Birgitta Hedelin

Eating problems and weight loss for patients with head and neck cancer: A chart review from diagnosis until one year after treatment

This descriptive study aimed to examine the occurrence and treatment of eating problems, and their causes and consequences during the trajectory of care for patients with head and neck cancer treated with radiotherapy. The method used was a review of patient records, conducted by means of an audit instrument developed for the study. The instrument audits demographic data and documented eating problems, their causes and consequences, and undertaken interventions in medical and nursing records from diagnosis until 1 year after completion of treatment. Data were collected prior to treatment, each week during radiotherapy and at the follow-up visits to the physician 1, 6, and 12 months after completion of treatment. The results show that eating problems were common before treatment started, and at the end of radiotherapy every patient suffered from eating problems. One year after treatment the majority still had eating problems. Weight loss occurred early during radiotherapy and became aggravated after treatment, but was not treated to an adequate extent. Implications of this study are that nutritional interventions must be initiated before the treatment starts and they need to be ongoing after completion of treatment.

Burden and health in relatives of persons with severe mental illness: a Norwegian cross-sectional study.

This study describes and investigates burden to and health of relatives of persons with severe mental illness in relation to background variables, everyday life with the mentally ill person, and sense of coherence. A cross-sectional design was used. The respondents were 226 relatives from the Norwegian National Association for Families of Mentally Ill Persons. In addition to background variables and variables about everyday life with the mentally ill person, the questionnaire was comprised of the Burden Assessment Schedule (BAS), Short Form Health Survey (SF-36), and Sense of Coherence Instrument (SOC). This study shows that the relatives were burdened and also reported poor health. Greater burden was experienced by women and by relatives who did not have anyone with whom to share the caregiving of the mentally ill person. For relatives who were single, divorced, or widowed, burden was greater and health was poorer; likewise for relatives who reported financial problems and frequent phone calls with the mentally ill person. Burden and poor health were associated with low SOC. The findings suggest a need for the health services to include and support these relatives in order for them to sustain health.

Left alone with straining but inescapable responsibilities: relatives' experiences with mental health services.

Relatives of persons with severe mental illness experience burden and straining changes in their lives that put their health at risk. Consequently, they need support from health professionals. The aim of this study was to describe experiences from encounters with mental health services as seen from the point of view of relatives of persons with severe mental illness. A qualitative, explorative study was performed, based on two open-ended questions in a cross-sectional study of relatives’ health, burden, and sense of coherence (n = 216). A manifest qualitative content analysis was used to describe the relatives’ experiences. The findings show that some relatives had experienced positive encounters with health personnel, but the majority of experiences reported were negative. The encounters can be summarized into one main category: “Left Alone with Straining but Inescapable Responsibilities.” Two categories emerged: “Striving for Involvement for the Sake of the Mentally Ill Person,” and “Wanting Inclusion for the Sake of Oneself.” There is a gap between relatives’ needs for support in order to handle their own situation in relation to their mentally ill next of kin, and what they actually receive from the mental health services. The findings suggest that health professionals should collaborate with and support these relatives.

Nurses’ dilemmas concerning support of relatives in mental health care

Relatives of persons with severe mental illness face a straining life situation and need support. Exclusion of relatives in mental health care has long been reported. The aim of this study was to describe conceptions of nurses in mental health care about supporting relatives of persons with severe mental illness. Focus group interviews with nurses from all levels of mental health care in Norway were performed. A phenomenographic approach was used. The nurses found that their responsibility first and foremost was the patient, especially to develop an alliance with him or her. Additional premises for supporting relatives were the context framing the nursing care, aspects of the actors, and relational concerns between them. Competing or contradictory demands were found within these premises. Two paths were identified concerning the nurses’ support of relatives: seeing the relative in the shadow of the patient or as an individual person.

Contending and Adapting Every Day: Norwegian Parents’ Lived Experience of Having a Child With ADHD

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders, and little attention has been paid to the parents and their experiences. The aim of this study was to gain a deeper understanding of the Norwegian parents’ lived experiences of having a child with an ADHD diagnosis. A descriptive design using phenomenological approach was chosen as the research method. Individual qualitative interviews with nine parents, who were members of the ADHD Association, were conducted. The interviews were analyzed according to Colaizzi’s method. The essential structure of the parents’ experiences was Contending and Adapting Every Day—Windsurfing in unpredictable waters which was embedded in the interrelated main themes: Maintaining the Self and Parenthood, and Interacting With the Surrounding World. Being the parent of a child with ADHD is a demanding situation. Nurses need to address the needs of these parents and focus on the family unit.

