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  • 1.
    Fredriksson, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Ethical approval, laws and publication of caring science in the Nordic countries2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 213-214Article in journal (Other academic)
  • 2.
    Fredriksson, Lennart
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Eriksson, Katie
    The ethics of the caring conversation2003In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 10, no 2, p. 138-148Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore the ethical foundations for a caring The analysis is based on the ethics of Paul Ricoeur and deals with questions such as what kind of person the nurse ought to be and how she or he engages in caring conversations with suffering others. According to Ricoeur, ethics (the aim of an accomplished life) has primacy over morality (the articulation of aims in norms). At the ethical level, self-esteem and autonomy were shown to be essential for a person (nurse) to act with respect and responsibility. The ethical relationship of a caring conversation was found to metrical, because of the passivity inflicted by suffering. This asymmetry was found to be potentially unethical if not balanced with reciprocity. In the ethical context, the caring conversation is one in which the nurse makes room through the ethos of caritas for a suffering person to regain his or her self-esteem, and thus makes a good life possible.

  • 3.
    Fredriksson, Lennart
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Lindstrom, UA
    Caring conversations - psychiatric patients' narratives about suffering2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 40, no 4, p. 396-404Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to increase and deepen the understanding of how psychiatric patients in conversations with nurses narrate their experience of suffering.

    METHODS: Data were obtained in the years 2001-2002 by audio recording of 20 individual caring conversations between eight patients and three psychiatric nurses at a psychiatric outpatient unit in Sweden. Before the data were gathered the study was approved by a local research ethics committee. The methodology is inspired by the hermeneutics of Paul Ricoeur. The data is given a naïve reading which is followed by two structural analyses which explain the text. Finally, the structural analyses and the pre-understanding are confronted in a critical reflection.

    FINDINGS: In the patients' narratives, suffering was at first concealed under a façade that helps the patient to cope with suffering and with shame. As they moved along to a turning point, something happened that made them able to risk everything, i.e. their very selves, but also gave them the possibility of regaining vital parts of themselves that where lost when the façade was constructed. As they took the suffering upon themselves, they grew to be fully visible as human beings and healing was possible as a re-establishment of the interpersonal bridge. This not only meant that the sufferer became open for relationships with others or an abstract other, but also that an opening in the relationship with themselves occurred.

    CONCLUSIONS: If psychiatric patients are allowed to narrate freely they develop different plot structures, which can either hide or reveal suffering. Patients who could establish an answer to the why-question of suffering could also interpret their suffering in a way that enabled growth and reconciliation. In order to do so, they had to abandon the shelter of the façade and confront suffering and shame. This turning point opened them up to life-sustaining relationships with themselves as well as with abstract and concrete others.

  • 4.
    Magnusson, Peter
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Karolinska Univ Hospital Solna, Dept Med, Cardiol Res Unit, SE-17176 Stockholm, Sweden.
    Jonsson, Jessica
    Uppsala Univ Reg Gavleborg, Ctr Res & Dev, SE-80187 Gavle, Sweden..
    Mörner, Stellan
    Umea Univ, Dept Publ Hlth & Clin Med, SE-90187 Umea, Sweden..
    Fredriksson, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Living with hypertrophic cardiomyopathy and an implantable defibrillator2017In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 17, article id 121Article in journal (Refereed)
    Abstract [en]

    Background: ICDs efficiently terminate life-threatening arrhythmias, but complications occur during long-term follow-up. Patients' own perspective is largely unknown. The aim of the study was to describe experiences of hypertrophic cardiomyopathy (HCM) patients with implantable defibrillators (ICDs).

    Methods: We analyzed 26 Swedish patient interviews using hermeneutics and latent content analysis.

    Results: Patients (aged 27-76 years) were limited by HCM especially if it deteriorates into heart failure. The ICD implies safety, gratitude, and is accepted as a part of the body even when inappropriate ICD shocks are encountered. Nobody regretted the implant. Both the disease and the ICD affected professional life and leisure time activities, especially at younger ages. Family support was usually strong, but sometimes resulted in overprotection, whereas health care focused on medical issues. Despite limitations, patients adapted, accepted, and managed challenges.

    Conclusion: HCM patients with ICDs reported good spirit and hope even though they had to adapt and accept limitations over time.

  • 5.
    Priebe, Åsa
    et al.
    Cty Council Stockholm, Stockholm, Sweden.
    Gustin, Lena Wiklund
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden;Arctic Univ Norway, Dept Hlth & Care Sci, Tromso, Norway.
    Fredriksson, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    A sanctuary of safety: A study of how patients with dual diagnosis experience caring conversations2018In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 27, no 2, p. 856-865Article in journal (Refereed)
    Abstract [en]

    The prevalence of dual diagnosis, that is, the combination of psychiatric illnesses and substance use disorders, is high. As a vast majority of previous research in this context focusses on the effects of different treatment methods, rather than interpersonal issues, the purpose of the present study was to explore and illuminate in what way patients with a dual diagnosis experience conversations with nurses in an outpatient clinic to be caring. Five patients were interviewed regarding their experiences of caring conversations. The analysis and interpretation were inspired by a previously-used hermeneutical process. These yielded three themes: (i) reciprocity creates safety and communion; (ii) suffering is made visible and understandable; and (iii) self-esteem is restored. When synthesized, these themes gave rise to a main theme - a sanctuary of safety - where suffering is alleviated and dignity and self-esteem are restored. It is concluded that the caring conversation contributes to experiences of safeness. In this specific context, safety appears to be more fundamental than trust for patients' recoveries. The caring conversation also contributes to recovery, as it supports the individual's learning and understanding as a way to cope with problems, which also enables patients to make informed decisions about their own care. The caring conversation contributes to the alleviation of suffering and restoration of dignity and self-esteem for patients with a dual diagnosis. However, there is a need for further research focussing on how the caring conversation can contribute to psychiatric nurses' caring expertise.

