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  • 1.
    Ahl, Caroline
    et al.
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    To Handle the Unexpected: The meaning of caring in pre-hospital emergency care2012In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 20, no 1, p. 33-41Article in journal (Refereed)
    Abstract [en]

    The patient’s voice has not been present to the same degree as the professional perspective in caring research in a pre-hospital context. In order to further develop and improve pre-hospital care, it is therefore important to explore patients’ situations not only in life threatening but also in non-traumatic situations. This is especially important as these patients might be defined as inappropriate attendees of ambulance services. The aim of this study was to interpret and explain experiences of caring in pre-hospital care situations that are not defined as traumatic or life threatening. Twenty informants aged between 34 and 82 years were interviewed. The design of the study was exploratory, and it used an interpretative approach in order to understand the meaning of pre-hospital caring. The findings show that pre-hospital caring can be understood and explained as a matter of interplay between carer(s) and patient with potentials for positive as well as negative outcomes. Our conclusion is that the initial meeting is of vital importance in how patients experience pre-hospital care. It is suggested that general public information on the development of Swedish pre-hospital care received in turn may facilitate the first encounter between patient and carer(s).

  • 2.
    Ahl, Caroline
    et al.
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Jansson, L
    Making up one’s mind: Patients Experiences of Calling an Ambulance2006In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 14, no 1, p. 11-19Article in journal (Refereed)
    Abstract [en]

    The issue of the inappropriate use of ambulance transport and care has mainly been studied from the professionals’ and caregivers’ perspective, with few studies focusing on the patient and his/her experiences. To further understand whether patients use ambulance care in an inappropriate manner and, if so, why, it is important to obtain an overall picture of the patients’ existential situation at the time they call an ambulance. The aim of this study was to analyse and describe patients’ experiences related to the decision to call an ambulance and the wait for it to arrive. The design was explorative, and twenty informants aged between 34 and 82 years were interviewed. Qualitative content analyses were performed. The findings showed that calling for an ambulance is a major decision that is preceded by hesitation and attempts to handle the situation by oneself. Our conclusion is that the definition of inappropriate use of valuable health care resources should not be based solely on the professionals’ point of view but also take account of the patients’ reactions when they experience a threat to their life and health.

  • 3.
    Björk Brämberg, Elisabeth
    et al.
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    To be an immigrant and a patient in Sweden: A study with an individualised perspective2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 3, p. 1-9Article in journal (Refereed)
    Abstract [en]

    The aim is to describe how experiences of being an immigrant can influencethe situation when becoming a patient in Swedish health care. A hermeneutic approach was used. Sixteen persons born in non-Nordic countries were interviewed. The data was analysed with an empirical hermeneutical method. The findings indicate that positive experiences (i.e., establishing oneself in a new home country) enhance the possibilities of taking part in caring situations and vice versa. Hence, there is a need for individually adapted care that takes one's whole life situation into consideration. Consequently, it is suggested that the concept, “cultural competence” merely serves the purpose of illuminating caregivers’ need for categorisation. It does not illuminate individual needs in a caring situation.

  • 4.
    Björk Brämberg, Elisabeth
    et al.
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Patient participation: A qualitative study of immigrant women and their experiences2010In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 1Article in journal (Refereed)
    Abstract [en]

    Patient participation in healthcare is a neglected area of interest in the rather extensive amount of research on immigrant so-called Selma patients in Swedish health care as well as worldwide. The aim is to explore the phenomenon ‘‘patient participation’’ in the context of the Swedish health care from the perspective of immigrants non-fluent in Swedish. A phenomenological lifeworld approach was chosen. Data were collected from patients within a municipal home care setting in Sweden. Eight women agreed to participate. In seven interviews, an interpreter was necessary for the translation of the interview. Five authorized interpreters were used. Data were analysed in accordance to a descriptive phenomenological method for caring research. The analysis led to an essence of the phenomenon with three constituents, ‘‘to experience participation,’’ ‘‘to refrain from participation,’’ and ‘‘to be deprived of participation.’’ Patient participation from the perspective of immigrant women means that patients are involved and active in their own health and caring processes. For these women, it is particularly important to have the opportunity to express themselves. Patient participation presupposes professional caregivers who act in a way that increases the patients’ opportunities to take part. A skilled interpreter is often necessary in order to enable the patient participation.

  • 5. Borovszky, Helena
    et al.
    Svensson, Leif
    Bolin, Peter
    Nyström, Maria
    University of Borås, School of Health Science.
    Stroke2009In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud, Stockholm: Liber , 2009, p. 325-330Chapter in book (Other academic)
  • 6.
    Brorström, Björn
    et al.
    University of Borås, School of Business and IT.
    Forsgren, Olov
    University of Borås, School of Business and IT.
    Hallnäs, Lars
    University of Borås, Swedish School of Textiles.
    Höglund, Lars
    University of Borås, Swedish School of Library and Information Science.
    Lindecrantz, Kaj
    University of Borås, School of Engineering.
    Nyström, Maria
    University of Borås, School of Health Science.
    Ordell Björkdahl, Susanne
    University of Borås, School of Education and Behavioural Science.
    Forskning vid Högskolan i Borås2007Report (Other academic)
  • 7.
    Carlsson, Gunilla
    et al.
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Drew, N
    Nyström, Maria
    University of Borås, School of Health Science.
    Violent encounters in psychiatric care: a phenomenological study of embodied caring knowledge2004In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 25, no 2, p. 191-217Article in journal (Refereed)
    Abstract [en]

    This article focuses on encounters that become violent, a problem in health care that has been the issue of many debates but is still not fully understood. Violent encounters refer to events where the patient expresses an aggressive and hostile attitude toward the caregiver. This study is part of a bigger project that aims to elucidate violent encounters from the caregivers' as well as the patients' perspectives. The purpose of this particular study was to describe the essence of violent encounters from the caregivers' perspective. Guided by a phenomenological method, data were analyzed within a reflective lifeworld approach. The essence of a violent encounter between caregivers and patients, as experienced by the caregivers, is a critical moment characterized by a tension between presence and distance, a moment where everything is happening at the same time. There are important meaning differences in relation to the violent encounter being viewed as positive rather than negative, based on the caregivers' ability to be present and their capacity in these trying situations to manage their fear. The findings also make explicit the particular knowledge that is needed for the caregiver to manage the threat of violence in a creative way.

  • 8.
    Carlsson, Gunilla
    et al.
    University of Borås, School of Health Science.
    Hantilson, Ulrica
    Nyström, Maria
    University of Borås, School of Health Science.
    Reflective team -. a clinical intervention for sustainable care improvement2014In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 15, no 3, p. 378-389Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to illustrate conditions for the successful implementation of a work model for sustainable care improvement, called Reflecting Team (RT). For this study team leaders were trained in a caring science education programme to lead the reflective processes, and RTs were introduced into two caring contexts. Within the study professional caregivers involved in the implementation of RT were interviewed, and their statements were interpreted according to a life world hermeneutic approach. Dialectic themes emerged that established four prerequisites for successful implementation of RT. A comprehensive understanding suggests that the lowest common denominator for the four prerequisites is mutual interaction. Thus, an atmosphere of sharing was found to be necessary. The challenge of creating such an atmosphere in a caring unit is the focus of the discussion section.

