Camilla Blach Rossen

Everyday life for users of electric wheelchairs - a qualitative interview study

Purpose: The aim of this paper is to explore how users of electric wheelchairs experience their everyday life and how their electric wheelchairs influence their daily occupation. Occupation is defined as a personalized dynamic interaction between person, task and environment, and implies the value and meaning attached. Method: Nine semi-structured interviews were conducted with experienced electric wheelchair users. ValMo was used as the theoretical framework for both interviewing and the analysis. The transcribed interviews were analysed using thematic analysis. Results: Findings revealed key elements in electric wheelchair users’ experience of how the use of a wheelchair influences everyday life and occupation. Four central themes emerged from the participants’ experiences 1) The functionality of the wheelchair, 2) The wheelchair as an extension of the body, 3) The wheelchair and social life, and 4) The wheelchair and identity issues. The themes were interrelated and show how all levels of occupation were influenced both in a positive and negative way, and how it affected identity. Conclusions: It is essential that professionals working with electric wheelchair users are aware of how all levels of occupation and identity are influenced by using a wheelchair. This will assist professionals in supporting the users living an autonomous and meaningful life. Implications for Rehabilitation All levels of occupation and identity are influenced by using a wheelchair. It is important that the electric wheelchair functions as an extension of the user’s body and that surroundings are made as accessible as possible. When choosing an electric wheelchair it is important that professionals make assessments that embrace all levels of the user’s occupation.

Adapting and Implementing Open Dialogue in the Scandinavian Countries: A Scoping Review

abstract Open Dialogue is a resource-oriented mental health approach, which mobilises a crisis-struck persons psychosocial network resources. This scoping review 1) identifies the range and nature of literature on the adoption of Open Dialogue in Scandinavia in places other than the original sites in Finland, and 2) summarises this literature. We included 33 publications. Most studies in this scoping review were published as “grey” literature and most grappled with how to implement Open Dialogue faithfully. In the Scandinavian research context, Open Dialogue was mainly described as a promising and favourable approach to mental health care.

The role of assessment packages for diagnostic consultations: A conversation analytic perspective

This article reports a conversation analysis of assessment package consultations. Healthcare delivery packages belong to a highly structured mode of healthcare delivery, in which specific courses of healthcare interventions related to assessment and treatment are predefined, both as to timing and content. Assessment packages are widely used in an increasing number of medical specialities; however, there is a lack of knowledge about how packaged assessment influences the interaction between doctor and patient. In this study, we investigate the final consultation in assessment packages, which is when the final clarification of the patient’s symptoms takes place. The primary data of the study were eight audio recordings of consultations, and the secondary data were ethnographic field descriptions. In most consultations, packaged assessment was a resource as it provided fast and efficient clarification. In most cases, clarification was treated as good news since it either confirmed the absence of a serious disease or resulted in a diagnosis leading to relevant treatment offers. However, in some cases, clarification was not perceived as good news. This was the case in consultations with patients whose goal was to leave the consultation with clarification in the form of a definite diagnosis, but who were not offered such clarification. These patients negotiated the outcome of the consultation by applying implicit and explicit pressure, which induced the doctors to disregard the boundaries of the package and offer the patient more tests. The study highlights some of the problems related to introducing narrow, specialized package assessment.

Balancing Risk: A Grounded Theory Study of Pregnant Women's Decisions to (Dis)Continue Antidepressant Therapy

This study explored how eight pregnant women diagnosed with depression managed the decision whether or not to take antidepressants during pregnancy. In total, 11 interviews were conducted and analysed by means of constructivist grounded theory. The major category constructed was Balancing risk, with two minor categories: Assessing depression and antidepressants and Evaluating the impact of significant others. The participants tried to make the safest decision, taking all aspects of their life into consideration. They described successful decision-making in the context of managing social norms that surround pregnancy, in a way that was acceptable to themselves, their significant others and healthcare professionals.

En kvalitativ metasyntese af psykiatriske sygeplejerskers oplevelser af transitionen fra at være studerende til at være nyuddannet

Introduction: It has proven difficult to develop standardised methods and definitions for qualitative meta-syntheses. In this paper we suggest a theory-guided approach to meta-synthesis that enabled us to study the transition from being a nurse student to being a newly educated nurse in psychiatric settings. Insight into this transition is crucial for developing strategies to increase recruitment and retention of nurses in these settings. Aim: The purpose of this study was to meta-synthesise psychiatric nurses experiences of the transition between being student and being newly educated and to discuss issues related to the particular approach to meta-synthesis. Methods: A systematic Literature search was made in CINAHL, PubMed, PsycINFO and Web of Science. References were critically evaluated and five studies were included in a qualitative meta-synthesis inspired by the methodological outline put forward by Sandelowski and Barroso. The studies were interpreted guided by theory from the social science position «symbolic interactionism». Results: Two central themes were identified: 1. Negotiation of roles and norms. 2. Interpretation of the institutional context. The newly educated psychiatric nurses felt a lack of formal introduction, had feelings of professional incompetence and were ambivalent towards their new role. Discussion and conclusion: The synthesis was evaluated and theory-guided interpretation could potentially be a significant contribution to qualitative meta-synthesis, which has not previously been explored in the Literature.

Identity work and illness careers of patients with medically unexplained symptoms

This article reports a case study of the illness career and identity work of patients who have had medically unexplained symptoms for many years with a particular emphasis on their interactions with a specialized and standardized health care system. Patients with medically unexplained symptoms often experience being met with mistrust and feel their identity threatened as a consequence of being illegitimately ill. There is a strong tendency in health care towards assessment thorough standardized so-called assessment packages. The study used a case study approach. Ethnographic fieldwork was carried out and several types of data were sampled through theoretical sampling, resulting in data from and about a sample of 13 patients, from which two patients were selected as cases. The study showed that a standardized health care system characterized by a tendency towards narrow diagnostic assessment with limited time can lead to a diagnostic limbo and that patients and health care professionals keep on searching for legitimate explanations for the patients’ still unexplained symptoms. Consequently the patients were left in a constant identity negotiation.