context of care for older adults with varying cognitive capacities. By privileging the daily life experiences of care home residents and employing the logic of process consent, we aim to include the voices of all participants, not just those who can provide written informed consent. However, obtaining ethics approval for this type of research presents several challenges, requiring careful negotiation and the inclusion of consultee advice. This paper highlights the tensions between procedural ethics and the need for better inclusion of vulnerable populations in ethnographic research on care. By addressing these challenges, we can move towards a more context-sensitive and humanised approach to research ethics that values the lived experiences of care recipients. 

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
Capacity to consent, Ethnography, Humanisation of care framework (HCF), Older adults, Process consent, Well-being, aged, article, career, ethics, ethnographic research, female, human, human dignity, human experiment, informed consent, logic, male, negotiation, personal experience, qualitative research, research ethics, resident, tension, voice, vulnerable population, wellbeing
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-30253 (URN)10.1016/j.jaging.2023.101162 (DOI)001052159700001 ()2-s2.0-85166249422 (Scopus ID)
Available from: 2023-08-15 Created: 2023-08-15 Last updated: 2023-09-08Bibliographically approved
Xiarchi, L., Nässén, K., Palmér, L., Cowdell, F. & Lindberg, E. (2023). Gender influences on caring, dignity and well‐being in older person care: A systematic literature review and thematic synthesis. Nursing Philosophy
Open this publication in new window or tab >>Gender influences on caring, dignity and well‐being in older person care: A systematic literature review and thematic synthesis
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2023 (English)In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769XArticle in journal (Refereed) Epub ahead of print
Abstract [en]

Globally, healthcare has become dominated by women nurses. Gender is also known to impact the way people are cared for in various healthcare systems. Considering gender from the perspective of how lived bodies are positioned through the structural relations of institutions and processes, this systematic review aims to explore the meaning of gender in the caring relationship between the nurse and the older person through a synthesis of available empirical data published from 1993 to 2022. CINAHL, PUBMED, EMBASE and Web of Science were searched from the beginning of each database's temporal range, and PRISMA guidelines were used for the screening, reviewing and selection processes of available records. A thematic synthesis of the available data resulted in three analytical themes: (i) vulnerability of the gendered body, (ii) norms and values related to gender and sexuality and (iii) balancing closeness and distance in the nurse-patient relationship. These themes are intertwined and represent different aspects of gender meaning in the nurse–patient relationship. This research shows that gender, through its influence on the gendered body, its relationship with power dynamics in the caring process, and its intersection with dimensions of identity, has a significant meaning for the experienced vulnerability in the nurse–patient relationship. This has implications for the well-being and sense of dignity of the older person as well as the nurse. 

Keywords
gender, nurses, older people, patients, qualitative research methods, relationships
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30719 (URN)10.1111/nup.12467 (DOI)001089114800001 ()2-s2.0-85175373584 (Scopus ID)
Funder
EU, Horizon 2020, 813928
Available from: 2023-11-07 Created: 2023-11-07 Last updated: 2024-11-26Bibliographically approved
Nässén, K., Gillsjö, C. & Berglund, M. (2023). Health care professionals' experiences of possibilities and constraints in caring for older adults living with long-term pain in community home care. Journal of Aging Studies, 65, Article ID 101134.
Open this publication in new window or tab >>Health care professionals' experiences of possibilities and constraints in caring for older adults living with long-term pain in community home care
2023 (English)In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 65, article id 101134Article in journal (Refereed) Published
Abstract [en]

Caring for a growing population of older adults with complex health problems in their homes is part of every-day work for many health care professionals in the world. This qualitative interview study explores the way health care professionals perceive possibilities and constraints when caring for older adults living with long-term pain in community home care in Sweden. The study aims to understand the relationship between health care professionals' subjective experiences and social structures such as the organization of care and shared norms and values in regard to their perceived space of action. Findings provide insight into how institutional structures such as organization and time, conflate with cultural notions, norms, and ideals, and how these enable and constrain health care professionals in their daily work but also create dilemmas. Findings suggest centering the meaning of structuring aspects in social organizations as a tool for reflection on priorities, improvement, and development in care settings.