  • 9. Cronquist, A
    et al.
    Lützén, K
    Nyström, Maria
    University of Borås, School of Health Science.
    Nurses’ lived experiences of moral stress support in the intensive care context2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 5, p. 405-413Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse and describe lived experiences of support in situations characterized by critical care situations and moral stress in intensive care nursing. An exploratory interpretative study was conducted. Data consisted of interviews with 36 nurses from different types of intensive care units. The first level of analysis of data identified contextual factors, such as type and purpose of support and working conditions. On the next level of analysis five tentative interpretations were identified: (1) receiving organized support is a matter of self-determination, (2) whether to participate in organized support or to be off duty are experienced as mutually exclusive, (3) dealing with moral stress is experienced as a private matter, (4) colleagues managing moral stress serve as models in stress support and (5) not being able to deal with moral stress urges one to seek outside support. A comparison of these interpretations identified three major themes: availability, accessibility and receptivity of support. The main interpretation and conclusion were: lived experience of moral stress support involves an interconnectedness between structural and existential factors. Thus, adequate moral stress support presupposes an allowable professional climate and access to caring supervision.

  • 10. Cronqvist, A
    et al.
    Nyström, Maria
    University of Borås, School of Health Science.
    A theoretical argumentation on the consequences of moral stress2007In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 15, no 4, p. 458-465Article in journal (Refereed)
    Abstract [en]

    Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden. agneta.cronqvist@esh.se BACKGROUND: Intensive care units are characterized by heavy workloads, increasing work complexity and ethical concerns related to life-and-death decisions. In the present study, it is assumed that there is a relationship between moral stress, support and competence for nurses in intensive care units. AIM: To analyse and describe the theoretical relationship between moral stress and support on the one hand and competence on the other, in the context of intensive care. METHOD: A form of qualitative secondary analysis based on the findings from three original studies. In the analytic process a theory on professional competence was used. FINDINGS: The findings suggest that imbalance due to moral stress between different competences hinders the development of collectively shared caring competence. CONCLUSIONS: Moral stress cannot be totally eliminated in the intensive care unit. But moral stress is not only a problem. It can also become a driving force to stimulate competence.

  • 11. Dahlberg, Karin
    et al.
    Dahlberg, Helena
    Nyström, Maria
    University of Borås, School of Health Science.
    Reflective Lifeword Research, 2. ed.2008Book (Other academic)
  • 12. Dahlberg, Karin
    et al.
    Drew, N
    Nyström, Maria
    University of Borås, School of Health Science.
    Reflective Lifeworld Research2001Book (Other academic)
  • 13. Dahlberg, Karin
    et al.
    Segesten, Kerstin
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Fagerberg, Ingegerd
    Att förstå vårdvetenskap2003Book (Other academic)
  • 14. Ekfeldt, Björn
    et al.
    Österberg, Rustan
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Preparing for Care in a Combat Environment2015In: International Journal of Caring Sciences, ISSN 1791-5201, E-ISSN 1792-037X, Vol. 8, no 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Background Working as a nurse in a war zone entails providing a unique form of care, and it is important to be well prepared before and during an international assignment. To improve organized preparations it is necessary to understand how nurses previously engaged in a military mission experienced their preparations.

    Objective The aim of this study is to describe military nurses’ experiences of preparations for a mission, including factors that contribute to their being meaningful.

    Methodology The data comprises eight interviews with Swedish military nurses who served in Afghanistan. The results are analyzed using a qualitative content analysis. Meaning units are condensed into codes which, via subcategories, form categories. The categories are abstracted into an overall theme.

    Results The results highlight the importance of recognizing challenges and making informed choices. The overall theme shows that adequate preparation promotes an accepting attitude.

    Conclusions It is concluded that organized preparation for care in a combat environment should stimulate realistic reflection without entrapping one in negative thinking.

  • 15. Erdner, A
    et al.
    Magnusson, A-B
    Nyström, Maria
    Lützén, K
    Social and Existential Alienation Experienced by People with Long-term Mental Illness2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 4, p. 373-380Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore how people suffering from long-term mental illness and who live in the community experience their daily lives. The study was based on an ethnographic framework involving participant observations with 23 individuals from two rehabilitation centres and interviews with six women and two men. The observational notes and interviews were recorded, transcribed into the data and analysed based on the phases of hermeneutic interpretation. The process consisted of identifying tentative interpretations that highlighted various impediments that prevent people with long-term mental illness from having an active life. The impediments can also be interpreted as a form of alienation, an interpersonal phenomenon and a consequence due to of the lack of social acceptance towards mental illness. The participants expressed concern about the future and lack of hope. Viewing themselves as being ‘odd’ is not a symptom of mental illness, but rather evidence of experiencing existential and social alienation not only as a consequence of other people's reactions but also their own negative attitudes towards mental illness and effects of their cognitive dysfunction.

  • 16. Erdner, A
    et al.
    Nyström, Maria
    University of Borås, School of Health Science.
    Lützen, K
    Severinsson, E
    Psychosocial Disadvantages in the Lives of Persons with long-term Mental illness i a Swedish Community2002In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 9, no 4, p. 457-463Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to gain in-depth knowledge of how persons with long-term mental illness experience their everyday situation, in order to identify potential psychosocial obstacles to a meaningful existence. The focus was on psychosocial aspects, such as contact with others and the quality of these contacts. An ethnographic design was used, in order to provide an inside perspective. Four persons with long-term mental illness participated in the study. Three open-ended interviews, at 1-week intervals, were conducted with each informant. Analysis of transcribed material consisted of naive reading and content analysis guided by the investigators’ understanding of the psychiatric context. Three themes were generated: feeling lonely but being unable to establish friendships; knowledge of what to do but lacking initiative; and awareness of the need for support but not wanting to be subject to control. These themes reflect contradictions between thoughts, feelings and actions, which seem to contribute to a psychosocial disadvantage in the life of persons with long-term mental illness.

  • 17. Friberg, Febe
    et al.
    Öhlén, J
    Nyström-Petersson, Maria
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Context and Methodological Decontextualisation in Nursing Research with Examples from Phenomenography2000In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, no 1, p. 37-43Article in journal (Refereed)
    Abstract [en]

    In both human science and nursing research the concept of context is important. However, context can be understood in different ways. The aim of this article is to elucidate, discuss and problematize context, decontextualization and recontextualization in some health care-related phenomenographical studies. A further aim is to problematize the concet of context in a wider perspective of human complex ohenomena which characterize nursing research demand a broad contextual understanding. Both the local or immediate experiences of the phenomen of interest as well as the socio-cultural discourse. A balance between openness and pliability t the phenomenon is suggested. Reflection is considered an important tool in this process. Within phenomenography, the interest i s directed towards conceptions of certain aspects of the worlds. Thus, context in a wider sense is given a subordinate role. Accordingly, phenomenography is considered to have limited applicability in nursing research when complex phenomena are to be studied.