Exploring intensive care nurses' team performance in a simulation-based emergency situation, − expert raters' assessments versus self-assessments: an explorative study

BackgroundEffective teamwork has proven to be crucial for providing safe care. The performance of emergencies in general and cardiac arrest situations in particular, has been criticized for primarily focusing on the individual’s technical skills and too little on the teams’ performance of non-technical skills. The aim of the study was to explore intensive care nurses’ team performance in a simulation-based emergency situation by using expert raters’ assessments and nurses’ self-assessments in relation to different intensive care specialties.MethodsThe study used an explorative design based on laboratory high-fidelity simulation. Fifty-three registered nurses, who were allocated into 11 teams representing two intensive care specialties, participated in a videotaped simulation-based cardiac arrest setting. The expert raters used the Ottawa Crisis Resource Management Global Rating Scale and the first part of the Mayo High Performance Teamwork Scale to assess the teams’ performance. The registered nurses used the first part of the Mayo High Performance Teamwork Scale for their self-assessments, and the analyses used were Chi-square tests, Mann–Whitney U tests, Spearman’s rho and Intraclass Correlation Coefficient Type III.ResultsThe expert raters assessed the teams’ performance as either advanced novice or competent, with significant differences being found between the teams from different specialties. Significant differences were found between the expert raters’ assessments and the registered nurses’ self-assessments.ConclusionsTeams of registered nurses representing specialties with coronary patients exhibit a higher competence in non-technical skills compared to team performance regarding a simulated cardiac arrest. The use of expert raters’ assessments and registered nurses’ self-assessments are useful in raising awareness of team performance with regard to patient safety.

Parental perception of family functioning in everyday life with a child with ADHD

Aim: The aim of this study was to describe and investigate family characteristics in relation to support, behaviour of the child, family functioning and sense of coherence from the parents’ perspective in families with a child with attention deficit hyperactivity disorder (ADHD). A further aim was to explore predictors of family functioning. Methods: The study population consisted of 1964 parents of children with ADHD aged 15 years old and younger. In all, 265 parents responded to a questionnaire (response rate 48.2%; 217 mothers and 48 fathers). In addition to questions about the parents, children, family characteristics and support from health services, the questionnaire included the Family Assessment Device (FAD), the Strengths and Difficulties Questionnaire (SDQ), Sense of Coherence (SOC) and Social Cohesion and Support Index (SCS). Data were analysed with descriptive, comparative and standard multiple regression analyses. Results: Parents with ADHD reported a weaker SOC and poorer FAD in the family than parents without ADHD. Parents with children medicated for ADHD were significantly more satisfied with social support (SCS), rated their children’s behaviour as less problematic and reported better family functioning. Parents’ age, SOC, SCS, SDQ and support from the community health services explained 46.2% of the variation in FAD. Conclusions: A strong SOC, social support and support from the community health services were strongly associated with a positive effect on family functioning. Parents with ADHD reported a weaker SOC and poorer family functioning than parents without ADHD. This knowledge may be useful and should be taken into account when planning support for such families.

Preceptors’ Expectations of Nursing Students’ Preparation before Placement in Psychiatry: Ability and Will to Reflect on and Exercise Knowledge

Nursing students must be prepared to provide nursing care regardless of the patients illness. This requires that nursing education, including clinical placements, strengthen knowledge and skills in mental health nursing. The aim of this qualitative study was to describe 15 preceptors’ expectations of nursing students’ preparedness before they entered the psychiatric field. Data was collected with focus group interviews and analysed using conventional content analysis. The findings show that preceptors are concerned about the nursing students’ will and ability to reflect on and exercise knowledge for managing the student role and themselves; for adapting their perspective on humanity; for their understanding of illness and how they are interacting with persons with mental illness. The conclusion is that the preceptors expect the educators to give sufficient theoretical knowledge and assess the students’ personal maturity prior to entering the psychiatric field.

Undergraduate Nursing Students' Evaluation of the Debriefing Phase in Mental Health Nursing Simulation.

The debriefing phase in mental health nursing simulation promotes a reflexive learning process with the opportunity to develop metacognitive and nontechnical skills. The aim of this quantitative study was to describe undergraduate nursing students’ evaluation of their experience during the debriefing phase following high fidelity human simulation (HFHS). Data was collected using the “Debriefing Experience Scale” and analysed with descriptive and comparative tests. The debriefing phase was evaluated as very good. Background data and group size revealed few significant differences. Students with little clinical praxis evaluated having time to acknowledge feelings as important. Differences between groups revealed that groups should consist of up to eighteen students.

“I got knowledge of myself and my prospects for leading an easier life”: Stroke patients’ experience of training with lower-limb CIMT

Abstract Rehabilitation after stroke has changed and more studies with intensive therapy have been conducted. When a new method – here lower-limb constraint-induced movement therapy (CIMT) – is introduced, it is important to investigate participants’ own experience of the therapy. The present purpose was accordingly to describe stroke patients’ experience of training with lower-limb CIMT. Qualitative interviews with seven stroke patients who had participated in lower-limb CIMT were conducted. The interviews were transcribed verbatim and analysed with qualitative content analysis. One theme, knowledge of myself and my prospects for leading an easier life, emerged. Two main categories were found: the therapy and me and my body, with four and three categories respectively. The therapy comprised the informants’ experience of preparation for CIMT, the actual intensive training and its effects, and their views on the physiotherapists involved. Me and my body comprised the informants’ reflections on their own significance for the therapy, how the reflections had affected them and what insight into their condition CIMT had given. The informants reported that CIMT for the lower extremity gave them knowledge of their body and their prospects for leading an easier life. The intensive training instilled hope, since the functional improvements showed the possibilities of improvements, increasing the respondents’ independence and self-esteem. Even though the intensive training is tough, it was experienced as entirely necessary.