Keywords
Culture, Health care professionals' experiences, home care, institutional structures, long-term pain, norms, older adults
National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-29686 (URN)10.1016/j.jaging.2023.101134 (DOI)000982197800001 ()2-s2.0-85151526681 (Scopus ID)
Funder
University of Borås
Available from: 2023-04-13 Created: 2023-04-13 Last updated: 2023-05-25
Mathiesen, K. L., Lindberg, E., Nässén, K., Cowdell, F. & Palmér, L. (2023). Home care nurses lived experiences of caring relationships with older adults: A phenomenological study. Scandinavian Journal of Caring Sciences
Open this publication in new window or tab >>Home care nurses lived experiences of caring relationships with older adults: A phenomenological study
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2023 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: This paper describes registered nurses' lived experiences of caring relationships in the context of homecare provision for older adults living in Denmark. With the growing ageing population throughout Europe, more older adults will require complex care solutions within already overburdened care systems. This development places demands on the competencies and organisation of homecare nurses, as they become key players in healthcare systems. Fostering caring relationships in homecare is a rewarding and valuable process that enhances the holistic and humanising aspects of caring for older adults. For a caring relationship to be truly caring, we must understand not only the subjective experience of such a relationship but also how it is experienced in relation to and shared with others. Aim: This study aimed to describe the essential meaning of the phenomenon of caring relationships in homecare for older adults based on the lived experiences of homecare nurses. Approach and Methods: Registered nurses working in homecare for older adults were interviewed, and a phenomenological analysis was conducted according to the methodological principles of the reflective lifeworld research approach. Findings: The essential meaning of the phenomenon is described as creating an existential and embodied space in which each patient's world is the foundation of caring. The constituents are as follows: caring for the whole person, a sense of ‘at-homeness’ through trusting ‘the other’, experiencing continuity as caring and prioritising the time to care. Conclusion: Caring competence in homecare for older adults relies on a nurse's ability to intertwine physical and existential care needs and articulate them in their daily work. A focus on the phenomenon of caring relationships brings value to and adds an extra layer to the discussion on caring competence.

Keywords
caring competence, caring relationship, caring science, existential care, homecare, lifeworld, older adults, phenomenology, reflective lifeworld research, registered nurses
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30637 (URN)10.1111/scs.13217 (DOI)001070388100001 ()2-s2.0-85172278121 (Scopus ID)
Funder
European Commission, 813928University of Borås
Available from: 2023-10-19 Created: 2023-10-19 Last updated: 2024-02-01Bibliographically approved
Gillsjö, C., Nässén, K. & Berglund, M. (2021). Suffering in silence: a qualitative study of older adults’ experiences of living with long-term musculoskeletal pain at home. European Journal of Ageing, 18(1), 55-63
Open this publication in new window or tab >>Suffering in silence: a qualitative study of older adults’ experiences of living with long-term musculoskeletal pain at home
2021 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 18, no 1, p. 55-63Article in journal (Refereed) Published
Abstract [en]

Long-term musculoskeletal pain is a major, disabling, and often undertreated health problem among the increasing number of older adults worldwide. However, there is limited knowledge of community-dwelling older adults’ experiences of living with this type of pain. The aim of the study was to deepen the understanding of the phenomenon: how older adults experience living with long-term musculoskeletal pain at home. The study design was an inductive qualitative Reflective Lifeworld Research approach grounded in phenomenological epistemology. Data were obtained from 20 community-dwelling older adults, aged 72–97 years. Data were collected through open-ended interviews and analyzed to understand the meanings of the phenomenon. The essence of the phenomenon entailed suffering in silence and encompassed the following constituents: loneliness and restrictions in daily living; ways to endure and distract from pain; not being taken seriously; fear of the future; and valuing joy and meaning in life. Living with long-term musculoskeletal pain restricts access to the world and leads to a suffering in silence. Finding ways to endure and distract from pain and to focus on issues that give joy and meaning in life is predominant in efforts to balance restraints from pain in life. Suffering is reinforced by loneliness, a sense of not being taken seriously by health care providers and fear of an uncertain future. It is necessary to foster increased attentiveness and sensitivity in meeting the needs of each older adult and provide a care that alleviates suffering and preserves and promotes health and well-being.