  • 18.
    Hallnäs, Lars
    et al.
    University of Borås, Swedish School of Textiles.
    Forsgren, Olov
    University of Borås, School of Business and IT.
    Höglund, Lars
    University of Borås, Swedish School of Library and Information Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Integrerad design: Några inledande tankar Juni 20062006Report (Other academic)
  • 19. Hammarlund, K.
    et al.
    Lundgren, Ingela
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    In the heat of the night it is difficult to get it right: teenager's attitudes and values toward sexual risk-taking2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 2, p. 103-112Article in journal (Refereed)
    Abstract [en]

    This study, using a hermeneutic approach, is based on data from four focus group interviews with 25 Swedish teenagers participating, ranging from 18-19 years of age. The aim is to gain a deeper understanding of teenagers' values and attitudes towards sexually transmitted infections (STIs) and sexual risk-taking. The teenagers seem to seek an excuse to fend off responsibility and deny their sexual risk-taking, an excuse provided by drunkenness. Under the influence of alcohol, teenagers are not too shy to have sex but remain embarrassed to talk about condom use. It seems as though the dialogue feels more intimate than the intercourse when it comes to protecting ones sexual health. To be able to act out in this sexual risk-taking the teenager often views the partner in a one-night-stand as an object, as opposed to a love relationship where they view their partner as subject, a person they care for. Engaging in sexual risk-taking often starts at a club where the teenagers go out to socialize and drink alcohol. They then play a game and a part of the game is to pretend that they do not play a game. In this game, certain rules are to be followed and the rules are set up by the girl, mainly to protect the romantic image of being carefully selected and thereby protected from being stigmatized as “sluts” or “whores”.

  • 20. Hammarlund, K
    et al.
    Lundgren, Ingela
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    To contract genital warts: a risk of losing love? Experiences of Swedish Men Living with Genital Warts2007In: International Journal of Men's Health, ISSN 1532-6306, E-ISSN 1933-0278, Vol. 6, no 2, p. 100-114Article in journal (Refereed)
    Abstract [en]

    Using a life-world hermeneutic approach, this study focused on the interviews with eight Swedish men living with genital warts. The men expressed a need for control over their situation, a control that was easier to maintain if the warts were invisible. Some of the men expressed prejudiced attitudes toward those who contract a venereal infection and their own feelings of shame appeared to correlate with these prejudices. In their meetings with health care providers, the men viewed a competent health care provider as someone who combined professional distance with a personal approach. Finally, the fact that men saw themselves as disease carriers was of great significance to them and influenced their views of future meaningful relationships.

  • 21. Hammarlund, K
    et al.
    Nyström, Maria
    University of Borås, School of Health Science.
    Jomeen, J
    Young women’s experiences of managing self-treatment for ano-genital warts2012In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, no 3, p. 117-121Article in journal (Refereed)
    Abstract [en]

    Objectives The purpose of this study is to explore the experiences of self-treatment for anogenital warts from the perspective of a group of young women who received it. Study design Ten young Swedish women were interviewed in the study, aged between16 and 21. The young women had been diagnosed with anogenital warts and self-managed their treatment with 0.5% podophyllotoxin solution. Results Self-management using 0.5% podophyllotoxin solution poses numerous difficulties. The nature of the treatment as a topical liquid is particularly testing for young women in terms of both application and genital pain, with implications for continuation of the treatment regime. The self-treatment challenges both personal integrity as well as interpersonal relations and creates a personal responsibility which appears to be somewhat overwhelming at times. Conclusions Health care professionals need to recognize the challenge that self-treatment poses to their clients. The issues that create difficulty in relation to topical liquid treatment regimes and importantly can lead to poor adherence to the treatment regime and discontinuation could easily be overcome by the use of different preparations. Continuity of care provider across treatments and alternative mechanisms of support would not only address some of the aspects that young women raise as particularly embarrassing and shameful, but also improve quality of care and increase general satisfaction with service provision.

  • 22. Hammarlund, Kina
    et al.
    Nyström, Maria
    University of Borås, School of Health Science.
    The Lived Experience of Genital Warts: The Swedish Example2004In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 25, no 5, p. 489-502Article in journal (Refereed)
    Abstract [en]

    Our aim in this study was to analyze and describe young Swedish women's experiences of living with genital warts. Interviews with 10 young women, aged 16-21 years, were interpreted within a lifeworld hermeneutic tradition. The women experience themselves as victims of a disgusting disease. Furthermore, they appear to disregard the fact that their own lifestyles could be a risk factor for contracting venereal infections. On the other hand they get to know their bodies better after the gynecological examinations where the treatment begins. Their loss of innocence is considerable; thus it seems fair to compare this experience with earlier epochs' ideas about loss of virginity due to the first intercourse. Consequently the young women also start looking at themselves as adults, and they take responsibility for the consequences of their sexuality.

  • 23.
    Högberg, K
    et al.
    University of Borås, School of Health Science.
    Sandman, L
    University of Borås, School of Health Science.
    Nyström, M
    University of Borås, School of Health Science.
    Stockelberg, D
    Broström, A
    Prerequisites required for the provision and use of web-based communication for psychosocial support in haematologic care2013In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, no 5, p. 596-602Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to describe the prerequisites required for the provision and use of web-based communication for psychosocial support within a haematology clinic, from a patient and family perspective. Method: A qualitative design using content analysis was used. A strategically selected sample of patients ( n ¼ 11) and family members ( n ¼ 6) were offered access to a web-based communication capability with a nurse. After four months, individual interviews were conducted with all participants, in order to identify necessary prerequisites. Results: Preferences and characteristics of the individual patient or family member are crucial as to whether web-based communication for support is perceived as useful. To feel comfortable with writing and to self-identify the need for support are fundamental in getting motivated to use web-based com- munication. An effective organization around psychosocial support in general is another prerequisite. Goals and responsibilities must be clearly de fi ned for patients and family members to understand their rights and enable the transformation of opportunities into practice. The use of web-based communi- cation must also be a convenient and naturally incorporated part of both individual and organizational use of the web in general. Conclusions: Prerequisites of taking into account caretakers ’ different preferences and needs, providing highly structured psychosocial support activities and providing a congruent range of web services, are necessary for successful provision and use of web-based communication for psychosocial support.

