Elsy Athlin

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.

Caregivers' attitudes to and interpretations of the behaviour of severely demented patients during feeding in a patient assignment care system

The feeding of six severely demented patients was changed from a task assignment to a patient assignment care system. Four caregivers participated in the study. Each caregiver fed her patient during 14 meals. Interviews with the caregivers after meal Nos 1, 7 and 14 revealed that this system made them feel more certain about how to interpret the eating behaviour of the patients. They also experienced a more positive attitude to the patient as well as more satisfaction with their work as feeders.

The meaning of good and bad care in the community care: older people’s lived experiences

In spite of a considerable body of research in the past decades on what does or does not constitute good care for older people, there are still few studies addressing this question in which older people narrate their experiences of being dependent on community care. This study was therefore carried out aiming to explore older peoples lived experiences of what good and bad care meant to them, when it was offered by community care services. Nineteen older persons in three Swedish communities participated in the study, which used a phenomenological-hermeneutic approach. Data were collected through unstructured interviews and Colaizzis framework was utilized in the analysis of the data. The key theme arising from the analysis was that of being encountered as a human being by caregivers who, through the provision of safe and secure care, provide opportunities for living life as usual. When any of these circumstances are lacking, bad care will be the consequence. As the general intention in society is to ensure good quality of care to older people as well as others, the findings in our study should have important implications for providers of community care for older people.

Patient participation in special care units for persons with dementia: A losing principle?

The aim of this study was to explore the experience of nursing personnel with respect to patient participation in special care units for persons with dementia in nursing homes, with focus on everyday life. The study has an explorative grounded theory design. Eleven nursing personnel were interviewed twice. Patient participation is regarded as being grounded in the idea that being master of one’s own life is essential to the dignity and self-esteem of all people. Patient participation was described at different levels as letting the resident make their own decisions, adjusting the choices, making decisions on behalf of the residents and forcing the residents. The educational level and commitment of the nursing personnel and how often they were on duty impacted the level that each person applied, as did the ability of the residents to make decisions, and organizational conditions, such as care culture, leadership and number of personnel.

Relatives’ participation in everyday care in special care units for persons with dementia

Background: Research concerning relatives’ participation in the everyday care related to persons living in special care units for persons with dementia is limited. Research questions: To examine relatives’ participation in their near one’s everyday care, the level of burden experienced and important factors for participation, in this special context. Design: The study had a cross-sectional design, and data collection was carried out by means of a study-specific questionnaire. Participants and context: A total of 233 relatives from 23 different special care units participated. Ethical consideration: The study was approved by the Norwegian Social Science Data Services. Results: A great majority of relatives reported that they visited weekly and were the resident’s spokesperson, but seldom really participated in decisions concerning their everyday care. Participation was seldom reported as a burden. Discussion: This study indicated that relatives were able to make a difference to their near one’s everyday life and ensure quality of care based on their biographical expertise, intimate knowledge about and emotional bond with the resident. Since knowing the resident is a prerequisite for providing individualised care that is in line with the resident’s preferences, information concerning these issues is of utmost importance. Conclusion: This study prompts reflection about what it is to be a spokesperson and whether everyday care is neglected in this role. Even though relatives were satisfied with the care provided, half of them perceived their participation as crucial for the resident’s well-being. This indicated that relatives were able to offer important extras due to their biographical expertise, intimate knowledge about and emotional bond with the resident. Good routines securing that written information about the residents’ life history and preferences is available and used should be implemented in practice.

Patients’ experiences of home enteral tube feeding (HETF) : a qualitative study

Use of home enteral tube feeding (HETF) has increased in Western countries but research is scarce, especially about patients’ experiences of daily life when being treated with HETF. This study aimed to explore what it means to live with HETF and how the situation can be managed. A qualitative method was carried out according to Grounded Theory. In total, 22 interviews were performed with 11 patients treated with HETF for between 8 weeks and 2 years, using open-ended questions. Sampling, data collection and data analysis were carried out simultaneously. To be treated with HETF was experienced as positive as it meant survival, but the most prominent finding told about experiences of restrictions, practical problems and distress in the patients’ daily lives. How daily life turned out seemed to depend on the patient’s ability to manage problems, but was also strongly related to the amount and quality of information and support they received from health professionals. Lacking preparation before discharge as well as lacking support at home meant insecurity and uncertainty. The findings stress the need for comprehensive preparation and support from health professionals, and improvements are needed to facilitate HETF patients’ daily life.

Vårdtyngdsmätning — Jämförelse och prövning av instrument för patientklassificering: Utvecklingsarbete på kirurgisk och medicinsk klinik

Biography Athlin E. Leg. siukskoterska, Vardlar, Dr Med Vet; Kirurgiska kliniken. Engstrom, B. Leg. sjukskoterska, Dr Med Vet., Neurologiska kliniken. Axelsson, K. Leg. sjukskoterska, Vardlar, Dr Med Vet., Institutionen for ornvardnadstorskning, Urnea universitet och Medicinska kliniken och Sandman. P. O. Leg. sjukskoterska, Dr Med Vet. Institutionen for ornvardnadstorskning, Umea universitet och Psykogeriatriska kliniken, Urnea Regionsjukhus.

Mätning av omvårdnadskvalitet - bearbetning och utprövning av Rush Medicus Process Instrument

Matning av omvardnadskvalitet - bearbetning och utprovning av Rush Medicus Process Instrument

En vårdfilosofi som utgångspunkt för förändringsarbete vid kirurgisk, medicinsk, neurologisk och psykogeriatrisk vård

En vardfilosofi som utgangspunkt for forandringsarbete vid kirurgisk, medicinsk, neurologisk och psykogeriatrisk vard