Place, publisher, year, edition, pages
Basel: Springer, 2021
Keywords
Endurance of pain, Meaning in life, Loneliness, Home, Qualitative interviews, Nursing
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-24445 (URN)10.1007/s10433-020-00566-7 (DOI)000557896000001 ()2-s2.0-85083768928 (Scopus ID)
Available from: 2020-12-17 Created: 2020-12-17 Last updated: 2021-07-07Bibliographically approved
Lindgren, H. E., Nässén, K. & Lundgren, I. (2017). Taking the matter into one's own hands - Women's experiences of unassisted homebirths in Sweden.. Sexual & Reproductive HealthCare, 11, 31-35, Article ID S1877-5756(16)30139-2.
Open this publication in new window or tab >>Taking the matter into one's own hands - Women's experiences of unassisted homebirths in Sweden.
2017 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 11, p. 31-35, article id S1877-5756(16)30139-2Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: There are no national guidelines or financial support for planned homebirths in Sweden. Some women choose to give birth at home without the assistance of a midwife. The objective of this study was to describe eight women's experience of unassisted planned homebirth in Sweden.

DESIGN: Women who had the experience of an unassisted planned home birth were interviewed. The material was analysed using a phenomenological approach.

RESULTS: The essential meaning of the phenomenon giving birth at home without the assistance of a midwife is understood as a conflict between, on one hand, inner responsibility, power and control and on the other hand insecurity in relation to the outside, to other people and to the social system. A wish to be cared for by a midwife is in conflict with the fear of not maintaining integrity and respect in this precious moment of birth.

CONCLUSION: Some women may be more sensitive to attitudes and activities that are routinely performed during pregnancy and childbirth and therefore choose not to turn to any representatives of the medical system. The challenge should be to provide safe care to all women so that assistance from a midwife becomes a reality in all settings.

Keywords
Home childbirth, Midwifery, Phenomenology, Unassisted birth
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-15239 (URN)10.1016/j.srhc.2016.09.005 (DOI)000394066700006 ()28159125 (PubMedID)2-s2.0-84988900386 (Scopus ID)
Available from: 2018-10-24 Created: 2018-10-24 Last updated: 2018-11-20Bibliographically approved
Berglund, M., Nässén, K., Hedén, L. & Gillsjö, C. (2016). Older Adults' Experiences of Reflective STRENGTH-Giving Dialogues: An Interview Study.. Journal of Gerontology & Geriatric Research
Open this publication in new window or tab >>Older Adults' Experiences of Reflective STRENGTH-Giving Dialogues: An Interview Study.
2016 (English)In: Journal of Gerontology & Geriatric Research, ISSN 2167-7182Article in journal (Refereed) Published
Abstract [en]

Background: A major health problem that frequently accompanies old age is long-term pain, but pain must be acknowledged by older adults and health care providers. Interventions are needed to alleviate pain and suffering while holistically providing health care that promotes wellbeing. The intervention project, Reflective STRENGTHGiving Dialogues© (STRENGTH) was implemented to increase health and wellbeing among community dwelling older adults living with long-term musculoskeletal pain at home. Aim: The aim of this study was to describe the older adults' experiences of the intervention Reflective STRENGTH-Giving Dialogue. Method: A life world hermeneutic approach was used in collection and analysis of data. Twenty community dwelling older adults participated were interviewed in their homes after the intervention. Findings: The findings consisted of five themes and showed that the older adults experienced the Reflective STRENGTH-Giving Dialogues as a continuous and trusting relationship that alleviates the pain and breaks the loneliness. They expressed it as a new way to talk about life with pain. The dialogues supported reflection and memory and resulted in a transition in orientation in life. Conclusion: The Reflective STRENGTH-Giving Dialogues helped the older adults to increase their intellectual, emotional, and physical engagement in daily living. The dialogues facilitated a transition in orientation from past to present, to the future, and from obstacles to opportunities. The dialogues were oriented towards enjoyments, meaning, courage and strength in life as a whole which promoted the older adults’ sense of well-being and vitality. The dialogues also facilitated carrying out small and large life projects. The Reflective STRENGTH-Giving Dialogues created a deepened caring relationship that contributed to an increased sense of security, strength and courage, all of which enhanced the potential for better health and wellbeing.

Keywords
Older adults, Long-term musculoskeletal pain, Home experience, Qualitative research
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-11872 (URN)10.4172/2167-7182.1000304 (DOI)
Available from: 2017-01-31 Created: 2017-01-31 Last updated: 2021-11-30Bibliographically approved
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