  • 24.
    Högberg, Karin
    et al.
    University of Borås, School of Health Science.
    Stockelberg, Dick
    Sandman, Lars
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Broström, Anders
    The meaning of web-based support: from the patients' perspective within a hematological healthcare setting.2015In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 38, no 2, p. 145-154Article in journal (Refereed)
    Abstract [en]

    Background: Being critically ill with a hematological disease is a challenge, sometimes causing a need for support in the adjustment to the stressful life situation. By providing Web-based communication for support from a nurse, patients get access to an alternative and untraditional way to communicate their issues. Objective: The aim was to describe the meaning of using Web-based communication for support from a patient perspective. Methods: A comprehensive randomized pilot study (n = 30) was conducted, allowing 15 patients in the experimental group to have access to the Web-based communication, to evaluate feasibility. Of these 15 participants, 10 were interviewed, focusing on their experiences. An empirical hermeneutical approach was used and the interpretive analysis focused on the meanings. Results: Web-based communication for support means a space for patients to have their say, consolidation of a matter, an extended caring relationship, access to individual medical assessment, and an opportunity for emotional processing. The main interpretation indicates that the patient's influence on the communication strengthens according to the asynchronous, faceless, and written communication. The increased, and in some sense constant, access to an individual medical and caring assessment, in turn, implies a feeling of safety. Conclusion: Web-based communication for support seems to have the potential to enhance patients' participation on their own terms. Implications for Practice: To achieve the possible advantages of Web-based communication for support, nurses must acquire knowledge about caring writing. It requires respect for the patient and articulated accuracy and attention in the response given.

  • 25.
    Höglund, Lars
    et al.
    University of Borås, Swedish School of Library and Information Science.
    Persson, Bengt
    University of Borås, School of Education and Behavioural Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Forsgren, Olov
    University of Borås, School of Business and IT.
    Sarv, Hans
    University of Borås, School of Engineering.
    Hallnäs, Lars
    University of Borås, Swedish School of Textiles.
    Torhell, Catta
    University of Borås, Library and Learning Resources.
    Brorström, Björn
    Sundeen, Johan
    University of Borås, Swedish School of Library and Information Science.
    Lindh, Maria
    University of Borås, Swedish School of Library and Information Science.
    Benner, Mats
    Liedman, Sven-Eric
    Sahlin, Kerstin
    Från Högskolan i Borås till Humboldt, volym 12010Report (Other academic)
    Abstract [sv]

    Under våren 2010 genomfördes en serie om fyra seminarier med namnet ”Från Högskolan i Borås till Humboldt: Perspektiv på universitetsidén under 200 år”. Det primära syftet var att diskutera den svenska högskolans roller i en tid präglad av stora förväntningar och motsägelsefulla krav på akademin. Denna rapport utgör en dokumentation av seminarieseriens innehåll. Professor Sven-Eric Liedman skriver med samtidskritisk udd om universitetens historia; professor Mats Benner beskriver och analyserar fyra historiska idealtyper av universitet samt belyser det förändringstryck som högskolesektorn verkar under; professor Kerstin Sahlin riktar intresset mot hur universitet skiljer sig från andra organisationer och ger sin bild av hur detta faktum bör återspegla sig i besluts- och ledningsstrukturer. Seminarieserien och rapporten är ett led i Högskolan i Borås kontinuerligt pågående självreflektion och arbete med frågor som rör professionslärosätets identitet och profil. I rapportens senare del presenteras sex korta reflektioner om och/eller seminarieseriens teman utifrån Högskolan i Borås horisont. Reflektionerna är skrivna av professorer från alla högskolans sex institutioner.

  • 26.
    Jarling, Aleksandra
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Rydström, Ingela
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Ernsth-Bravell, Marie
    Institute of Gerontology, Jönköping University.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Becoming a guest in your own home: Home care in Sweden from the perspective of older people with multimorbidities2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 3Article in journal (Refereed)
    Abstract [en]

    Abstract Background: In line with changing demographics, conditions for older people have also changed. Older people are expected to live and be cared for in their own home for as long as possible. Increasing age also increases the risk of multimorbidity and the need for social services and health care services. Home care, instituted by different laws, is complex and requires cooperation from an older person when his/her home becomes a workplace for service providers.

    Aim: This study aims to illuminate the meaning of being an older person with multimorbidity who lives alone and who is cared for in his/her own home.

    Design: This study uses a qualitative design with a lifeworld approach.

    Methods: Conducted in Sweden in 2016, the researchers interviewed 12 older persons that live alone and receive home care. Data was analysed using qualitative content analysis.

    Results: The findings illustrate four sub-themes: adapting to a caring culture, being exposed, participation with limitations and being dependent on forced relationships. The overall theme reveals that older people experience a life-changing situation when receiving home care and they become a guest in their own home.

    Conclusions: Becoming older with increased needs means to disrupt one’s life when one’s private home becomes a public arena. Caregivers need to be aware of the gap between their rights by law and an older person’s experiences of receiving home care. Only then can care be offered that enables older people to have a sense of control and experience their home as their own.

    Implications for Practice: The findings emphasise the need to view older people as being self-determinant and independent. Older people receiving home care need to be seen as individuals, and their entire life situation should be considered by also acknowledging the important role played by relatives and caregivers.

  • 27. Johansson, Rose-Marie
    et al.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Reflective team and process-oriented supervision – a case study on differences2017In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, p. 737-749Article in journal (Refereed)
    Abstract [en]

    To meet the Swedish healthcare legislation’s requirements for evidence-based care, a work model for reflection has been developed, called a reflective team (RT). Because this RT model can be perceived as either a competitor of or a complement to caring supervision, this case study aims to explore what distinguishes these two in psychiatric care. Five members of one RT who are psychiatric nurses with previous experiences in caring supervision were interviewed. The transcribed interviews were analysed according to phenomenography. The findings reveal three qualitatively separated categories, which describe differences in focus, competencies, and relationships between confirmation and demands. It is concluded that an RT by no means replaces supervision. Instead, both can contribute to care improvement by complementing each other and increasing the professionalism of psychiatric nurses

  • 28.
    Jonasson, Lise-Lotte
    et al.
    University of Borås, School of Health Science.
    Carlsson, Gunilla
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Prerequisites for sustainable care improvement using the reflective team as a work model2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 23934Article in journal (Refereed)
    Abstract [en]

    A work model for sustainable care improvement is enhanced by a professional approach in whichattitudes, opinions, and discussions are further developed into creative reflection. This requires not only a personal reflective attitude but also a collegial environment, interested in mutual support in morethorough reflection. Optimal conditions for such development occur when there is an organizational structure at the caring unit which makes it possible to intertwine these factors so that they become a natural part of the work climate.

  • 29.
    Jonasson, Lise-Lotte
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Rydström, Ingela
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Reflective team in caring for people living with dementia: A base for care improvement.2017In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 18, no 3, p. 397-409Article in journal (Refereed)
    Abstract [en]

    A reflective team (RT) is a team of professional carers who reflect on a specific caring issue under the direction of an RT leader. The goal for the reflective process is to accomplish care improvement based on research and proven experience, and the first step is to reflect upon the competence that already exists in the context where RT takes place. This study aims to bring previous unarticulated competence for dementia care to the surface, after it has been reflected during RT sessions. Ten staff nurses who work close to patients with dementia and attend RT sessions on regular basis were interviewed about their competence for dementia care. Through a phenomenographic analyze two qualitatively separated categories emerged; general caring skills and specific dementia caring skills. It is concluded that specific skills for dementia care build on general caring skills, and that tacit knowledge can emerge to proven experience when it has been reflected in RT.