  • 6.
    Sundgren, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Hallqvist, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Fredriksson, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. CFUG centrum för forskning och utveckling Uppsala Universitet/Region Gävleborg.
    Health for smokers with schizophrenia: a struggle to maintain a dignified life2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 5, p. 416-422Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To investigate the health and lifestyle habits of smokers with schizophrenia and describe their experience of smoking in relation to health.

    METHODS: Semi-structured interviews with 10 smokers with schizophrenia were conducted in Sweden from May to October 2013. A hermeneutic phenomenological approach was used to describe and interpret respondents' experiences.

    FINDINGS: Good health for a person with schizophrenia was defined as accepting their mental illness, having strategies to gain control over psychotic symptoms, and engaging in activities and good relationships. Lifestyle habits were described as structures in the respondents' daily life: arising in the morning, taking a cigarette, reading the newspaper, eating breakfast and doing the things planned for the day.

    CONCLUSION: The meaning of health for smokers with schizophrenia is not the same as being well or ill. Rather, health is an experience of a struggle to maintain a dignified life, including self-acceptance of the mental illness and control over the psychotic symptoms. People with schizophrenia have high willingness but low motivation to stop smoking because they fear that cigarette withdrawal will increase their psychotic symptoms. Therefore, they find it difficult to stop smoking. To succeed with health care intervention, health care providers must understand the life style habits and experiences specific to smokers with schizophrenia and the unique experience of health and life style habits that people with schizophrenia experience.

  • 7.
    Sving, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Fredriksson, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Gunningberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Mamhidir, Anna-Greta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden..
    Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multifaceted intervention in a hospital setting2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 19-20, p. 3200-3211Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To describe registered nurses', assistant nurses' and first-line managers' experiences and perceptions of a multifaceted hospital setting intervention focused on implementing evidence-based pressure ulcer prevention.

    Background: Pressure ulcer prevention is deficient. Different models exist to support implementation of evidence-based care. Little is known about implementation processes.

    Design: A descriptive qualitative approach.

    Method: Five focus-group nurse interviews and five individual first-line manager interviews were conducted at five Swedish hospital units. Qualitative content analysis was used.

    Result: The findings support that the intervention and the implementation process changed the understanding and way of working with pressure ulcer prevention: from treating to preventing. This became possible as Changed understanding enables changed actions - through one's own performance and reflection on pressure ulcer prevention'. Having a common outlook on pressure ulcer prevention, easy access to pressure-reducing equipment, and external and internal facilitator support were described as important factors for changed practices. Bedside support, feedback and discussions on current results increased the awareness of needed improvements.

    Conclusion: The multifaceted intervention approach and the participants' positive attitudes seemed to be crucial for changing understanding and working more preventatively. The strategies used and the skills of the facilitators need to be tailored to the problems surrounding the context. Feedback discussions among the staff regarding the results of the care provided also appear to be vital.

    Relevance to clinical practice. It is crucial that dedicated facilitators are involved to promote the implementation process. A preventative mindset should be strived for. Creating an implementation plan with an outcome and a process evaluation should be emphasised. It is important to give the staff regular feedback on the quality of care and on those occasions allocate time for discussion and reflection.

  • 8. Vincze, Mattias
    et al.
    Fredriksson, Lennart
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Gustin, Lena Wiklund
    To do good might hurt bad: Exploring nurses' understanding and approach to suffering in forensic psychiatric settings2015In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 24, no 2, p. 149-157Article in journal (Refereed)
    Abstract [en]

    Patients in forensic psychiatric settings not only have to deal with their mental illness, but also memories of criminal activities and being involuntarily hospitalized. The aim of the present study was to explore how nurses working in forensic psychiatric services understand and approach patients' experiences of suffering. Data were generated by semistructured interviews with psychiatric nurses from two different forensic psychiatric units in Sweden. Data were analysed by means of a hermeneutic approach inspired by Ricoeur's hermeneutics. The findings are reflected in four main themes: (i) ignoring suffering; (ii) explaining suffering as a natural and inevitable part of daily life in the forensic context; (iii) ascribing meaning to suffering; and, (iv) being present in suffering. To engage in alleviating suffering is a struggle that demands courage and the strength to reflect on its character and consequences. To encounter suffering means that nurses are not only confronted with patients' suffering, but also their own reactions to those patients. If suffering is not recognized or encountered, there is a risk that actions may have a negative impact on patients.

1 - 8 of 8
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