Bjørg Th. Landmark

Living with newly diagnosed breast cancer--the meaning of existential issues. A qualitative study of 10 women with newly diagnosed breast cancer, based on grounded theory.

&NA; This study aimed to describe how 10 Norwegian women diagnosed with breast cancer experienced living with the disease. A qualitative method was used, including open‐ended in‐depth interviews based on principles in Grounded Theory. Data revealed that existential awareness was a central phenomenon in the women’s experience. This central finding created the basis for the core category in data: the will to live. This core category includes existential aspects such as different levels of life expectations, the fight against death, life related to the future, religious beliefs and doubts, and increased awareness of values in life. Knowledge and an understanding of how women experience being diagnosed with cancer are prerequisites for supporting the women in a process of normalization. This study has shown that the existential aspects connected with the core category, the will to live, are a central issue in recovery and survival. The study suggests that health professionals, by increasing their awareness of existential aspects connected with the will to live, can assist women and their families in developing coping strategies.

Women with newly diagnosed breast cancer and their perceptions of needs in a health‐care context

AIM The purpose of this study was to investigate how women with newly diagnosed breast cancer experience their needs in a health-care context. DESIGN A qualitative design, using a focus group, was used to identify womens perceptions of needs. METHOD A group of seven women met six times over a period of 10 weeks during 2004. Meetings were audio-recorded, and the data were coded and analysed using Kvales methods of qualitative content analysis. FINDINGS Women described experiences related to two categories of needs that influenced their ability to cope with changed life situations: the need for knowledge and the need for psychosocial support. These categories may be divided into three themes: knowledge and psychosocial support related to physical, emotional and social perspectives of daily living. CONCLUSIONS Findings suggest that health-care services provided by breast diagnostic centres should be based on requirements defined by women with breast cancer. In addition to medical treatment, services ought to meet womens needs for knowledge and psychosocial support at the time of diagnosis, and during and after treatment. This study can provide nurses and other health professionals with a deeper understanding of womens demands as they face challenges related to breast cancer. RELEVANCE FOR CLINICAL PRACTICE The findings from this study underline the need to include emotional and social perspectives in standards for breast cancer diagnosis and treatment, and can provide a foundation for the development of user-designed health services.

“To Be stuck in It—I Can’t Just Leave” A Qualitative Study of Relatives’ Experiences of Dementia Suffers Living at Home and Need for Support

The large number of individuals affected by dementia entails major challenges for home health care (HHC) and dementia-affected families. The aim of the study was to explore and describe relatives’ experiences of people with dementia living at home and to reveal the relatives’ needs for support. Focus group interviews (10 people) were used for data collection. The analysis was qualitative content analysis. The results show that relatives are unable to escape the situation and that the dignity of the person with dementia is threatened. Relatives experience a sense of powerlessness due to fragmented services. The continuity of HHC services constitutes a major challenge. Personnel should focus more on ethical considerations and on dialogue between formal and informal caregivers.

Using a new interrater reliability method to test the modified Oulu Patient Classification instrument in home health care

To test the interrater reliability of the modified Oulu Patient Classification instrument, using a multiple parallel classification method based on oral case presentations in home health care in Norway.

Healthcare personnel’s experiences of enhancing social community for people living in dementia special care units:

Building trustworthy relationships that promote equal participation is a fundamental feature of daily living in dementia care. Creating a social community is thus a key component of quality of life for residents in dementia special care units. The aim of this study was to explore healthcare personnel’s experiences of enhancing social community in common spaces in dementia special care units. A qualitative descriptive design consisted of four focus-group interviews with 15 healthcare personnel. The transcribed interviews were analyzed inductively using qualitative content analysis. The findings revealed that healthcare personnel’s experiences of enhancing social community in common spaces were related to three main themes, expressed as dilemmas between knowing versus not knowing each other, safety versus unsafety and presence versus absence. Our analysis indicates that to enhance social community, it is essential for healthcare personnel to be able to create different forms of proximity to residents: physical, narrative and moral. Moreover, the meaning and role of ‘proximity’ in dementia care should be further explored as organizational context influences spatial-structural practices and may disrupt proximity in dementia care.