  • 30.
    Karlsson, Katarina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Enskär, Karin
    Jönköping University.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Rydström, Ingela
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Experiencing Support During Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3-7 Years)2016In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 31, no 6, p. 667-677Article in journal (Refereed)
    Abstract [en]

    Needle-related medical procedures (NRMPs) are something that all young children need to undergo at some point. These procedures may involve feelings of fear, pain and anxiety, which can cause problems later in life either when seeking healthcare in general or when seeking care specifically involving needles. More knowledge is needed about supporting children during these procedures.

    AIM:

    This study aims to explain and understand the meaning of the research phenomenon: support during NRMPs. The lived experiences of the phenomenon are interpreted from the perspective of younger children.

    METHOD:

    The analysis uses a lifeworld hermeneutic approach based on participant observations and interviews with children between 3 and 7years of age who have experienced NRMPs.

    RESULTS:

    The research phenomenon, support for younger children during NRMPs, is understood through the following themes: being the centre of attention, getting help with distractions, being pampered, becoming involved, entrusting oneself to the safety of adults and being rewarded. A comprehensive understanding is presented wherein younger children experience support from adults during NRMPs in order to establish resources and/or strengthen existing resources.

    CONCLUSIONS:

    The manner in which the child will be guided through the procedure is developed based on the child's reactions. This approach demonstrates that children are actively participating during NRMPs. Supporting younger children during NRMPs consists of guiding them through a shared situation that is mutually beneficial to the child, the parent and the nurse. Play during NRMP is an important tool that enables the support to be perceived as positive.

  • 31.
    Karlsson, Katarina
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Rydström, Ingela
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Enskär, Karin
    Jönköping University.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Consequences of Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3–7 Years)2015In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 31, no 2, p. 109-118Article in journal (Refereed)
    Abstract [en]

    Background Needle-related medical procedures (NRMPs) are often frightening and cause children anxiety and pain. Only a few studies have examined the perspectives of younger children. More knowledge is needed about younger children's experiences in caring situations such as NRMPs. Aim The aim of this study was to explain and understand the consequences related to NRMPs from younger children's perspectives. Methods Participant observations and interviews with younger children who had experienced NRMPs were analysed using a lifeworld hermeneutic approach. Results Experiencing fear is central for younger children during an NRMP and interpretation of its consequences formed the basis for the following themes: seeking security, realizing the adult's power, struggling for control, feeling ashamed, and surrendering. A comprehensive understanding is presented wherein younger children's experiences of NRMPs vary across time and space related to weakening and strengthening their feelings of fear. Conclusions Awareness is needed that adults' power becomes more obvious for children during an NRMP. Children's surrender does not necessarily imply acceptance of the procedure. Providing children with opportunities to control elements of the procedure creates a foundation for active participation, and vice versa.

  • 32.
    Norberg Boysen, Gabriella
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Christensson, Lennart
    Department of Nursing, Jönköping University, Jönköping, Sweden.
    Wireklint Sundström, Birgitta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Jutengren, Göran
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Use of the Medical emergency services by patients with suspected acte primary healthcare problems: Developing av questionnaire measure patient trust in healthcare2016In: European Journal for Person Centered Healthcare, ISSN 2052-5648, E-ISSN 2052-5656, Vol. 4, no 3, p. 444-452Article in journal (Refereed)
    Abstract [en]

    Rationale aims and objectives: The objective of this study was to develop a questionnaire measuring the level of trust and its constituents in patients calling the Emergency Medicak Services (EMS) for suspected acute primary healthcare problems. The questionnaire is called the Patient Trust Questionnaire (PTQ). The following frontline service providers were involved: 1) The Dispatch Centre, 2) the Emergency Medical Services and 3) the recieving unit (the Emergency Department/Healthcare Centre)

    Method: Cross-sectional data were collected repeately and redundant items were discarded using a step-by-step approach. Based on litterature review, the PTQ was developed in line with the folowing 4-step procedure: 1) item construction, 2) a face-to-face evaluation of separate items, 3) an emerical pre-evaluation targeting each separate frontline service provider and 4) an emperical full-scale evaluation. The inclusion criteria for participating were that the patient must be 18 years of age or older and suspected having a suspected acute primary care problem when calling the EMS. In the finale full-scale evaluation of the questionnaire, 427 patients were included.

    Results: A set of 8 items with good phsycometric properties remained through the developing procedure. Two constituents of trust emerged (labelled credibility and accessibility), witch were robust across all fronline service providers.

    Conclusion: A new measuring instrument has been developed for this particular healthcare chain, for patients with suspected acute primary care problem calling the EMS. Althought not yet validated, the PTQ is a potentially usefull tool in future healthcare research with reference to the concept of patient trust.

  • 33.
    Norberg Boysen, Gabriella
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Christensson, Lennart
    Jönköpings universitet.
    Herlitz, Johan
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wireklint Sundström, Birgitta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Trust in the early chain of healthcare: lifeworld hermeneutics from the patient's perspective2017In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 12, no 1Article in journal (Refereed)
    Abstract [en]

    Purpose: Patients must be able to feel as much trust for caregivers and the healthcare system at the healthcare centre as at the emergency department. The aim of this study is to explain and understand the phenomenon of trust in the early chain of healthcare, when a patient has called an ambulance for non-urgent condition and been referred to the healthcare centre.

    Method: A lifeworld hermeneutic approach from the perspective of caring science was used. Ten patient participated: seven female and three male. The setting is the early chain of healthcare in south-wetern Sweden.

    Results: The findings show that the phenomenon of trust does not automatically involve medical care. However, attention to the patient's lifeworld in a professional caring relationship enables the patient to trust the caregiver and the healthcare environment. It is clear that the "voice of lifeworld" enables the patient to feel trust.

    Conclusion: Trust in the early chain of healthcare entails caregivers' ability to play attention to both medical and existentioal issues in compliance with the patient's information and questions. Thus, the patient must be invited to participate in assessment and decisions concerning his or her own healthcare, in a credible manner and using everyday language.

  • 34.
    Norberg, Gabriella
    et al.
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Wireklint Sundström, Birgitta
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Christensson, Lennart
    Nyström, Maria
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Herlitz, Johan
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Swedish emergency medical services' identification of potential candidates for primary healthcare: Retrospective patient record study.2015In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 33, no 4, p. 311-317Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate patients who called the emergency medical services (EMS) for primary healthcare (PHC) problems.

    DESIGN: A retrospective and exploratory patient record study from an EMS perspective, comparing two groups: those who were potential candidates for PHC and those who were not. All data were gathered from EMS and hospital records.

    SETTINGS: The study was completed at the EMS and five hospital areas in the western region of Sweden.

    SUBJECTS: The patients (n = 3001) who called the EMS in 2011. Data were missing for 10%.

    MAIN OUTCOME MEASURES: The frequency and the clinical characteristics of the patients who called the EMS and were actually potential candidates for PHC.

    RESULTS: Of a total of 2703 patients, a group of 426 (16%) were assessed as potential candidates for PHC and could thus be treated at a level of care other than the emergency department. Patients who were classified as suitable for PHC were found at all priority levels and within all symptom groups, but were younger and healthier than the other group.

    CONCLUSION: Numerous patients seeking help from the EMS do not end up at the most appropriate level in the healthcare system.

    IMPLICATIONS: In the EMS, guidelines are needed to enable pre-hospital emergency nurses to assess and triage patients to the most appropriate level of healthcare. Key points Patients calling the emergency medical services do not always end up at an appropriate level of healthcare. In total, 16% of patients were identified by the Swedish emergency medical services as potential candidates for primary healthcare. These patients were younger and healthier than those needing care at the emergency department. They were found at all priority levels and within all symptom groups.

  • 35. Nydén, K
    et al.
    Petersson, M
    Nyström, Maria
    University of Borås, School of Health Science.
    Unsatisfied basic needs of older people in emergency care environments: obstacles to an active role in decision making2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 2, p. 268-274Article in journal (Refereed)
    Abstract [en]

    Little attention is paid in Emergency Care Units (ECUs) in Sweden to the special needs of older people. The aim of this study was thus to analyse older people's basic needs in the emergency care environment. The study was carried out with a life-world interpretative approach, and the theoretical framework for interpretation was Abraham Maslow's theory of motivation and personality. Seven informants aged between 65 and 88 years, with various experiences of being patients with urgent as well as non-urgent health-related problems, were interviewed about their experiences of ECU care. Their basic needs at the lower levels of Maslow's hierarchy were well-represented in the data. Higher needs, such as desire to know and understand, appeared to be totally neglected. Safety needs dominated the whole situation. Our conclusion is that standards of care must be developed in Sweden to make older patients feel safer and more secure in ECUs. Furthermore, the principles of nursing care for older patients need to be defined in order to encourage them to take an active part in their own health process.

  • 36.
    Nyström, Maria
    University of Borås, School of Health Science.
    A Bridge Between a Lonely Soul and the Surrounding World: A study on Existential Consequences of being Closely Related to a person with Aphasia.2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4Article in journal (Refereed)
    Abstract [en]

    This study illuminates existential consequences of being closely related to a person suffering from aphasia. Seventeen close relatives were interviewed and their narratives were interpreted with inspiration from Ricoeur, Levinas, Husserl, Winnicot, and Maurice Merleau-Ponty. The emerging interpretations resulted in four themes that illuminate a life characterized by lost freedom, staying, a new form of relationship, and growing strong together with others. An overarching theme suggests that a life together with an aphasic person means being used as a bridge between the aphasic person and the surrounding world. Moreover, it illuminates that a close relative to a person with aphasia is a person who does not leave, despite a heavy burden of lonely responsibility. It is concluded that community services need to fulfill their responsibility of providing support to informal caregivers as suggested by the Swedish lawmakers.

  • 37.
    Nyström, Maria
    University of Borås, School of Health Science.
    A patient-oriented perspective in existential issues: a theoretical argument for applying Peplau's interpersonal relation model in healthcare science and practice2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 2, p. 282-288Article in journal (Refereed)
    Abstract [en]

    Since Hildegard Peplau's interpersonal relation model for psychodynamic nursing, in the 1950s, many theories about humanity have been expanded in the discipline of nursing. For this purpose Rosemarie Rizzo Parse, for example, synthesized principles and concepts from Martha Rogers with existential phenomenology, when she introduced the idea of a simultaneity paradigm as unique for the discipline of nursing in opposition to Peplau's psychodynamic model. The aim of this paper is to discuss borrowed theories in relation to the efforts to find a unique theoretical foundation for healthcare science and practice. It is suggested that Parse's division in a totality vs. a simultaneity paradigm is an artificial distinction. The discussion is concluded with reflections about Peplau's interpersonal relation model, a patient-oriented perspective and psychodynamic theory, as example of a theory, which may help to further understand patients' existential situation.

  • 38.
    Nyström, Maria
    University of Borås, School of Health Science.
    Määttä, Sylvia (Editor)
    University of Borås, School of Health Science.
    Afasi: en existentiell bristsituation2007In: Vårdens språk - en antologi / [ed] Sylvia Määttä, Kerstin Segesten, Liber , 2007, p. 137-165Chapter in book (Other academic)
  • 39.
    Nyström, Maria
    University of Borås, School of Health Science.
    Allvarligt psykiskt störda människors vardagliga tillvaro1999Doctoral thesis, monograph (Other academic)
  • 40.
    Nyström, Maria
    University of Borås, School of Health Science.
    Aphasia- An Existential Loneliness: A Study of the Loss of the World of Symbols2006In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 1, no 1, p. 38-49Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse the existential consequences of aphasia and the struggle to regain the ability to communicate. Data were collected by means of interviews, published books and diaries from four women and five men, who varied in type of aphasia and time since cerebral lesion. Data were interpreted in accordance with a lifeworld hermeneutic approach. The findings led to six interpretations, which serve as a base for a comprehensive understanding and which indicate that the intentional, non-verbal act when something is recognized as something is not affected by aphasia. Aphasia affects the world of symbols, which is necessary for interaction with others. It is connected, therefore, with feelings of alienation, inferiority and shame in social settings. Losing one’s ability to recognize symbols thus makes it essential to cope with existential loneliness. The outcome, a sense of community or alienation, appears to depend on the quality of interpersonal relations. The results thus demonstrate that interaction and communication are important aspects of professional care giving.

  • 41.
    Nyström, Maria
    University of Borås, School of Health Science.
    Aphasia Management Practice: Care and Support – A Mutual concern and a Shared responsibility.2013In: Aphasia: Classification, Management Practices and Prognosis. / [ed] Edvin Holmgren, Ellinor Rudkilde, Nova Publishers , 2013, p. 1-40Chapter in book (Refereed)
    Abstract [en]

    Aphasia is an acquired impairment of production or comprehension of language or both resulting from damage to the language network in the brain. In this book, the authors present topical research in the study of the classification, management practices and prognosis of an aphasia diagnosis. Topics discussed include aphasia consequences to the patient and care-givers; the clinical patterns of aphasia; intensive treatment, pharmacotherapy, transcranial magnetic/electric stimulation as a potential adjuvant treatment for aphasia; diagnosis and management of language impairment in acute stroke; and aphasia classifications.

  • 42.
    Nyström, Maria
    University of Borås, School of Health Science.
    Att arbeta med psykiskt funktionshindrade personer: Professionella vårdgivares uppfattningar2002In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 22, no 3, p. 32-38Article in journal (Refereed)
    Abstract [en]

    Different ideological standpoints shape the understanding of severe mental illness and the actions taken in psychiatric care and social services. Decentralised and community-based care is today, after the psychiatric reform in Sweden 1995, replacing the mental hospitals. Deinstitutionalisation has thus caused a larger interest in the issue of knowledge and competence when caring for people with severe mental illness. This study focuses on similarities and differences of opinions and attitudes among professional caregivers. A questionnaire was distributed to 162 professional caregivers, 65 from psychiatric care and 97 from social welfare services. The results indicated that professionals within social welfare service did neither consider their knowledge of severe mental illness adequate, nor did they find their options to get further education and supervision satisfactory. Furthermore they felt they did not receive enough information when taking over responsibility from psychiatric care. When the participants were asked what personal characteristic they find most important in their work with people with severe mental illness, none of the questioned, either within psychiatric care or within social welfare service, made a priority to ”believe what a person with severe mental illness says”. Hence, booth organizations appear to put their confidence in professional knowledge, in favor of experiences expressed by people with severe mental illness.Different ideological standpoints shape the understanding of severe mental illness and the actions taken in psychiatric care and social services. Decentralised and community-based care is today, after the psychiatric reform in Sweden 1995, replacing the mental hospitals. Deinstitutionalisation has thus caused a larger interest in the issue of knowledge and competence when caring for people with severe mental illness. This study focuses on similarities and differences of opinions and attitudes among professional caregivers. A questionnaire was distributed to 162 professional caregivers, 65 from psychiatric care and 97 from social welfare services. The results indicated that professionals within social welfare service did neither consider their knowledge of severe mental illness adequate, nor did they find their options to get further education and supervision satisfactory. Furthermore they felt they did not receive enough information when taking over responsibility from psychiatric care. When the participants were asked what personal characteristic they find most important in their work with people with severe mental illness, none of the questioned, either within psychiatric care or within social welfare service, made a priority to ”believe what a person with severe mental illness says”. Hence, booth organizations appear to put their confidence in professional knowledge, in favor of experiences expressed by people with severe mental illness.

  • 43.
    Nyström, Maria
    University of Borås, School of Health Science.
    Bekräftelse är något mer än bara en klapp på axeln2013In: Borås Tidning, ISSN 1103-9132Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Vårdvetenskap handlar om människorna i vården, och inom forskningen betonas ofta vikten av att vi människor blir sedda och bekräftade, som patienter, som anhörigvårdare eller som professionella vårdare. Hur man ger och får bekräftelse på ett bra sätt är dock inte självklart. En klapp på axeln eller schablonartat beröm känns sällan ärligt, framför allt inte om man genomskådar det som ett sätt att få oss att arbeta mera, eller ta ansvar för något som ingen annan vill göra. För många behövs det nog inget direkt beröm, det räcker med att det man säger och gör tas på allvar, t.ex. att personen man talar med inte riktar all uppmärksamhet åt sin Iphone. Frågan om sund bekräftelse kan emellertid också vara komplicerad. En del människor tycks ju ha väldigt stora behov av att bli sedda och anstränger sig extra mycket för just det. Men det är inte detta vi andra ser. Vi ser bara en individ som är väldigt kompetent. Vid närmare bekantskap finns det dock anledning att häpna över att denna fantastiskt duktiga, engagerade person, som alltid genomför sina uppgifter på ett oklanderligt sätt, inte riktigt tycks duga inför sig själv. Självföraktet lurar i farstun, och den uppmuntran som följer av beröm varar inte särskilt länge. Snart kommer nya känslor av att inte duga och då behövs ny bekräftelse. Osäkerheten inför utebliven bekräftelse kan leda till ett behov av att betrakta den andre som en oviktig person. Och går det så långt börjar det bli riktigt förvirrande, för det vi ser är en på ytan självsäker person som tycks gilla bilden av sig själv. Den osäkra människan bakom den här fasaden förblir osynlig, men kan avslöja sig som en kraftig reaktion på allt som kan uppfattas som kritik. Men trots att frågan om bekräftelse kan vara komplicerad tror jag på den forskning som visar att man inom hälso- och sjukvården behöver vara extra uppmärksam på de människor som finns där, som patienter, närstående eller vårdare. I många vårdsituationer uppstår svåra existentiella frågor, och här behövs andra människors gensvar som guide i det mellanmänskliga samspelet. För att kunna ge en god vård är det förstås viktigt att försöka förstå hur patienter och närstående själva upplever den situation som fört dem till vården, samt den vård som de erbjuds. Det är också viktigt att på ledningsnivå förstå arbetssituationen hos dem som förväntas möta utsatthet och lidande på ett både medmänskligt och professionellt sätt, trots brist på tid och andra resurser. Frågan om bekräftelse kanske också handlar om hur vårdarbete bekräftas i form av ade-kvat lönesättning. Ett svar på den frågan skulle kanske göra det möjligt att förstå varför så många lämnar ett vårdyrke långt före pensionsdagen.

  • 44.
    Nyström, Maria
    University of Borås, School of Health Science.
    Daily experiences of the long-term mentally ill after de-institutionalization2002In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 22, no 63, p. 31-36Article in journal (Refereed)
    Abstract [en]

    The first aim of this study was to investigate how long-term mentally ill persons adjusted to life after de-institutionalisation. The second aim was to estimate the relevance of interpretations made previously in a qualitative study, concerning long term mentally ill person’s incapability to benefit from new experiences. A survey was conducted in 1996 and a follow- up was made in 1998. A randomly chosen sample of longterm mentally ill persons replied to questions about their living conditions as well as interpersonal relations, personal experiences and self-esteem. Most of the participants in the study were living alone and their everyday lives seemed lonely and inactive. In spite of decreased psychiatric consultations after the psychiatric de-institutionalisation, they changed neither their external nor their internal world during the two years covered by this study.

  • 45.
    Nyström, Maria
    University of Borås, School of Health Science.
    Ett liv på egna villkor: vård och omsorg vid psykiska funktionshinder2003Book (Other academic)
  • 46.
    Nyström, Maria
    University of Borås, School of Health Science.
    Fakultetsopponenten sammanfattar: Britt Bragés Kroppens mening: Studier i psykosomatiska lösningar2010In: Pedagogisk forskning i Sverige, ISSN 1401-6788, Vol. 15, no 1, p. 60-63Article in journal (Other academic)
  • 47.
    Nyström, Maria
    University of Borås, School of Health Science.
    Fakultetsopponenten sammanfattar: Kroppens mening - studier av psykosomatiska sammanbrott2010In: Pedagogisk forskning i Sverige, ISSN 1401-6788, E-ISSN 2001-3345, Vol. 15, no 1, p. 60-63Article in journal (Other academic)
  • 48.
    Nyström, Maria
    University of Borås, School of Health Science.
    Forskning som ser människan bakom diagnosen2012In: Borås Tidning, ISSN 1103-9132, no 2012-09-23Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Under 1900-talets sista decennium blev jag ombedd att anordna möten för närstående till personer med schizofreni. Forskning hade visat att stöd till anhöriga ökade deras möjligheter att hantera problem istället för att hjälplöst bevittna hur en nära och kär person försvann in i en psykossjukdom. Men jag blev snart varse att den här gången handlade det inte bara om att ge stöd och hjälp. Nu skulle mentalsjukhusen stängas och familjerna förväntades ta över en del av det ansvar som den professionella vården tidigare stått för. Med Ädelreformen i färskt minne var företeelsen bekant. Argumenten för att alla former av institutioner skulle bort hade under flera år vuxit sig allt starkare. Tilltron till kommunernas förmåga att ta över rehabiliteringsinsatser var nästan oändlig. För många med olika former av funktionshinder, kroppsliga såväl som psykiska, har det förmodligen inneburit ökad livskvalitet att bo kvar hemma även i perioder som tidigare ansågs kräva institutionsvård. Men förändringen har också medfört en ny form av utsatthet för familjerna. Därför ska kommunerna numera ge konkret stöd till anhörigvårdare. Den vårdvetenskapliga forskningen inkluderar ofta ett närståendeperspektiv. Den här hösten presenteras två sådana avhandlingar av doktorander vid Högskolan i Borås. Thomas Eriksson disputerade den 19 oktober med forskning om närståendes betydelse inom intensivvård. Det visade sig att anhörigas närvaro hjälpte svårt sjuka patienter att knyta an till livet igen. Därför är det viktigt att skapa förutsättningar för närstående att behålla gemenskapen med den sjuke även inom den tekniktyngda intensivvården. I dag disputerar Marie Rusner med en avhandling om hur det är att leva med bipolär sjukdom. I de första delstudierna undersöktes detta ur ett patientperspektiv. Familjens roll blev då så tydlig att Rusner valde att gå vidare med att undersöka vad närstående behöver för att få vardagslivet att fungera. Det visade sig att tillvaron präglas av både anspänning och motsägelser, för såväl patienter som närstående. Därför behöver den professionella vården präglas av samsyn, samarbete och transparent kommunikation. Forskningen bakom de här två avhandlingarna har alltså genomförts inom två helt olika vårdsammanhang. Men de har två viktiga saker gemensamt. Båda riktar intresset mot människorna bakom de medicinska diagnoserna, och båda utgår från att vi vanligtvis inte lever i ett vakuum. Men det är inte desto mindre angeläget att tillägga att när det gäller långvariga vård- och omsorgsbehov är det viktigt att förstå förutsättningarna för att anhöriga ska känna sig delaktiga på sina egna villkor. Närstående som fungerar som anhörigvårdare behöver både stöd och avlastning, och det är viktigt att både sjukvården och socialtjänsten tar det ansvaret på allvar.

  • 49.
    Nyström, Maria
    University of Borås, School of Health Science.
    Lindh, Maria
    University of Borås, Swedish School of Library and Information Science.
    Fregatten Högskolan i Borås2010In: Vetenskap för profession, ISSN 1654-6520, no 15, p. 69-72Article in journal (Other academic)
    Abstract [sv]

    Vilka trender kännetecknar dagens högre utbildning? Högre utbildning har idag blivit en självklarhet för nästan hälften av Sveriges befolkning. Detta har fört med sig att studenterna inte längre ser sig som någon elit, och inte heller beter sig som en sådan. Uppdraget som universitetslärare ser i viss mån följdriktigt annorlunda ut än för femtio år sedan. Studenternas kursvärderingar kan till exempel handla om tråkiga föreläsningar, något som i sin tur aktualiserar frågan om vi ska vara underhållare eller utbildare.

  • 50.
    Nyström, Maria
    University of Borås, School of Health Science.
    Hellre promenad med mamma än smygfilmning2012In: Borås Tidning, ISSN 1103-9132Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Vi vill gärna tro att allt som är naturligt är bra, och bortse från det faktum att naturen bryter ner människor på samma sätt som den bryter ner allt annat levande. Som unga kan vi några år till betrakta detta faktum på avstånd. Frågor kring äldre och åldrande kan relativt länge begränsas till debatter om konkurrensutsättning av offentliga omsorgsalternativ eller vinster i välfärden, åtminstone till den dag då våra föräldrar behöver vård och omsorg. I min egen hemkommun har man genomfört ett försök med äldreomsorg i form av övervakningskameror i hemmet. Här räcker fantasin till för ett ideologiskt argument. Hur lyder det? Jo, det känns tryggare att bli kameraövervakad i sängen än att en person från hemtjänsten kommer och stör nattetid! Äldre med demenssjukdom tillfrågas inte om kameraövervakning, så här handlar det om personer med full förmåga att använda hemtjänstens larmsystem. Varför dessa behöver kamera-övervakning framgår inte av rapporteringen i lokalpressen. Den berättar istället om hur positiv respons de första försöken med kameraövervakning har fått. Men den äldre kvinna som intervjuas lägger till att det inte får innebära färre mänskliga kontakter. Från medias sida tycks det då och då finnas ett engagemang för frågor om vårdkvalitet. Mest intensiv blir dock rapporteringen när det gäller brist på kvalitet, helst vårdskandaler. Förvirrade avklädda personer utan möjligheter att själva ge sitt godkännande visas upp för en häpen allmänhet. Men var är diskussionen om integritet och etiska gränser för god journalistik när enskilda individer inte själva kan ta ställning till att medverka i reportage som avslöjar brister i äldrevården? Något som brukar få stor medial uppmärksamhet är när ett vårdbiträde tappat tålamodet och sagt eller gjort något olämpligt som spelats in i smyg. Sådana reportage kryddas gärna med utsagor från familjemedlemmar som berättar att ”mamma har inte fått komma ut på ett halvår”. Vad vill jag egentligen ha sagt med detta? Kanske att frågan om vad naturen gör med oss i livets slutskede innehåller en plågsam existentiell dimension som vi väljer att blunda för. Därför skapar vi syndabockar, precis som jag gör nu när jag berättar om märkliga saker i min egen hemkommun. Självklart bör vi fortsätta att ställa höga krav på äldreomsorgen, och lika självklart måste vi reagera på missförhållanden. Men om vi bara letar efter fel hos vårdgivare, biståndsbedömare och vårdbiträden finns det en risk att vi missar det mest väsentliga. Om vi vågar öppna ögonen för naturens gång kommer vi inte längre att kunna avfärda äldre som avskilda från oss själva, och göra halt vid de frågor som jag hittills har nämnt. Fortare än vi idag kan föreställa oss kan vi själva vara i samma situation som den dementa människa som idag hasar över TV-rutan. Jag tror att det finns många frågor kring äldre och åldrande som då kommer att öka i angelägenhetsgrad. Varför varierar t.ex. tillgången till bromsmediciner med olika läkares åsikter om bromsmediciners effektivitet? För en god äldreomsorg är det förstås också angeläget att lyfta fram vårdbiträdenas arbete som en viktig samhällsinsats. Istället för att smygfilma kan man kanske själv ta ut lilla mamma för en promenad!

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